bluuebunny/crossref_metadata_2025 huggingface dataset:
Fetal Alcohol Spectrum Disorders in a Rocky Mountain Region City: Child Characteristics, Maternal Risk Traits, and Prevalence
Authors: May Philip A. , Hasken Julie M. , Bozeman Rosemary , Jones Jo‐Viviane , Burns Mary Kay , Goodover Joelene , Kalberg Wendy O. , Buckley David , Brooks Marita , Ortega Marian A. , Elliott Amy J. , Hedrick Dixie M. , Tabachnick Barbara G. , Abdul‐Rahman Omar , Adam Margaret P. , Jewett Tamison , Robinson Luther K. , Manning Melanie A. , Hoyme H. Eugene
Published: April 2020

Objective

To document prevalence and traits of children with fetal alcohol spectrum disorders (FASD) and maternal risk factors in a Rocky Mountain city.

Methods

Variations on active case ascertainment methods were used in 2 first‐grade cohorts in all city schools. The consent rate was 59.2%. Children were assessed for physical growth, dysmorphology, and neurobehavior and their mothers interviewed.

Results

Thirty‐eight children were diagnosed with FASD and compared with 278 typically developing controls. Total dysmorphology scores summarized well the key physical indicators of FASD and defined specific diagnostic groups. On average, children with FASD performed significantly poorer than controls on intellectual, adaptive, learning, attention, and behavioral tasks. More mothers of children with FASD reported drinking prior to pregnancy and in the first and second trimesters, and had partners with drinking problems than mothers of controls; however, reports of comorbid alcohol use and 6 other drugs were similar for mothers of children with FASD and mothers of controls. Mothers of children with FASD were significantly younger at pregnancy, had lower average weight before pregnancy and less education, initiated prenatal clinic visits later, and reported more health problems (e.g., stomach ulcers and accidents). Children with FASD had significantly lower birth weight and more problems at birth, and were less likely to be living with biological mother and father. Controlling for other drug and tobacco use, a FASD diagnosis is 6.7 times (OR = 6.720, 95% CI = 1.6 to 28.0) more likely among children of women reporting prepregnancy drinking of 3 drinks per drinking day (DDD) and 7.6 times (OR = 7.590, 95% CI = 2.0 to 31.5) more likely at 5 DDD. Prevalence of FAS was 2.9–5.8 per 1,000 children, and total FASD was 34.9 to 82.5 per 1,000 children or 3.5 to 8.3% at this site.

Conclusion

This site had the second highest prevalence of FASD of the 4 Collaboration on FASD Prevalence sites and clearly identifiable child and maternal risk traits.
Biomarkers of endothelial dysfunction in cocaine overdose and overdose‐related cardiovascular events
Authors: Manini Alex F. , Gibson Claire L. , Miller Michael L. , Richardson Lynne D. , Vargas‐Torres Carmen C. , Vedanthan Rajesh , Hurd Yasmin L.
Published: April 2020

Overdose of stimulant drugs has been associated with increased risk of adverse cardiovascular events (ACVE), some of which may be ascribed to endothelial dysfunction. The aims of this study were to evaluate biomarkers of endothelial dysfunction in emergency department (ED) patients with acute cocaine overdose and to assess the association between in‐hospital ACVE in ED patients with any acute drug overdose. This was a prospective consecutive cohort study over 9 months (2015–2016) at two urban, tertiary‐care hospital EDs. Consecutive adults (≥18 years) presenting with suspected acute drug overdose were eligible and separated into three groups: cocaine (n = 47), other drugs (n = 128), and controls (n = 11). Data were obtained from medical records and linked to waste serum specimens, sent as part of routine clinical care, for biomarker analysis. Serum specimens were collected and analyzed using enzyme‐linked immunosorbent assay kit for three biomarkers of endothelial dysfunction: (a) endothelin‐1 (ET‐1), (b) regulated upon activation normal T cell expressed and secreted (RANTES), and (c) soluble intercellular adhesion molecule‐1 (siCAM‐1). Mean siCAM was elevated for cocaine compared with controls and other drugs (p < .01); however, mean RANTES and ET‐1 levels were not significantly different for any drug exposure groups. Receiver operating characteristics curve analysis for prediction of in‐hospital ACVE revealed excellent performance of siCAM‐1 (area under curve, 0.86; p < .001) but lack of predictive utility for either RANTES or ET‐1. These results suggest that serum siCAM‐1 is a viable biomarker for acute cocaine overdose and that endothelial dysfunction may be an important surrogate for adverse cardiovascular events following any drug overdose.
Preventing Early‐Onset Group B Streptococcus neonatal infection and reducing antibiotic exposure using a rapid PCR test in term prelabour rupture of membranes
Authors: Wang Mandy , Keighley Caitlin , Watts Matthew , Plymoth Martin , McGee Therese M.
Published: April 2020

Background

How best to target intrapartum antibiotic prophylaxis (IAP) to minimise both Early‐Onset Group B Streptococcus (EOGBS) neonatal infection and maternal/fetal antibiotic exposure is uncertain, with both routine‐screening and risk‐factor approaches available.

Aims

This retrospective cohort study was undertaken to examine the outcomes of a hybrid risk‐and‐screen approach to EOGBS prevention using GBS polymerase chain reaction (PCR). The target population was women with term prelabour rupture of membranes (TermPROM) having the risk factor of prolonged rupture of membranes (ROM) ≥18 h.

Materials and Methods

Non‐labouring TermPROM women had rapid GBS PCR testing at presentation. GBS screen‐positive women proceeded to induction of labour and received IAP. GBS screen‐negative women were allowed home to await spontaneous labour and not given IAP regardless of duration of ROM, unless other risk factors developed. For all other women, the risk‐factor approach was followed.

Results

From 2009 to 2018, there were 20 cases of culture‐positive EOGBS, a rate of 0.36/1000 live births (95% CI 0.22–0.56/1000), comparable to other recent reports. Over 2010–2018 when laboratory data were available, 1120 TermPROM women with ROM ≥18 h avoided antibiotics because they were GBS PCR‐negative (2.3% of all births, 3.6% of vaginal births) while 338 TermPROM women with ROM <18 h received targeted antibiotics for being GBS‐positive. No cases of EOGBS occurred in TermPROM women, those with ROM ≥18 h, or due to protocol‐compliance failure.

Conclusions

A hybrid approach involving risk‐factor‐based IAP and intrapartum GBS PCR screening of non‐labouring TermPROM women delivers acceptably low rates of EOGBS while minimising and better targeting antibiotic exposure.
Resolution of subclinical porphyria cutanea tarda after hepatitis C eradication with direct‐acting anti‐virals
Authors: Sastre Lydia , To‐Figueras Jordi , Lens Sabela , Rodriguez‐Tajes Sergio , Bartres Concepció , Aguilera Paula , Badenas Celia , Oliva Rafael , Pocurull Anna , Forns Xavier , Mariño Zoe
Published: April 2020

Background

Hepatitis C virus (HCV) is a risk factor for porphyria cutanea tarda (PCT), a rare disease originating in the liver characterised by overproduction of porphyrins. Although hepatitis C infection is highly prevalent among patients with porphyria, only a minority of hepatitis C patients develop PCT.

Aims

To explore the presence of porphyrin abnormalities in a cohort of asymptomatic hepatitis C‐infected patients and the impact of anti‐viral therapy.

Methods

Eighty‐four consecutive patients with HCV infection treated with direct‐acting antivirals after 1 January 2018 were longitudinally evaluated for the presence of porphyrin abnormalities. Those patients with biochemical abnormalities at baseline were additionally evaluated at follow‐up. Porphyrins in urine were screened by fluorometry and isomer separation was performed by liquid chromatography.

Results

In five patients, all of them asymptomatic, porphyrin profile abnormalities were detected: three presented significant increased urinary porphyrins with a typical PCT profile, and two showed normal levels of urinary porphyrins, but abnormal porphyria‐like profiles. Urine evaluation after hepatitis C cure showed complete normalisation of the urinary porphyrins in all patients, confirming the biochemical cure of the disease.

Conclusions

We document the existence of rare cases of hepatitis C‐infected patients with significant uroporphyrinuria in the absence of dermatological manifestations. Anti‐viral therapy normalises the biochemical disorder, preventing patients from presenting PCT associated complications.
High‐temperature performance of two‐layered ceramics and the implications for Roman crucibles
Authors: Gardner Carlotta , Müller Noémi S. , Vekinis George , Freestone Ian C. , Kilikoglou Vassilis
Published: April 2020

Roman metalworking crucibles are frequently characterized by an extra outer layer of clay, applied to a pre‐formed vessel. Three‐point bending and standardized dead‐weight loading tests were conducted to determine the advantages offered by the extra outer layer. Deformation and fracture behaviour, at temperatures up to 1100°C, of two‐layer, monolithic and tempered‐monolithic briquettes were compared. Measurements indicated that the two‐layer briquettes were more resistant to fracture at high temperatures: > 850°C they showed more extensive plastically deformed regions than monolithic briquettes. The influence of temper was consistent with previous results: tempering caused quasi‐stable fracture and reduced fracture strength. The results suggest extra outer layers assisted in preventing catastrophic failure.
Personal Relative Deprivation and Mental Health Among University Students: Cross‐sectional and Longitudinal Evidence
Authors: Smith Heather J. , Ryan Desiree A. , Jaurique Alexandria , Duffau Elise
Published: April 2020

Colleges and universities are a unique context in which students encounter similar aged peers from a wide range of economic backgrounds. As emerging adults coping with major life transitions, students may be especially sensitive to upward contrasts with other students who have advantages that they feel they deserve (personal relative deprivation or PRD). We surveyed a population of university students when they were second‐ and third‐year students (N = 309), and 2 years later, when they were fourth‐ and fifth‐year students (N = 400). Increased PRD predicted increased anxiety and depression—even after accounting for students’ access to social support, the degree to which they identified with the university, and their gender, family income, ethnic background, and whether the student was a first‐generation college student. For a third separate sample of students who completed both surveys (N = 168), PRD predicted students’ mental health two years later even after accounting for their earlier anxiety and depression. In all three samples, PRD mediated the relationship between self‐reported family income and mental health. These data indicate that universities and colleges should consider a broad range of interventions and policies that can mitigate the impact of upward social contrasts.
Tender Labor: Transnational Young People and Continuums of Familial Care
Authors: Shaw Jennifer E.
Published: April 2020

As migrant Filipina mothers embark on domestic labor abroad, their children respond in novel and dynamic ways to the work that needs doing within their households. Such work includes caring for siblings and responding to parents’ emotional and marital struggles. This labor emerges from the feminization of the global labor market, which leaves a care slot that young people register and work to fill. Attention to young people’s perspectives on their families and to their enactments of what I call “tender labor” recasts ongoing discussions about care work by highlighting how young people actively participate in the processes of transnational family separation and reunification. A pair of case studies reveals the impact of care extraction in the recesses of domestic life, as children struggle to mitigate the precarity of life for themselves and their loved ones.
The role of hybrid learning spaces in enhancing higher education students’ employability
Authors: Bennett Dawn , Knight Elizabeth , Rowley Jennifer
Published: April 2020

Graduate employment rates and self‐reported employability are increasingly a feature of higher education funding measures. However, graduate outcomes do not denote the whole learning experience of the student nor is the student experience reducible to a single statistic. This paper discusses a design‐centric approach to employability development which was enacted within a hybrid learning space. The study engaged 52 final‐year speech pathology students, their lecturer, the lead researcher and a career practitioner (advisor) at an Australian university. Students first created personalized employability profiles using an established online self‐reflection tool. The online tool produced a personalized report and enabled students to access developmental resources relating to employability and student success. The project team used anonymized student data to transform a previously generic “careers” workshop into a targeted workshop in which students explored individual and cohort findings and participated in developmental activities informed by the data. The initiative’s contribution to learning space research is in its composition as a hybrid learning space in which educators and students engaged as learners and developers of their online learning spaces, and educators collaborated to analyze student data and inform learning and teaching enhancements within the same study period. It is anticipated that the data from subsequent years will inform the curricular review, particularly if subsequent student cohorts express similar concerns. Implications for higher education policy and practice are discussed.
Epistemic roles of materiality within a collaborative invention project at a secondary school
Authors: Mehto Varpu , Riikonen Sini , Hakkarainen Kai , Kangas Kaiju , Seitamaa‐Hakkarainen Pirita
Published: April 2020

In this study, we examined maker‐centred learning from an epistemic perspective, highlighting the agentic role of material engagement and artefacts in learning and creativity. The use of physical materials plays a crucial role in maker activities where the socio‐epistemic aspects of knowledge creation entangle with the designing and making of physical artefacts. By taking a case study perspective, we analysed video data from nine design sessions involving a team of students (aged 13 to 14) developing an invention. First, we analysed knowledge that was built during the process. Our analysis revealed how design ideas evolved from preliminary to final stages and, together with the expressed design problems and conversations preceding the ideas, formed an epistemic object pursued by the team. Next, we included non‐human agencies into the analysis to understand the role of materials in the process. Features of materials and human design intentions both constrained and enabled idea improvement and knowledge creation, intermixing meanings and materials. Material making invited the students to not only rely on human rationalisation, but also to think together with the materials.
Exploring occupancy of the histamine H3 receptor by pitolisant in humans using PET
Authors: Rusjan Pablo , Sabioni Pamela , Di Ciano Patricia , Mansouri Esmaeil , Boileau Isabelle , Laveillé Alexia , Capet Marc , Duvauchelle Thierry , Schwartz Jean‐Charles , Robert Philippe , Le Foll Bernard
Published: April 2020

Background and Purpose

BF2.649 (pitolisant, Wakix®) is a novel histamine H3 receptor inverse agonist/antagonist recently approved for the treatment of narcolepsy disorder. The objective of the study was to investigate in vivo occupancy of H3 receptors by BF2.649 using PET brain imaging with the H3 receptor antagonist radioligand [11C]GSK189254.

Experimental Approach

Six healthy adult participants were scanned with [11C]GSK189254. Participants underwent a total of two PET scans on separate days, 3 h after oral administration of placebo or after pitolisant hydrochloride (40 mg). [11C]GSK189254 regional total distribution volumes were estimated in nine brain regions of interest with the two tissue‐compartment model with arterial input function using a common VND across the regions. Brain receptor occupancies were calculated with the Lassen plot.

Key Results

Pitolisant, at the dose administered, provided high (84 ± 7%; mean ± SD) occupancy of H3 receptors. The drug was well‐tolerated, and participants experienced few adverse events.

Conclusion and Implications

The administration of pitolisant (40 mg) produces a high occupancy of H3 receptors and may be a new tool for the treatment of a variety of CNS disorders that are associated with mechanisms involving H3 receptors.
An investigation of the complementary effects of technology, market, and design capabilities on exploratory and exploitative innovations: Evidence from micro and small‐sized tech enterprises in China
Authors: Xue Jie , Swan K. Scott
Published: April 2020

Technology, market, and design are important driving forces for enterprise innovation activities. Unfortunately, their combined effects on exploratory and exploitative innovations are less clear, especially for micro and small businesses critical to the economy. By using data from a two‐stage survey of 357 micro and small‐sized tech enterprises (MSTEs) in the fast‐developing region of Foshan, this study investigates how diverse complementarities between technology, market, and design capabilities contribute to exploratory innovation and exploitative innovation. The results reveal how distinct contributions from the capabilities affect exploratory and exploitative innovations in differentiated ways. Specifically, exploratory innovation benefits from the three‐way complementarity of technology, market, and design capabilities, whereas exploitative innovation only benefits from the two‐way complementarities between technology and market capabilities and between market and design capabilities. These findings contribute to the resource‐based view (RBV) literature, while providing managers with guidelines to improve capability investment and allocation decisions that foster exploratory and exploitative innovations.
Relationship of sputum mast cells with clinical and inflammatory characteristics of asthma
Authors: Fricker Michael , Qin Ling , Niessen Natalie , Baines Katherine J. , McDonald Vanessa M. , Scott Hayley A. , Simpson Jodie L. , Gibson Peter G.
Published: April 2020

Background

Mast cells (MCs) are innate immune cells that regulate atopic and non‐atopic inflammation in the airways. MCs play a critical role in the pathogenesis of asthma, yet their relationship to airway and systemic inflammation and clinical characteristics of asthma is poorly understood.

Objective

To quantify MCs in induced sputum samples and understand their relationship to airway and circulatory immune cells, and clinical variables in asthma.

Methods

We employed flow cytometry of sputum samples to quantify MCs, basophils and other immune cells in 51 participants (45 asthma and 6 non‐asthma controls). Relationship of MCs to airway (n = 45) and blood (n = 19) immune cells, participant demographics, asthma history, spirometry and airways hyperresponsiveness (AHR) to hypertonic saline was determined by correlation and comparison of cut‐off–based sputum MC high vs low participants.

Results

Mast cells, basophils and eosinophils were increased in asthma vs non‐asthma control sputum. In asthma sputum, MCs, basophils and eosinophils were significantly intercorrelated, and MCs and basophils were elevated in participants with eosinophilic asthma. MCs and basophils, but not eosinophils, correlated with AHR. Sputum MC high asthma was characterized by an increased proportion of participants with uncontrolled asthma and reduced FEV1 and FVC. Trends towards similar clinical associations with elevated MCs were observed in a paucigranulocytic subpopulation (n = 15) lacking airway eosinophilia or neutrophilia. Receiver operator characteristic (ROC) analysis showed peripheral blood eosinophil (PBE) count predicted elevated sputum eosinophils and basophils, but not MCs.

Conclusions and Clinical Relevance

Sputum MCs are elevated in asthma, and their measurement may be useful as they relate to key clinical features of asthma (spirometry, asthma control, AHR). PBE count did not predict airway MC status, suggesting direct measurement of airway MCs by sensitive methods such as flow cytometry should be further developed.
#10‐Year Challenge
Authors: Yap Darren , Ng Miane , Moorthy Ram
Published: April 2020

Introduction

Adequate management of post‐tonsillectomy pain is an important consideration in postoperative management after tonsillectomy. A 2008 meta‐analysis showed that the use of local anaesthetic either by infiltration or topical application reduced postoperative pain.

Objectives

To review the current evidence for the use of local anaesthetic as a means of reducing post‐tonsillectomy pain and compare current evidence to the previous meta‐analysis 10 years ago.

Method

Systematic literature searches of MEDLINE [*"ANESTHETICS, LOCAL"/ AND *TONSILLECTOMY/], EMBASE [*"LOCAL ANESTHETIC AGENT"/ AND *TONSILLECTOMY/] and PubMed [(Tonsillectomy).ti,ab AND (Local Anaesthetic).ti,ab OR (Local Anesthetic).ti,ab]. A meta‐analysis of randomised control trials assessing the use of local anaesthetic agents for post‐tonsillectomy pain.

Results

Twenty‐three studies were included in the meta‐analysis. Overall, local anaesthetic, applied topically or infiltrated, significantly reduces pain scores compared with controls at 4‐6 hours [−0.65 (95% CI: −0.77; −0.53)]; 24 hours [−0.50 (95% CI: −0.66, −0.35)]; and 5‐7 days [−0.78 (95% CI: −0.90, −0.65)] (standardised mean differences).

Conclusion

Current studies suggest that use of peri‐operative local anaesthetic during tonsillectomy does improve postoperative pain outcomes. The limitations of the analysis are as follows: all studies are small, and a multi‐centred larger trial is recommended to guarantee statistical reliability. There was no description of significant adverse side effects from local anaesthetic use.
Evaluating the association of the new National Surgical Quality Improvement Program modified 5‐factor frailty index with outcomes in elective colorectal surgery
Authors: Keller D. S. , Reif de Paula T. , Kiran R. P. , Nemeth S. K.
Published: April 2020

Background

The 5‐factor modified frailty index (mFI‐5) is a new, NSQIP‐based, predictive tool for mortality and postoperative complications. The mFI‐5’s predictive ability has been validated within the large‐scale NSQIP database but applicability in institutional databases has not been investigated. We sought to assess the association between the mFI‐5 and morbidity/mortality at the institutional level.

Methods

A divisional database was queried for 2017 elective colorectal resections and an mFI‐5 calculated. The main outcome measure was the association and predictive value of the mFI‐5 with major morbidity/mortality and minor complications. Univariable analyses were performed via the Cochran‐Armitage Test and Cramer’s V. Logistic regression evaluated the relationship between the mFI‐5 and morbidity/mortality while accounting for demographics and pre‐operative risk factors. Receiver operating characteristic (ROC) curves were plotted to visualize the predictive strength for outcomes.

Results

Four hundred and twelve patients were analyzed. 8.7% had major morbidity/mortality and 31.6% minor complications. The mFI‐5 categorized patients into 0 (n = 335), 1 (n = 58), and 2+ (n = 19) groups. Univariable analysis showed a higher mFI‐5 was associated significantly with major morbidity/mortality (P = 0.004), but not minor (P = 0.281). Multivariable logistic regression showed a strong association between an mFI‐5 score of 2+ with major complications (Major: OR = 4.616, CI [1.442–14.776], P = 0.010). ROC curves showed the mFI‐5 was poor for predicting outcomes and performed better when other risk factors were added to the model.

Conclusion

The mFI‐5 tool has an independent association with major morbidity/mortality in an institutional dataset for elective colorectal surgery, but is not predictive. Its predictive ability is enhanced when other patient‐specific risk factors are incorporated.
Dyeing of poly(lactic acid) fibres with synthesised novel heterocyclic disazo disperse dyes
Authors: Avinc Ozan , Bakan Emine , Demirçalı Aykut , Gedik Görkem , Karcı Fikret
Published: April 2020

Poly(lactic acid) (PLA) is the first melt‐processable, renewable, sustainable and biodegradable natural‐based synthetic fibre. It has a broad range of uses and combines ecological advantages with outstanding performance in textiles. PLA fibre, as an aliphatic polyester, can be dyed with disperse dyes. Apart from the limited number of commercial disperse dyes, disperse dye exhaustion on PLA is generally lower than that on  poly(ethylene terephthalate) (PET). In this study, new heterocyclic disazo disperse dyes, substituted with methyl, nitro and chloro groups at their ortho‐, meta‐ and para‐ positions, synthesised in our previous study, were applied to PLA and PET fibres to examine their dyeing performance, and colour fastness and dye exhaustion properties. Different shades of yellow, orange, reddish brown and brown were obtained. Most of the synthesised novel heterocyclic disazo disperse dyes exhibited good build‐up properties with high K/S levels on both fibres. Para‐ bonding substituent provided higher K/S values than meta‐ and ortho‐ positions for –NO2 and –Cl substituents for both fibres. Overall, the most synthesised novel heterocyclic disazo disperse dyes in this study exhibited good build‐up properties with high K/S, exhaustion and wet fastness levels on both PLA and PET fibres.
Sexually transmitted coinfections in patients with anogenital warts – a retrospective analysis of 196 patients
Authors: Mueller Simon M. , Menzi Sheryl , Kind André B. , Blaich Annette , Bayer Michael , Navarini Alexander , Itin Peter , Brandt Oliver
Published: April 2020

Background and objectives

Anogenital warts (AGWs) are most commonly caused by low‐risk human papillomavirus (HPV) types, and although they are the most frequent viral sexually transmitted infections (STIs), little is known about STI coinfections in affected patients. We therefore sought to assess STI coinfection rates in patients with AGW, specify STI coinfections and calculate the number needed to screen (NNS) for each STI.

Methods

A retrospective cross‐sectional study analyzing data sets from AGW patients treated in our clinic between 2008–2016.

Results

142/196 (72 %) patients had been variably screened for infections with HIV, HBV and HCV, Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and HSV. The STI coinfection rate in all tested patients was 24.6 %, yielding an NNS of 4.1 to detect any STI. Of note, the coinfection rate did not differ significantly between heterosexual men, homosexual men and women, respectively. The NNS for syphilis was 8.4, for HIV 14.0, for HCV 28.5 and for HBV 39.0. The NNS for asymptomatic patients tested for HSV, Chlamydia trachomatis and Mycoplasma genitalium were 1.4, 5.3 and 12.0, respectively.

Conclusion

Due to the high prevalence of STI coinfections, AGW patients should be screened for other STIs.
Rezepturen in der Dermatologie – eine Analyse des Verordnungsverhaltens im Alltag
Authors: Salzmann Stefan , Salzmann Martin , Staubach Petra
Published: April 2020

Hintergrund

Rezepturarzneimittel sind in Deutschland besonders im Bereich der topischen Therapie als wichtige Ergänzung zu zugelassenen Fertigarzneimitteln unverzichtbar. Bundesweit werden im ambulanten kassenärztlichen Bereich pro Quartal etwa 2 Mio. Rezepturen verordnet, 50 % davon durch Dermatologen.

Methodik

Die Verordnungspraxis wurde evaluiert mittels eines Fragebogens, der an 186 niedergelassene Dermatologen sowie 1491 Apotheken in Rheinland‐Pfalz und dem Saarland versendet wurde. Ziel war Erfassung und Einordnung von Verordnungsgewohnheiten und Problemen in der interdisziplinären Zusammenarbeit zur Optimierung der Patientenversorgung.

Ergebnisse

In 351 Fällen (23,5 %) wurde ein beantworteter Fragebogen von Apothekern und in 53 Fällen (28,4 %) von Dermatologen zurückgesendet. Als häufigster Beweggrund (83 %) für die Verordnung eines Rezepturarzneimittels wurde von Dermatologen die Verordnung großer Mengen angegeben, häufigste Krankheitsbilder für die Verwendung von Rezepturen waren die Schuppenflechte und Ekzeme. Die am häufigsten verordneten Wirkstoffe waren Triamcinolonacetonid (80 %), Erythromycin (78,3 %) sowie Clotrimazol (72,5 %). Apotheker gaben an, dass die Kommunikation mit Ärzten „mit Ärger verbunden“ (58 %) sei und in einem viel zu geringen Umfang stattfinde (34 %).

Schlussfolgerungen

Rezepturarzneimittel sind wichtige Instrumente zur optimalen Patientenversorgung. Die interdisziplinäre Zusammenarbeit stellt Apotheker und Ärzte vor Probleme. Expertisen müssen besser vereint werden, beispielsweise durch intensivere Aus‐ und Fortbildung. Studien zum Rezepturen‐Management sollten Probleme und Chancen in diesem Feld weiter untersuchen.
S3‐Leitlinie „Aktinische Keratose und Plattenepithelkarzinom der Haut“ – Kurzfassung, Teil 2: Epidemiologie, chirurgische und systemische Therapie des Plattenepithelkarzinoms, Nachsorge, Prävention und Berufskrankheit
Authors: Leiter Ulrike , Heppt Markus V. , Steeb Theresa , Amaral Teresa , Bauer Andrea , Becker Jürgen C. , Breitbart Eckhardt , Breuninger Helmut , Diepgen Thomas , Dirschka Thomas , Eigentler Thomas , Flaig Michael , Follmann Markus , Fritz Klaus , Greinert Rüdiger , Gutzmer Ralf , Hillen Uwe , Ihrler Stephan , John Swen Malte , Kölbl Oliver , Kraywinkel Klaus , Löser Christoph , Nashan Dorothee , Noor Seema , Nothacker Monika , Pfannenberg Christina , Salavastru Carmen , Schmitz Lutz , Stockfleth Eggert , Szeimies Rolf‐Markus , Ulrich Claas , Welzel Julia , Wermker Kai , Garbe Claus , Berking Carola
Published: April 2020

Aktinische Keratosen (AK) sind häufige Hautveränderungen bei hellhäutigen Menschen mit dem Potenzial, in ein kutanes Plattenepithelkarzinom (PEK) überzugehen. Beide Erkrankungen können mit erheblicher Morbidität verbunden sein und stellen eine große Krankheitslast insbesondere in der älteren Bevölkerung dar. Um eine evidenzbasierte, klinische Entscheidungsfindung zu unterstützen, wurde die Leitlinie „Aktinische Keratose und kutanes Plattenepithelkarzinom“ auf der Methodikebene S3 nach dem Regelwerk der AWMF entwickelt. Die Leitlinie richtet sich dabei an Dermatologen, Allgemeinmediziner, HNO‐Ärzte, Chirurgen, Onkologen, Radiologen und Strahlentherapeuten in Klinik und Praxis sowie an andere medizinische Fachgebiete, die sich mit der Diagnose und Behandlung von Patienten mit AK und PEK befassen. Die Leitlinie richtet sich auch an betroffene Patienten, deren Angehörige, politische Entscheidungsträger und Versicherungsgesellschaften. In diesem Teil behandeln wir die Themen Epidemiologie, Ätiologie, chirurgische und systemische Behandlung des PEK, Nachsorge des PEK, Prävention und Berufskrankheit durch AK und PEK.
Three‐dimensional Transesophageal images of a pulmonary autograft in the mitral position (Ross II Procedure) in an adult
Authors: Haddy Steven
Published: April 2020

Few images are available in the literature of the Ross II procedure wherein the pulmonary valve is autotransplanted into the mitral position. These images are from a 33‐year‐old woman who underwent the procedure 18 years ago.
AGENDA CONTROL AND RECIPROCITY IN SEQUENTIAL VOTING DECISIONS
Authors: Fischbacher Urs , Schudy Simeon
Published: April 2020

We study how reciprocity affects the extent to which a chair can exploit her control over an agenda if a committee votes sequentially on a known series of binary proposals. We show in a parsimonious laboratory experiment that committee members form vote trading coalitions favoring early proposals not only when the sequence of proposals is exogenously given, but also when a chair controls the sequence of proposals. Vote trading occurs even though chairs manipulate the agenda in their favor. Punishment for chairs exploiting agenda control is weak as chairs reciprocate support by others more frequently than nonchairs. (JEL C92, D71, D72)
Feasibility study on the mhGAP‐IG as a tool to enhance parental awareness of symptoms of mental disorders in lower primary (6‐10 year old) school‐going children: Towards inclusive child mental health services in a Kenyan setting
Authors: Mutiso Victoria , Musyimi Christine , Tele Albert , Gitonga Isaiah , Ndetei David
Published: April 2020

Aims

(1) To determine the feasibility of involving parents as key partners in school mental health activities; (2) to determine whether educating parents on mental health treatment Gap Intervention Guideline (mhGAP‐IG) section on children leads to enhanced parent perception of mental health symptoms in their children; and (3) to determine context appropriate social demographic predictors of the parental awareness following the psychoeducation using the mhGAP‐IG children version.

Methods

Consenting parents completed the Child Behaviour Checklist (CBCL) and the Brief Problem Monitor for Parents (BPM‐P) about their children at baseline and at 6 months post‐baseline respectively. Immediately after post‐baseline, they received psychoeducation on the importance of mental well‐being in children and how to recognize symptoms of mental disorders, using the mhGAP‐IG section on children. This psychoeducation was the intervention between baseline and 6 months post‐baseline. We analysed means of mental disorder symptoms and prevalence of the various mental syndromes/problems on the CBCL/BPM‐P scores to determine the statistical significance of the changes between baseline and 6 months.

Results

Overall, there was significant increase (P < 0.05) in the symptoms mean scores and prevalence of syndromes/problems between baseline and 6 months post‐psychoeducation. However, there were some differences between urban and rural settings and in some parents and children socio‐demographics and gender that should be considered in individual cases.

Conclusion

It is feasible to include parents in school mental health programmes as key stakeholders. The mhGAP‐IG section on children is a good tool for psychoeducation. However, there are predictors of outcomes that need further research.
Suicidality and social problem‐solving skills among individuals with first‐episode psychosis participating in Coordinated Specialty Care
Authors: Breitborde Nicholas J. K. , Wastler Heather , Pine Jacob G. , Moe Aubrey M.
Published: April 2020

Aim

Although suicidal ideation may decrease over the course of participation in specialized clinical programmes for first‐episode psychosis (FEP), it is unclear whether such improvements exceed those that occur during treatment as usual. Clarifying the mechanisms underlying reductions in suicidal ideation and behaviour among individuals with first‐episode psychosis may highlight important strategies through which specialized clinical programmes can increase the potency of their services to reduce suicidality among this high‐risk population. Thus, the goal of this study is to evaluate the longitudinal relationships between suicidality and social problem‐solving skills among individuals with FEP participating in Coordinated Specialty Care.

Methods

Within‐subject mediational and moderational models were applied to explore the interrelationships and longitudinal course of suicidality, social problem‐solving and duration of untreated psychosis (DUP).

Results

Over the first 6 months of care, individuals with FEP experienced improvements in social problem‐solving skills that were found to mediate concurrent reductions in suicidality. Although longitudinal changes in social problem‐solving skills were moderated by DUP, these results should be interpreted cautiously as they may stem in part from a relatively limited number of participants with longer durations of illness.

Conclusions

Improvements in social problem‐solving skills during participation in CSC may facilitate reductions in suicidality. Treatments targeting suicidality among individuals with FEP may thus benefit from working to enhance social problem‐solving skills among these individuals. Further research is needed to clarify if and how DUP may influence the magnitude of change in social problem‐solving skills during participation in CSC.
An objective tool to measure the effect of botulinum toxin in blepharospasm and hemifacial spasm
Authors: Osaki M. H. , Osaki T. H. , Garcia D. M. , Osaki T. , Gameiro G. , Belfort R. , Cruz A. A. V.
Published: April 2020

Background and purpose

It is challenging to assess patients with blepharospasm (BSP) and hemifacial spasm (HFS) as these patients exhibit a wide range of amplitudes of eyelid movements. In order to quantify these movements, a mathematical algorithm, i.e. Fast Fourier Transform, can be employed to convert the signal from the time domain to the frequency domain. The result of this quantification represents the energy generated during the eyelid movements. In order to objectively assess the therapeutic effects of botulinum toxin (BoNT) in these patients, we evaluated the energy generated by the upper eyelid during spontaneous eyelid movements before and after treatment.

Methods

A total of 39 patients with BSP and HFS were evaluated before and 30 days after receiving onabotulinum toxin A injections. A high‐speed camera and micro light‐emitting diodes were used to register the spontaneous eyelid movements. The result of the quantification obtained using Fast Fourier Transform permitted assessment of the activity associated with the eyelid movements.

Results

We studied 78 eyelids. The total energy generated during spontaneous eyelid movements was significantly reduced after treatment in the patients with BSP (P = 0.0018) and on the affected side in the patients with HFS (P = 0.0058).

Conclusions

The assessment of the energy generated by the upper eyelid during spontaneous eyelid movements enabled us to measure the therapeutic effects of BoNT in patients with these conditions. The use of this system could enable customized and fine adjustments to BoNT doses based on each patient’s needs.
Ex vivo COX‐1 and COX‐2 inhibition in equine blood by phenylbutazone, flunixin meglumine, meloxicam and firocoxib: Informing clinical NSAID selection
Authors: Fogle C. , Davis J. , Yechuri B. , Cordle K. , Marshall J. , Blikslager A.
Published: April 2020

Newer cyclo‐oxygenase‐2 (COX‐2) selective nonsteroidal anti‐inflammatory drugs (NSAIDs), such as firocoxib, are proposed to reduce inhibition of cyclo‐oxygenase‐1 (COX‐1) and avoid undesirable side effects, while continuing to inhibit inflammation associated with COX‐2. However, COX selectivity is typically based on in vitro testing, which may not provide sufficient information critical for treatment selection. This study investigated the pharmacokinetics and ex vivo COX‐1 and COX‐2 inhibition of phenylbutazone, flunixin meglumine, meloxicam and firocoxib. Horses (n = 3) were administered one of the four drugs, in a randomised cross‐over design, with 3‐week washout periods. For each drug, three doses were given and sampling performed. Drug plasma concentrations, thromboxane B2 (TXB2) and prostaglandin E2 (PGE2) were determined. After one dose, TXB2 and PGE2 levels were significantly higher in horses administered firocoxib compared to flunixin meglumine. Following the third dose, TXB2 levels in horses administered firocoxib and meloxicam were significantly higher compared to flunixin meglumine or phenylbutazone; all drugs reduced PGE2 to a similar degree. The mean plasma half‐lives were 5.97 ± 0.47, 4.74 ± 0.14, 8.24 ± 3.74 and 47.42 ± 7.41 h for phenylbutazone, flunixin meglumine, meloxicam and firocoxib, respectively. Firocoxib and meloxicam exhibited significantly less COX‐1 inhibition compared to flunixin meglumine and phenylbutazone; all drugs inhibited COX‐2. The plasma half‐life of firocoxib was longer than the other NSAIDs, including meloxicam. Data from this study have important clinical relevance and should be used to inform practitioners’ drug selection of a COX‐1 sparing or traditional NSAID and dose selection and to provide knowledge of the duration for the four NSAIDs studied.
A metatheory explaining how patients manage tooth loss
Authors: Al‐Sahan Maha M. , MacEntee Michael I. , Bryant S. Ross
Published: April 2020

Objectives

To explore how a metatheory composed of five dominant psychosocial theories of communication, developmental regulation, emotions, resources and social cognition, explains the beliefs, concerns and experiences, of people experiencing tooth loss.

Background

Complete tooth loss is the leading cause of disability associated with oral conditions in 19 of 21 global regions, and it is among the most difficult treatment challenges in dentistry.

Methods

Interviews with 18 participants were analysed inductively using interpretive description and qualitative synthesis to explain their beliefs and experiences relating to tooth loss.

Results

Theoretical constructs from the five dominant theories constituting the metatheory explained the beliefs, concerns and experiences of the participants. For example, both before and after tooth loss they engaged in adaptive behaviours according to developmental regulation theory; implemented management strategies according to emotion theory, social cognitive theory, and resource theory; sought help from friends and dental professionals according to communication theory; and modified their physical and social activities according to social cognitive theory.

Conclusion

A metatheory synthesised from five dominant theories addressing communication, personal background, emotions, resources and social awareness, offers a comprehensive and plausible explanation of how people respond psychologically and socially to the loss of their teeth, and expands the scope of information needed to help manage their loss and subsequent treatment.
Characteristics of detected and undetected dementia among community‐dwelling older people in Metropolitan Tokyo
Authors: Ura Chiaki , Okamura Tsuyoshi , Inagaki Hiroki , Ogawa Madoka , Niikawa Hirotoshi , Edahiro Ayako , Sugiyama Mika , Miyamae Fumiko , Sakuma Naoko , Furuta Ko , Hatakeyama Akira , Ogisawa Fumiko , Konno Michiko , Suzuki Takahiro , Awata Shuichi
Published: April 2020

Aim

Although a series of policies have been adapted to deliver an early diagnosis of dementia, many people living with dementia remain undetected and undiagnosed. The aim of this study is to investigate the characteristics of undetected dementia in community‐dwelling older people in Metropolitan Tokyo.

Methods

We conducted a three‐step survey. First, the questionnaires were mailed, in total, to 7614 residents aged ≥70 years in one area in Tokyo, and 5430 were retrieved. Secondly, 2020 individuals attended the face‐to‐face survey, including Mini‐Mental State Exam (MMSE). Thirdly, 198 of 335 individuals who scored <24 on MMSE were visited. Diagnosis of dementia, Clinical Dementia Rating and need for social support were assessed by the interdisciplinary team at their home, and psychological variables, sociological variables and sociodemographic variables were evaluated.

Results

Among the 198 participants, 78 (39.4%) were assessed to have dementia. Among those who had dementia, 34 had received a previous diagnosis of dementia in a clinical setting, i.e., the rate of undetected dementia among our 198 participants was 56.4%. People living with dementia without a dementia diagnosis tended to have more complex social support needs, particularly in the domains of dementia diagnosis, medical check‐ups for physical conditions, continuous medical care and housing support. In addition, they exhibited signs of frailty.

Conclusions

Given that people living with dementia without a dementia diagnosis are at risk of losing housing or physical health, it is a threat to human rights. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2020; ••: ••–••.
Elevated CO2 promotes satellite stomata production in young cotyledons of Arabidopsis thaliana
Authors: Higaki Takumi , Akita Kae , Hasezawa Seiichiro
Published: April 2020

Stomata are tiny pores on plant leaves and stems surrounded by a pair of differentiated epidermal cells known as guard cells. Plants undergo guard cell differentiation in response to environmental cues, including atmospheric CO2. To quantitatively evaluate stomatal development in response to elevated CO2, imaging analysis of stomata was conducted using young cotyledons of Arabidopsis thaliana grown under ambient (380 ppm) and elevated (1,000 ppm) CO2 conditions. Our analysis revealed that treatment with 1,000 ppm CO2 did not affect stomatal numbers on abaxial sides of cotyledons but increased cotyledon area, resulting in decreased stomatal density, 7 days after germination. Interestingly, this treatment also perturbed the uniform distribution of stomata via excess satellite stomata and stomatal precursor cells. We used overexpression lines of the DNA replication licensing factor gene CDC6, a reported positive regulator of satellite stomata production. CDC6 overexpression decreased the speed of cotyledon expansion, even under treatment with 1,000 ppm CO2, possibly by suppressing pavement cell maturation. In contrast, treatment with 1,000 ppm CO2 induced stomatal distribution changes in the overexpressor. These results suggest that treatment with 1,000 ppm CO2 enhances both cotyledon expansion and satellite stomata production via independent pathways, at least in young cotyledons of A. thaliana.
The Never‐ending Shift: A feminist reflection on living and organizing academic lives during the coronavirus pandemic
Authors: Boncori Ilaria
Published: April 2020

This article offers a feminist reflection written as a nocturnal stream of consciousness exposing the embodied, emotional and professional experience of living and working during a pandemic outbreak. Framed within a feminist approach, this personal narrative provides an example of the effects of such unexpected and unprecedented circumstances on personal and professional academic lives. Developed during the first stage of the (inter)national coronavirus pandemic, my reflections address issues of privilege; emotional labour; the virtual invasion of the home space within the current increasingly ambiguous space of ‘the workplace'; workload; and wellbeing. Further, I consider how the newly enforced flexible work measures based on online tools have turned current work–life dynamics into a ‘Never‐ending Shift'.