bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of ureteric stent removal by string on patient's quality of life and on complications at post‐ureteroscopy for urolithiasis: a controlled trial
Authors: Inoue Takaaki , Okada Shinsuke , Hamamoto Shuzo , Yoshida Takashi , Murota Takashi , Matsuda Tadashi ,   On behalf of the SMART Study Group
Published: November 2018

Objectives

To evaluate the impact of ureteric stent removal by string vs ureteric stent removal by cystoscope with regard to pain at ureteric stent removal, complications and quality of life, as well as patients’ self‐rated symptoms, after ureteroscopy (URS) for urolithiasis.

Patients and Methods

Of 328 patients who underwent URS for upper urinary tract stones at our institution, 149 were randomly divided into a ureteric stent removal by string group (string group) and a ureteric stent removal by flexible cystoscope group (cystoscope group), using gender as a stratification factor. We focused on four sites, namely, the upper abdomen, bladder, flank and urethra, to evaluate the most painful site at stent removal. The primary endpoint was total pain scores for four sites at stent removal in the string group vs the cystoscope group. Secondary endpoints included comparison of the psychological well‐being scores of patients using the five‐item World Health Organization well‐being index (WHO‐5) preoperatively, pre‐stent removal and 2 weeks after stent removal between the string group and cystoscope group.

Results

Of 149 patients analysed, 74 were in the string group and 75 were in the cystoscope group. In most patients, the ureteric stent was removed ~10 days after URS. The string group experienced significantly less pain than the cystoscope group (mean visual analogue scale [VAS] scores 2.73 vs 5.67; P < 0.001). Although VAS scores for women were not significantly different between the groups (P = 0.300), those for men were significantly lower in the string group (P < 0.001). In particular, men in the string group experienced significantly less urethral pain than those in the cystoscope group. The WHO‐5 scores were not significantly different between the groups preoperatively, pre‐stent removal or 2 weeks after stent removal. Stent string‐related complications and self‐rated symptoms were also not significantly different.

Conclusion

Ureteric stent removal by string after URS led to significantly less pain than removal by cystoscope in men. Patients in the string group experienced no more complications in terms of urinary tract infections or accidental dislodgement than those in the cytoscope group.
Characterization of kinetics of human cytochrome P450s involved in bioactivation of flucloxacillin: inhibition of CYP3A‐catalysed hydroxylation by sulfaphenazole
Authors: Dekker Stefan J , Dohmen Floor , Vermeulen Nico P E , Commandeur Jan N M
Published: November 2018

Background and Purpose

The aim of this study was to characterize the human cytochrome P450s (CYPs) involved in oxidative bioactivation of flucloxacillin to 5‐hydroxymethyl flucloxacillin, a metabolite with high cytotoxicity towards biliary epithelial cells.

Experimental Approach

The CYPs involved in hydroxylation of flucloxacillin were characterized using recombinant human CYPs, pooled liver microsomes in the presence of CYP‐specific inhibitors and by correlation analysis using a panel of liver microsomes from 16 donors.

Key Results

Recombinant CYPs showing the highest specific activity were CYP3A4, CYP3A7 and to lower extent CYP2C9 and CTP2C8. Michaelis–Menten enzyme kinetics were determined for pooled human liver microsomes, recombinant CYP3A4, CYP3A7 and CYP2C9. Surprisingly, sulfaphenazole appeared to be a potent inhibitor of 5′‐hydroxylation of flucloxacillin by both recombinant CYP3A4 and CYP3A7.

Conclusions and Implications

The combined results show that the 5′‐hydroxylation of flucloxacillin is primarily catalysed by CYP3A4, CYP3A7 and CYP2C9. The large variability of the hepatic expression of these enzymes could affect the formation of 5′‐hydroxymethyl flucloxacillin, which may determine the differences in susceptibility to flucloxacillin‐induced liver injury. Additionally, the strong inhibition in CYP3A‐catalysed flucloxacillin metabolism by sulfaphenazole suggests that unanticipated drug–drug interactions could occur with coadministered drugs.
Prevalence of heart failure and the diagnostic value of MR‐proANP in outpatients with type 2 diabetes
Authors: Jensen Jesper , Schou Morten , Kistorp Caroline , Faber Jens , Hansen Tine W. , Jensen Magnus T. , Andersen Henrik U. , Rossing Peter , Vilsbøll Tina , Jørgensen Peter G.
Published: November 2018

The prevalence of heart failure (HF) in patients with type 2 diabetes (T2DM) is debatable and no data exist concerning the diagnostic value of mid‐regional pro‐atrial natriuretic peptide (MR‐proANP). We aimed to identify HF prevalence and evaluate the diagnostic value of MR‐proANP in outpatients followed in two specialized diabetes clinics. HF was pre‐defined as HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). The prevalence of HFrEF and HFpEF was 2.4% and 17.5%, respectively. An MR‐proANP <60 pmol/L ruled out HFrEF in the total population (n = 806) and in patients reporting dyspnea (n = 311) with a sensitivity of 94.7% and 87.5%, a negative predictive value of 99.7% and 99.0%, a specificity of 39.5% and 33.0%, and a positive predictive value of 3.6% and 3.3%, respectively. In a multivariable model including age, sex, T2DM duration, albuminuria, uncontrolled systolic blood pressure, abnormal electrocardiogram and ischaemic heart disease for diagnosis of HF in patients reporting dyspnea, adding MR‐proANP increased the area under the curve from 0.69 to 0.78 (P < 0.001). In conclusion, HFrEF was rare among outpatients with T2DM. MR‐proANP rules out HFrEF and contributes independent information relevant to diagnosis of HF in patients reporting dyspnea.
The prodromes of Parkinson's disease
Authors: Rees Richard Nathaniel , Noyce Alastair John , Schrag Anette
Published: November 2018

Whilst the diagnosis of Parkinson's disease (PD) relies on the motor triad of bradykinesia, rigidity and tremor, the underlying pathological process starts many years before these signs are overt. In this prodromal phase of PD, a diverse range of non‐motor and motor features can occur. Individually they do not allow a diagnosis of PD, but when considered together, they reflect the gradual development of the clinical syndrome. Different subgroups within the prodromal phase may exist and reflect different underlying pathology. Here, we summarise the evidence on the prodromal phase of PD in patient groups at increased risk of PD with well described prodromal features: patients with idiopathic rapid eye movement sleep behaviour disorder, patients with idiopathic anosmia and families with monogenic mutations that are closely linked to PD pathology. In addition, we discuss the information on prodromal features from ongoing studies aimed at detecting prodromal PD in the general population. It is likely that better delineation of the clinical prodromes of PD and their progression in these high‐risk groups will improve understanding of the underlying pathophysiology.
Early sensitivity of evoked potentials to surface and volumetric structure during the visual perception of three‐dimensional object shape
Authors: Leek E. Charles , Roberts Mark V. , Dundon Neil M. , Pegna Alan J.
Published: November 2018

This study used event‐related potentials (ERPs) to elucidate how the human visual system processes three‐dimensional (3‐D) object shape structure. In particular, we examined whether the perceptual mechanisms that support the analysis of 3‐D shape are differentially sensitive to higher order surface and volumetric part structure. Observers performed a whole‐part novel object matching task in which part stimuli comprised sub‐regions of closed edge contour, surfaces or volumetric parts. Behavioural response latency data showed an advantage in matching surfaces and volumetric parts to whole objects over contours, but no difference between surfaces and volumes. ERPs were analysed using a convergence of approaches based on stimulus dependent amplitude modulations of evoked potentials, topographic segmentation, and spatial frequency oscillations. The results showed early differential perceptual processing of contours, surfaces, and volumetric part stimuli. This was first reliably observed over occipitoparietal electrodes during the N1 (140–200 ms) with a mean peak latency of 170 ms, and continued on subsequent P2 (220–260 ms) and N2 (260–320 ms) components. The differential sensitivity in perceptual processing during the N1 was accompanied by distinct microstate patterns that distinguished among contours, surfaces and volumes, and predominant theta band activity around 4–7 Hz over right occipitoparietal and orbitofrontal sites. These results provide the first evidence of early differential perceptual processing of higher order surface and volumetric shape structure within the first 200 ms of stimulus processing. The findings challenge theoretical models of object recognition that do not attribute functional significance to surface and volumetric object structure during visual perception.
Rate of denitrification and stoichiometry of its products in fluvo‐aquic Cambisols for sterilized and unsterilized incubations
Authors: Wang Yajing , Cao Wenchao , Zhang Xinmu , Guo Jingheng
Published: November 2018

There has been an increase in studies suggesting that both biotic and abiotic (i.e. chemical) denitrification in soil contribute to nitrate (NO3−) loss and nitrogenous gas (NO, N2O and N2) emissions, and that rates of reaction and stoichiometry of products depend on soil pH. However, their relative importance and product composition have not been addressed simultaneously, limiting our understanding on their in‐situ coupling pathways and mechanisms of response to changes in soil pH. Here, we present changes in NOx− (i.e. NO3− and NO2−) concentrations and nitrogenous gas amounts during 15 days of anaerobic incubations of sterilized and unsterilized fluvo‐aquic Cambisols after the addition of NO3− and adjustments to pH. Nitrate losses in sterilized soil were 47.7, 27.5 and 52.9 mg N kg−1 at pH 6.5, 7.1 and 8.3, respectively, accounting for 90.0, 79.5 and 179% of the corresponding values for unsterilized soil. The rates of nitrate reduction increased with pH in sterilized soil, whereas the largest rate in unsterilized soil was at the lowest pH (6.5). Moreover, the rates of reaction of the stepwise reductions from nitrite (NO2−) to N2 tended to increase with pH in both sterilized and unsterilized soils. These results verify the potential importance of abiotic denitrification to the nitrogen cycle in alkaline soils and demonstrate the difference between abiotic and biotic nitrate reductions in responses to changes in soil pH. These findings improve our ability to assess the coupling mechanisms and eco‐environmental influence of biotic and abiotic denitrification in circumneutral and alkaline soils.

Highlights

Abiotic denitrification is an important pathway for nitrate loss in circumneutral and alkaline fluvo‐aquic soils.

Abiotic and biotic nitrate reduction respond differently to changes in soil pH.

Stepwise reduction rates from NO2− to N2 increased with pH in both sterilized and unsterilized soils.

Abiotic nitrate reduction should be incorporated in biotic and abiotic denitrification coupling in alkaline soils.
Life Course Trajectories of Negative and Positive Marital Experiences and Loneliness in Later Years: Exploring Differential Associations
Authors: Wickrama Kandauda A. S. , O'Neal Catherine W. , Klopack Eric T. , Neppl Tricia K.
Published: November 2018

Loneliness is relatively common among older adults in the United States, and there can be significant physical, psychological, and cognitive impairments associated with feelings of loneliness. Consequently, this study seeks to uncover determinants of loneliness, particularly the impact of couples’ negative and positive marital experiences (i.e., marital strain and strength) over the life course on loneliness in later adulthood. To accomplish this goal, an integrated analytical framework is utilized, incorporating growth curves within an actor‐partner interdependence model, to capture the initial level and the rate of change in marital strain and strength over a period of 25 years (from 1991 to 2015) with a sample of 257 couples in enduring, long‐term marriages. Couples first participated in the Iowa Youth and Family Project in 1989 and most recently participated in the Later Adulthood Study in 2015. The confirmatory factor analyses showed that latent constructs of marital strain and marital strength are distinct constructs. The univariate growth curve analyses showed that there were significant interindividual variations in the initial level (1991) and rate of change (1991–2015) in marital strain and marital strength for both husbands and wives. While the initial level and rate of change in perceived marital strain from 1991 to 2015 was generally of consequence for both spouses’ loneliness in 2015 (actor and partner effects), only actor effects were noted for marital strength. Findings are discussed as they relate to health policies and interventions focusing on the well‐being of married couples in later life.
Engaging election contention: Understanding why presidents engage with contentious issues
Authors: McNaughtan Jon , McNaughtan Elisabeth Day
Published: November 2018

In recent years, technology has made it possible, and in some ways critical, for college and university presidents to increase campus‐wide communication. Following the 2016 US presidential election, many college presidents across the country sent campus‐wide communications in response to the election, while others chose not to respond. The resulting reactions from campus and community stakeholders to these communications, or the lack of communication, from presidents was mixed due to the contentious nature of the election. In an effort to better understand a president’s decision to communicate, this study utilised coded interviews with 12 US flagship institution presidents or vice‐presidents for communication, providing insight into why presidents generally respond to contentious events and, more specifically, why presidents chose to respond to the 2016 election of Donald Trump. Four motivations that generally influenced presidential communications were identified (i.e., responsibility to campus stakeholders, pressure to respond, emphasise university values and the role of a public university), and subsequent sub‐themes were identified while analysing why presidents responded to the 2016 election specifically. This study concludes by offering implications for presidential communication and directions for future research on presidential engagement with contentious events.
Epoxide functionalized γ‐Al2O3/Fe3O4/SiO2 nanocomposite and comparative adsorption behavior of a model reactive azo dye
Authors: Bristy Sadia Salsabil , Rahman Mohammad Mostafizar , Rahman Mohammad Mahbubor , Alam Mohammad Ashraful , Karim Mohammad Rabiul , Ahmad Hasan
Published: November 2018

In this investigation, magnetic γ‐Al2O3 nanocomposite polymer particles with epoxide functionality were prepared following a multistep process. The prepared nanocomposite polymer particle was named as γ‐Al2O3/Fe3O4/SiO2/poly(glycidyl methacrylate (PGMA). The surface property was evaluated by carrying out the adsorption study of Remazol Navy RGB (RN), a model reactive azo dye, on both γ‐Al2O3/Fe3O4/SiO2 and γ‐Al2O3/Fe3O4/SiO2/PGMA nanocomposite particles, that is, before and after epoxide functionalization. A contact time, temperature, adsorbent dose, and dye concentration dependent change in adsorption behavior was observed on both nanocomposite particles. The adsorption amount reached equilibrium (qe) value within 5 minutes at the respective point of zero charge (PZC). The adsorption density of RN per unit specific surface area on epoxide functional γ‐Al2O3/Fe3O4/SiO2/PGMA nanocomposite polymer particles (1.30 mg/m2) was higher relative to that on γ‐Al2O3/Fe3O4/SiO2 nanocomposite particles (0.87 mg/m2). The optimum adsorbent dose for obtaining the maximum adsorption density was 0.01 g. Comparatively, Langmuir isotherm model was better to describe the adsorption process and the adsorption process was favorable at low temperature (283 K). Batch kinetic adsorption experiment suggested that a pseudo‐second‐order rate kinetic model is more appropriate. Nanocomposite polymer particles were used as adsorbent up to third cycle with almost 99% adsorption efficiency.
Effect of CaO and Al2O3 addition on the properties of K2O–Na2O–P2O5 glass system
Authors: Faivre Annelise , Despetis Florence , Duffours Laurent , Colombel Pascale
Published: November 2018

This work reports the effect of substituting Al2O3 for P2O5 and substituting CaO for (Na2O + K2O) in the ternary 0.46 (K2O + Na2O) 0.54 P2O5 glass system, with certain of these compositions being eventually of interest for biomedical applications. Different properties are analyzed here. When CaO replaces (Na2O + K2O; constant O/P ratio) or when Al2O3 replaces P2O5 (increasing O/P ratio), it is shown that the density of the glasses increased, the coefficient of thermal expansion decreased, and the glass transition temperature increased. A partial and limited study of dissolution behavior in water indicates that the dissolution rates decreased by orders of magnitude with the introduction of CaO or Al2O3, in agreement with the trends reported in the literature. The pH values of the dissolution solutions were also measured. The pH quickly decreased and saturated to around 2.5 for glasses with no alumina, that is, with the highest P2O5 content. On another hand, when Al2O3 was substituted for P2O5 (ie, when P2O5 content decreased and O/P increased), the pH initially increased to more basic values (around 7) and always remained above 5. Some interpretation of the structural role of CaO and Al2O3 are proposed to explain these changes in properties with composition.
Variation in thermal tolerances of native freshwater fishes in South Africa's Cape Fold Ecoregion: examining the east–west gradient in species' sensitivity to climate warming
Authors: Reizenberg Jody‐Lee , Bloy Lesley E. , Weyl Olaf L. F. , Shelton Jeremy M. , Dallas Helen F.
Published: November 2018

The Cape Fold Ecoregion (CFE) is a biodiversity hotspot with high levels of endemism in its freshwater fish fauna. This study examined inter and intra‐specific variation in critical thermal maxima (TCmax) for eight native species of freshwater fish from the CFE. Cape galaxias Galaxias zebratus, Breede River redfin Pseudobarbus burchelli, Berg River redfin Pseudobarbus burgi, Clanwilliam redfin Pseudobarbus calidus and fiery redfin Pseudobarbus phlegethon were the most thermally sensitive (TCmax = 29.8–32.8°C). Clanwilliam rock‐catfish Austroglanis gilli, Eastern Cape redfin Pseudobarbus afer and Cape kurper Sandelia capensis were moderately sensitive (TCmax = 33.0–36.8°C). An increase in intra‐specific thermal sensitivity of S. capensis was observed from east to west. The results were related to in situ water temperature, which influenced TCmax for all species, suggesting that thermal history is a major driver of variation in thermal tolerance amongst populations. These thermal tolerance data for freshwater fishes in the CFE demonstrate that resilience to climate warming follows a geographical cline and that the more sensitive western species and regions are conservation priorities.
Ecology of fish hearing
Authors: Putland Rosalyn L. , Montgomery John C. , Radford Craig A.
Published: November 2018

Underwater sound is directional and can convey important information about the surrounding environment or the animal emitting the sound. Therefore, sound is a major sensory channel for fishes and plays a key role in many life‐history strategies. The effect of anthropogenic noise on aquatic life, which may be causing homogenisation or fragmentation of biologically important signals underwater is of growing concern. In this review we discuss the role sound plays in the ecology of fishes, basic anatomical and physiological adaptations for sound reception and production, the effects of anthropogenic noise and how fishes may be coping to changes in their environment, to put the ecology of fish hearing into the context of the modern underwater soundscape.
Emerging trends of inflammatory bowel disease in South Korea: A nationwide population‐based study
Authors: Kwak Min Seob , Cha Jae Myung , Lee Hun Hee , Choi Yong Sung , Seo Seung In , Ko Kyung Jin , Park Dong Il , Kim Sung Hun , Kim Tae Jun
Published: November 2018

Background and Aim

Little is known regarding the exact burden of inflammatory bowel disease (IBD) in Asian countries because previous epidemiologic studies were hospital based. We aimed to develop and validate an operational definition of IBD cases from health insurance claims data and to examine the epidemiological features of IBD in Korea.

Methods

We analyzed stratified sample data from the Korean Health Insurance Review and Assessment (2010–2016) database using 12 different definitions and applied the best definition to the entire (2007–2016) dataset.

Results

The definition that combined the International Classification of Disease 10th revision code with IBD‐specific medications had the best performance characteristics among the 12 tested definitions. During the 8‐year study period, IBD prevalence increased from 25 345 in 2009 to 47 444 in 2016. Over that period, the prevalence of Crohn's disease increased 1.9‐fold (from 16.0/100 000 in 2009 to 29.6/100 000 in 2016) and that of ulcerative colitis increased 1.6‐fold (from 41.4/100 000 in 2009 to 66.0/100 000 in 2016). Similarly, the estimated incidence of Crohn's disease also increased 1.2‐fold (from 2.4 to 2.9 per 100 000) and that of ulcerative colitis rose 1.3‐fold (from 4.0 to 5.3 per 100 000). During the study period, the predominant increase in IBD incidence was among younger individuals, especially those aged < 30 years.

Conclusion

Patients with IBD can be accurately identified using Korean insurance claims data by combining information regarding the International Classification of Disease 10th revision codes and the IBD medications used. The prevalence of IBD continues to increase, with an apparent shift toward younger (< 30 years) age groups.
Prognostic value of serum liver enzymes in oral and oropharynx squamous cell carcinomas
Authors: Zhu Zaiou , Zhou Junbo , Xiong Xianbin , Liu Dong , Zheng Yang , Ding Xu , Du Yifei , Gu Ning , Wu Yunong , Song Xiaomeng
Published: November 2018

Background

Serum liver enzymes, which catalyze relevant catabolic pathways, have been indicated to be diagnostic and prognostic tools for several malignant tumors. The correlation between serum liver enzymes levels and survival in patients with oral and oropharynx squamous cell carcinomas (OSCC) is still absent. Here, we conducted a study focusing on predictive value of serum liver enzymes in terms of prognosis in the patients.

Methods

A retrospective study including 134 OSCC patients from years 2009 to 2014 was performed to investigate the association between levels of pre‐treatment serum liver enzymes, various clinical parameters and prognostic outcomes, which are overall survival (OS) and disease‐free survival (DFS). Log‐rank tests with Kaplan‐Meier method were used to detect potential prognostic biomarkers. Multivariate analyses by Cox proportional hazards model were used to identify significant predictors of prognosis.

Results

Serum adenosine deaminase (ADA) level was associated with patients’ OS and DFS by univariate analyses (P = 0.006 and P = 0.024, respectively). Multivariate analyses showed that higher serum ADA (>17.2 U/L) (P = 0.019) as well as positive lymph node status (P = 0.035) independently predicted worse OS of patients with OSCC. In addition, older age (≥60 years) (P = 0.043) and positive lymph node status (P = 0.027) were independently prognostic parameters for poorer DFS.

Conclusions

Pre‐operative serum ADA levels may serve as a reliable independent prognostic predictor for OS in OSCC patients.
Circulating exosomes regulate T‐cell–mediated inflammatory response in oral lichen planus
Authors: Peng Qiao , Zhang Jing , Zhou Gang
Published: November 2018

Background

Exosomes are newly recognized natural nanocarrier and intercellular messenger that emerge as important mediators of signal transmission. Exosomes have been reported to modulate the inflammatory response of a number of diseases. This study investigated the effects of circulating exosomes from oral lichen planus (OLP) on T cells.

Methods

Plasma‐derived exosomes were purified from both OLP patients and control groups. T cells were observed under a confocal laser scanning microscope after co‐cultivation with PKH67 labeled exosomes for 12, 24, and 48 hours. The effects of exosomes exposure on T cells were analyzed with several functional assays, investigating proliferation, apoptosis, and migration. Production of interleukin (IL)‐2, ‐4, ‐10, and interferon (IFN)‐γ was measured via enzyme‐linked immunosorbent assay.

Results

PKH67‐labeled exosomes were taken up by T cells in a time‐ and dose‐dependent manner. Several biological functions of T cells were promoted. In particular, the circulating erosive OLP exosomes significantly enhanced T‐cell proliferation and attenuated the apoptosis. The migration capacity of T cells increased remarkably in response to erosive OLP exosome treatment. In addition, the ratio of IFN‐γ/IL‐4 was significantly elevated in OLP patients.

Conclusions

Our findings indicate that the circulating OLP exosomes are involved in the biological functions of T cells, potentially promoting the OLP progression by regulating the T‐cell–mediated inflammatory response.
Effects of rheological properties of rice dough during manufacture of rice cracker on the quality of the end product
Authors: Takei Ryo , Maruyama Kentaro , Washio Hideaki , Watanabe Toshiyuki , Takahashi Tsutomu
Published: November 2018

Influence of the viscoelastic properties of rice dough on the mechanical properties and the microstructure of rice crackers was experimentally investigated to predict and control the quality of the rice cracker in the early stage of the lengthy manufacturing process. Various rice doughs steamed for 5, 30, or 60 min and kneaded for 5, 10, or 15 min were examined. Longer steaming and kneading resulted in lower G′ and G″ and higher tan δ, specific volume of the rice crackers, decreased nonuniform and deficient network, and thinner cell wall in rice cracker sections. There was a high correlation between tan δ of rice dough and specific volume of the rice cracker samples (R2 > 0.79). The hardness of the rice crackers increased with extending the kneading time for 5 and 30 min as the tan δ increased, while those of the rice crackers made from the rice doughs steamed for 60 min decreased inversely. These results indicated that qualities of rice crackers can be predicted and quantified by measuring viscoelasticity of actual rice doughs during the process.

Practical applications

Improved methods to control quality of end product in manufacturing process and to develop new products with unique textures are desired. We established the new method to quantify the rice dough and this method has already been used for confirming equivalency or improvement of rice dough during manufacture of rice crackers when instrument or condition have changed.
Prevalence and normative values for jaw functional limitations in the general population in Sweden
Authors: Oghli Ibrahim , List Thomas , John Mike T. , Häggman‐Henrikson Birgitta , Larsson Pernilla
Published: November 2018

Objectives

For jaw functional limitations measured by the Jaw Functional Limitation Scale (JFLS), (a) determining prevalence in the Swedish general adult population, (b) investigating the influence of demographic factors and self‐reported dental status and (c) deriving normative values.

Methods

A random sample of the general adult population in Sweden was approached (response rate: 46%, N = 1,372). Prevalence was determined for the JFLS summary score and individual items. The influence of age, gender and dental status was investigated with regression analyses and normative values presented.

Results

The JFLS median score was 0, and all items had prevalences ≤30%. Age and gender did not influence jaw functional limitations but dental status did. Normative JFLS scores were 1, 9 and 28 for the 7th, 8th and 9th deciles, respectively. In dental status‐stratified norms, 9th deciles were 20, 43 and 100, for subjects with natural teeth only, removable and complete dentures, respectively.

Conclusions

The Swedish general adult population had excellent jaw function, but dental status was major determinant. In the absence of information linking JFLS scores to important patient concerns, the score distribution can serve as a reference with the 9th decile as threshold for functional limitation.
Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation
Authors: Dai Ruoxi , Lam Otto L. T. , Lo Edward C. M. , Li Leonard S. W. , McGrath Colman
Published: November 2018

Objectives

This study was to assess the effectiveness of a conventional oral hygiene care programme (COHCP) and an advanced oral hygiene care programme (AOHCP) on prevalence and viable counts of oral opportunistic pathogens among patients undergoing stroke rehabilitation.

Methods

A total of 94 patients were randomized to two groups. Subjects were block randomized to either (a) COHCP: manual toothbrushing with oral hygiene instruction (OHI); or (b) AOHCP: powered toothbrushing, mouthrinsing with chlorhexidine and OHI. Prevalence and viable counts of oral opportunistic pathogens including yeasts, aerobic and facultative anaerobic gram‐negative bacilli, Staphylococcus aureus, were assessed at baseline, the end of 3 and 6 months.

Results

No significant difference was observed in the prevalence of oral opportunistic pathogens within each group over the clinical trial period. A significant decrease in the viable counts of S. aureus was found over the clinical trial period within AOHCP group (p < 0.05), while the viable counts of yeasts and anaerobic gram‐negative bacillus (AGNB) remained stable within each group. Regression analysis failed to detect an association between intervention and the prevalence/viable counts of oral opportunistic pathogens.

Conclusions

Neither oral healthcare programme significantly affects AGNB, yeast or S. aureus over the study period in terms of prevalence and viable counts.
A study of the dosage and duration for levobupivacaine infusion by the caudal‐epidural route in infants aged 3‐6 months
Authors: Vashisht Rita , Bendon Anju A. , Okonkwo Ijeoma , Patel Davandra , Fullwood Catherine , Ogungbenro Kayode , Aarons Leon , Darwich Adam S.
Published: November 2018

Background

The local anesthetic, levobupivacaine, is the safer enantiomer of racemic bupivacaine. Present protocols for levobupivacaine are based on studies and pharmacokinetic modeling with racemic bupivacaine.

Aims

The aim is to investigate total serum levobupivacaine concentrations after a caudalepidural loading dose followed by a maintenance infusion over 48 hours in infants aged 3‐6 months.

Methods

The clinical trial was conducted in eight infants aged 3‐6 months, undergoing bladder exstrophy repair. Pharmacokinetic modeling allowed optimization of clinical sampling to measure total levobupivacaine and α1‐acid glycoprotein and prediction of the effect of α1‐acid glycoprotein on levobupivacaine plasma protein binding.

Results

The observed median total levobupivacaine serum concentration was 0.30 mg/L (range: 0.20‐0.70 mg/L) at 1 hour after the loading dose of 2 mg/kg. The median total levobupivacaine concentration after 47 hours of infusion, at 0.2 mg/kg/h, was 1.21 mg/L (0.07‐1.85 mg/L). Concentrations of α1‐acid glycoprotein were found to rise throughout the study period. Pharmacokinetic modeling suggested that unbound levobupivacaine quickly reached steady state at a concentration of approximately 0.03 mg/L.

Conclusion

The study allows the development of a pharmacokinetic model, combining levobupivacaine and α1‐acid glycoprotein data. Modeling indicates that unbound levobupivacaine quickly reaches steady state once the infusion is started. Simulations suggest that it may be possible to continue the infusion beyond 48 hours.
Predictive factors for adverse outcomes in pediatric patients undergoing low‐risk skin and soft tissue surgery: A database analysis of 6730 patients
Authors: Cheon Eric C. , Longhini Anthony B. , Lee Joseph , Hansen Jennifer , Jagannathan Narasimhan , De Oliveira Gildasio S. , Suresh Santhanam
Published: November 2018

Background

There is a paucity of data regarding risk stratification of pediatric patients presenting for low‐risk skin and soft tissue surgery.

Aims

We sought to determine the incidence and independent predictors of postoperative complications and unplanned 30‐day readmission in a cohort of children undergoing low‐risk skin and soft tissue surgery.

Methods

The study included pediatric patients who underwent minor procedures of the skin and soft tissue at continuously enrolled American College of Surgeons National Surgical Quality Improvement Program Pediatric hospitals over a two‐year period. The primary outcome was a 30‐day postoperative complication composite. The secondary outcome was unplanned 30‐day readmission.

Results

The final analysis included 6,730 patients. There were a total of 170 postoperative complications among 152 patients (2.23%) with the majority of complications being either wound‐related or postoperative mechanical ventilation. The independent predictors for an increased risk of postoperative complication were American Society of Anesthesiologists classification ≥3 and nutritional deficiency. There were 41 unplanned readmissions (0.61%). The presence of a postoperative wound complication or a postoperative pulmonary complication during the index hospital stay was an independent risk factor for unplanned 30‐day readmission.

Conclusion

Pediatric patients with American Society of Anesthesiologists classification ≥3 and nutritional deficiency undergoing low‐risk surgery are at risk for the development of postoperative complications. Patients who develop wound and postoperative pulmonary complications are at higher risk for unplanned 30‐day readmission. Identification of these higher risk patients may allow the anesthesiologist to implement targeted therapies to minimize the likelihood of occurrence of these complications.
Information-Anchored Sensitivity Analysis: Theory and Application
Authors: Cro Suzie , Carpenter James R. , Kenward Michael G.
Published: November 2018

Analysis of longitudinal randomized clinical trials is frequently complicated because patients deviate from the protocol. Where such deviations are relevant for the estimand, we are typically required to make an untestable assumption about post-deviation behaviour to perform our primary analysis and to estimate the treatment effect. In such settings, it is now widely recognized that we should follow this with sensitivity analyses to explore the robustness of our inferences to alternative assumptions about post-deviation behaviour. Although there has been much work on how to conduct such sensitivity analyses, little attention has been given to the appropriate loss of information due to missing data within sensitivity analysis. We argue that more attention needs to be given to this issue, showing that it is quite possible for sensitivity analysis to decrease and increase the information about the treatment effect. To address this critical issue, we introduce the concept of information-anchored sensitivity analysis. By this we mean sensitivity analyses in which the proportion of information about the treatment estimate lost because of missing data is the same as the proportion of information about the treatment estimate lost because of missing data in the primary analysis. We argue that this forms a transparent, practical starting point for interpretation of sensitivity analysis. We then derive results showing that, for longitudinal continuous data, a broad class of controlled and reference-based sensitivity analyses performed by multiple imputation are information anchored. We illustrate the theory with simulations and an analysis of a peer review trial and then discuss our work in the context of other recent work in this area. Our results give a theoretical basis for the use of controlled multiple-imputation procedures for sensitivity analysis.
Carbon isotope and rare earth element composition of Late Quaternary sediment gravity flow deposits on the mid shelf of East China Sea: Implications for provenance and origin of hybrid event beds
Authors: Shan Xin , Shi Xuefa , Clift Peter D. , Qiao Shuqing , Jin Lina , Liu Jianxing , Fang Xisheng , Xu Taoyu , Li Shunli , Kandasamy Selvaraj , Zhao Mengwei , Zhu Ying , Zhang Hui , Zhang Dan , Wang Huawei , Li Yalong , Yao Zhengquan , Wang Sai , Xu Jun
Published: November 2018

The East China Sea Shelf has an unusually wide and low gradient shelf, supplied from sediment‐charged rivers and large river delta systems, with bottom currents sweeping the sea floor and located in the path of strong typhoons. Sediment gravity flow deposits, including four hybrid event beds and a high density turbidite, are identified in a core from the mid‐shelf of the East China Sea. The hybrid event beds typically comprise three or two internal divisions from the base to the top: (i) H1, H3 and H5; or (ii) H3 and H5. Radiocarbon ages of the hybrid event beds were in the range of 3821 to 8526 yr bp. Based on correlation with surrounding cores, the hybrid events may have happened at any time between 1930 yr bp and 3890 yr bp. The δ13C values in hybrid event beds together with bathymetry data suggest local erosion on the shelf. The average δ13C value for the H1 division is similar to the H3 division in the hybrid event beds, implying that the organic matter in the H1 and H3 divisions may come from the same source area. Cross‐plots of upper continental crust normalized rare earth elements in the five units reveal that the sediment source of the four hybrid event beds and the turbidite was ultimately primarily from Korean rivers. Partial transformation from a moderate‐strength debris flow with the additional role of erosional bulking can explain occurrences of hybrid event beds on the East China Sea Shelf. The data indicate that hybrid sediment gravity flow deposits were sourced from intra‐shelf failures and subsequently transformed and deposited as hybrid event beds. The study shows that hybrid sediment gravity flows and turbidity currents may not necessarily indicate proximity to a major fluvial or deltaic system and that intra‐shelf sedimentation can be a sediment source. It is unlikely that the debris flows and turbidity currents were triggered by a hyperpycnal flow or tsunami, because both can carry continental and/or coastal signals which have not been recognized in the core. Typhoons are the probable triggering mechanism.
A coupled role for CsMYB75 and CsGSTF1 in anthocyanin hyperaccumulation in purple tea
Authors: Wei Kang , Wang Liyuan , Zhang Yazhen , Ruan Li , Li Hailin , Wu Liyun , Xu Liyi , Zhang Chengcai , Zhou Xiaogui , Cheng Hao , Edwards Robert
Published: November 2018

Cultivars of purple tea (Camellia sinensis) that accumulate anthocyanins in place of catechins are currently attracting global interest in their use as functional health beverages. RNA‐seq of normal (LJ43) and purple Zijuan (ZJ) cultivars identified the transcription factor CsMYB75 and phi (F) class glutathione transferase CsGSTF1 as being associated with anthocyanin hyperaccumulation. Both genes mapped as a quantitative trait locus (QTL) to the purple bud leaf color (BLC) trait in F1 populations, with CsMYB75 promoting the expression of CsGSTF1 in transgenic tobacco (Nicotiana tabacum). Although CsMYB75 elevates the biosynthesis of both catechins and anthocyanins, only anthocyanins accumulate in purple tea, indicating selective downstream regulation. As glutathione transferases in other plants are known to act as transporters (ligandins) of flavonoids, directing them for vacuolar deposition, the role of CsGSTF1 in selective anthocyanin accumulation was investigated. In tea, anthocyanins accumulate in multiple vesicles, with the expression of CsGSTF1 correlated with BLC, but not with catechin content, in diverse germplasm. Complementation of the Arabidopsis tt19‐8 mutant, which is unable to express the orthologous ligandin AtGSTF12, restored anthocyanin accumulation, but did not rescue the transparent testa phenotype, confirming that CsGSTF1 did not function in catechin accumulation. Consistent with a ligandin function, transient expression of CsGSTF1 in Nicotiana occurred in the nucleus, cytoplasm and membrane. Furthermore, RNA‐Seq of the complemented mutants exposed to 2% sucrose as a stress treatment showed unexpected roles for anthocyanin accumulation in affecting the expression of genes involved in redox responses, phosphate homeostasis and the biogenesis of photosynthetic components, as compared with non‐complemented plants.
Reporter‐based forward genetic screen to identify bundle sheath anatomy mutants in A. thaliana
Authors: Döring Florian , Billakurthi Kumari , Gowik Udo , Sultmanis Stefanie , Khoshravesh Roxana , Das Gupta Shipan , Sage Tammy L. , Westhoff Peter
Published: November 2018

The evolution of C4 photosynthesis proceeded stepwise with each small step increasing the fitness of the plant. An important pre‐condition for the introduction of a functional C4 cycle is the photosynthetic activation of the C3 bundle sheath by increasing its volume and organelle number. Therefore, to engineer C4 photosynthesis into existing C3 crops, information about genes that control the bundle sheath cell size and organelle content is needed. However, very little information is known about the genes that could be manipulated to create a more C4–like bundle sheath. To this end, an ethylmethanesulfonate (EMS)‐based forward genetic screen was established in the Brassicaceae C3 species Arabidopsis thaliana. To ensure a high‐throughput primary screen, the bundle sheath cells of A. thaliana were labeled using a luciferase (LUC68) or by a chloroplast‐targeted green fluorescent protein (sGFP) reporter using a bundle sheath specific promoter. The signal strengths of the reporter genes were used as a proxy to search for mutants with altered bundle sheath anatomy. Here, we show that our genetic screen predominantly identified mutants that were primarily affected in the architecture of the vascular bundle, and led to an increase in bundle sheath volume. By using a mapping‐by‐sequencing approach the genomic segments that contained mutated candidate genes were identified.
Can Google Trends data improve forecasting of Lyme disease incidence?
Authors: Kapitány‐Fövény Máté , Ferenci Tamás , Sulyok Zita , Kegele Josua , Richter Hardy , Vályi‐Nagy István , Sulyok Mihály
Published: November 2018

Background

Online activity‐based epidemiological surveillance and forecasting is getting more and more attention. To date, Google search volumes have not been assessed for forecasting of tick‐borne diseases. Thus, we performed an analysis of forecasting of the Lyme disease incidence based on the traditional data extended with Google Trends.

Methods

Data on the weekly incidence of Lyme disease in Germany from 16 June 2013 to 27 May 2018 were obtained from the database of the Robert Koch Institute. Data of Internet searches were obtained from Google Trends searching “Borreliose” in Germany for the “last 5 years” as a timespan category. Data were split into the training (from 16 June 2013 to 11 June 2017) and validation (from 12 June 2017, to 27 May 2018) data sets. A seasonal autoregressive moving average model, SARIMA (0,1,1) (0,1,1) [52] model was selected to describe the time series of the weekly Lyme incidence. After this, we added the Google Trends data as an external regressor and identified the SARIMA (0,1,1) (0,1,1) [52] model as optimal. We made predictions for the validation interval using these two models and compared predictions with the values of the validation data set.

Results

Forecasting for the validation timespan resulted in similar values for the models. Comparing the forecasted values with the reported ones resulted in an residual mean squared error (RMSE) of 0.3763; the mean absolute percentage error (MAPE) was 8.233 for the model without Google searches with an RMSE of 0.3732; and the MAPE was 8.17495 for the Google Trends values‐expanded model. The difference between the predictive performances was insignificant (Diebold‐Mariano Test, p‐value = 0.4152).

Conclusion

Google Trends data are a good correlate of the reported incidence of Lyme disease in Germany, but it failed to significantly improve the forecasting accuracy in models based on traditional data.
Experiences of adults participating in infertility support groups: a qualitative systematic review protocol
Authors: Bedi Sarah C. , Ferrell Christina , Harris Janet Y.
Published: November 2018

Objective:

The objective of this review is to identify and synthesize the best available evidence on the experiences of adults participating in infertility support groups to understand the value of support groups for this population.

Introduction:

Infertility can impact a person physically, mentally, emotionally, spiritually and financially. Infertility support groups may represent a beneficial tool that these adults can utilize to improve their quality of life. The findings may inform or promote more effective and appropriate health care and, based on the results, a change in the standard of care for the treatment of infertility.

Inclusion criteria:

This review will consider studies that include infertile women, men and couples of any age, race or marital status, in any geographic region and with any co-morbidity who participate in infertility support groups. Studies published in English that focus on qualitative data, without any restriction of year of publication, will be considered. This review will consider studies that utilize any media of material for infertility support groups.

Methods:

The key information sources to be searched are: CINAHL, PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, Scopus, MedNar and ProQuest Dissertations and Theses. A three-step search strategy will be undertaken to find both published and unpublished studies and will include searching of reference lists within articles selected for critical appraisal. Each of the included studies will be assessed for methodological quality independently by two reviewers, and findings will be extracted and synthesized.