bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of expressing antenatal colostrum in women with diabetes in pregnancy: A retrospective cohort study
Authors: Casey Jordan R.R. , Banks Jennifer , Braniff Kathleen , Buettner Petra , Heal Clare
Published: March 2019

Background

Some women with diabetes in pregnancy express and store colostrum in the antenatal period for the purposes of preventing and treating neonatal hypoglycaemia.

Aims

Our primary aim was to compare rates of neonatal hypoglycaemia in babies born to mothers who express and store antenatal colostrum to babies born to mothers who do not.

Materials and methods

Retrospective cohort study involving 357 women with diabetes in pregnancy, who had live, singleton births delivered after 36 weeks gestation, in a regional hospital in North Queensland (2014–2015). Multivariable binary logistic regression modelling identified independent characteristics associated with primary outcomes.

Results

Eighty women (23%) expressed antenatal colostrum and 223 (62%) did not. One hundred and thirty‐one babies (37%) were diagnosed with hypoglycaemia. Aboriginal and Torres Strait Islander women were less likely to express than Caucasian women (odds ratio (OR) 0.10, 95% confidence interval (CI) 0.01–0.77). There were no significant differences in the rates of hypoglycaemia, or median blood glucose levels in babies born to mothers who expressed antenatal colostrum compared to babies born to mothers who did not express. Babies born to mothers who expressed were significantly less likely to receive formula in hospital compared to babies born to mothers who did not (OR 0.12, 95% CI 0.05–0.32).

Conclusions

We found no independent association of expressing antenatal colostrum on rates of neonatal hypoglycaemia or median blood glucose levels. Expressing antenatal colostrum may have some benefits to the newborn such as reduced formula consumption in hospital. Further research into other methods of reducing neonatal hypoglycaemia appears warranted.
Sperm functional aspects and enriched proteomic pathways of seminal plasma of adult men with obesity
Authors: Ferigolo P. C. , Ribeiro de Andrade M. B. , Camargo M. , Carvalho V. M. , Cardozo K. H. M. , Bertolla R. P. , Fraietta R.
Published: March 2019

Background

Previous studies have demonstrated an association between obesity and the decreased male fertility.

Objective

to observe the mechanisms by which obesity affects semen quality.

Materials and methods

A prospective study was performed including 47 male volunteers, of which 27 were obese group (body mass index >30 kg/m2) and 20 were eutrophic (body mass index between 18.5 and 25 kg/m2) controls. Sperm functional analysis was performed. The remaining seminal plasma was pooled—four pools per group— and submitted to proteomic analysis by liquid chromatography coupled to tandem mass spectrometry. Groups were compared by an unpaired Student's t‐test. Differentially expressed proteins were submitted to functional enrichment analysis using the online platform PantherDB.

Results

Obese men presented decreased non‐progressive motility, morphology, acrosome integrity, mitochondrial activity, and increased sperm DNA fragmentation. In proteomics analysis, 69 proteins were differentially expressed between the two groups. Among them, one protein was absent, 19 were down‐regulated, 49 were up‐regulated, and one was exclusive in the study group. The main functions enriched were as follows: negative regulation of the intrinsic pathway of apoptosis, activation of immune and inflammatory, antioxidant activity, among others.

Conclusion

molecular pathways suggest there is a causative link, and that the effector mechanisms alter sperm metabolic status and defective testicular selection 5 mechanisms.
Incidence of gynecological fistula and its surgical treatment: A national registry‐based study
Authors: Børseth Katrine F. , Acharya Ganesh , Kiserud Torvid , Trovik Jone
Published: March 2019

Introduction

Gynecological fistula (affecting female genital organs) leads to involuntary loss of urine or feces. In industrialized societies, fistulas occur mostly as complications of surgery, radiation therapy or inflammatory bowel disease. We sought to determine the incidence of gynecological fistula and type of surgical treatment provided in Norway.

Material and methods

This was a retrospective national cohort study of women treated for gynecological fistula (International Classification of Disease‐10 code N82) during 2008‐2014, identified from the mandatory Norwegian Patient Registry. To compare groups, we utilized Chi‐square or non‐parametric tests.

Results

In all, 1627 women (.06% of the female Norwegian population) had 4475 hospital admissions with a diagnosis of gynecological fistula. In total, 1214/1627 (75%) had fistula as the main diagnosis: 346 (29%) a urogenital fistula, 672 (55%) an enterogenital, 38 (3%) a genitocutaneous and 22 (2%) both urinary and enteral fistula. Surgery for gynecological fistula was performed in 723 women, an incidence rate of 4.2 per 100 000 person‐years (95% confidence interval [CI] 4.2‐4.3); gynecological procedures (mostly vaginal/perineal) were performed in 163 women (23%), urological in 43 (6%), enteral in 267 (37%) and surgery involving multiple pelvic compartments in 250 (35%). Women undergoing fistula surgery had a median of three hospital contacts (95% CI 3‐3), for 370 women (52%), the procedure was performed by a gynecologist, and 212 of these (29%) were also operated by urologists or gastroenterologists.

Conclusions

Gynecological fistula is rare in Norway, with an overall incidence of 6/10 000 in the female population, whereas the incidence of surgically treated fistula is 4.2/100 000. However, the condition represents considerable morbidity for the individual patient.
Miniaturized centrifugal ventricular assist device for bridge to decision: Preclinical chronic study in a bovine model
Authors: Shimamura Junichi , Mizuno Toshihide , Takewa Yoshiaki , Tsukiya Tomonori , Naito Noritsugu , Akiyama Daichi , Iizuka Kei , Katagiri Nobumasa , Nishimura Takashi , Ono Minoru , Tatsumi Eisuke
Published: March 2019

We developed a novel miniaturized extracorporeal centrifugal pump “BIOFLOAT NCVC (Nipro Corporation Osaka, Japan) as a ventricular assist device (VAD) and performed a preclinical study that is part of the process for its approval as a bridge to decision by the pharmaceutical and medical device agencies. The aim of this study was to assess the postoperative performance, hemocompatibility, and anticoagulative status during an extended period of its use. A VAD system, consisting of a hydrodynamically levitated pump, measuring 64 mm by 131 mm in size and weighing 635 g, was used. We installed this assist system in 9 adult calves (body weight, 90 ± 13 kg): as left ventricular assist device (LVAD) in 6 calves and right ventricular assist device (RVAD) in 3 calves, for over 30 days. Perioperative hemodynamic, hematologic, and blood chemistry measurements were obtained and end‐organ effects on necropsy were investigated. All calves survived for over 30 days, with a good general condition. The blood pump was operated at a mean rotational speed and a mean pump flow of 3482 ± 192 rpm and 4.08 ± 0.15 L/min, respectively, for the LVAD and 3902 ± 210 rpm and 4.24 ± 0.3 L/min, respectively, for the RVAD. Major adverse events, including neurological or respiratory complications, bleeding events, and infection were not observed. This novel VAD enabled a long‐term support with consistent and satisfactory hemodynamic performance and hemocompatibility in the calf model. The hemodynamic performance, hemocompatibility, and anticoagulative status of this VAD system were reviewed.
Influence of social anxiety and emotional self‐efficacy on pre‐transition concerns, social threat sensitivity, and social adaptation to secondary school
Authors: Nowland Rebecca , Qualter Pamela
Published: March 2019

Background

Much of the literature on school transfers has centred on academic adjustment and/or achievement, but school transfers also involve social adaption. Children who are socially anxious or lack emotional self‐efficacy are likely to have difficulties with social aspects of the transition.

Aim(s)

We examined the influence of social anxiety, depressive symptoms, and emotional self‐efficacy on (1) pre‐transition concerns about the move to secondary school and social threat sensitivity relating to that transition experience, and (2) school and peer connectedness after the school transfer. We also examined whether pre‐transition concerns predicted school and peer connectedness after the move.

Sample

Year 6 children (10–11 years) from 15 primary schools in Northern England.

Method

Children (N = 266) completed a questionnaire in their primary schools before the move to secondary school. A sub‐group (n = 156) of those children also completed measures immediately after the move to secondary school and then again 4 months later.

Results

Social anxiety influenced pre‐transition concerns. Higher emotional self‐efficacy was associated with lower social threat sensitivity pre‐transition and with reductions over time. Higher emotional self‐efficacy also influenced greater social adaption 4 months after the school move. Pre‐transition concerns about the move were a good indicator of poorer social adaption later on.

Conclusions

Based on the findings, interventions should target social anxiety to reduce pre‐transition concerns. Programmes that target emotional self‐efficacy are most likely to impact school and peer connectedness.
Mitochondrial dysfunction in neurodegenerative diseases and the potential countermeasure
Authors: Wang Yan , Xu Erin , Musich Phillip R. , Lin Fang
Published: March 2019

Mitochondria not only supply the energy for cell function, but also take part in cell signaling. This review describes the dysfunctions of mitochondria in aging and neurodegenerative diseases, and the signaling pathways leading to mitochondrial biogenesis (including PGC‐1 family proteins, SIRT1, AMPK) and mitophagy (parkin‐Pink1 pathway). Understanding the regulation of these mitochondrial pathways may be beneficial in finding pharmacological approaches or lifestyle changes (caloric restrict or exercise) to modulate mitochondrial biogenesis and/or to activate mitophagy for the removal of damaged mitochondria, thus reducing the onset and/or severity of neurodegenerative diseases.
Short‐term outcomes of en bloc combined heart and liver transplantation in the failing Fontan
Authors: Vaikunth Sumeet S. , Concepcion Waldo , Daugherty Tami , Fowler Michael , Lutchman Glen , Maeda Katsuhide , Rosenthal David N. , Teuteberg Jeffrey , Woo Y. Joseph , Lui George K.
Published: March 2019

Patients with failing Fontan physiology and liver cirrhosis are being considered for combined heart and liver transplantation. We performed a retrospective review of our experience with en bloc combined heart and liver transplantation in Fontan patients > 10 years old from 2006 to 18 per Institutional Review Board approval. Six females and 3 males (median age 20.7, range 14.2‐41.3 years) underwent en bloc combined heart and liver transplantation. Indications for heart transplant included ventricular dysfunction, atrioventricular valve regurgitation, arrhythmia, and/or lymphatic abnormalities. Indication for liver transplant included portal hypertension and cirrhosis. Median Fontan/single ventricular end‐diastolic pressure was 18/12 mm Hg, respectively. Median Model for End‐Stage Liver Disease excluding International Normalized Ratio score was 10 (7‐26), eight patients had a varices, ascites, splenomegaly, thrombocytopenia score of ≥ 2, and all patients had cirrhosis. Median cardiopulmonary bypass and donor ischemic times were 262 (178‐307) and 287 (227‐396) minutes, respectively. Median intensive care and hospital stay were 19 (5‐96) and 29 (13‐197) days, respectively. Survival was 100%, and rejection was 0% at 30 days and 1 year post‐transplant. En bloc combined heart and liver transplantation is an acceptable treatment in the failing Fontan patient with liver cirrhosis.
“Like Poles Repel While Unlike Poles Attract”: Contextual Performance Effects of Supply Base R & D, Focal Firm R & D, and Commercialization
Authors: Pathak Surya , Sen Pradyot K. , Jayaram Jayanth , Miller James M.
Published: March 2019

We show that the ability of a firm to enhance its performance through R & D and commercialization efforts is dependent on the alignment of R & D intensity of the firm's supply base with its own R & D intensity. We employ a multi‐industry dataset consisting of 163 focal firms and their supply bases, spanning the years 1976 to 2009. Focal firms that have higher R & D expenditure compared to their industry average, enjoy greater performance benefits from their own R & D and commercialization efforts, as compared to when they have a Low R & D‐intense supply base. On the other hand, focal firms with lower R & D expenditure compared to their industry average, benefit more from their own R & D and commercialization expenditure when they have a High R & D supply base. When levels of R & D expenditure are matched with respect to the supply base (Low–Low or High–High), focal firms tend to derive less marginal performance benefits from their own R & D and commercialization expenditures. This pattern of results constitutes a “polarity effects” phenomenon, i.e., unlike poles attract. Further, for the High R & D focal firm–Low R & D supply base combination (and vice versa), we show that although both R & D and commercialization efforts have a separate and positive effect on the focal firm's financial performance; taken together, they have a negative synergy. Through a response surface analysis, we are able to show that there is a commercialization threshold, below which the Low R & D focal firm–High R & D supply base derives lower total benefits as compared to a High R & D focal firm–Low R & D supply base combination.
Challenges to diagnostic standardization of Barrett's esophagus in Asia
Authors: Soh Yu Sen Alex , Lee Yeong Yeh , Gotoda Takuji , Sharma Prateek , Ho Khek‐Yu ,   Asian Barrett's Consortium
Published: March 2019

Barrett's esophagus (BE), a premalignant condition of the lower esophagus, is increasingly prevalent in Asia. However, endoscopic and histopathological criteria vary widely between studies across Asia, making it challenging to assess comparability between geographical regions. Furthermore, guidelines from various societies worldwide provide differing viewpoints and definitions, leading to diagnostic challenges that affect prognostication of the condition. In this review, the authors discuss the controversies surrounding the diagnosis of BE, particularly in Asia. Differences between guidelines worldwide are summarized with further discussion regarding various classifications of BE used, different definitions of gastroesophageal junction used across geographical regions and the clinical implications of intestinal metaplasia in the setting of BE. Although many guidelines recommend the Seattle protocol as the preferred approach regarding dysplasia surveillance in BE, some limitations exist, leading to poor adherence. Newer technologies, such as acetic acid‐enhanced magnification endoscopy, narrow band imaging, Raman spectroscopy, molecular approaches and the use of artificial intelligence appear promising in addressing these problems, but further studies are required before implementation into routine clinical practice. The Asian Barrett's Consortium also outlines its ongoing plans to tackle the challenge of standardizing the diagnosis of BE in Asia.
Orthodontic treatment need, self‐esteem, and oral health‐related quality of life among 12‐yr‐old schoolchildren
Authors: Herkrath Ana P. C. Q. , Vettore Mario V. , de Queiroz Adriana C. , Alves Paula L. N. , Leite Sarah D. C. , Pereira Juliana V. , Rebelo Maria A. B. , Herkrath Fernando J.
Published: March 2019

The aim of this study was to investigate the association between orthodontic treatment need and oral health‐related quality of life (OHRQoL) among 12‐yr‐old children. The study also assessed whether self‐esteem modifies and/or moderates this relationship. Cross‐sectional data on 406 schoolchildren aged 12 yr were analyzed. Data on socio‐economic and demographic characteristics, dental pain, self‐esteem, and OHRQoL were collected using validated questionnaires. Orthodontic treatment need was assessed, through dental examinations, using the dental aesthetic index (DAI). Multiple negative binomial regression and path analysis were used to estimate the association of orthodontic treatment need and self‐esteem with OHRQoL. A modifying effect of self‐esteem on the relationship between DAI and OHRQoL was observed. Self‐esteem did not mediate the abovementioned relationship. Children with lower scores of self‐esteem had worse OHRQoL among those with lower orthodontic treatment need (a DAI score of < 31). However, self‐esteem did not influence the association between DAI and OHRQoL in children with greater orthodontic treatment need (a DAI score of ≥ 31). Self‐esteem attenuated the impact of malocclusion on OHRQoL in children with minor or definite malocclusion, but not among those with severe or very severe malocclusion. Self‐esteem appears to buffer the impact of malocclusion on OHRQoL in children with minor orthodontic treatment need.
Investigating the potential for call combinations in a lifelong vocal learner
Authors: Walsh Sarah L. , Townsend Simon W. , Morgan Kate , Ridley Amanda R.
Published: March 2019

The ability for humans to create seemingly infinite meaning from a finite set of sounds has likely been a critical component in our success as a species, allowing the unbounded communication of information. Syntax, the combining of meaningful sounds into phrases, is one of the primary features of language that enables this extensive expressivity. The evolutionary history of syntax, however, remains largely debated, and it is only very recently that comparative data for syntax in animals have been revealed. Here, we provide further evidence for a structural basis of potential syntactic‐like call combinations in the vocal communication system of a group‐living songbird. Acoustic analyses indicate that Western Australian magpies (Gymnorhina tibicen dorsalis) structurally combine generic alarm calls with acoustically distinct alert calls to produce an alarm alert sequence. These results are distinct from previous examples of call combinations as, to our knowledge, evidence for this capacity is yet to be demonstrated in the natural communication of a non‐human species that is capable of vocal learning throughout life. These findings offer prospects for experimental investigation into the presence and function of magpie call combinations, extending our understanding of animal vocal complexity.
An updated classification of hair follicle morphogenesis
Authors: Saxena Nivedita , Mok Ka‐Wai , Rendl Michael
Published: March 2019

Hair follicle (HF) formation in developing embryonic skin requires stepwise signalling between the epithelial epidermis and mesenchymal dermis, and their specialized derivatives, the placode/germ/peg and dermal condensate/papilla, respectively. Classically, distinct stages of HF morphogenesis have been defined, in the mouse model, based on (a) changes in cell morphology and aggregation; (b) expression of few known molecular markers; (c) the extent of follicle downgrowth; and (d) the presence of differentiating cell types. Refined genetic strategies and recent emerging technologies, such as live imaging and transcriptome analyses of isolated cell populations or single cells, have enabled a closer dissection of the signalling requirements at different stages of HF formation, particularly early on. They have also led to the discovery of precursor cells for placode, dermal condensate and future bulge stem cells that, combined with molecular insights into their fate specification and subsequent formation, serve as novel landmarks for early HF morphogenetic events and studies of the signalling networks mediating these processes. In this review, we integrate the emergence of HF precursor cell states and novel molecular markers of fate and formation to update the widely used 20‐year‐old seminal classification guide of HF morphogenetic stages by Paus et al. We then temporally describe the latest insights into the early cellular and molecular events and signalling requirements for HF morphogenesis in relation to one another in a holistic manner.
Corruption and citizen participation in local government: Evidence from Latin America
Authors: Neshkova Milena I. , Kalesnikaite Vaiva
Published: March 2019

Prior research indicates that corruption hampers economic growth and imposes high social costs. From the perspective of democratic theory, corruption does not just violate the fiduciary obligations with which the public entrusts government officials; it has detrimental effects on the legitimacy of the democratic process as a whole. If citizens view their government as corrupt and dishonest, they become cynical about political life, and as a result, they are less likely to participate in democratic governance. This article examines the effect of corruption—measured through both perception and experience—on citizen participation in local government. Using data from the AmericasBarometer survey on the new democracies in Latin America, we test whether the withdrawal effects registered in terms of participation in elections hold for the participation in city administration. The results show that citizens' willingness to participate in local governance relates positively with their experience of corruption, but not with their perception of corruption.
Preferred reporting items for systematic reviews and meta‐analyses for abstracts: best practice for reporting abstracts of systematic reviews in Endodontology
Authors: Nagendrababu V. , Duncan H. F. , Tsesis I. , Sathorn C. , Pulikkotil S. J. , Dharmarajan L. , Dummer P. M. H.
Published: March 2019

An abstract is a brief overview of a scientific, clinical or review manuscript as well as a stand‐alone summary of a conference abstract. Scientists, clinician–scientists and clinicians rely on the summary information provided in the abstracts of systematic reviews to assist in subsequent clinical decision‐making. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) for Abstracts checklist was developed to improve the quality, accuracy and completeness of abstracts associated with systematic reviews and meta‐analyses. The PRISMA for Abstracts checklist provides a framework for authors to follow, which helps them provide in the abstract the key information from the systematic review that is required by stakeholders. The PRISMA for Abstracts checklist contains 12 items (title, objectives, eligibility criteria, information sources, risk of bias, included studies, synthesis of results, description of the effect, strength and limitations, interpretation, funding and systematic review registration) under six sections (title, background, methods, results, discussion, other). The current article highlights the relevance and importance of the items in the PRISMA for Abstracts checklist to the specialty of Endodontology, while offering explanations and specific examples to assist authors when writing abstracts for systematic reviews when reported in manuscripts or submitted to conferences. Strict adherence to the PRISMA for Abstracts checklist by authors, reviewers and journal editors will result in the consistent publication of high‐quality abstracts within Endodontology.
Differential clinical characteristics, management and outcome of delirium among ward compared with intensive care unit patients
Authors: Canet Emmanuel , Amjad Sobia , Robbins Raymond , Lewis Jane , Matalanis Michelle , Jones Daryl , Bellomo Rinaldo
Published: March 2019

Background

Delirium is common in hospitalised patients but its epidemiology remains poorly characterised.

Aims

To test the hypothesis that patient demographics, clinical phenotype, management and outcomes of patient with delirium in hospital ward patients differ from intensive care unit (ICU) patients.

Methods

Retrospective cohort of patients admitted to an Australian university‐affiliated hospital between March 2013 and April 2017 and coded for delirium at discharge using the International Classification of Diseases System, 10th revision, criteria.

Results

Among 61 032 hospitalised patients, 2864 (4.7%) were coded for delirium. From these, we studied a random sample of 100 ward patients and 100 ICU patients. Ward patients were older (median age: 84 vs 65 years; P < 0.0001), more likely to have dementia (38% vs 2% for ICU patients; P < 0.0001) and less likely to have had surgery (24% vs 62%; P < 0.0001). Of ward patients, 74% had hypoactive delirium, while 64% of ICU patients had agitated delirium (P < 0.0001). Persistent delirium at hospital discharge was more common among ward patients (66% vs 17%, P < 0.0001). On multivariable analysis, age and dementia predicted persistent delirium, while surgery predicted recovery.

Conclusions

Delirium in ward patients is profoundly different from delirium in ICU patients. It has a dominant hypoactive clinical phenotype, is preceded by dementia and is less likely to recover at hospital discharge. Therefore, delirium prevention, detection and goals of care should be adapted to the environment in which it occurs.
Discharge treatment with angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker after a heart failure hospitalisation is associated with a better prognosis irrespective of left ventricular ejection fraction
Authors: Vicent Lourdes , Cinca Juan , Vazquez‐García Rafael , Gonzalez‐Juanatey José R. , Rivera Miguel , Segovia Javier , Pascual‐Figal Domingo , Bover Ramón , Worner Fernando , Delgado‐Jiménez Juan , Fernández‐Avilés Francisco , Martínez‐Sellés Manuel
Published: March 2019

Background

Medical therapy could improve the prognosis of real‐life patients discharged after a heart failure (HF) hospitalisation.

Aim

To determine the impact of discharge HF treatment on mortality and readmissions in different left ventricular ejection fraction (LVEF) groups.

Methods

Multicentre prospective registry in 20 Spanish hospitals. Patients were enrolled after a HF hospitalisation.

Results

A total of 1831 patients was included (583 (31.8%) HF with reduced ejection fraction (HFrEF); 227 (12.4%) HF with midrange ejection fraction (HFmrEF); 610 (33.3%) HF with preserved ejection fraction (HFpEF), and 411 (22.4%) with unknown LVEF). Angiotensin‐converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARB) at discharge were independently associated with a reduction in: (i) all‐cause mortality: hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.41–0.74, P < 0.001, with a similar effect in the four groups; (ii) mortality due to refractory HF HR 0.45, 95% CI 0.29–0.64, P < 0.001, with a similar effect in the three groups with known LVEF; (iii) mortality/HF admissions (HR 0.61; 95% CI: 0.50–0.74), more evident in HFrEF (HR 0.54; 95% CI: 0.38–0.78) compared with HRmEF (HR 0.64; 95% CI 0.40–1.02), or HFpEF (HR 0.70; 95% CI 0.53–0.92). In patients with HFrEF triple therapy (ACE inhibitor/ARB + beta blocker + mineralocorticoid receptor antagonist) was associated with the lowest mortality risk (HR 0.21; 95% CI: 0.08–0.57, P = 0.002) compared with patients that received none of these drugs.

Conclusions

Discharge treatment with ACE inhibitor/ARB after a HF hospitalisation is associated with a reduction in all‐cause and refractory HF mortality, irrespective of LVEF.
Success rates of preformed metal crowns placed with the modified and standard hall technique in a paediatric dentistry setting
Authors: Midani Rama , Splieth Christian H. , Mustafa Ali Mahmoud , Schmoeckel Julian , Mourad Said M. , Santamaria Ruth M.
Published: March 2019

Background

The Hall Technique is a less invasive caries management technique for treating carious primary molars. It has become a routine treatment at specialists’ practices.

Aim

To retrospectively evaluate the clinical success and survival rates of preformed metal crowns placed on primary molars using the Hall Technique in a Paediatric Dentistry Setting.

Design

Patient records of children receiving Hall crowns (with or without proximal slicing) between 2011 and 2017 were reviewed. Teeth with no clinical or radiographic evidence of pulp involvement at baseline and at least six months’ follow‐up were included. Kaplan‐Meier survival analyses and Mantel‐Cox statistics were carried out.

Results

In total, 181 Hall crowns performed in 2‐ to 10‐year‐olds with a mean follow‐up period of 22 months were included for analysis. Mean d3mft/D3MFT was 6.55 ± 3.48/0.18 ± 0.66. The majority of crowns were successful (92.3%; n = 167), four presented at least one minor failure (2.2%; reversible pulpitis, crown lost, or secondary caries) and ten were major failures (5.5%; irreversible pulpitis or abscess). When comparing crowns performed with no tooth preparation to crowns performed with proximal slicing, no differences were observed (P = 0.70, CI = 0.68‐0.83).

Conclusion

The survival rate and clinical efficacy of Hall crowns were high in a secondary care‐based setting. The HT is an effective and less invasive management option for asymptomatic carious primary molars.
FER1L4/miR‐372/E2F1 works as a ceRNA system to regulate the proliferation and cell cycle of glioma cells
Authors: Xia Liang , Nie Dekang , Wang Guangtao , Sun Caixing , Chen Gao
Published: March 2019

Long non‐coding RNAs have recently become a key regulatory factor for cancers, whereas FER1L4, a newly discovered long non‐coding RNA, has been mostly studied in gastric carcinoma and colon cancer cases. The functions and molecular mechanism of FER1L4 have been rarely reported in glioma malignant phenotypes. In this study, it was found that the expression of LncRNA FER1L4 is upregulated in high‐grade gliomas than in low‐grade cases and that a high expression of LncRNA FER1L4 predicts poor prognosis of gliomas. Meanwhile, in vitro study suggests that expression of FER1L4 with SiRNA knockdown obviously suppresses cell cycle and proliferation. It is further demonstrated by experiments that the FER1L4 knockdown suppresses growth of in vivo glioma. Besides, it is found in our study that LncRNA FER1L4 expression is positively correlated with E2F1 mRNA expression. After knockdown of FER1L4 expression, E2F1 expression is significantly down‐regulated, whereas the expression of miR‐372 is significantly up‐regulated; the up‐regulation of miR‐372 leads to significant down‐regulation of FER1L4 and E2F1 expression. In addition, it is also found that FER1L4 can be used as competitive endogenous RNA to interact or bind with miR‐371 and thereby up‐regulate E2F1, thus promoting the cycle and proliferation of glioma cells. It may be one of the molecular mechanisms in which FER1L4 plays its oncogene‐like role in gliomas.
Egr1 mediates retinal vascular dysfunction in diabetes mellitus via promoting p53 transcription
Authors: Ao Haocheng , Liu Bingqian , Li Haichun , Lu Lin
Published: March 2019

Objectives

This study focused on investigating the expression and underlying molecular mechanism of early growth response 1 (Egr1) in diabetic retinopathy.

Methods

A microarray assay was applied to examine differentially expressed genes in the retina tissues of normal rats, as well as in those of streptozotocin‐induced diabetic rats. Human retinal vascular endothelial cells (HRVECs) transfected with sh‐NC, sh‐Egr1 or sh‐Egr1+ pVax1‐p53 were cultured under high‐glucose conditions and then used to explore the role of Egr1 in vitro. The effect of Egr1 on retinal vascular dysfunction caused by diabetes was examined by sh‐Egr1 administration in vivo

Results

Early growth response 1 was found to be up‐regulated in the retinas of diabetic rats compared to those of normal rats. Down‐regulation of Egr1 in HRVECs under high‐glucose conditions inhibited the apoptosis, migration and tube formation in vitro. Moreover, sh‐Egr1 partially reduced the injurious effects of hyperglycaemia on retinal vascular function by decreasing apoptotic cells and microvascular formation in vivo. The reduction of Egr1 evidently down‐regulated the p53 expression. Overexpression of p53 rescued the inhibition of sh‐Egr1 in HRVECs under high‐glucose concentration on apoptosis, migration and tube formation in vitro.

Conclusion

Down‐regulation of Egr1 partially reduced the injurious effects of hyperglycaemia on retinal vascular function via inhibiting p53 expression.
Development and validation of a predictive model for periodontitis using NHANES 2011–2012 data
Authors: Montero Eduardo , Herrera David , Sanz Mariano , Dhir Sangeeta , Van Dyke Thomas , Sima Corneliu
Published: March 2019

Aim

To develop and validate a predictive model for moderate‐to‐severe periodontitis in the adult USA population, with data from the 2011–2012 National Health and Nutrition Examination Survey (NHANES) cycle.

Material and Methods

A subset of 3017 subjects aged >30 years, with >14 teeth present and having received a periodontal examination in addition to data collected on cardio‐metabolic risk measures (smoking habit, body mass index [BMI], blood pressure, total cholesterol and glycated haemoglobin [HbA1c]) were used for model development by multivariable logistic regression.

Results

The prevalence of moderate and severe periodontitis using CDC/AAP classification was 37.1% and 13.2%, respectively. A multivariable logistic regression model revealed that HbA1c ≥5.7% was significantly associated with moderate‐to‐severe periodontitis (odds ratio, OR = 1.29; p < 0.01). A predictive model including age, gender, ethnicity, HbA1c and smoking habit as variables had 70.0% sensitivity and 67.6% specificity in detecting moderate‐to‐severe periodontitis in US adults.

Conclusions

Periodontitis is a common disease in North American adults, and its prevalence is significantly higher in individuals with pre‐diabetes or diabetes. The present study demonstrates that a model including age, gender, ethnicity, HbA1c and smoking habit could be used as a reliable screening tool for periodontitis in primary medical care settings to facilitate referral of patients at risk for periodontal examination and diagnosis.
Bullous pemphigoid: more than one disease?
Authors: Ludwig R.J.
Published: March 2019

Linked article: This is a commentary on M. Zheng et al., pp. 595–600 in this issue. To view this article visit https://doi.org/10.1111/jdv.15325.
Skin diseases are more common than we think: screening results of an unreferred population at the Munich Oktoberfest
Authors: Tizek L. , Schielein M.C. , Seifert F. , Biedermann T. , Böhner A. , Zink A.
Published: March 2019

Background

Skin diseases are ranked as the fourth most common cause of human illness, resulting in an enormous non‐fatal burden. Despite this, many affected people do not consult a physician. Accordingly, the actual skin disease burden might be even higher since reported prevalence rates are typically based on secondary data that exclude individuals who do not seek medical care.

Objective

The aim of the study was to investigate the prevalence of skin diseases in an unreferred population in a real‐life setting.

Methods

A cross‐sectional study of 9 days duration was performed in 2016 at the ‘Bavarian Central Agricultural Festival’, which is part of the Munich Oktoberfest. As part of a public health check‐up, screening examinations were performed randomly on participating visitors. All participants were 18 years or older and provided written informed consent.

Results

A total of 2701 individuals (53.5% women, 46.2% men; mean age 51.9 ± 15.3 years) participated in the study. At least one skin abnormality was observed in 1662 of the participants (64.5%). The most common diagnoses were actinic keratosis (26.6%), rosacea (25.5%) and eczema (11.7%). Skin diseases increased with age and were more frequent in men (72.3%) than in women (58.0%). Clinical examinations showed that nearly two‐thirds of the affected participants were unaware of their abnormal skin findings.

Conclusion

Skin diseases might be more common than previously estimated based on the secondary data of some sub‐populations. Further information and awareness campaigns are needed to improve people's knowledge and reduce the global burden associated with skin diseases.
Evidence‐based medicine—Not a panacea for the problems of a complex adaptive world
Authors: Sturmberg Joachim P.
Published: March 2019

The recent sacking of Peter Gøtzsche from the Cochrane Collaboration Board raised strong responses and highlights the neglected issue about priorities—maintaining the reputation of the organization or vigorously debating the merits of scientific approaches to find answers to complex problems? The Cochrane approach hales the randomized trial (RCT) as the gold standard research approach and affirms that meta‐analysis provides the ultimate proof (or platinum standard) to settle contentious issues confronting the clinician. However, most published medical research is wrong, and critics coined the acronym GIGO (garbage in, garbage out) as a meme to highlight the risks of blind faith in the hyped‐up procedures of the EBM movement.

This paper firstly explores the differences between the prevailing scientific method arising from the linear cause‐and‐effect assumption and the complex adaptive systems science methods arising from observations that most phenomena emerge from nonlinearity in networked systems. Most medical conditions are characterized by necessary features that by themselves are not sufficient to explain their nature and behaviour. Such nonlinear phenomena require modelling approaches rather than linear statistical and/or meta‐analysis approaches to be understood. These considerations also highlight that research is largely stuck at the data and information levels of understanding which fails clinicians who depend on knowledge—the synthesis of information—to apply in an adaptive way in the clinical encounter.

Clinicians are constantly confronted with the linked challenges of doing things right and doing the right thing for their patients. EBM and Cochrane with their restrictive approaches are the antithesis to a practice of medicine that is responsive to constantly changing patient needs. As such, the EBM/Cochrane crisis opens a window of opportunity to re‐examine the nature of health, illness and disease, and the nature of health care and its systems for the benefits of its professionals and their patients. We are at the cusp of a paradigmatic shift towards an understanding a praxis of health care that takes account of its complexities.
Resistance of resin‐infiltrated enamel to surface changes in response to acidic challenge
Authors: Enan Enas T. , Aref Neven S. , Hammad Shaza M.
Published: March 2019

Objective

To investigate the ability of resin infiltration to protect demineralized enamel against acidic challenge.

Materials and methods

Forty‐five extracted healthy premolars were selected for the study, each of which was sectioned vertically into 2 halves, giving 90 specimens. Specimens were then divided into three groups, where specimens of group A were not decalcified (control), while those of groups B and C were either subjected to decalcification only, or decalcification followed by Icon resin infiltration, respectively. Each group was further divided into three subgroups, according to the type of storage medium (water, Coca‐Cola, or Redbull). Evaluation parameters included color difference and surface roughness. Scanning electron microscope was used to evaluate enamel surface topography. Statistical analysis was performed by ANOVA followed by least significant difference test.

Results

Although Coca‐Cola caused the highest color change and surface roughness among the studied specimens, yet, the resin‐infiltrated enamel was more resistant to surface changes than the nonresin infiltrated enamel, even under acid attack.

Conclusion

Resin infiltration has the ability to provide and maintain protection to the demineralized enamel against acidic attack.

Clinical significance

Resin infiltration may be considered as a promising solution to restore esthetic of demineralized enamel following orthodontic treatment and to protect it against acidic beverages.
Development of attenuated erythromycin‐resistant Streptococcus agalactiae vaccine for tilapia (Oreochromis niloticus) culture
Authors: Liu Ling , Lu Dan‐Qi , Xu Jun , Luo Heng‐Li , Li An‐Xing
Published: March 2019

Streptococcus agalactiae is an important pathogen in fish, causing great losses of intensive tilapia farming. To develop a potential live attenuated vaccine, a re‐attenuated S. agalactiae (named TFJ‐ery) was developed from a natural low‐virulence S. agalactiae strain TFJ0901 through selection of resistance to erythromycin. The biological characteristics, virulence, stability and the immunization protective efficacy to tilapia of TFJ‐ery were determined. The results indicated that TFJ‐ery grew at a slower rate than TFJ0901. The capsule thickness of TFJ‐ery was significantly less (p < 0.05) than TFJ0901. When Nile tilapia were intraperitoneally (IP) injected with TFJ‐ery, the mortality of fish was decreased than that injected with TFJ0901. The RPS of fish immunized with TFJ‐ery at a dose of 5.0 × 107 CFU was 95.00%, 93.02% and 100.00% at 4, 8 and 16 weeks post‐vaccination, respectively. ELISA results showed that the vaccinated fish produced significantly higher (p < 0.05) antibody titres compared to those of control at 2 or 4 weeks post‐vaccination. Taken together, our results suggest that erythromycin could be used to attenuate S. agalactiae, and TFJ‐ery is a potent attenuated vaccine candidate to protect tilapia against S. agalactiae infections.
Noneffectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome
Authors: Mak Arthur Dun‐Ping , Chung Vincent Chi Ho , Yuen Suet Ying , Tse Yee Kit , Wong Samuel Yeung Shan , Ju Yanli , Hung Sheung Sheung , Leung Ka Chun , You Joyce Hoi Sze , Lui Rashid , Wong Sunny Hei , Leung Owen Ngo Wang , Lam Linda Chiu Wa , Lee Sing , Wu Justin Che Yuen
Published: March 2019

Background and Aim

Comorbid generalized anxiety disorder and irritable bowel syndrome are common and therapeutically challenging. We aimed to assess the effectiveness of electroacupuncture in relieving anxiety and bowel symptoms in Chinese adults with this form of comorbidity.

Methods

In a single‐blind randomized sham‐controlled trial, subjects with comorbid generalized anxiety disorder and irritable bowel syndrome were randomly assigned to receive 10 weekly sessions of electroacupuncture or sham electroacupuncture. Patients were assessed at baseline, immediately after intervention and at 6‐week follow‐up. Primary outcome was anxiety (7‐item Patient Health Questionnaire section for anxiety). Secondary outcomes included bowel symptoms (bowel symptoms questionnaire), depressive symptoms (9‐item Patient Health Questionnaire), somatic symptoms (15‐item Patient Health Questionnaire), and health‐related quality of life (EuroQol‐5 Dimensions).

Results

Eighty subjects, 40 in each arm, were randomized. All but two in the sham group completed 10 weekly sessions. There was no significant difference in the proportion of patients experiencing significant (≥ 50%) reduction of anxiety symptoms between the two groups immediately after intervention (32.4% vs 21.6%, P = 0.06) and at 6‐week follow‐up (25.7% in electroacupuncture vs 27% in sham, P = 0.65). Anxiety, depressive symptom, and bowel symptom severity did not differ significantly between electroacupuncture and sham groups.

Conclusions

Findings failed to support the effectiveness of electroacupuncture for comorbid generalized anxiety disorder and irritable bowel syndrome. Further studies are needed to identify effective acupuncture treatment protocols for such comorbidity.
Facilitators and barriers to a dietitian‐implemented blended care weight‐loss intervention (SMARTsize): a qualitative study
Authors: Heideman W. H. , Rongen F. C. , Bolleurs C. , Govers E. , Kroeze W. , Steenhuis I. H. M.
Published: March 2019

Background

Dietitians play an important role in the intervention and prevention of being overweight and obesity. More and more blended care interventions are being implemented. The present study aimed to evaluate the delivery by Dutch dietitians of a multicomponent, evidence‐based weight‐loss programme (SMARTsize), including counselling for relapse prevention. The aim of this qualitative study was to identify facilitators and barriers to the delivery of SMARTsize.

Methods

Nine semi‐structured interviews were conducted with 10 dietitians who participated in a larger implementation study. Each interview was recorded and transcribed verbatim. Determinants of theory of implementation, including characteristics of the user, the innovation, organisational context and setting, and innovation strategy guided interviews and analysis. Data were coded and analysed using the framework approach.

Results

According to dietitians, the SMARTsize intervention had a positive influence on patients. The main implementation facilitators were the availability of implementation materials, such as a manual, training in relapse prevention and social support from other dietitians. The main barriers to implementation were organisation and financial reimbursement of cooking classes, the belief that patients need more individual counselling in the starting phase, and the unsuitability for people with low levels of health literacy.

Conclusions

Most dietitians considered that implementation of the SMARTsize intervention consisting of e‐health, written information and cooking classes and face‐to‐face counselling is challenging but feasible. Further development of the SMARTsize intervention and implementation tools is needed to lower experienced barriers. It is also recommended that a version of the intervention to be developed that is suitable for patients with lower levels of health literacy.
Clinical and neuropathological differences between Parkinson's disease, Parkinson's disease dementia and dementia with Lewy bodies – current issues and future directions
Authors: Walker Lauren , Stefanis Leonidas , Attems Johannes
Published: March 2019

Lewy body diseases share clinical, pathological, genetic and biochemical signatures, and are regarded as a highly heterogeneous group of neurodegenerative disorders. Inclusive of Parkinson's disease (PD), Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), controversy still exists as to whether they should be considered as separate disease entities or as part of the same disease continuum. Here we discuss emerging knowledge relating to both clinical, and neuropathological differences and consider current biomarker strategies as we try to improve our diagnostic capabilities and design of disease modifying therapeutics for this group of debilitating neurodegenerative disorders.

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This article is part of the Special Issue “Synuclein”.
HOW DO RATING AGENCIES’ DECISIONS IMPACT STOCK MARKETS? A META‐ANALYSIS
Authors: Hubler Jérôme , Louargant Christine , Laroche Patrice , Ory Jean‐Noёl
Published: March 2019

The purpose of this study is to examine how credit rating agencies’ decisions impact the stock market using a systematic and quantitative review of existing empirical studies. Specifically, we employ a meta‐regression analysis (MRA) to investigate the extent and nature of the effect of rating agencies’ decisions on the stock market. We survey 62 studies published between 1978 and 2015. Our first finding is that the cumulative average abnormal returns calculated from this empirical literature are affected by publication bias. After controlling for publication bias, the main findings of our meta‐analysis indicate that negative rating decisions cause statistically significant negative abnormal returns. This evidence suggests an informational effect. Our results also indicate that positive rating decisions do not have a significant effect. Finally, the MRA results reveal the importance of several factors related to primary study design, as well as to the nature of the data.