bluuebunny/crossref_metadata_2025 huggingface dataset:
The psychosocial burden of hand eczema: Data from a European dermatological multicentre study
Authors: Marron Servando E. , Tomas‐Aragones Lucia , Navarro‐Lopez Jorge , Gieler Uwe , Kupfer Jörg , Dalgard Florence J. , Lien Lars , Finlay Andrew Y. , Poot Françoise , Linder Dennis , Szepietowski Jacek C. , Misery Laurent , Jemec Gregor B. E. , Romanov Dmitry , Sampogna Francesca , Szabo Csanad , Altunay Ilknur K. , Spillekom‐van Koulil Saskia , Balieva Flora , Ali Faraz M. , Halvorsen Jon A. , Marijuan Pedro C.
Published: February 2018

Background

The essential physical role, visibility and social importance of the hands place a major psychological burden on patients with hand eczema.

Objectives

The aim of this study was to identify the psychological, social and clinical characteristics of patients with hand eczema, in particular the prevalences of depression, anxiety, suicidal ideation, and comorbidities.

Materials and methods

Data on patients with hand eczema were analysed from a large European multicentre study conducted with dermatology outpatients from 13 countries. Groups of patients and controls were compared to analyse the psychological burden of hand eczema.

Results

Female patients with hand eczema had higher Hospital Anxiety and Depression Scale (HADS) scores for anxiety (n = 86, median = 7.0) than controls (n = 900, median = 5.0, P = .02), and for depression (median = 4.0) than controls (3.0, P < .001). Patients with high suicidal ideation, with low socioeconomic status and who were widowed or divorced were more likely to fulfil the HADS criteria for anxiety [odds ratio (OR) > 1, P = .038, P < .001, and P < .001, respectively]. The median Dermatology Life Quality Index score was 7.0 (n = 68).

Discussion

This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients.
Policy‐relevant behaviours predict heavier drinking and mediate the relationship with age, gender and education status: Analysis from the International Alcohol Control Study
Authors: Casswell Sally , Huckle Taisia , Wall Martin , Parker Karl , Chaiyasong Surasak , Parry Charles D. H. , Viet Cuong Pham , Gray‐Phillip Gaile , Piazza Marina
Published: February 2018

Introduction and Aims

To investigate behaviours related to four alcohol policy variables (policy‐relevant behaviours) and demographic variables in relation to typical quantities of alcohol consumed on‐premise in six International Alcohol Control study countries.

Design and Methods

General population surveys with drinkers using a comparable survey instrument and data analysed using path analysis in an overall model and for each country. Measures: typical quantities per occasion consumed on‐premise; gender, age; years of education, prices paid, time of purchase, time to access alcohol and liking for alcohol advertisements.

Results

In the overall model younger people, males and those with fewer years of education consumed larger typical quantities. Overall lower prices paid, later time of purchase and liking for alcohol ads predicted consuming larger typical quantities; this was found in the high‐income countries, less consistently in the high‐middle‐income countries and not in the low middle‐income country. Three policy‐relevant behaviours (prices paid, time of purchase, liking for alcohol ads) mediated the relationships between age, gender, education and consumption in high‐income countries.

Discussion and Conclusions

International Alcohol Control survey data showed a relationship between policy‐relevant behaviours and typical quantities consumed and support the likely effect of policy change (trading hours, price and restrictions on marketing) on heavier drinking. The path analysis also revealed policy‐relevant behaviours were significant mediating variables between the effect of age, gender and educational status on consumption. However, this relationship is clearest in high‐income countries. Further research is required to understand better how circumstances in low‐middle‐income countries impact effects of policies.
Prediction of postoperative atrial fibrillation with left atrial mechanical functions and NT‐pro ANP levels after coronary artery bypass surgery: A three‐dimensional echocardiography study
Authors: Hidayet Şiho , Yağmur Julide , Bayramoğlu Adil , Taşolar M. Hakan , Kurtoğlu Ertuğrul , Özyalın Fatma
Published: February 2018

Objective

Postoperative AF (POAF) is the most common cause of morbidity after coronary artery bypass surgery. In this study, we aimed to show the relationship between POAF and N‐terminal pro‐atrial natriuretic peptide (NT‐pro ANP) levels and the relationship between mechanical functions and left atrial volume measured using preoperative three‐dimensional echocardiography (3D ECHO) among patients that will undergo isolated coronary artery bypass grafting (CABG) in elective conditions.

Method

Sixty‐six consecutive patients (51 male, 15 female) who were decided to undergo CABG and had normal sinus rhythm were involved in the study. Patients were followed by continuous electrocardiography monitoring and daily electrocardiogram. LA volume and mechanical functions were calculated with 3D ECHO. In addition, for the analysis of plasma levels of NT‐pro ANP, blood samples were collected before the surgery.

Results

During follow‐up after the operation, 15 patients (22.7%) had postoperative atrial fibrillation. LA Vmax, Vmin, VpreA values were higher (P < .001, P = .004, P < .001 respectively) Also in POAF‐developed group and SR group, LAVI values were 27.56 ± 4.2 and 20.7 ± 4.64 mL/m2, respectively (P < .001). In POAF‐developing group, NT‐pro ANP levels were significantly higher (P < .001). In multiple logistic regression analysis, age (β = 0.355, P = .007) and LAVI (β = 0.668, P = .012) are independent predictors of POAF.

Conclusion

It was found that 3D echocardiography can be used as a helping noninvasive method to show subclinical atrial volume and mechanical dysfunction in patients undergoing CABG. Also, blood levels of NT‐pro ANP in POAF group were increased.
Pathophysiology of axial spondyloarthritis: Consensus and controversies
Authors: de Koning Anoek , Schoones Jan W. , van der Heijde Desiree , van Gaalen Floris A.
Published: February 2018

Background

Axial spondyloarthritis (axSpA) is a common inflammatory arthritis of the sacroiliac joints and the spine. The best‐known and most studied form of axSpA is ankylosing spondylitis.

Design

In this review, we provide a brief overview of the pathophysiology of axSpA. In addition, we performed a quantitative text analysis of reviews on the pathogenesis of axSpA published in the last 10 years to establish the current consensus in various fields of research into the pathogenesis of axSpA.

Results

There appears to be broad consensus on genetic risk factors and the involvement of the immune system in the initiation phase of the disease although little consensus was found on which specific immune cells drive disease. Moreover, despite relatively little data available, alterations in the microbiome are commonly thought to be involved in disease. Abnormal bone formation is the most prominent pathogenic factor thought to be involved in disease progression.

Conclusion

So, although the pathophysiology of axSpA remains incompletely understood, the progress in recent years in several fields of research in axSpA including genetics, diagnosis, imaging and therapeutics, hold great promise for the future.
Endogenous factors and mechanisms of renoprotection and renal repair
Authors: Perco Paul , Mayer Gert
Published: February 2018

Background

An imbalance between renal damaging molecules and nephroprotective factors contributes to the development and progression of kidney diseases. Molecules with renoprotective properties might serve as biomarkers, drug targets as well as therapeutic options themselves.

Materials and methods

For this review, we generated a set of renoprotective factors based on GeneRIF (Gene Reference Into Function) information available at NCBI's PubMed. The final set of manually curated renoprotective factors was investigated with respect to tissue‐specific expression, subcellular location distribution and involvement in biological processes using information from gene ontology as well as information from protein‐protein interaction databases. We furthermore investigated the factors in the context of clinical trials of renal disease and diabetes.

Results

One hundred and ninety‐three factors could be retrieved from the set of GeneRIFs on nephroprotection and renal repair. A large number of factors were either secretory molecules or plasma membrane receptors. Next to the elevated expression in renal tissue, also higher expression in connective tissue and pancreas was observed. The proteins could be assigned to the broad functional categories of cell proliferation and signalling, inflammatory response, apoptosis, blood pressure regulation as well as cellular response to different kinds of insults such as hypoxia, heat or mechanical stimulus. Eight factors are studied in clinical trials with additional ones being targeted by compounds.

Conclusions

We have generated a set of renoprotective factors based on the literature information, which was functionally annotated and evaluated with respect to tested compounds in kidney disease and diabetes clinical trials.
Development of heart failure in patients with rheumatoid arthritis: A Danish population‐based study
Authors: Løgstrup Brian B. , Ellingsen Torkell , Pedersen Alma B. , Kjærsgaard Anders , Bøtker Hans‐Erik , Maeng Michael
Published: February 2018

Background

To investigate the incidence of heart failure (HF) and ischaemic heart disease (IHD) in different time spans following incident rheumatoid arthritis (RA) and, furthermore, to investigate the impact of IHD on the development of HF and the impact of different treatment era of RA.

Materials and methods

This matched cohort study used nationwide, prospectively collected data. From the total Danish population of approximately 5.7 million inhabitants, we identified 51 859 patients (between 1995 and July 2016) with incident RA and a sex‐ and age‐matched cohort from the general population (256 653 persons).

Results

The hazard ratio (HR) for HF among RA patients compared with persons from comparison cohort was 2.28 within the first year of index date, 1.39 within the 1‐5 years of index date and 1.38 within the 5‐10 years of index date. No difference was identified regarding different treatment era of RA. For IHD, the subdistribution hazard ratio (sHR) was 1.93 within the first year of index date, 1.26 within the 1‐5 years of index date and 1.31 within the 5‐10 years of index date. Coronary revascularization was also more common within the first year after diagnosis of RA. An increased risk of percutaneous coronary intervention and coronary artery bypass grafting within 10 years following the RA diagnosis was observed. HR for new onset of HF in RA without IHD was 1.23, while the HR for new onset of HF in patients with RA and IHD was 2.06.

Conclusions

Rheumatoid arthritis patients had higher rates of HF and IHD throughout the entire observation period compared to the comparison cohort. RA was associated with a larger risk of developing HF.
Pathogeography: leveraging the biogeography of human infectious diseases for global health management
Authors: Murray Kris A. , Olivero Jesús , Roche Benjamin , Tiedt Sonia , Guégan Jean‐Francois
Published: February 2018

Biogeography is an implicit and fundamental component of almost every dimension of modern biology, from natural selection and speciation to invasive species and biodiversity management. However, biogeography has rarely been integrated into human or veterinary medicine nor routinely leveraged for global health management. Here we review the theory and application of biogeography to the research and management of human infectious diseases, an integration we refer to as ‘pathogeography’. Pathogeography represents a promising framework for understanding and decomposing the spatial distributions, diversity patterns and emergence risks of human infectious diseases into interpretable components of dynamic socio‐ecological systems. Analytical tools from biogeography are already helping to improve our understanding of individual infectious disease distributions and the processes that shape them in space and time. At higher levels of organization, biogeographical studies of diseases are rarer but increasing, improving our ability to describe and explain patterns that emerge at the level of disease communities (e.g. co‐occurrence, diversity patterns, biogeographic regionalisation). Even in a highly globalized world most human infectious diseases remain constrained in their geographic distributions by ecological barriers to the dispersal or establishment of their causal pathogens, reservoir hosts and/or vectors. These same processes underpin the spatial arrangement of other taxa, such as mammalian biodiversity, providing a strong empirical ‘prior’ with which to assess the potential distributions of infectious diseases when data on their occurrence is unavailable or limited. In the absence of quality data, generalized biogeographic patterns could provide the earliest (and in some cases the only) insights into the potential distributions of many poorly known or emerging, or as‐yet‐unknown, infectious disease risks. Encouraging more community ecologists and biogeographers to collaborate with health professionals (and vice versa) has the potential to improve our understanding of infectious disease systems and identify novel management strategies to improve local, global and planetary health.
Non‐invasive brain stimulation of motor cortex induces embodiment when integrated with virtual reality feedback
Authors: Bassolino M. , Franza M. , Bello Ruiz J. , Pinardi M. , Schmidlin T. , Stephan M.A. , Solcà M. , Serino A. , Blanke O.
Published: February 2018

Previous evidence highlighted the multisensory‐motor origin of embodiment – that is, the experience of having a body and of being in control of it – and the possibility of experimentally manipulating it. For instance, an illusory feeling of embodiment towards a fake hand can be triggered by providing synchronous visuo‐tactile stimulation to the hand of participants and to a fake hand or by asking participants to move their hand and observe a fake hand moving accordingly (rubber hand illusion). Here, we tested whether it is possible to manipulate embodiment not through stimulation of the participant's hand, but by directly tapping into the brain's hand representation via non‐invasive brain stimulation. To this aim, we combined transcranial magnetic stimulation (TMS), to activate the hand corticospinal representation, with virtual reality (VR), to provide matching (as contrasted to non‐matching) visual feedback, mimicking involuntary hand movements evoked by TMS. We show that the illusory embodiment occurred when TMS pulses were temporally matched with VR feedback, but not when TMS was administered outside primary motor cortex, (over the vertex) or when stimulating motor cortex at a lower intensity (that did not activate peripheral muscles). Behavioural (questionnaires) and neurophysiological (motor‐evoked‐potentials, TMS‐evoked‐movements) measures further indicated that embodiment was not explained by stimulation per se, but depended on the temporal coherence between TMS‐induced activation of hand corticospinal representation and the virtual bodily feedback. This reveals that non‐invasive brain stimulation may replace the application of external tactile hand cues and motor components related to volition, planning and anticipation.
Beta‐gamma burst stimulations of the inferior olive induce high‐frequency oscillations in the deep cerebellar nuclei
Authors: Cheron Julian , Cheron Guy
Published: February 2018

The cerebellum displays various sorts of rhythmic activities covering both low‐ and high‐frequency oscillations. These cerebellar high‐frequency oscillations were observed in the cerebellar cortex. Here, we hypothesised that not only is the cerebellar cortex a generator of high‐frequency oscillations but also that the deep cerebellar nuclei may also play a similar role. Thus, we analysed local field potentials and single‐unit activities in the deep cerebellar nuclei before, during and after electric stimulation in the inferior olive of awake mice. A high‐frequency oscillation of 350 Hz triggered by the stimulation of the inferior olive, within the beta‐gamma range, was observed in the deep cerebellar nuclei. The amplitude and frequency of the oscillation were independent of the frequency of stimulation. This oscillation emerged during the period of stimulation and persisted after the end of the stimulation. The oscillation coincided with the inhibition of deep cerebellar neurons. As the inhibition of the deep cerebellar nuclei is related to inhibitory inputs from Purkinje cells, we speculate that the oscillation represents the unmasking of the synchronous activation of another subtype of deep cerebellar neuronal subtype, devoid of GABA receptors and under the direct control of the climbing fibres from the inferior olive. Still, the mechanism sustaining this oscillation remains to be deciphered. Our study sheds new light on the role of the olivo‐cerebellar loop as the final output control of the intercerebellar circuitry.
Mosaicism of de novo pathogenic SCN1A variants in epilepsy is a frequent phenomenon that correlates with variable phenotypes
Authors: de Lange Iris M. , Koudijs Marco J. , van 't Slot Ruben , Gunning Boudewijn , Sonsma Anja C. M. , van Gemert Lisette J. J. M. , Mulder Flip , Carbo Ellen C. , van Kempen Marjan J. A. , Verbeek Nienke E. , Nijman Isaac J. , Ernst Robert F. , Savelberg Sanne M. C. , Knoers Nine V. A. M. , Brilstra Eva H. , Koeleman Bobby P. C.
Published: February 2018

Objective

Phenotypes caused by de novo SCN1A pathogenic variants are very variable, ranging from severely affected patients with Dravet syndrome to much milder genetic epilepsy febrile seizures plus cases. The most important determinant of disease severity is the type of variant, with variants that cause a complete loss of function of the SCN1A protein (α‐subunit of the neuronal sodium channel Nav1.1) being detected almost exclusively in Dravet syndrome patients. However, even within Dravet syndrome disease severity ranges greatly, and consequently other disease modifiers must exist. A better prediction of disease severity is very much needed in daily practice to improve counseling, stressing the importance of identifying modifying factors in this patient group. We evaluated 128 participants with de novo, pathogenic SCN1A variants to investigate whether mosaicism, caused by postzygotic mutation, is a major modifier in SCN1A‐related epilepsy.

Methods

Mosaicism was investigated by reanalysis of the pathogenic SCN1A variants using single molecule molecular inversion probes and next generation sequencing with high coverage. Allelic ratios of pathogenic variants were used to determine whether mosaicism was likely. Selected mosaic variants were confirmed by droplet digital polymerase chain reaction and sequencing of different tissues. Developmental outcome was classified based on available data on intelligence quotient and school functioning/education.

Results

Mosaicism was present for 7.5% of de novo pathogenic SCN1A variants in symptomatic patients. Mosaic participants were less severely affected than nonmosaic participants if only participants with truncating variants are considered (distribution of developmental outcome scores, Mann‐Whitney U, P = .023).

Significance

Postzygotic mutation is a common phenomenon in SCN1A‐related epilepsies. Participants with mosaicism have on average milder phenotypes, suggesting that mosaicism can be a major modifier of SCN1A‐related diseases. Detection of mosaicism has important implications for genetic counseling and can be achieved by deep sequencing of unique reads.
Atopic dermatitis in diverse racial and ethnic groups—Variations in epidemiology, genetics, clinical presentation and treatment
Authors: Kaufman Bridget P. , Guttman‐Yassky Emma , Alexis Andrew F.
Published: February 2018

Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects diverse ethnic groups with varying prevalence. Despite a predominance of studies in individuals of European ancestry, AD has been found to occur more frequently in Asian and Black individuals than Whites. Therefore, an understanding of the unique clinical features of AD in diverse ethnic groups, as well as the differences in genetic polymorphisms that influence susceptibility to AD and response to current therapies, is paramount for management of an increasingly diverse patient population. In this article, we review key nuances in the epidemiology, pathophysiology, clinical presentation and treatment of AD in non‐White ethnic groups, which are largely underappreciated in the literature. We highlight the need for studies evaluating the tissue molecular and cellular phenotypes of AD in non‐White patients, as well as greater inclusion of minority groups in clinical trials, to develop targeted treatments for a multi‐ethnic population.
Future directions in assessment: Influences of standards and implications for language learning
Authors: Cox Troy L. , Malone Margaret E. , Winke Paula
Published: February 2018

As Foreign Language Annals concludes its 50th anniversary, it is fitting to review the past and peer into the future of standards‐based education and assessment. Standards are a common yardstick used by educators and researchers as a powerful framework for conceptualizing teaching and measuring learner success. The impact of standards on language assessment, teaching, curricula, course design, and educational policy is indisputable, but can they even be more impactful, more beneficial? In this article, we reflect upon the role of language learning standards on world language practices and assessments and discuss standards’ design, implementation, and appropriation issues that will challenge the field over the next few decades. Although predicting the future is risky, forward thinking is critical when examining an issue as large and complex as the teaching and learning of world languages.
Antagonistic effects of growing season and autumn temperatures on the timing of leaf coloration in winter deciduous trees
Authors: Liu Guohua , Chen Xiaoqiu , Zhang Qinghua , Lang Weiguang , Delpierre Nicolas
Published: February 2018

Autumn phenology remains a relatively neglected aspect in climate change research, which hinders an accurate assessment of the global carbon cycle and its sensitivity to climate change. Leaf coloration, a key indicator of the growing season end, is thought to be triggered mainly by high or low temperature and drought. However, how the control of leaf coloration is split between temperature and drought is not known for many species. Moreover, whether growing season and autumn temperatures interact in influencing the timing of leaf coloration is not clear. Here, we revealed major climate drivers of leaf coloration dates and their interactions using 154 phenological datasets for four winter deciduous tree species at 89 stations, and the corresponding daily mean/minimum air temperature and precipitation data across China's temperate zone from 1981 to 2012. Results show that temperature is more decisive than drought in causing leaf coloration, and the growing season mean temperature plays a more important role than the autumn mean minimum temperature. Higher growing season temperature and lower autumn minimum temperature would induce earlier leaf coloration date. Moreover, the mean temperature over the growing season correlates positively with the autumn minimum temperature. This implies that growing season mean temperature may offset the requirement of autumn minimum temperature in triggering leaf coloration. Our findings deepen the understanding of leaf coloration mechanisms in winter deciduous trees and suggest that leaf life‐span control depended on growing season mean temperature and autumn low temperature control and their interaction are major environmental cues. In the context of climate change, whether leaf coloration date advances or is delayed may depend on intensity of the offset effect of growing season temperature on autumn low temperature.
Prevalence of neuropathic pain and sensory alterations after dental implant placement in a university‐based oral surgery department: A retrospective cohort study
Authors: Vázquez‐Delgado Eduardo , Viaplana‐Gutiérrez Marta , Figueiredo Rui , Renton Tara , Gay‐Escoda Cosme , Valmaseda‐Castellón Eduard
Published: February 2018

Objective

To determine the prevalence and the clinical features of patients with neuropathic pain and sensory alterations after dental implant placement.

Background

Literature is very scarce concerning the prevalence of neuropathic pain after dental implant placement.

Patients and Methods

A retrospective cohort study was made in patients submitted to dental implant placement in the Dental Hospital of the University of Barcelona. A descriptive analysis of the data was made, and the 95% confidence intervals (95% CI) were calculated for the prevalences.

Results

The study sample was composed of 1156 subjects of whom, 1012 patients (3743 dental implants) met the study inclusion criteria. Four hundred and seventeen patients (41.2%) were male and 595 (58.8%) were female, with a mean age of 60.7 years (range 16‐90 years). Three patients were diagnosed as having painful post‐traumatic trigeminal neuropathy (PPTN), which corresponds to a prevalence of 0.3% (95% CI: 0%‐0.6%). Additionally, 5 patients (0.5%; 95% CI: 0%‐1.07%) presented trigeminal neuropathy without pain (TNWP). The combined prevalence of both disorders was 0.8% (95% CI: 0.02%‐1.3%). All patients with PPTN and TNWP were 60 years old or older, with a total combined prevalence of 1.48% (95% CI: 0.46%‐2.5%) in this age group. Additionally, the prevalence in this age group for women was 1.85% (95%CI: 0.38%‐3.31%).

Conclusions

Neuropathic pain after dental implant placement is very infrequent (0.3%) in a University Oral Surgery department. However, the presence of trigeminal neuropathies can be slightly higher and can affect up to 0.5% of patients. Older female patients seem to be more prone to this rare and disabling complication.
Primordial odontogenic tumour: report of two cases
Authors: Almazyad Asma , Li Chia‐Cheng , Tapia Roberto O C , Robertson Javier P , Collette David , Woo Sook‐Bin
Published: February 2018

Aims

Primordial odontogenic tumour (POT) is a rare mixed odontogenic neoplasm that is composed of primitive ectomesenchyme resembling dental papilla, surfaced by odontogenic epithelium resembling inner enamel epithelium, without hard tissue formation. Most reported cases have presented in the posterior mandible as a well‐demarcated radiolucency associated with an unerupted tooth in the first two decades of life. The aim of this report is to describe the clinicopathological features of two more cases of POT.

Methods and results

Each presented as an asymptomatic well‐delineated radiolucency in the mandible in a 15‐year‐old female and an 18‐year‐old male, respectively. Both tumours were composed of a proliferation of plump spindle and stellate cells in delicately collagenous and myxoid stroma, surfaced by columnar‐squamous epithelial cells with reverse nuclear polarisation at the tumour periphery. In one case, the formation of abortive tooth germ‐like structures was noted. This has not been reported previously and supports the hypothesis of the primordial nature of this tumour. Both patients showed no recurrence at 3‐ and 20‐month follow‐up, respectively.

Conclusion

This report describes two additional cases of POT for a total of 11 cases reported in the English language literature.
Primary peri‐anal adenocarcinoma of intestinal type – a new proposed entity
Authors: Gill Pelvender S , Wong Newton A C S
Published: February 2018

Aims

The currently recognised subtypes of anal canal/peri‐anal adenocarcinoma are those arising from low rectal mucosa or columnar cuff, fistula‐related tumours and anal gland carcinoma. This report presents two examples of a hitherto undescribed subtype of peri‐anal adenocarcinoma with an intestinal phenotype.

Methods and results

A 74‐year‐old man had a peri‐anal tumour locally excised, whereas a 73‐year‐old female underwent an abdominoperineal resection for peri‐anal Paget's disease with an underlying carcinoma. Neither patient had a history of perineal fistulae, Crohn's disease or previous gastrointestinal neoplasia, and neither showed clinical, radiological or endoscopic evidence of another abdominal or pelvic tumour. Both resection specimens contained adenocarcinoma, which were similar in demonstrating an intestinal morphology and CDX2 immunopositivity. The man has shown a disease‐free outcome thus far, but the woman has suffered with nodal and pelvic recurrence within a few months of surgery.

Conclusions

The name ‘primary peri‐anal adenocarcinoma of intestinal type’ is proposed for this previously unrecognised subtype of perineal neoplasia. Awareness of its distinct existence – by recognising its intestinal morphology and immunophenotype while excluding metastasis from the intestinal tract – should help to collate data to determine its specific prognosis and to formulate its best management.
Basal cell carcinoma induced by therapeutic radiation for tinea capitis—clinicopathological study
Authors: Oshinsky Shlomit , Baum Sharon , Huszar Monica , Debby Assaf , Barzilai Aviv
Published: February 2018

Aims

An increased prevalence of aggressive histological subtypes, such as micronodular and morpheaform, has been seen, irrespective of the clinical course, in basal cell carcinoma (BCC) following irradiation for tinea capitis. The aim of this study was to assess the histopathological features of BCCs among patients irradiated for tinea capitis and correlate them with the clinical course.

Methods and results

The medical records and BCC biopsy specimens of individuals who were previously irradiated for tinea capitis were reviewed. Demographic data and clinical characteristics were retrieved. Biopsy specimens were evaluated for histological subtype classification and additional histopathological features. A telephone survey was conducted to assess the clinical behaviour of the tumours. Thirty‐one patients (17 male; 14 female) were included. The average age at time of first biopsy was 56 years. The total number of lesions was 185, with 80% of subjects showing multiple lesions. The nodular subtype was the most prevalent, followed by superficial, micronodular and mixed tumours. One‐third of the BCCs could be classified as aggressive histologically. Stromal fibroplasia and melanin deposits were common. There was no mortality related to BCC. None of the 17 patients who completed the survey had evidence of local invasiveness or metastases.

Conclusions

BCCs following radiation therapy for tinea capitis show unique histological characteristics related to aggressive behaviour. These aggressive features did not reflect the clinical behaviour in the current cohort.
Hepatic elastin content is predictive of adverse outcome in advanced fibrotic liver disease
Authors: Kendall Timothy J , Dolman Grace E , Duff Catherine M , Paish Emma C , Zaitoun Abed , Irving William , Fallowfield Jonathan A , Guha Indra N
Published: February 2018

Aims

The aim of this study was to determine if elastin content in needle core native liver biopsies was predictive of clinical outcome in patients with chronic hepatitis C virus‐related chronic liver disease.

Methods and results

Elastin contents in liver biopsies were determined by image analysis, technically validated in an independent centre, and correlated with outcome in patients with advanced (Ishak stage ≥5) chronic hepatitis C virus‐related chronic liver disease. Elastin was robustly quantified in an operator‐independent and laboratory‐independent manner, with very strong correlation of elastin staining measured with two methods of image classification (rs = 0.873, P < 0.00001). Elastin content (but not absolute scar content or Ishak stage) was predictive for future clinical outcomes. In a cohort of patients without sustained virological response, the median hepatic elastin content was 3.4%, and 17 patients (57%) progressed to a liver‐related clinical outcome; 11 of the 15 patients (73%) with a hepatic elastin content of >3.4% progressed to a clinical outcome, as compared with only six of 15 (40%) with an elastin content of <3.4%. The difference in time to outcome was significant.

Conclusions

We describe a simple and reproducible method for elastin quantification in liver biopsies that provides potentially valuable prognostic information to inform clinical management.
Microstructure evolution and performance improvement of TiN‐based cermets with carbon addition
Authors: Wu Yuxue , Xiong Huiwen , Zeng Wenmiao , Yuan Yue , Gan Xueping
Published: February 2018

In this work, TiN‐based cermets with excellent performance and uniform microstructure were successfully manufactured by conventional vacuum sintering with 0‐5 wt% carbon addition at 1500°C. Influence of carbon addition on the microstructure and mechanical properties of cermets was investigated by scanning electron microscope, transmission electron microscope, X‐Ray diffraction, electron probe microanalysis, and mechanical tests. The results showed that small amount of carbon helped to improve significantly the wettability between TiN and Ni/Co, leading to well‐distributed structure and perfect core‐rim phases. As the carbon content increased from 0 to 5 wt%, mechanical properties of cermets increased initially, displayed a maximum and then decreased. For the experimental conditions considered, the cermets with 3 wt% carbon addition revealed best mechanical properties. The relative density, the transverse rupture strength, fracture toughness, and Rockwell hardness of the cermets were 99.78%, 1836 MPa, 14.7 MPa m1/2, and 88, respectively.
Noticings with instructional implications in post‐licence driver training
Authors: Rauniomaa Mirka , Lehtonen Esko , Summala Heikki
Published: February 2018

Drawing on ethnomethodology and conversation analysis, the study examines video data in which drivers with a valid licence participate in voluntary instructor‐led training. The study discusses noticings by the instructor that concern current events or states of affairs and prompt the driver to adjust her driving or that concern habitual practices developed by the driver over time and encourage her to alter them in the future. The former are simple noticings, whereas the latter are prefaced with “I notice that.” The design and timing of the noticings reveal how they are to be understood with respect to the mobile instructional situation. Moreover, they make visible the instructor's ongoing monitoring and assessment of the driver's performance and the instructor's expectations regarding the driver's experience and competence.
Financial literacy and high‐cost borrowing: Exploring the mechanism
Authors: Pak Tae‐Young
Published: February 2018

Recent studies have suggested that financial literacy is an important determinant of informed borrowing decisions. Despite the evidence that financially literate consumers are less likely to use alternative financial services, the mechanism through which financial literacy discourages demand for alternative financial services has yet to be fully understood. The previous studies proposed several explanations, such as the ability to undertake complex financial calculations and understand contract terms, to link financial literacy to savvy credit choices. This study evaluates the validity of this argument by examining whether or not financial knowledge plays a greater role in borrowing decisions where consumers are forced to rely on financial knowledge. It is assumed that consumers in an information‐sparse environment have a greater incentive to utilize financial knowledge to infer the hidden cost of borrowing contracts. To test this argument, this study examines the extent to which information availability moderates the negative impact of financial knowledge on rent‐to‐own transactions. Information content is captured by state‐level disclosure mandates for rental contracts, given that consumer in a loosely regulated state are exposed to less pricing information. The results illustrate that limited information strengthens the negative association between financial knowledge and rent‐to‐own transactions. This confirms the previous arguments that consumers are active thinkers who refer to financial knowledge to estimate the overall cost of borrowing.
Current practice for genetic counselling by nurses: An integrative review
Authors: Barr Jennieffer A. , Tsai Lily P. , Welch Anthony , Faradz Sultana M.H. , Lane‐Krebs Katrina , Howie Virginia , Hillman Wendy
Published: February 2018

Aim

To examine current practice of genetic counselling by nurses.

Background

Recent debate argues that genetic counselling is a specialist advanced practice role, whilst others argue it is the role of all nurses. Current evidence is required to determine if genetic counselling could be included in all nurses' scope of practice.

Design

Integrative literature review.

Data Sources

A search of electronic databases (CINHAL, Medline, PubMed, Scopus), and reference lists published between January 2012 and March 2017, was undertaken.

Review Methods

Studies were critically appraised for methodological quality using the Critical Appraisal Skills Programme. Data from each study were extracted and categorized according to their primary findings.

Results

The inclusion criteria were met in 10 studies. Main findings were identified: role of genetic counselling, current knowledge, need for further education, and client satisfaction with nurse genetic counsellors.

Conclusion

This paper concludes that some nurses do engage in genetic counselling, but how they engage is not consistent, nor is there consensus about what should be the scope of practice. Further investigation into credentialing, role recognition support and education for nurse genetic counselling are strongly recommended. As nurses are widely available, nurses can make a significant contribution to supporting those affected by genetic problems.
The lymphoid cell network in the skin
Authors: Tikoo Shweta , Jain Rohit , Kurz Angela RM , Weninger Wolfgang
Published: February 2018

Cutaneous immunity represents a crucial component of the mammalian immune response. The presence of a large array of commensal microorganisms along with a myriad of environmental stresses necessitates constant immuno‐surveillance of the tissue. To achieve a perfect balance between immune‐tolerance and immune‐activation, the skin harbors strategically localized immune cell populations that modulate these responses. To maintain homeostasis, innate and adaptive immune cells assimilate microenvironmental cues and coordinate cellular and molecular functions in a spatiotemporal manner. The role of lymphoid cells in cutaneous immunity is gaining much appreciation due to their important roles in regulating skin health and pathology. In this review, we aim to highlight the recent advances in the field of cutaneous lymphoid biology.
Association of peak atrial longitudinal strain with atrial fibrillation recurrence in patients with chronic lung diseases following radiofrequency ablation
Authors: Bai Ying , Zhao Ying , Li Jie , Zhang Ying , Bai Rong , Du Xin , Dong Jian‐Zeng , He Yi‐Hua , Ma Chang‐Sheng
Published: February 2018

Background

Strain was shown associated with atrial fibrillation (AF) recurrence after radiofrequency ablation (RFA), but data on AF patients complicated with chronic lung diseases (CLD) were rare.

Aim

This study was designed to evaluate the relationship of baseline atrial function with AF recurrence in these patients using speckle‐tracking echocardiography.

Methods

Average strain values (median: 2 days before RFA) were calculated for 87 AF patients (Mean age: 61.91 years, male: 71.26%) with CLD undergoing RFA from 2013 to 2014. Of these patients, 25 (28.74%) experienced AF recurrence during a mean follow up of 10.3 months.

Results

Peak right atrial longitudinal strain (R‐PALS) was associated with peak left atrial longitudinal strain (L‐PALS, Standardised β = 0.45, P < 0.001) in multivariate linear regression. Multivariate Cox regression analysis showed R‐PALS was associated with AF recurrence (hazard ratio, 0.86; 95% confidence interval (CI), 0.78–0.96, P = 0.005) in CLD. Patients with R‐PALS ≥14.69% had higher AF free rate compared with R‐PALS<14.69% using Kaplan–Meier analysis (log‐rank, P < 0.001). R‐PALS had similar C‐index compared to L‐PALS (difference: 0.03, 95%CI: −0.06–0.12, P = 0.53) and combined R‐PALS and L‐PALS (difference: 0.005, 95%CI: −0.04–0.05, P = 0.84) associated with AF recurrence in CLD.

Conclusion

R‐PALS, L‐PALS and combined R‐PALS and L‐PALS are important factors associated with AF recurrence following RFA in patients with CLD.
Perceived utility and relevance of intern well‐being sessions
Authors: Ward Susannah , Outram Sue , Heslop Benjamin
Published: February 2018

Background/Aim

We conducted a pilot project assessing the perceived utility and relevance of well‐being sessions provided to interns at a large regional teaching hospital in Australia, with the aim of promoting intern well‐being and fostering a nurturing and supportive learning and work hospital culture.

Methods

Our intervention involved two separate 60‐min lectures covering well‐being topics and skills to approximately 50 interns within protected teaching time, along with emailed well‐being resources. Participants were emailed an online survey asking questions about value and novelty of the sessions, and work satisfaction and stress, as well as open comments. A request for an additional interview to explore responses in more depth was included.

Results

Fifty interns attended at least one of the sessions and 35 participated in the survey, six to an additional interview. Survey and interview data showed that the majority of interns perceived the sessions as valuable, relevant and useful and felt that ongoing sessions would benefit junior medical officers in future years. Feedback highlighted the importance of providing future sessions in person, incorporating an interactive approach and emphasised that work site factors and medical culture play a large causative role in their stress.

Conclusions

We conclude that well‐being sessions are acceptable and useful to interns and should be incorporated into hospital teaching curricula, and evaluated. However, these programmes are unlikely to change the high stress experienced unless external and systemic stressors are addressed by all stakeholders.
T‐cell modulation by cyclophosphamide for tumour therapy
Authors: Hughes Ellyn , Scurr Martin , Campbell Emma , Jones Emma , Godkin Andrew , Gallimore Awen
Published: February 2018

The power of T cells for cancer treatment has been demonstrated by the success of co‐inhibitory receptor blockade and adoptive T‐cell immunotherapies. These treatments are highly successful for certain cancers, but are often personalized, expensive and associated with harmful side effects. Other T‐cell‐modulating drugs may provide additional means of improving immune responses to tumours without these disadvantages. Conventional chemotherapeutic drugs are traditionally used to target cancers directly; however, it is clear that some also have significant immune‐modulating effects that can be harnessed to target tumours. Cyclophosphamide is one such drug; used at lower doses than in mainstream chemotherapy, it can perturb immune homeostasis, tipping the balance towards generation of anti‐tumour T‐cell responses and control of cancer growth. This review discusses its growing reputation as an immune‐modulator whose multiple effects synergize with the microbiota to tip the balance towards tumour immunity offering widespread benefits as a safe, and relatively inexpensive component of cancer immunotherapy.
Molecular characteristics of rhesus macaque interleukin‐22: cloning, in vitro expression and biological activities
Authors: Yu Lei , Wang Feng‐Jie , Cui Yan‐Fang , Li Dong , Yao Wen‐Rong , Yang Gui‐Bo
Published: February 2018

Interleukin‐22 (IL‐22) is a potential therapeutic agent for diseases driven by epithelial injury. To characterize the IL‐22 expressed by rhesus macaques, animals that are irreplaceable for human disease research, rhesus macaque IL‐22 (rhIL‐22) was cloned and expressed, and its biological activity and in vivo distribution were examined. It was found that the rhIL‐22 gene consists of five introns and six exons, including a short non‐coding exon starting 22 bp downstream of a putative TATA box. The amino acid sequence of rhIL‐22 showed 95·5% identity to that of humans, and it shared two conserved disulphide bonds, three N‐glycosylation sites and all the critical residues for binding to IL‐22R1. High levels of IL‐22 mRNA were observed in the liver, pancreas, lymphoid tissues and especially in the outer‐body barriers such as the intestinal tract of rhesus macaques. Functionally, purified rhIL‐22 has a similar but a little earlier effect on signal transducer and activator of transcription 3 phosphorylation at Tyr705 compared with that of commercial human IL‐22. The expression of the antibacterial proteins β‐defensin‐2, S100A8, S100A9, RegIIIα and Muc1 by HT‐29 cells was largely upregulated after stimulation with rhIL‐22. Recombinant rhIL‐22 could also significantly promote the proliferation of human intestinal epithelial cells without affecting cell apoptosis. These data indicate that rhesus macaque IL‐22 is highly similar to that of humans in both structure and function, and tests of therapeutic effects of human IL‐22 on human diseases in rhesus macaques are warranted.
Growth hormone‐releasing peptide 6 prevents cutaneous hypertrophic scarring: early mechanistic data from a proteome study
Authors: Fernández‐Mayola Maday , Betancourt Lázaro , Molina‐Kautzman Alicia , Palomares Sucel , Mendoza‐Marí Yssel , Ugarte‐Moreno Dayana , Aguilera‐Barreto Ana , Bermúdez‐Álvarez Yilian , Besada Vladimir , González Luis J. , García‐Ojalvo Ariana , Mir‐Benítez Ana J. , Urquiza‐Rodríguez Aleida , Berlanga‐Acosta Jorge
Published: February 2018

Hypertrophic scars (HTS) and keloids are forms of aberrant cutaneous healing with excessive extracellular matrix (ECM) deposition. Current therapies still fall short and cause undesired effects. We aimed to thoroughly evaluate the ability of growth hormone releasing peptide 6 (GHRP6) to both prevent and reverse cutaneous fibrosis and to acquire the earliest proteome data supporting GHRP6's acute impact on aesthetic wound healing. Two independent sets of experiments addressing prevention and reversion effects were conducted on the classic HTS model in rabbits. In the prevention approach, the wounds were assigned to topically receive GHRP6, triamcinolone acetonide (TA), or vehicle (1% sodium carboxy methylcellulose [CMC]) from day 1 to day 30 post‐wounding. The reversion scheme was based on the infiltration of either GHRP6 or sterile saline in mature HTS for 4 consecutive weeks. The incidence and appearance of HTS were systematically monitored. The sub‐epidermal fibrotic core area of HTS was ultrasonographically determined, and the scar elevation index was calculated on haematoxylin/eosin‐stained, microscopic digitised images. Tissue samples were collected for proteomics after 1 hour of HTS induction and treatment with either GHRP6 or vehicle. GHRP6 prevented the onset of HTS without the untoward reactions induced by the first‐line treatment triamcinolone acetonide (TA); however, it failed to significantly reverse mature HTS. The preliminary proteomic study suggests that the anti‐fibrotic preventing effect exerted by GHRP6 depends on different pathways involved in lipid metabolism, cytoskeleton arrangements, epidermal cells’ differentiation, and ECM dynamics. These results enlighten the potential success of GHRP6 as one of the incoming alternatives for HTS prevention.