bluuebunny/crossref_metadata_2025 huggingface dataset:
Pregnancy outcome in women with cerebral palsy: A nationwide population‐based cohort study
Authors: Sundelin Heléne E. K. , Stephansson Olof , Johansson Stefan , Ludvigsson Jonas F.
Published: November 2019

Introduction

Cerebral palsy (CP) is a lifelong disorder with a high rate of comorbidities and complications. We hypothesized that women with CP are at increased risk of adverse pregnancy outcome.

Material and methods

In this nationwide population‐based cohort study 1997‐2011, we examined the outcome of 770 births in women with CP vs 1 247 408 births in women without a CP diagnosis using the Swedish Medical Birth Register. We used unconditional logistic regression, adjusting for maternal age, smoking, parity, year of birth and epilepsy, to calculate adjusted odds ratios for adverse pregnancy outcome. Main adverse outcome was preterm birth. Secondary outcomes were cesarean section, induction of labor, low 5‐min Apgar score, small for gestational age, large for gestational age, and stillbirth.

Results

After adjusting for potential confounders, maternal CP was associated with increased risk of preterm birth (12.9% vs 4.9%; adjusted odds ratio [aOR] 2.8, 95% CI 2.3‐3.5), cesarean delivery (aOR 1.9, 95% CI 1.6‐2.2), induced delivery (aOR 1.4, 95% CI 1.1‐1.6), low 5‐min Apgar score (aOR 1.8, 95% CI 1.1‐2.9) and small of gestational age birth (aOR 1.6, 95% CI 1.2‐2.3). We found no increased risk of large for gestational age or stillbirth.

Conclusions

Women with CP are at increased risk of preterm birth and other adverse pregnancy outcomes, suggesting that they deserve extra surveillance during antenatal care. Further studies, with information on type of CP and gross motor function, are warranted to better understand the association between CP and pregnancy outcome.
Cytokine adsorption as a promising option for septic shock and multiple organ failure due to Candida infection and decompensated type 1 diabetes mellitus
Authors: Klinkmann Gerd , Stope Matthias B. , Meyer Andreas
Published: November 2019

Type 1 diabetes mellitus (T1DM) represents one of the most common chronic diseases in childhood. It is associated with high morbidity and mortality rates due to metabolic dysregulation, immunosuppressive effects, and a predisposition to fungal infections. Candidiasis is a severe infection and its prevalence has increased throughout the last decades. We report the case of a 19‐year‐old female patient admitted to our intensive care unit with T1DM and Candida infection associated with severe metabolic acidosis. In the absence of response to high dose catecholamine cardiovascular therapy and the presence of severe metabolic acidosis, a CytoSorb cartridge was implemented into the extracorporeal dialysis circuit resulting in a stabilization of hemodynamics accompanied by a tremendous decrease in vasopressor requirements, control of the hyperinflammatory response, as well as a resolution of metabolic acidosis and regeneration of renal function. Treatment with CytoSorb was safe and feasible without technical problems. Notably, this is the first case description reporting on the effects of CytoSorb in a patient with Candida infection as part of T1DM.
Patterns of morphologic alteration correlate with vision in diabetic macular oedema: a cross‐sectional evaluation of patients using the SAVE II protocol
Authors: Bolz Matthias , Podkowinski Dominika , Pretzl Josef , Mursch‐Edlmayr Anna‐Sophie , Luft Nikolaus , Ring Michael ,   for the SAVE Study Group
Published: November 2019

Purpose

We sought to describe and evaluate patients with clinically significant diabetic macular oedema (CSME) according to the improved SAVE II protocol and correlate findings with visual acuity and systemic parameters in the outpatient clinic for DR (diabetic retinopathy) management.

Methods

This was a cross‐sectional case series study of patients with CSME, regardless of prior treatment. Visual acuity testing was performed according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) protocol. Optical coherence tomography (OCT) and fluorescence angiography (FA) were performed. All imaging data were evaluated according to an improved version of the SAVE grading protocol for CSME (SAVE II). The main outcome measures were SAVE II oedema types and best‐corrected visual acuity. Additional parameters of a blood sample (fasting glucose, haemoglobin A1c, serum creatinine, triglycerides, cholesterol, low‐density lipoproteins, and high‐density lipoproteins) were taken.

Results

In total, 66 eyes of 66 patients were included. The mean age of the patients was 64.9 ± 8.2 years. Two eyes were classified as SAVE oedema type 1, 19 eyes as SAVE oedema type 2, 28 eyes as SAVE oedema type 3, and 28 eyes as SAVE oedema type 4, respectively. Central retinal thickness and laboratory parameters were not significantly different between the groups. There was a statistically significant difference in ETDRS visual acuity between the SAVE groups 2 and 4 (p < 0.001) with lower vision in group 4. There was no statistically significant difference between oedema types 2 and 3 (p = 0.065) and oedema types 3 and 4 (p = 0.13).

Conclusion

There was a significant correlation between the four defined oedema types and visual acuity. Morphologic findings did not correlate with any of the evaluated blood parameters.
Burden of dry eye disease in Germany: a retrospective observational study using German claims data
Authors: Siffel Csaba , Hennies Nora , Joseph Corey , Lascano Valeria , Horvat Pia , Scheider Maria , Ganzera Frank
Published: November 2019

Purpose

To evaluate the clinical and economic burden of dry eye disease (DED) among affected patients in Germany.

Methods

Adult patients (≥18 years) with ≥1 confirmed diagnosis of DED during the study period (2008–2015) were identified from the medical claims of ~3.6 million insured patients from Betriebskrankenkassen, a German statutory health insurance database. Prevalence (per 1000 patients) and incidence (per 1000 person‐years at risk) were estimated, and demographic and clinical characteristics, treatment history (excluding over‐the‐counter tear supplements), healthcare resource use (HCRU) and costs were assessed.

Results

In this population, the prevalence of DED increased from 20.24 in 2008 to 23.13 per 1000 patients in 2014. Overall incidence was 6.24 per 1000 person‐years at risk (2008–2015). Prevalence and incidence increased with age and were higher in women. Mean age at index was 63.4 years (incident cohort, n = 35 026). The most common ocular comorbidity was cataract (48.5%), and ~36% of patients were dispensed a reimbursed DED‐specific medication during the postindex period – most commonly, corticosteroids alone (13.2%) or in combination with anti‐infectives (21.8%). HCRU was high in patients with DED, mostly due to comorbidities. HCRU and associated costs were highest in patients ≥60 years. Total costs during the postindex period were higher in the DED cohort than among matched controls (€117 million versus €107 million; p < 0.001).

Conclusion

This retrospective database analysis provides a better understanding of the epidemiology, clinical characteristics, real‐world treatment patterns, HCRU and costs associated with DED in patients living in Germany.
Next‐generation sequencing‐aided precise diagnosis of Stickler syndrome type I
Authors: Wang Dan‐Dan , Gao Feng‐Juan , Hu Fang‐Yuan , Li Jian‐Kang , Zhang Sheng‐Hai , Xu Ping , Chang Qing , Jiang Rui , Wu Ji‐Hong
Published: November 2019

Purpose

To explore an early, rapid and precise diagnosis of Stickler syndrome type I (STL1) and to enrich the spectrum ofCOL2A1mutations in the Chinese population, which is poorly studied at present.

Methods

In the current study, we analysed 115 patients with high myopia by next‐generation sequencing and identified fiveSTL1 patients from four unrelated Chinese families. The clinical features of all patients were reviewed in detail.

Results

Four variants ofCOL2A1were identified, including two novel variants (c.1435delG and c.184delG) and two previously reported variants (c.1221+1G>A and c.1030C>T). Three variants caused premature termination codons which were common inSTL1. In addition, we proposed a new diagnostic tactic to improve early diagnostics ofSTL1 in patients.

Conclusion

In this study, our findings expanded the spectrum ofCOL2A1mutations with two novel variants and provided a new diagnostic tactic for reference, which was of great significance. Precise diagnosis on the basis of clinical manifestations and genetic testing will become the gold standard to diagnose inherited ocular disorders or syndromes in the future.
The orientation of young and older adults' mental representations of their home town with familiar and new landmarks
Authors: Muffato Veronica , Meneghetti Chiara , Doria Silvia , De Beni Rossana
Published: November 2019

Familiarity with an environment produces refined mental representations in adults of all ages, but it is not clear whether these representations tend to have a north‐up orientation and whether familiarity facilitates the learning of new spatial information, especially in ageing. Thirty‐two young and 32 older adults studied a map of their home town that included familiar and new fictitious landmarks, then performed pointing tasks, some aligned with the cardinal points south–north (SN), and others counter‐aligned, north–south (NS). A measure of visuo‐spatial working memory (VSWM) and a questionnaire on pleasure in exploring were also administered. The results showed that performance was better when pointing SN than NS (alignment effect), whereas pointing performance for familiar landmarks was similar for SN and NS alignments (no alignment effect). No interaction involving age was found. VSWM emerged as a significant predictor of pointing performance. Spatial mental representations of familiar environments are elaborate and flexible as regards familiar landmarks, in both young and older adults; and a familiar layout does not seem to enhance older adults' spatial memory as regards new landmarks.
The Use of a Malleable Medium in the Psychoanalytic Treatment of Psychosis
Authors: Valon Philippe
Published: November 2019

The psychoanalytic treatment of psychotic patients is often difficult through a sole reliance on associative speech. Psychotic subjects might not be apt at pursuing the course of regression induced by associative speech or this regression might lead them to psychic areas where de‐symbolization is so extensive that only delusion or dissociation are available to them. A medium has often been suggested so that the representation of the drive and the formalization of infantile sexuality may unfold more safely and efficiently. Two modalities of use of a malleable medium will be considered in this paper: Gisela Pankow's clay modelling and psychoanalytic psychodrama as it has developed in France, Belgium and Switzerland since the end of the 1950s.
Working with Remembered Childhood Nightmares in Adult Psychotherapy
Authors: Ingham Toby
Published: November 2019

This essay explores work with adult clients who have a particular attachment to their childhood nightmares. The essay argues that in the remembered nightmares, we have access to particularly well preserved dynamics and memories that can aid work and understanding. It is interesting that in cases where so much may have been forgotten, particularly in cases that involve trauma, memories of these dreams have endured. There is the somewhat tragic sense that some of the problems that have gone on to trouble the client's life were visible in the nightmares, and there to be addressed all those years ago. How different a life might have been if the issues in the childhood nightmares had been addressed at the time when they were first dreamt. The essay pursues the idea that remembered childhood nightmares can supply us with, firstly, important information that can support understanding of clinical work; and secondly, the possibility of assisting someone in carrying out work that has been long neglected.
Post‐ejaculatory modifications to sperm (PEMS)
Authors: Pitnick Scott , Wolfner Mariana F. , Dorus Steve
Published: November 2019

Mammalian sperm must spend a minimum period of time within a female reproductive tract to achieve the capacity to fertilize oocytes. This phenomenon, termed sperm ‘capacitation’, was discovered nearly seven decades ago and opened a window into the complexities of sperm–female interaction. Capacitation is most commonly used to refer to a specific combination of processes that are believed to be widespread in mammals and includes modifications to the sperm plasma membrane, elevation of intracellular cyclic AMP levels, induction of protein tyrosine phosphorylation, increased intracellular Ca2+ levels, hyperactivation of motility, and, eventually, the acrosome reaction. Capacitation is only one example of post‐ejaculatory modifications to sperm (PEMS) that are widespread throughout the animal kingdom. Although PEMS are less well studied in non‐mammalian taxa, they likely represent the rule rather than the exception in species with internal fertilization. These PEMS are diverse in form and collectively represent the outcome of selection fashioning complex maturational trajectories of sperm that include multiple, sequential phenotypes that are specialized for stage‐specific functionality within the female. In many cases, PEMS are critical for sperm to migrate successfully through the female reproductive tract, survive a protracted period of storage, reach the site of fertilization and/or achieve the capacity to fertilize eggs. We predict that PEMS will exhibit widespread phenotypic plasticity mediated by sperm–female interactions. The successful execution of PEMS thus has important implications for variation in fitness and the operation of post‐copulatory sexual selection. Furthermore, it may provide a widespread mechanism of reproductive isolation and the maintenance of species boundaries. Despite their possible ubiquity and importance, the investigation of PEMS has been largely descriptive, lacking any phylogenetic consideration with regard to divergence, and there have been no theoretical or empirical investigations of their evolutionary significance. Here, we (i) clarify PEMS‐related nomenclature; (ii) address the evolutionary origin, maintenance and divergence in PEMS in the context of the protracted life history of sperm and the complex, selective environment of the female reproductive tract; (iii) describe taxonomically widespread types of PEMS: sperm activation, chemotaxis and the dissociation of sperm conjugates; (iv) review the occurence of PEMS throughout the animal kingdom; (v) consider alternative hypotheses for the adaptive value of PEMS; (vi) speculate on the evolutionary implications of PEMS for genomic architecture, sexual selection, and reproductive isolation; and (vii) suggest fruitful directions for future functional and evolutionary analyses of PEMS.
Suspension, not expungement: Rationalizing misguided policy decisions around cannabis amnesty in Canada
Authors: McAleese Samantha
Published: November 2019

Hundreds of thousands of Canadians continue to carry the burden of convictions for minor possession of cannabis obtained prior to legalization. Despite support for an automatic expungement process to eliminate the collateral consequences of punishment, the Trudeau government opted for a less favourable policy instrument – record suspensions. Drawing from parliamentary debate and committee hearings, the author summarizes the discussion and debate on Bill C‐93 and analyzes this misguided decision using Miljan’s work on policy instrument choice and rationality. The emphasis on bureaucratic rationality specifically resulted in a maintenance of the status quo when it comes to criminal justice policy and an uninspiring approach to cannabis amnesty in Canada.
Inhibition of Ctsk modulates periodontitis with arthritis via downregulation of TLR9 and autophagy
Authors: Wei Wei , Ren Jie , Yin Wuwei , Ding Handong , Lu Qiuyu , Tan Liangyu , Deng Shibing , Liu Jie , Yang Qin , Wang Jiajia , Wang Min , Yue Yuan , Hao Liang
Published: November 2019

Objectives

The mechanisms underlying the effects of Toll‐like receptor 9 (TLR9) and autophagy on rheumatoid arthritis (RA)‐aggravated periodontitis are unclear. We aimed to explore a novel target, cathepsin K (Ctsk)‐mediated TLR9‐related autophagy, during the progress of periodontitis with RA.

Materials and Methods

DBA/J1 mouse model of periodontitis with RA was created by local colonization of Porphyromonas gingivalis (Pg) and injection of collagen. The expression of Ctsk was inhibited by adeno‐associated virus (AAV). Micro‐CT, immunohistochemistry (IHC), Western blot and quantitative real‐time polymerase chain reaction (qRT‐PCR) were used to detect the expression of TLR9‐related autophagy in periodontitis with RA. Small interfering RNA (siRNA) and CpG oligodeoxynucleotides (CpG ODN) were applied in macrophages. Western blot, immunofluorescence (IF) and qRT‐PCR were used to verify the in vivo results.

Results

RA can promote periodontitis bone destruction in the lesion area, while inhibiting Ctsk could effectively alleviate this effect. The infiltration of macrophages, TLR9, autophagy proteins (TFEB and LC3) and inflammatory cytokines increased in the periodontitis‐with‐RA group and was reduced by the inhibition of Ctsk in the periodontal region. Macrophage stimulation confirmed the in vivo results. With the activation of TLR9 by CpG ODN, inhibition of Ctsk could suppress both TLR9 downstream signalling proteins and autophagy‐related proteins.

Conclusions

This study advanced a novel role for Ctsk in TLR9 and autophagy to explain the interaction between periodontitis and RA.
Modelled distributions and conservation status of the wild relatives of chile peppers (CapsicumL.)
Authors: Khoury Colin K. , Carver Daniel , Barchenger Derek W. , Barboza Gloria E. , van Zonneveld Maarten , Jarret Robert , Bohs Lynn , Kantar Michael , Uchanski Mark , Mercer Kristin , Nabhan Gary Paul , Bosland Paul W. , Greene Stephanie L.
Published: November 2019

Aim

To fill critical knowledge gaps with regard to the distributions and conservation status of the wild relatives of chile peppers (CapsicumL.).

Location

The study covered the potential native ranges of currently recognized wildCapsicumtaxa, throughout the Americas.

Methods

We modelled the potential distributions of 37 wild taxa in the genus, characterized their ecogeographic niches, assessed their ex situ and in situ conservation status, and performed preliminary threat assessments.

Results

We categorize 18 of the taxa as “high priority” for further conservation action as a consequence of a combination of their ex situ and in situ assessments, 17 as “medium priority,” and two as “low priority.” Priorities for resolving gaps in ex situ conservation were determined to be high for 94.6%, and medium or high with regard to increased habitat protection for 64.9% of the taxa. The preliminary threat assessment indicated that six taxa may be critically endangered, three endangered, ten vulnerable, six near threatened and 12 least concern.

Main conclusions

Taxonomic richness hot spots, especially along the Atlantic coast of Brazil, in Bolivia and Paraguay, and in the highlands of Colombia, Ecuador, Peru and Venezuela, represent particularly high priority regions for further collecting for ex situ conservation as well as for enhanced habitat conservation.
“Long‐hood method” for identification of the bleeding site in colonic diverticular hemorrhage
Authors: Kobayashi Katsumasa , Furumoto Yohei , Narasaka Toshiaki
Published: November 2019

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Allogeneic stem cell transplant in myelodysplastic syndrome‐factors impacting survival
Authors: Prem Shruti , Atenafu Eshetu G. , Lam Wilson , Law Arjun , Michelis Fotios V. , Kim Dennis , Viswabandya Auro , Howard Lipton Jeffrey , Mattsson Jonas , Kumar Rajat
Published: November 2019

Objectives

The primary aim of this study was to evaluate survival outcomes following allo‐HCT in myelodysplastic syndrome (MDS), and the secondary aim was to study variables impacting survival.

Methods

This analysis describes patient characteristics, treatment, and outcomes in 125 consecutive adult patients with MDS transplanted from 2005 to 2018.

Results

The median age was 61 years, and median follow‐up in patients alive at last follow‐up was 29 months. The 2‐year OS and RFS were 39% (95%CI 30%‐48%) and 35.3% (95% CI: 27%‐44%), respectively. Transfusion dependence, high‐risk cytogenetics, and high serum ferritin were independent risk factors for death. The cumulative incidence of relapse (CIR) and non‐relapse mortality (NRM) at 2 years were 23% and 41.6%, respectively. High serum ferritin was significantly associated with NRM. There was no association between the percentage of bone marrow blasts (either at diagnosis or at pretransplant evaluation), on relapse or survival. Induction chemotherapy did not offer any survival advantage in MDS RAEB‐2 patients compared to cytoreduction with azacytidine alone.

Conclusion

Our results highlight the importance of karyotype on survival after allo‐HCT and identify serum ferritin and transfusion dependence as important surrogate markers of outcome. In addition, our results demonstrate the efficacy of azacytidine for pretransplant cytoreduction.
Myelin and oligodendrocyte lineage cell dysfunctions: New players in the etiology and treatment of depression and stress‐related disorders
Authors: Boda Enrica
Published: November 2019

Depressive disorders are complex, multifactorial disorders that have been traditionally attributed exclusively to neuronal abnormalities. However, recent studies have increased our understanding of the contribution of glial cells—and particularly of oligodendroglia—to the pathogenesis and treatment outcome of depression and stress‐related disorders. This review scrutinizes recent studies focusing on the neurosupportive functions exerted by myelin and oligodendrocyte lineage cells and their disruption in depression and stress‐related disorders. It also illustrates how myelin and oligodendroglia respond to antidepressants and non‐pharmacological treatment alternatives and proposes oligodendroglia‐directed approaches as novel therapeutic options for depressive disorders.
Investigation into inconsistent lateralisation of language functions as a potential risk factor for language impairment
Authors: Bradshaw Abigail R. , Woodhead Zoe V. J. , Thompson Paul A. , Bishop Dorothy V. M.
Published: November 2019

Disruption to language lateralisation has been proposed as a cause of developmental language impairments. In this study, we tested the idea that consistency of lateralisation across different language functions is associated with language ability. A large sample of adults with variable language abilities (N = 67 with a developmental disorder affecting language and N = 37 controls) were recruited. Lateralisation was measured using functional transcranial Doppler sonography (fTCD) for three language tasks that engage different language subprocesses (phonological decision, semantic decision and sentence generation). The whole sample was divided into those with consistent versus inconsistent lateralisation across the three tasks. Language ability (using a battery of standardised tests) was compared between the consistent and inconsistent groups. The results did not show a significant effect of lateralisation consistency on language skills. However, of the 31 individuals showing inconsistent lateralisation, the vast majority (84%) were in the disorder group with only five controls showing such a pattern, a difference that was higher than would be expected by chance. The developmental disorder group also demonstrated weaker correlations between laterality indices across pairs of tasks. In summary, although the data did not support the hypothesis that inconsistent language lateralisation is a major cause of poor language skills, the results suggested that some subtypes of language disorder are associated with inefficient distribution of language functions between hemispheres. Inconsistent lateralisation could be a causal factor in the aetiology of language disorder or may arise in some cases as the consequence of developmental disorder, possibly reflective of compensatory reorganisation.
Dihydroergotamine (DHE) – Then and Now: A Narrative Review
Authors: Silberstein Stephen D. , Shrewsbury Stephen B. , Hoekman John
Published: November 2019

Objective

To provide a narrative review of clinical development programs for non‐oral, non‐injectable formulations of dihydroergotamine (DHE) for the treatment of migraine.

Background

Dihydroergotamine was one of the first “synthetic drugs” developed in the 20th century for treating migraine. It is effective and recommended for acute migraine treatment. Since oral DHE is extensively metabolized, it must be given by a non‐oral route. Intravenous DHE requires healthcare personnel to administer, subcutaneous/intramuscular injection is challenging to self‐administer, and the approved nasal spray formulation exhibits low bioavailability and high variability that limits its efficacy. Currently there are several attempts underway to develop non‐oral, non‐injected formulations of DHE.

Method

A systematic search of MEDLINE/PubMed and ClinicalTrials.gov databases, then narrative review of identified reports, focusing on those published in the last 10 years.

Results

Of 1881 references to DHE from a MEDLINE/PubMed search, 164 were from the last 10 years and were the focus of this review. Further cross reference was made to ClinicalTrials.gov for 19 clinical studies, of which some results have not yet been published, or are studies that are currently underway. Three nasal DHE products are in clinical development, reawakening interest in this route of delivery for migraine. Other routes of DHE administration have been, or are being, explored.

Conclusion

There is renewed appreciation for DHE and the need for non‐oral, non‐injected delivery is now being addressed.
Medical library services in Switzerland: catching up with EBM
Authors: Bissels Gerhard , Klein Sabine D. , de Kaenel Isabelle
Published: November 2019

The feature is a part of the series about medical library services in various countries. It gives an overview of medical library services to support research, education and clinical practice in Switzerland. Data were collected by means of an online survey and set in the wider context of the Swiss healthcare system. Key findings are that library services, including support by academic librarians, are provided to health care staff in hospitals – both university and others, while there is no information service infrastructure to serve the large number of GPs and specialists who mostly run their own practice. The authors recommend that – if the health authorities take EBM seriously – information services should be introduced for these small practices. J.M.
Work productivity and activity impairment in patients with hidradenitis suppurativa: a cross‐sectional study
Authors: Yao Yiqiu , Jørgensen Astrid‐Helene Ravn , Thomsen Simon Francis
Published: November 2019

Background

The understanding of absenteeism, presenteeism, and impairments in daily activities among patients with hidradenitis suppurativa (HS) is limited. We examined the impact of disease‐specific factors of HS on work and daily life among a cohort of outpatients in a tertiary hospital setting.

Methods

Consecutive patients with HS were clinically evaluated and completed the Work Productivity and Activity Impairment (WPAI) questionnaire modified for HS.

Results

A total of 100 patients were included. Among 57 (57.0%) patients who were employed, 21.2% reported missing work, and 60.4% reported loss of work productivity during the preceding week as a result of HS. The overall work productivity was reduced by 26.6%. Seventy‐two percent reported daily activity impairment, averaging 32.7% reduction in daily activities. Moderate to strong correlations were observed between reduction in quality of life and the WPAI outcomes; presenteeism, overall work impairment, and activity impairment (r = 0.50–0.77). There were moderate correlations between disease severity and the same outcomes (r = 0.35–0.46). The mean rank of activity impairment among patients with Hurley stage I was 34.8, 60.1 for Hurley stage II, and 64.0 for Hurley stage III, P < 0.0001. Unemployed patients had higher activity impairment compared with employed patients (mean rank: 61.0 vs. 42.6, P = 0.001).

Conclusion

There are considerable rates of presenteeism, overall work impairment, and activity impairment in HS patients. Presenteeism, loss of overall work productivity, and activity impairment are positively correlated with greater disease severity and reduction in quality of life.
Systems immunology reveals a linked IgG3–C4 response in patients with acute rheumatic fever
Authors: Chung Amy W , Ho Timothy KC , Hanson‐Manful Paulina , Tritscheller Susanne , Raynes Jeremy M , Whitcombe Alana L , Tay Mei Lin , McGregor Reuben , Lorenz Natalie , Oliver Jane R , Gurney Jason K , Print Cristin G , Wilson Nigel J , Martin William J , Williamson Deborah A , Baker Michael G , Moreland Nicole J
Published: November 2019

Acute rheumatic fever (ARF) and chronic rheumatic heart disease (RHD) are autoimmune sequelae of a Group A streptococcal infection with significant global mortality and poorly understood pathogenesis. Immunoglobulin and complement deposition were observed in ARF/RHD valve tissue over 50 years ago, yet contemporary investigations have been lacking. This study applied systems immunology to investigate the relationships between the complement system and immunoglobulin in ARF. Patients were stratified by C‐reactive protein (CRP) concentration into high (≥10 μg mL−1) and low (<10 μg mL−1) groups to distinguish those with clinically significant inflammatory processes from those with abating inflammation. The circulating concentrations of 17 complement factors and six immunoglobulin isotypes and subclasses were measured in ARF patients and highly matched healthy controls using multiplex bead‐based immunoassays. An integrative statistical approach combining feature selection and principal component analysis revealed a linked IgG3–C4 response in ARF patients with high CRP that was absent in controls. Strikingly, both IgG3 and C4 were elevated above clinical reference ranges, suggesting these features are a marker of ARF‐associated inflammation. Humoral immunity in response to M protein, an antigen implicated in ARF pathogenesis, was completely polarized to IgG3 in the patient group. Furthermore, the anti‐M‐protein IgG3 response was correlated with circulating IgG3 concentration, highlighting a potential role for this potent immunoglobulin subclass in disease. In conclusion, a linked IgG3–C4 response appears important in the initial, inflammatory stage of ARF and may have immediate utility as a clinical biomarker given the lack of specific diagnostic tests currently available.
Asset pricing factors in Islamic equity returns
Authors: Safiullah Md , Shamsuddin Abul
Published: November 2019

Previous studies have compared risk–return characteristics of Islamic equity indices with their conventional counterparts, which may produce spurious results because a conventional equity index includes both Islamic and non‐Islamic constituents. Hence, this study compares Islamic equity portfolios with their non‐Islamic counterparts. We find that aggregate Islamic equity portfolios generally outperform non‐Islamic equity portfolios after controlling for the five asset pricing factors—market, size, value, profitability, and investment (Fama and French, 2015). The average cost of equity is 2.77 percentage points lower for Islamic firms compared to non‐Islamic firms. The findings hold for the various segments of the global equity market, and remain robust when the interest rate‐augmented and the liquidity factor‐augmented versions of the Fama–French five‐factor model are employed. The GRS test results suggest these asset pricing models may not be adequate for pricing both Islamic and non‐Islamic equities.
The transactional model of stress and coping as guidance for understanding adolescent patients' experience with thalassemia: Case report
Authors: Abu Shosha Ghada M. , Al‐Kalaldeh Mahmoud
Published: November 2019

Purpose: This case report investigated the transactional model of stress and coping as guidance for nursing care of an adolescent patient with thalassemia.

Sources Used: A case study of a 15‐year‐old female patient with β‐thalassemia major. Data were collected using patient medical records, an interview with the patient and physical examination.

Results: Four issues related to coping were isolated: Worsening physical symptoms; psychosocial consequences, coping process, and building supportive networks. These issues and the patient's adaption are explored via the transactional model.

Conclusions: Having thalassemia was cognitively appraised by the patient as a stressful and taxing situation with detrimental consequences, such as changes in physical appearance, stigmatization, and depression. Nurses should evaluate each patient's physical and psychosocial needs, utilizing appropriate theoretical models for designing a suitable care plan. As the case study demonstrates, the transactional model was an effective guide for nurses in planning care of an adolescent patient with thalassemia.
Latent class analysis categorizes chronic hand eczema patients according to skin barrier impairment
Authors: Tauber M. , Bérard E. , Lourari S. , Questel E. , Redoules D. , Paul C. , Simon M.
Published: November 2019

Background

Chronic hand eczema (CHE) is the most common skin disorder affecting the hands. It causes major physical and psychological burden for patients. Classification of CHE remains challenging because of its aetiological and clinical heterogeneity.

Objectives

Using latent class analysis (LCA) on a large categorical data set, our aim was to identify distinct phenotypes in a cohort of unselected CHE patients based upon clinical, genetic, molecular and physical parameters of the affected skin.

Methods

We performed two independent LCA on a cohort of 71 well‐characterized patients that initially integrated clinical severity, total immunoglobulin E plasma level, transepidermal water loss, hydration index, interleukin(IL)‐8 lesional skin level, Staphylococcus (aureus and epidermidis) colonization, FLG genotype and the expression (mRNA) of genes involved either in the filaggrin degradation and the natural moisturizing factor synthesis, the cornified envelope formation, the tight junctions’ structure and the desquamation process, or encoding antimicrobial peptides and chemokines.

Results

The first LCA categorized patients into a group displaying high severity of CHE, high skin barrier impairment, high Staphylococcus colonization, high IL‐8 skin level and high frequency of mutation in the FLG gene and a second group with opposite characteristics. The second LCA identified two independent groups of patients categorized by their low or high level of skin barrier impairment and corresponding changes in the expression of the related genes.

Conclusions

Our study suggests that the degree of skin barrier dysfunction is the most important parameter to discriminate CHE patients and probably plays a pivotal role in the pathogenesis of the disease whatever the aetiological factors. As far as we know, this is the first study to address this topic using a statistical categorization method without preconception.
Surface roughness and color stability of surface sealants and adhesive systems applied over a resin‐based composite
Authors: Cortopassi Lucas S. , Shimokawa Carlos A. K. , Willers Amanda E. , Sobral Maria A. P.
Published: November 2019

Objective

To evaluate coating materials regarding color and roughness changes when applied over a composite resin.

Materials and Methods

Specimens were made using Filtek Supreme Ultra. Coating materials were applied over the specimens' surface: Control (CTRL); Adper Single Bond Plus (SB); Scotchbond Universal (US); Clearfil SE (CL); Ambar APS (APS); Bioforty (BF); Fortify (FF); PermaSeal (PS); G‐CoatPlus (GC). Specimens were evaluated regarding color changes (∆E00) using spectrophotometer (n = 10); surface roughness (Ra), using optical profilometer (n = 10); surface topography, using scanning electron microscopy (n = 1); and thickness of material, using optical microscopy (n = 1). Analyses were made before and after 24, 72, and 168 hours of storage in wine, used as a staining solution. Data was statistically analyzed using analysis of variance, Tukey and Pearson tests (α:.05).

Results

None of the materials presented color stability. ∆E00 increased with increasing storage time at red wine, until 72 hours. BF, FF, PS, SB, and CTRL presented the lowest ∆E00 after 24 hours. APS presented the highest ∆E00 (32.59; P < .05). Regarding roughness, initially, surface sealants and APS presented the lowest values. After 168 hours, GC presented the lowest Ra (0.60; P < .05).

Conclusions

All the materials presented color and roughness changes after storage in red wine.

Clinical Relevance

Some coating materials can be applied over the surface of RBC restorations without changing its color stability or surface roughness.
Diet of six deep‐sea grenadiers (Macrouridae)
Authors: Stevens Darren W. , Dunn Matthew R. , Pinkerton Matthew H. , Bradford‐Grieve Janet M.
Published: November 2019

Feeding habits of six deep‐sea demersal trawl‐caught macrourids on Chatham Rise, New Zealand, were examined from stomach contents during the austral summer. Three species were predominantly benthic foragers: smallbanded rattail Coelorinchus parvifasciatus on small epifaunal crustaceans, twosaddle rattail Coelorinchus biclinozonalis on epifaunal decapods and humpback rattail Coryphaenoides dossenus on benthic fishes and epifaunal decapods. Three species were predominantly benthopelagic foragers: banded rattail Coelorinchus fasciatus on hyperiid and gammarid amphipods and calanoid copepods, blackspot rattail Lucigadus nigromaculatus on small epifaunal crustaceans and suprabenthic mysids and Mahia rattail Coelorinchus matamua on epifaunal decapods and calanoid copepods. The most important predictors of diet variability were identified using distance‐based linear models and included areal predictors in C. parvifasciatus, L. nigromaculatus and C. dossenus, fish size in C. dossenus, C. biclinozonalis and C. matamua, sample year in C. biclinozonalis and C. fasciatus and depth in C. matamua. Results are compared with previously published data for four other macrourid species from the same study area. The 10 grenadier species comprise benthic, benthopelagic and mesopelagic foraging guilds. This study brings the number of grenadier species for which diet on Chatham Rise has been described in detail to 12.
It is just that people treat you like a human being: The meaning of dignity for patients with substance use disorders
Authors: Solberg Hege , Nåden Dagfinn
Published: November 2019

Introduction

Patients who suffer from substance use disorder (SUD) might receive services from different service providers in an opioid maintenance treatment programme (OMT) and have a widespread and complex need for nursing.

Background

Literature reveals that prejudices against people with SUD exist. There is a lack of studies exploring patients with SUD experiences of preserving their dignity in the encounter with healthcare staff. The aim of the study was to gain insight into the meaning of dignity for patients with SUD.

Methods

The research design was descriptive and interpretative. In the interpretation of qualitative in‐depth interviews with six patients, a hermeneutical approach based on Gadamer (Truth and method, Sheed & Ward, London, UK, 1989) was used.

Results

Analysis resulted in three mains themes about the meaning of dignity: (a) The material dimension. (b) To be respected by others. (c) The inner experience. Factors enhancing dignity in the encounters were as follows: (a) Being respected and acknowledged. (b) Being cared for. (c) Knowledge and persistent relation. Factors depriving dignity were as follows: (a) Stigma and prejudice. (b) Insufficient relations and lack of confirmation. (c) Experiencing disrespectful/patronising attitudes and lack of knowledge.

Conclusions

The material dimension of dignity containing an aesthetically aspect was important for these patients. Dignity was also experienced as strongly connected to respect. Dignity can be enhanced by treating patients with SUD with understanding and respect, and dignity can be inhibited through stigmatization of patients with SUD, as well as by caregivers’ lack of knowledge.

Relevance to clinical practice

The study clarifies a need for more knowledge about SUD among healthcare staff, as well as promotes ethical awareness in encounters with patients regardless of their background.
Sinomenine's protective role and mechanism in stress load-induced heart failure
Authors: Fu Yan-Fei , Li Le , Fang Pu , Song Jie , Sun Xiao-Hui , Meng Tian-Hua , Tao Hou-Quan
Published: November 2019

Objectives

This study is designed to investigate the effects and mechanisms of sinomenine (Sin) in stress load-induced heart failure in mice.

Methods

We used aortic constriction (AB) to cause pressure overload as our heart failure model. Sin was received in mice as the treatment group. Cardiac function and structural changes were detected using echocardiography. Heart–lung mass ratios were measured. The serum levels of IL-10 and IL-17 proteins were detected by using ELISA, cardiac hypertrophy markers atrial natriuretic peptide (ANP), myocardial I and III collagen mRNA levels were detected by RT-PCR. Myocardial type I and III collagen protein levels were detected by Western blotting.

Key findings

Sin significantly improved stress load-induced heart failure (P < 0.05), reduced the heart–lung mass ratio, ANP, collagen-I and -III mRNA and protein levels (P < 0.05); Sin can enhance the ratio of IL-10/IL-17.

Conclusion

Sin may be a promising drug target to improve heart failure. Its role is related to reduce serum ANP levels, inhibit the mRNA and protein level of type I and III collagen and enhance the ratio of IL-10/IL-17.
Evaluation of the effect of vincristine on platelet count in dogs with lymphoma
Authors: Campbell O. , MacDonald V. S. , Dickinson R. M. , Gagnon J.
Published: November 2019

Objectives

To determine the effect of vincristine administration on the platelet count, platelet morphology and incidence of thrombocytopenia in dogs diagnosed with lymphoma.

Material and Methods

Medical records of 59 dogs with lymphoma receiving vincristine sulphate were reviewed retrospectively.

Results

Following vincristine administration the platelet count was higher and the number of thrombocytopenic patients was lower. No difference was found in the number of dogs with enlarged and elliptical platelets following vincristine treatment.

Clinical Significance

Vincristine administration increases platelet counts in dogs with lymphoma. It is not contra‐indicated to administer vincristine to dogs with lymphoma that are thrombocytopenic.
Intraperitoneal and incisional analgesia in small animals: simple, cost‐effective techniques
Authors: Steagall P. V. M. , Benito J. , Monteiro B. , Lascelles D. , Kronen P. W. , Murrell J. C. , Robertson S. , Wright B. , Yamashita K.
Published: November 2019

The World Small Animal Veterinary Association Global Pain Council (WSAVA‐GPC) has recently published its first “capsule review” by Monteiro et al. These are short articles that present a brief assessment of the scientific evidence and practical recommendations on important, and sometimes controversial, subjects in pain management. The capsules will be published regularly in the Journal of Small Animal Practice, the official journal of the WSAVA. This second article discusses the use of intraperitoneal and incisional analgesia in small animal practice, including their limitations and recommendations by the authors.
Existence of a calibrated regime switching local volatility model
Authors: Jourdain Benjamin , Zhou Alexandre
Published: November 2019

By Gyöngy's theorem, a local and stochastic volatility model is calibrated to the market prices of all European call options with positive maturities and strikes if its local volatility (LV) function is equal to the ratio of the Dupire LV function over the root conditional mean square of the stochastic volatility factor given the spot value. This leads to a stochastic differential equation (SDE) nonlinear in the sense of McKean. Particle methods based on a kernel approximation of the conditional expectation, as presented in Guyon and Henry‐Labordère [Risk Magazine, 25, 92–97], provide an efficient calibration procedure even if some calibration errors may appear when the range of the stochastic volatility factor is very large. But so far, no global existence result is available for the SDE nonlinear in the sense of McKean. When the stochastic volatility factor is a jump process taking finitely many values and with jump intensities depending on the spot level, we prove existence of a solution to the associated Fokker–Planck equation under the condition that the range of the squared stochastic volatility factor is not too large. We then deduce existence to the calibrated model by extending the results in Figalli [Journal of Functional Analysis, 254(1), 109–153].
How can we best use opportunities provided by routine maternity care to engage women in improving their diets and health?
Authors: Lawrence Wendy , Vogel Christina , Strömmer Sofia , Morris Taylor , Treadgold Bethan , Watson Daniella , Hart Kate , McGill Karen , Hammond Julia , Harvey Nicholas C. , Cooper Cyrus , Inskip Hazel , Baird Janis , Barker Mary
Published: November 2019

Pregnancy provides motivation for women to improve their diets and increase their physical activity. Opportunistic brief interventions delivered as part of routine primary care have produced improvements in patients' health behaviour. Consequently, there have been calls for midwives to use contacts during pregnancy in this way. This study explored the experiences of pregnant women and research midwives/nurses of a brief intervention called Healthy Conversation Skills (HCS) being delivered as part of a randomised control trial, assessing the acceptability and feasibility of including this intervention in routine maternity care. Three research questions were addressed using mixed methods to produce four datasets: face‐to‐face interviews with participants, a focus group with the HCS‐trained midwives/nurses, case reports of participants receiving HCS and audio‐recordings of mid‐pregnancy telephone calls to the women which produced midwife/nurse HCS competency scores. Midwives/nurses used their HCS to support women to make plans for change and set goals. Women welcomed the opportunity to address their own health and well‐being as distinct from that of their baby. Midwives/nurses were competent in using the skills and saw healthy conversations as an effective means of raising issues of diet and physical activity. Recent extension of maternity appointment times provides ideal opportunities to incorporate a brief intervention to support behaviour change. Incorporating HCS training into midwifery education and continuing professional development would facilitate this. HCS is a scalable, brief intervention with the potential to improve the diets and physical activity levels of women during pregnancy, and hence the health of themselves and their babies.
Aufstehen, Hinsetzen
Authors: Kreutz Adrian
Published: November 2019

Why the European left needs to rethink its pragmatism