bluuebunny/crossref_metadata_2025 huggingface dataset:
Enrichment of white flour with spices positively impacts safety and consumer acceptance of bread
Authors: Issaoui Manel , Nesrine Mahfoudhi , Flamini Guido , Delgado Amélia
Published: October 2020

Aiming at increasing the nutritional value and sensory quality of bread, we assessed the enrichment of white flour with different levels of powdered cinnamon and pomegranate peel, through rheological, nutritional, aromatic, textural and sensory analyses. These extra ingredients were chosen for their richness in bioactive compounds, and they differently affected bread quality. In relation to raw flour, introduced ingredients slightly decreased moisture and protein content, while increasing ash, fibre and radical scavenging activity, which can be attributed to the sharing of aromatic compounds by cinnamon and pomegranate peel during the bread making process. When cinnamon was incorporated at 1%, the content of all furan derivatives was reduced up to 1/4 of initial value, 2‐pentyl furan totally disappeared, and furfuryl alcohol was reduced to 2.1%. Despite enriched bread’s texture was slightly worse, it was still acceptable in sensory tests, as 150 interviewed naive consumers preferred the new product over the control.
Obstructive sleep apnoea and adherence to continuous positive airway therapy among Australian women
Authors: Heraganahally Subash S. , Zaw Kyi K. , Tip Sai , Jing Xinlin , Mingi Joy J. , Howarth Timothy , Roy Anil , Falhammar Henrik , Sajkov Dimitar
Published: October 2020

Background

Clinical characteristics of women with different obstructive sleep apnoea (OSA) severity and adherence to continuous positive airway pressure (CPAP) therapy have not been previously explored.

Aims

To assess OSA prevalence, predictors, clinical and polysomnographic (PSG) characteristics and adherence to CPAP therapy among adult Australian women in a retrospective study.

Methods

All female patients who underwent a diagnostic PSG between 2014 and 2015 were included. CPAP adherence was assessed during the study period between 2018 and 2019 using multiple regression models.

Results

Among a total of 591 women included in this study (Aboriginal, n = 86), OSA was diagnosed in 458/591 (78%) patients; mild, moderate and severe OSA was present in 44%, 27% and 29% respectively. Older age, higher BMI and hypertension predicted the presence and severity of OSA. The Epworth Sleepiness Scale (ESS) score was not significantly different with (8 (5, 12)) or without (10 (5, 13)) OSA. PSG showed the rapid eye movement (REM) sleep‐associated apnoea−hypopnea index (AHI) was higher with all severity of OSA. Adherence to CPAP therapy was noted in 171 (57%) patients; 47% mild, 57% moderate and 63% with severe OSA respectively. Three multiple regression models (clinical, PSG parameters, OSA severity, combined (clinical and PSG)) showed the combined model had the strongest predictive value and demonstrated that higher ESS and more severe oxygen desaturation were associated with CPAP adherence irrespective of OSA severity.

Conclusions

Older age, higher BMI and the presence of hypertension predicted the presence of OSA. The REM sleep‐related AHI was higher. Adherence to CPAP was associated with symptomatic OSA and severe oxygen desaturation.
Characteristics and outcomes of Aboriginal and Torres Strait Islander patients with dialysis‐dependent kidney disease in Australian intensive care units
Authors: Dunlop William A. , Secombe Paul J. , Agostino Jason W. , van Haren Frank M. P.
Published: October 2020

Background

In Australia, 531 people per million population have dialysis‐dependent chronic kidney disease (CKD5D). The incidence is four times higher for Aboriginal and Torres Strait Islander (indigenous) people compared with non‐Indigenous Australians. CKD5D increases the risk of hospitalisation, admission to the intensive care unit (ICU) and mortality compared with patients without CKD5D. There is limited literature describing short‐term outcomes of patients with CKD5D who are admitted to the ICU, comparing indigenous and non‐indigenous patients.

Aims

This registry‐based retrospective cohort analysis compared demographic and clinical data between indigenous and non‐indigenous patients with CKD5D and tested whether indigenous status predicted short‐term outcomes independently of other contributing factors. Adjusted hospital mortality was the primary outcome measure.

Methods

Data were from the Australian and New Zealand Intensive Care Society's Centre for Outcome and Resource Evaluation Adult Patient Database. Australian ICU admissions between 2010 and 2017 were included. Data from 173 ICU (2136 beds) include 1 051 697 ICU admissions, of which 23 793 had a pre‐existing diagnosis of CKD5D.

Results

Indigenous patients comprised 11.9% of CKD5D patients in ICU. CKD5D was prevalent among 4.9% of indigenous and 2.9% of non‐indigenous ICU admissions. Indigenous patients were 13.5 years younger, had fewer comorbidities and lower crude mortality despite equivalent calculated mortality risk. After adjusting for age, remoteness and severity of illness, indigenous status did not predict mortality.

Conclusions

Socioeconomic disadvantage contributes to earlier development of CKD5D and the overrepresentation in ICU of indigenous people. Mortality is equivalent once correcting for confounders, but addressing inequality requires strengthening preventative care.
Prospective analysis of stroke recognition, stroke risk factors, thrombolysis rates and outcomes in Indigenous Australians from a large rural referral hospital
Authors: Santos Angela Dos , Mohr Katherine , Jude Martin , Simon Neil G. , Parsons Mark , Eades Sandra , Burchill Luke , Davis Stephen , Donnan Geoffrey , Churliov Leonid , Delcourt Candice
Published: October 2020

Background

Cardiovascular disease is the most common cause of death and disability in indigenous communities but limited prospective data exist about stroke.

Aims

To estimate the difference in stroke recognition, risk factors, treatment rates and outcomes between indigenous and non‐indigenous peoples admitted to the Wagga Wagga Rural Referral Hospital (WWRRH) over a 5‐year period with a suspected acute stroke.

Methods

All suspected strokes presenting to the 33 peripheral hospitals within the Murrumbidgee Local Health District (MLHD) were transferred to the WWRRH and prospectively assessed over a 5‐year period from 1 January 2012 to 31 December 2017. Actions at stroke onset, risks factors, stroke type, treatment and outcomes were analysed.

Results

A total of 1843 patients were included. Of these, 45 (2.5%) patients were indigenous. Only 26.6% of indigenous and 34% of non‐indigenous patients knew of the face, arm, speech, time (FAST) acronym. Indigenous patients were younger (mean age 62.0 years vs 74.4 years) and more likely to have diabetes (risk difference (RD) 22.3% (95% CI: 3%, 41.7%)), dyslipidaemia (RD 19.4% (95% CI: 21.%, 36.7%)), and be ever smokers (RD 24.9% (95% CI: 9.5%, 40.3%)). Stroke types were similar except lacunar infarcts were more common (19.2% vs 8.4%). Treatment rates and outcomes were similar between the two groups.

Conclusions

Indigenous Australians with stroke are a decade younger and have a higher prevalence of important, modifiable stroke‐risk factors. Delayed presentation to hospital is more common, due in part to stroke symptoms being underrecognised. When admitted to a specialised stroke unit, treatment rates and outcomes are comparable.
Paediatric Oral Health during and after the COVID‐19 Pandemic
Authors: Luzzi Valeria , Ierardo Gaetano , Bossù Maurizio , Polimeni Antonella
Published: October 2020

Background

During the period of health emergency linked to the current COVID‐19 pandemic, the paediatric dentists’ management of oral health problems in children must have as primary objective the control of the spread of the disease according to specific protocols aimed at minimizing the risk of viral transmission.

Aim

This paper examines the possible clinical conditions that may require intervention by the paediatric dentist, distinguishing clinical situations that fall into the category of paediatric dental emergencies from conditions of oral pathologies that normally do not represent an emergency. The definition of rigorous and highly effective infection control protocols in the dental settings must therefore be complemented by the development and strengthening of remote communication techniques with the parents, who must be adequately educated on preventive and palliative measures for the management of their children's oral health, with the aim of postponing clinical attendance to when the circumstances become favourable.

Conclusions

The experience gained with these approaches and models of treatment, where remote interaction techniques play a central role, will hone the communication skills of the paediatric dentist and will retain its usefulness even at the end of the current emergency period.
Linked data analysis of learning disability health checks and emergency hospital admissions in the Kent Integrated Dataset
Authors: Cuccu Zara , Bourne Tom , Abi‐Aad Gerrard , Bennett Samantha
Published: October 2020

Background

People with learning disabilities have higher rates of admitted patient care than the general population. This study explored emergency hospital admissions during 2018/19 in association with learning disability health check recording in general practice within the Kent Integrated Dataset during 2016/17 to 2018/19.

Methods

Multiple logistic regression evaluated the odds of emergency hospital admission by sex, age, deprivation, residence, risk score, long‐term conditions, severe health needs and health check. During 2018/19, one or more emergency hospital admissions were recorded for 10.9% of the 5,759 persons recorded with learning disability.

Results

There were lower odds of emergency hospital admission in persons having had learning disability health check in the past 3 years even after adjustment.

Conclusions

Comparison to nationally representative research suggests a consistent finding of benefit from learning disability health check on indicators of unplanned care use, supporting the view that learning disability health checks facilitate the addressing of key health needs.
Measurement of Parental Autonomy Support: A Review of Theoretical Concerns and Developmental Considerations
Authors: McCurdy Amy L. , Williams Kenneshia N. , Lee Grace Y. , Benito‐Gomez Marta , Fletcher Anne C.
Published: October 2020

This review focuses on the measurement of parental autonomy support across different developmental periods. We begin with a summary of current theoretical perspectives on autonomy development and how they have informed the conceptualization of autonomy supportive parenting. We then discuss four different developmental periods (infancy/early childhood, middle childhood, early/middle adolescence, and late adolescence), summarizing developmental considerations for each and how such considerations have an impact on both the nature of autonomy support and how it is assessed. We hope that this information will serve as a resource for researchers who study parental autonomy support across a range of developmental periods, supporting them as they make measurement decisions.
Restless in the mouse cage—A new genetic model for restless legs syndrome
Authors: Stegmüller Judith
Published: October 2020

Restless legs syndrome (RLS) is a movement disorder that is characterized by an uncomfortable sensation in the legs, and the urge to move the legs. Meis1 has previously identified as a risk gene for RLS. This Editorial highlights the study by Lyu and colleagues who developed a novel genetic mouse model heterozygous for Meis1 expression in neurons of the central nervous system. Using behavioral tests, the authors established hyperactivity of the mice, reminiscent of symptoms found in RLS patients. In addition, the authors took a closer look at the iron, dopaminergic, and cholinergic system of these mice.

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The forearm and hand musculature of semi‐terrestrial rhesus macaques (Macaca mulatta) and arboreal gibbons (fam.Hylobatidae). Part II. Quantitative analysis
Authors: Vanhoof Marie J. M. , van Leeuwen Timo , Galletta Lorenzo , Vereecke Evie E.
Published: October 2020

Nonhuman primates have a highly diverse locomotor repertoire defined by an equally diverse hand use. Based on how primates use their hands during locomotion, we can distinguish between terrestrial and arboreal taxa. The ‘arboreal’ hand is likely adapted towards high wrist mobility and grasping, whereas the ‘terrestrial’ hand will show adaptations to loading. While the morphology of the forearm and hand bones have been studied extensively, functional adaptations in the forearm and hand musculature to locomotor behaviour have been documented only scarcely. In this paper, we investigate the forelimb musculature of the highly arboreal gibbons (includingHylobates lar,Hylobates pileatus,Nomascus leucogenys,Nomascus concolor and Symphalangus syndactylus) and compare this with the musculature of the semi‐terrestrial rhesus macaques (Macaca mulatta). Anatomical data from previous dissections on knuckle‐walking bonobos (Pan paniscus) and bipedal humans (Homo sapiens) are also included to further integrate the analyses in the scope of catarrhine hand adaptation. This study indicates that the overall configuration of the arm and hand musculature of these primates is very similar but there are some apparent differences in relative size which can be linked to differences in forelimb function and which might be related to their specific locomotor behaviour. In macaques, there is a large development of wrist deviators, wrist and digital flexors, and m. triceps brachii, as these muscles are important during the different phases of palmi‐ and digitigrade quadrupedal walking to stabilize the wrist and elbow. In addition, their m. flexor carpi ulnaris is the most important contributor to the total force‐generating capacity of the wrist flexors and deviators, and is needed to counteract the adducting torque at the elbow joint during quadrupedal walking. Gibbons show a relatively high force‐generating capacity in their forearm rotators, wrist and digital flexors, which are important muscles in brachiation to actively regulate forward movement of the body. The results also stress the importance of the digital flexors in bonobos, during climbing and clambering, and in humans, which is likely linked to our advanced manipulation skills.
Damage to the human lumbar cartilage endplate and its clinical implications
Authors: Huang Bao , Liu Junhui , Wei Xiaoan , Li Shengwen , Xiang Yufeng , Wu Hao , Chen Jian , Zhao Fengdong
Published: October 2020

The cartilaginous endplate (CEP) is a thin layer of hyaline cartilage, and plays an important role in the diffusion of nutrients into the intervertebral discs. Its damage may seriously affect the disc degeneration, and result in low back pain (LBP). However, the structural features of damaged CEPs have not been well characterized, and this hinders our understanding of the etiology of disc degeneration and pain. To present the structural features of micro‐damaged CEPs in patients with disc degeneration and LBP that might even be regarded as an initial factor for disc degeneration, we performed a histological study of micro‐damaged CEPs harvested from human lumbar intervertebral discs and analyzed its clinical implications. Human lumbar CEPs were excised from 35 patients (mean age 60.91 years) who had disc degeneration and LBP. Control tissue was obtained from 15 patients (mean age 54.67 years) with lumbar vertebral burst fractures. LBP and disability were assessed clinically, and all patients underwent anterior vertebral body fusion surgery. CEPs together with some adjacent nucleus pulposus (NP) were sectioned at 4 µm, and stained using H&E, Safranin O/Fast Green, and Alcian Blue. Immunostaining and PCR were used to identify various markers of degeneration, innervation, and inflammation. Histology demonstrated physical micro‐damage in 14/35 CEPs from the disc degeneration group. Six major types of damage could be distinguished: fissure, traumatic nodes, vascular mimicry, incorporation of NP tissue within the CEP, incorporation of bone within the CEP, and incorporation of NP and bone within the CEP. Pain and disability scores (ODI: p = 0.0190; JOA: p = 0.0205; JOABPEQ: p = 0.0034) were significantly higher in those with micro‐damaged CEPs (N = 14) than in those with non‐damaged CEPs (N = 21). CEP damage was significantly associated with elevated MMP3 (p = 0.043), MMP13 (p = 0.0191), ADAMTS5 (p = 0.0253), TNF‐α (p = 0.0011), and Substance P (p = 0.0028), and with reduced Sox9 (p = 0.0212), aggrecan (p = 0.0127), and type II collagen (p = 0.0139). In conclusion, we presented a new classification of human lumbar micro‐damaged CEPs. Furthermore, we verify disc degeneration, innervation, and discogenic pain in micro‐damaged CEPs.
A pregnant woman with congenital hepatic fibrosis delivers a healthy neonate
Authors: Zhang Yiwen , Meng Zhanao , Li Zhe , Wang Li , Qiu Suli , Xu Chengfang
Published: October 2020

Background and Aims

Congenital hepatic fibrosis (CHF) is a rare disease associated with polycystic kidney gene mutation and is characterized by liver fibrosis and portal hypertension. The pathology of CHF has common characteristics with hepatitis B cirrhosis. Currently, little is known about the clinical course of CHF during pregnancy or its effect on maternal and fetal outcomes.

Methods

Whole exome sequencing (WES), and laboratory and histopathological findings of the patient were documented.

Results

We report the case of a 30‐year‐old Chinese woman who had been diagnosed with hepatitis B cirrhosis 17 years before and whose diagnosis was revised to CHF based on confirmation by liver biopsy and WES. She conceived naturally and delivered a healthy live infant.

Conclusions

The diagnostic methods for CHF are liver biopsy and WES. In pregnant patients with CHF, prenatal monitoring is mainly performed to monitor liver function, platelet and clotting function, portal hypertension and degree of esophageal and gastric varices. Precise guidelines for screening and management of patients with CHF need to be better defined.
Obstacles to HBV functional cure: Late presentation in HIV and its impact on HBV seroconversion in HIV/HBV coinfection
Authors: van Bremen Kathrin , Hoffmann Christian , Mauss Stefan , Lutz Thomas , Ingiliz Patrick , Spinner Christoph D. , Scholten Stefan , Schwarze‐Zander Carolynne , Berger Florian , Breitschwerdt Sven , Schneeweiss Stephan , Busch Fabian , Wasmuth Jan‐Christian , Fätkenheuer Gerd , Lehmann Clara , Rockstroh Jürgen K. , Boesecke Christoph
Published: October 2020

Several cohorts have shown that long‐term tenofovir‐containing combination antiretroviral therapy (cART) leads to higher HBsAg seroclearance rates in HIV/HBV coinfected patients vs HBV‐monoinfected patients under tenofovir disoproxil fumarate (TDF)‐based therapy. We have analysed data on determinants of HBsAg loss in a retrospective multicentric cohort of 359 HIV/HBV coinfected patients. Median CD4 T‐cell count at baseline was 359/ul (321‐404), CDC stage was C in 20% (n = 70). Most patients (68%) were ART‐naïve when TDF‐ or tenofovir alafenamide (TAF)‐containing cART was initiated (baseline). After a median follow‐up of 11 years HBsAg loss had occurred in 66/359 (18%) patients. However, patients with stage CDC C (P ≤ .001), lower CD4 gain (P = .043) and not receiving TDF/FTC (P = .008) were less likely to lose HBsAg. Long‐term TDF‐containing cART appears to achieve higher rates of HBsAg seroclearance compared to published data for HBV monoinfected subjects. However, late presentation for HIV and poor immune recovery significantly impair HBV seroconversion rates.
Cell‐type‐specific hypertranslocation of effectors by the Pseudomonas aeruginosa type III secretion system
Authors: Armentrout Erin I. , Kundracik Emma C. , Rietsch Arne
Published: October 2020

Many Gram‐negative pathogens use a type III secretion system (T3SS) to promote disease by injecting effector proteins into host cells. Common to many T3SSs is that injection of effector proteins is feedback inhibited. The mechanism of feedback inhibition and its role in pathogenesis are unclear. In the case of P. aeruginosa, the effector protein ExoS is central to limiting effector injection. ExoS is bifunctional, with an amino‐terminal RhoGAP and a carboxy‐terminal ADP‐ribosyltransferase domain. We demonstrate that both domains are required to fully feedback inhibit effector injection. The RhoGAP‐, but not the ADP‐ribosyltransferase domain of the related effector protein ExoT also participates. Feedback inhibition does not involve translocator insertion nor pore‐formation. Instead, feedback inhibition is due, in part, to a loss of the activating trigger for effector injection, and likely also decreased translocon stability. Surprisingly, feedback inhibition is abrogated in phagocytic cells. The lack of feedback inhibition in these cells requires phagocytic uptake of the bacteria, but cannot be explained through acidification of the phagosome or calcium limitation. Given that phagocytes are crucial for controlling P. aeruginosa infections, our data suggest that feedback inhibition allows P. aeruginosa to direct its effector arsenal against the cell types most damaging to its survival.
Elongation factor P is required for EIIGlc translation in Corynebacterium glutamicum due to an essential polyproline motif
Authors: Pinheiro Bruno , Petrov Dimitar Plamenov , Guo Lingyun , Martins Gustavo Benevides , Bramkamp Marc , Jung Kirsten
Published: October 2020

Translating ribosomes require elongation factor P (EF‐P) to incorporate consecutive prolines (XPPX) into nascent peptide chains. The proteome of Corynebacterium glutamicum ATCC 13032 contains a total of 1,468 XPPX motifs, many of which are found in proteins involved in primary and secondary metabolism. We show here that synthesis of EIIGlc, the glucose‐specific permease of the phosphoenolpyruvate (PEP): sugar phosphotransferase system (PTS) encoded by ptsG, is strongly dependent on EF‐P, as an efp deletion mutant grows poorly on glucose as sole carbon source. The amount of EIIGlc is strongly reduced in this mutant, which consequently results in a lower rate of glucose uptake. Strikingly, the XPPX motif is essential for the activity of EIIGlc, and substitution of the prolines leads to inactivation of the protein. Finally, translation of GntR2, a transcriptional activator of ptsG, is also dependent on EF‐P. However, its reduced amount in the efp mutant can be compensated for by other regulators. These results reveal for the first time a translational bottleneck involving production of the major glucose transporter EIIGlc, which has implications for future strain engineering strategies.
L‐Aspartate as a high‐quality nitrogen source in Escherichia coli: Regulation of L‐aspartase by the nitrogen regulatory system and interaction of L‐aspartase with GlnB
Authors: Schubert Christopher , Zedler Sandra , Strecker Alexander , Unden Gottfried
Published: October 2020

Escherichia coli uses the C4‐dicarboxylate transporter DcuA for L‐aspartate/fumarate antiport, which results in the exploitation of L‐aspartate for fumarate respiration under anaerobic conditions and for nitrogen assimilation under aerobic and anaerobic conditions. L‐Aspartate represents a high‐quality nitrogen source for assimilation. Nitrogen assimilation from L‐aspartate required DcuA, and aspartase AspA to release ammonia. Ammonia is able to provide by established pathways the complete set of intracellular precursors (ammonia, L‐aspartate, L‐glutamate, and L‐glutamine) for synthesizing amino acids, nucleotides, and amino sugars. AspA was regulated by a central regulator of nitrogen metabolism, GlnB. GlnB interacted with AspA and stimulated its L‐aspartate deaminase activity (NH3‐forming), but not the reverse amination reaction. GlnB stimulation required 2‐oxoglutarate and ATP, or uridylylated GlnB‐UMP, consistent with the activation of nitrogen assimilation under nitrogen limitation. Binding to AspA was lost in the GlnB(Y51F) mutant of the uridylylation site. AspA, therefore, represents a new type of GlnB target that binds GlnB (with ATP and 2‐oxoglutarate), or GlnB‐UMP (with or without effectors), and both situations stimulate AspA deamination activity. Thus, AspA represents the central enzyme for nitrogen assimilation from L‐aspartate, and AspA is integrated into the nitrogen assimilation network by the regulator GlnB.
Cold‐blooded forests in a warming world
Authors: Cavaleri Molly A.
Published: October 2020

This article is a Commentary onDrakeet al. (2020),228: 1511–1523.
Risk of autoimmune diseases in recurrent aphthous ulcer patients: A nationwide population study
Authors: Lee Young Chan , Jeong Su Jin , Eun Young‐Gyu , Song Ran , Oh In‐Hwan
Published: October 2020

Objective

To estimate the risk of developing autoimmune disease in patients diagnosed having recurrent aphthous stomatitis (RAS) through a nationwide population‐based cohort study.

Methods

This study included two group of patients who had three or more episodes with aphthae diagnosed from their physician (RAS group) and a similar matched group of patients without aphthae (control group). Both groups were collected within the period of 2005–2007 from the Korean National Health Insurances claims database. Non‐RAS cohort was matched after frequency matching. The final enrolled subjects were observed during a follow‐up period from 2008 to 2015 and those who received autoimmune diseases diagnoses during follow‐up were identified. The hazard ratio (HR) for developing autoimmune diseases was estimated.

Results

A total of 4,637 patients with RAS and 4,637 controls were included. The risk of overall autoimmune diseases was significantly increased in the RAS group (adjusted HR [aHR)], 1.19). With regard to each disease entity, patients with RAS showed an increased risk of Behcet's disease (31.16), systemic lupus erythematous (SLE) (1.74), ankylosing spondylitis (AS) (1.47), gout (1.47), Hashimoto thyroiditis (1.42), Graves' disease (1.37), and rheumatoid arthritis (RA) (1.19).

Conclusion

RAS‐like lesion may be an early sign of systemic autoimmune disease, as it was associated with an increased risk of Graves' disease, Hashimoto thyroiditis, SLE, AS, gout, RA, and Behcet's disease from real‐world data.
Subgingival endotoxin and lipoteichoic acid modulate cytokine production in diabetic subjects: A Case–control Study
Authors: Rangel Thiago P. , Reis Aurelio A. , Caponi Lara , Pena Larissa C. S. , Ruiz Karina G. S. , Santamaria Mauro P. , Mathias‐Santamaria Ingrid F. , Casati Marcio Z. , Casarin Renato C. V.
Published: October 2020

Background

Periodontal disease and diabetes mellitus (DM) are highly prevalent and interrelated diseases, resulting in altered host response microbiota. Thus, this study aimed to evaluate the impact of DM on local levels of lipopolysaccharide (LPS) and lipoteichoic acid (LTA) and their relationship with cytokines and matrix metalloproteinases’ (MMPs) profile.

Methods

This case–control study included diabetic (n = 15) and non‐diabetic (n = 15) subjects presenting Stage 3‐4, Grade C, Periodontitis. Gingival crevicular fluid (GCF) was collected, and LPS and LTA levels were analyzed by enzyme‐linked immunosorbent assay (ELISA), while IFN‐γ, IL‐10, IL‐17, IL‐1β, IL‐4, MMP‐2, and MMP‐9 were measured by LUMINEX/MAGpix. Mann–Whitney and Spearman’s correlation tests were used to compared and to correlate variables (p < 0.05).

Results

Higher levels of LTA, LPS, IL‐10, IL‐1β, and MMP‐2 (p < 0.05) and lower levels of IL‐17 were found in the DM group (p < 0.05). Non‐diabetic subjects presented higher LPS, IFN‐γ, IL‐17, and MMP‐2 levels and lower IL‐10 concentration (p < 0.05). No significant correlation was seen between LPS and cytokine profile in non‐diabetic. Local levels of LTA were positively correlated with IL‐17 and MMP‐2 and negatively with IL‐10.

Conclusion

LTA and LPS drove the inflammatory profile through the modulation of cytokines and MMPs in a different manner in DM and non‐diabetic subjects.
Photobiomodulation is effective in oral lichen planus: A randomized, controlled, double‐blind study
Authors: Ferri Elza P. , Cunha Karen R. L. , Abboud Clery S. , de Barros Gallo Camila , de Sousa Sobral Sérgio , de Fatima Teixeira da Silva Daniela , Horliana Anna Carolina R. T. , Franco Adriana L.‐d.‐S. , Rodrigues Maria Fernanda Setúbal D.
Published: October 2020

Objectives

To compare the efficacy of photobiomodulation to that of topical clobetasol 0.05% in patients with symptomatic oral lichen planus (OLP).

Subjects

Thirty‐four patients with symptomatic OLP were randomly allocated into two groups: (a) the Control group (n = 17), application of topical clobetasol propionate 0.05% three times a day for 30 consecutive days with laser placebo applied twice a week to mask the treatment, and (b) the photobiomodulation group (n = 17), laser application twice a week, totalling 8 sessions, and gel placebo for 30 consecutive days to mask the treatment. Evaluations were performed once a week during treatment and 30, 60 and 90 days after treatment. The following parameters were evaluated: pain, clinical scores, clinical resolution and recurrence rate.

Results

Photobiomodulation and propionate clobetasol 0.05% were able to significantly decrease pain in oral lichen planus patients and improve clinical scores during treatment and follow‐up. Both the Control and photobiomodulation groups presented similar clinical resolution and recurrence rates. Most importantly, no difference was observed between treatments during treatment and follow‐up.

Conclusions

These findings indicate that photobiomodulation twice a week is as effective as corticoid therapy in treating oral lichen planus. Moreover, photobiomodulation is a safe and non‐invasive therapy with the remarkable advantage of no adverse effects.
Oral mucositis after tacrolimus/sirolimus or cyclosporine/methotrexate as graft‐versus‐host disease prophylaxis
Authors: Garming Legert Karin , Ringdén Olle , Remberger Mats , Törlén Johan , Mattsson Jonas , Dahllöf Göran
Published: October 2020

Objectives

To determine whether treatment with tacrolimus plus sirolimus (Tac/Sir) as a prophylaxis for graft‐versus‐host disease worsens severe oral mucositis and delays healing compared to cyclosporine plus methotrexate (CsA/Mtx) following haematopoietic stem cell transplantation.

Subjects and Methods

The study comprised 141 patients: 73 randomized to receive Tac/Sir and 68 to receive CsA/Mtx. The oral mucositis assessment scale and toxicity grading according to WHO were used to assess the severity, peak and duration of oral mucositis from the day −3 to day 24 post‐transplant.

Results

Eighty‐seven patients developed oral mucositis in the first 24 days post‐transplant. No significant difference in oral mucositis severity between the Tac/Sir and CsA/Mtx groups was observed. The peak oral mucositis score occurred on day 10 in both groups. Although oral mucositis scores had returned to baseline in the CsA/Mtx group on day 24 post‐transplant, no significant difference compared with the Tac/Sir group was found.

Conclusions

The introduction of tacrolimus/sirolimus as a graft‐versus‐host disease prophylaxis in haematopoietic stem cell transplantation increased neither the incidence nor severity of oral mucositis compared with cyclosporine/methotrexate. Furthermore, oral mucositis healing was not prolonged and followed the same time pattern as cyclosporine/methotrexate.
The effect of non‐surgical periodontal treatment on gingival crevicular fluid periostin levels in patients with gingivitis and periodontitis
Authors: Arslan Rana , Karsiyaka Hendek Meltem , Kisa Ucler , Olgun Ebru
Published: October 2020

Objective

The objective of the study was to evaluate the effect of non‐surgical periodontal treatment on gingival crevicular fluid (GCF) periostin levels in patients with gingivitis (G) and periodontitis (P).

Subjects and methods

A total of 90 subjects, 30 patients with P, 30 with G, and 30 periodontally healthy (H) subjects were included. Patients with periodontal disease received non‐surgical periodontal treatment. GCF periostin levels were assessed at baseline, at the 6th week, and the 3rd month after treatment.

Results

It was found that GCF periostin level was the lowest in the H group (89.31[47.12] pg/30 sec), followed by the G group (132.82[145.14] pg/30 sec), and the highest in the P group (207.75[189.45] pg/30 sec). These differences were statistically significant between H and the other groups (p < .001). After treatment, GCF periostin levels significantly decreased at the 6th week and the 3rd month in the G group, at the 3rd month in the P group compared to baseline values (p < .05).

Conclusion

The results of this study suggest that GCF periostin plays a role as a reliable biological marker in the pathogenesis of periodontal disease and non‐surgical periodontal treatment is effective in decreasing GCF periostin levels.
Parents of ataxia‐telangiectasia patients display a distinct cellular immune phenotype mimicking ATM‐mutated patients
Authors: Ogulur Ismail , Ertuzun Tugce , Kocamis Burcu , Kendir Demirkol Yasemin , Uyar Emel , Kiykim Ayca , Baser Dilek , Yesil Gozde , Akturk Hacer , Somer Ayper , Ozen Ahmet , Karakoc‐Aydiner Elif , Muftuoglu Meltem , Baris Safa
Published: October 2020

Background

Heterozygous relatives of ataxia‐telangiectasia (AT) patients are at an increased risk for certain AT‐related manifestations. We also show that there is an increase of infection frequency in parents of AT patients. Thus, we hypothesized that the parents might exhibit immune alterations similar to their affected children.

Methods

Lymphocyte phenotyping to enumerate T‐ and B‐cell subsets was performed. Functional analyses included in vitro quantified γ‐H2AX, poly (ADP‐ribose) polymerase (PARP) and caspase‐9 proteins. Chromosomal instability was determined by comet assay.

Results

We analyzed 20 AT patients (14F/6M), 31 parents (16F/15M), and 35 age‐matched healthy controls. The AT patients’ parents exhibited low frequency of naive CD4+ T‐ (n = 14, 45%) and recent thymic emigrants (n = 11, 35%) in comparison with the age‐matched healthy donors. Interestingly, parents with low naive T cells also demonstrated high rate of recurrent infections (9/14, 64%). In comparison with age‐matched controls, parents who had recurrent infections and low naive T cells showed significantly higher baseline γ‐H2AX levels and H2O2‐induced DNA damage as well as increased cleaved caspase‐9 and PARP proteins.

Conclusion

Parents of AT patients could present with recurrent infections and display cellular defects that mimic AT patients. The observed immunological changes could be associated with increased DNA double‐strand breaks.
Subclass distribution of low‐density lipoprotein triglyceride and the clustering of metabolic syndrome components in Japanese children
Authors: Tonouchi Ryousuke , Okada Tomoo , Abe Yuriko , Kazama Minako , Kuromori Yuki , Yoshino Yayoi , Iwata Fujihiko , Hara Mitsuhiko , Saito Emiko , Morioka Ichiro
Published: October 2020

Background

Recent studies demonstrated that low‐density lipoprotein‐tryglyceride (LDL‐TG) may represent another marker of cardiovascular risks. We therefore measured LDL‐TG including the low‐density lipoprotein (LDL) subclass distribution and investigated the association between LDL‐TG subclass profile and the clustering of metabolic syndrome (MetS) components and insulin resistance in Japanese children.

Methods

The study included 237 schoolchildren (boys 115, girls 122). Four subclasses of low‐density lipoprotein‐tryglyceride (large, medium, small, and very small) was quantified using high‐performance liquid chromatography. Total LDL‐TG and TG levels in LDL subclasses were evaluated among four MetS component groups; non‐abdominal obesity, abdominal obesity, pre‐MetS, and MetS.

Results

Total LDL‐TG (P = 0.0003, P = 0.0175) and triglyceride levels in LDL subclasses were significantly different among four MetS component groups (large: P = 0.0002, P = 0.0084; medium: P = 0.0009, P = 0.0491; small: P =0.0025, P = 0.0509; very small: P = 0.0808, P = 0.0228; boys and girls, respectively). Total LDL‐TG (r = 0.411, P < 0.0001, r = 0.378. P < 0.0001) and triglyceride levels in LDL subclasses correlated positively with the homeostasis model of assessment ratio (large: r = 0.396, P < 0.0001, r = 0.346, P < 0.0001; medium: r = 0.274, P = 0.0030, r = 0.228, P = 0.0115; small: r = 0.342, P = 0.0002, r = 0.292, P = 0.0011; very small: r = 0.385, P < 0.0001, r = 0.426, P < 0.0001, boys and girls, respectively).

Conclusions

Subclass distribution of LDL‐TG was significantly associated with the clustering of MetS components in both sexes, and insulin resistance is a significant determinant of LDL‐TG in all LDL subclasses. Lipoprotein‐tryglyceride subclass analysis, rather than LDL‐C, may provide a precise evaluation for cardiovascular disease risks in children with MetS.
Non‐dipping phenomenon effects in monosymptomatic nocturnal enuresis treatment?
Authors: Çelakıl Mehtap
Published: October 2020

Background

Monosymptomatic enuresis nocturna patients are shown to have disrupted blood‐pressure regulation accompanying polyuria. In our study, we aimed to research the desmopressin response of enuresis patients with blood‐pressure regulation problems.

Methods

The study included 175 patients, aged from 6–15 years, with a diagnosis of monosymptomatic enuresis nocturna. Before treatment, 24 h ambulatory blood‐pressure monitoring (ABPM) was used to identify 52 non‐dipper patients and 73 patients with normal results. The responses to desmopressin treatment and clinical and demographic characteristics affecting response were compared.

Results

The response to desmopressin treatment was found to be significantly low in the patients who were non‐dippers on 24 h ABPM before treatment compared to those with normal ABPM results (P < 0.05). Similarly, the waking problems in the non‐dipper group were found to be high by a significant degree (P < 0.05). In the non‐dipper group, the systolic non‐dipping rate was higher.

Conclusions

Before desmopressin use, assessment of patients with a 24 h ABPM may be beneficial to select the method to be used for treatment.
Psychological functioning and psychosocial issues in pediatric kidney transplant recipients
Authors: Amatya Kaushalendra , Monnin Kara , Steinberg Christofferson Elizabeth
Published: October 2020

Research demonstrates that psychological factors are important for positive transplant outcomes, though there is little literature that synthesizes these factors in a comprehensive model among pediatric kidney transplant patients. This review analyzes psychological and psychosocial factors related to medical outcomes and overall well‐being post‐transplant by utilizing the PPPHM and referencing the existing literature on risk and resilience. Pediatric kidney transplant recipients are more susceptible to mental health concerns such as depression, anxiety, and ADHD, as well as developmental and neurocognitive delays, compared to healthy peers. Complex medical care and psychosocial needs for patients have implications for family functioning, parental and sibling mental health, and youth readiness to transition to adult care. It is important to carefully monitor patient functioning with empirically validated tools and to intervene in a multidisciplinary setting as early as possible to identify patients at risk and reduce potential negative impact. Psychologists are uniquely trained to assess and address these issues and are a valuable component of multidisciplinary, culturally competent care. While research in this expansive field is improving, more data are needed to establish gold standard approaches to mental health and psychosocial care in this population.
Safety and Clinical Impact of a Single Red Light Irradiation on Breast Tumor‐Bearing Mice
Authors: Pereira Saulo T. , Silva Camila R. , Nuñez Silvia C. , Ribeiro Martha S.
Published: October 2020

Low‐level light therapy has been used in health care as a therapeutic strategy for different diseases. However, its effects on cancer are controversial. This work evaluated the effects of three energies on breast cancer‐bearing mice after a single red light‐emitting diode (LED) irradiation. 4T1 cells were inoculated into the mammary fat pad of female BALB/c mice. When tumor volume reached 100 mm3, animals were irradiated by a LED irradiator (660 ± 11 nm) with energies of 1.2, 3.6, and 6.0 J. Control without irradiation and healthy animals were also evaluated. Mice were monitored regarding tumor volume and total blood count. After euthanasia, their organs were examined. We observed that a single irradiation does not increase tumor volume. All irradiated groups exhibited better clinical conditions than control, which presented a significant decrease in platelet and red blood cell levels compared with healthy mice. The energy of 3.6 J arrested neutrophil‐lymphocyte rate besides promoting longer survival and a lower number of metastatic nodules in the lungs. These findings suggest that a single red LED irradiation causes no impact on the course of the disease. Besides, the intermediary dose‐effect should be further investigated since it seems to promote better outcomes on breast cancer‐bearing mice.
Photodestruction of Stromal Fibroblasts Enhances Tumor Response to PDT in 3D Pancreatic Cancer Coculture Models
Authors: Karimnia Vida , Rizvi Imran , Slack Frank J. , Celli Jonathan P.
Published: October 2020

Pancreatic ductal adenocarcinoma (PDAC) is among the most lethal of human cancers. The dismal response of PDAC to virtually all therapeutics is associated, in part, with a characteristically dense fibrotic stroma. This stroma not only acts as a barrier to drug perfusion, but also promotes tumor survival through paracrine crosstalk and biophysical interactions. Photodynamic therapy (PDT) is being explored for PDAC treatment, though the impact of tumor‐promoting stromal crosstalk on PDT response in PDAC is not well‐characterized. The current study assesses the effect of tumor‐stroma interactions on response to PDT or chemotherapy in heterocellular 3D cocultures using PDAC cells and two different fibroblastic cell types (pancreatic stellate cells, PSCs, and a normal human fibroblast cell line, MRC5) embedded in extracellular matrix (ECM). While stromal fibroblasts promote resistance to chemotherapy as expected, PDAC 3D nodules in coculture with fibroblasts exhibit increased response to PDT relative to homotypic cultures. These results point to the potential for PDT to overcome tumor‐promoting stromal interactions associated with poor therapeutic response in PDAC.
UV‐C light: A powerful technique for inactivating microorganisms and the related side effects to the skin
Authors: Ploydaeng Monthanat , Rajatanavin Natta , Rattanakaemakorn Ploysyne
Published: October 2020

Hospital‐associated infections have led to a significant increment of morbidity and mortality among patients. As a result, the public health had concentrated on preventing the transmission of infection using environmental controls. UV‐C radiation or ultraviolet germicidal irradiation (UVGI) had caught interest for decades as it can potentially degrade many kinds of microorganisms. This review aims to highlight the current information regarding the ability of UV‐C radiation in terms of disinfection and focuses on its application and safety in the medical field.
Treatment of paediatric eczema with narrowband ultraviolet light B therapy
Authors: Hunjan Manrup K. , Brockley Julia R. , Buka Richard , Ramesh Raakhee
Published: October 2020

Background

Narrowband ultraviolet B phototherapy (nbUVB) is a well‐established, well‐tolerated and efficacious treatment for eczema. There is a distinct lack of literature surrounding the therapeutic use of nbUVB in eczema in children and especially in children with higher skin phototypes (III to VI).

Methods

We undertook a retrospective review of children aged 18 years and under with eczema who had undergone nbUVB in our department between 1 January 2011 and 31 December 2017. Abstracted data included sex, age, skin phototype, severity as graded by a paediatric dermatologist, cumulative dose, response to treatment and subsequent remission.

Results

In total, 60 children had nbUVB. Of those, 56 had more than 10 nbUVB exposures. Complete or near‐complete clearance was achieved in 31 children (52%). Of those, 24 (77%) had a skin phototype of III or greater. Clinical remission rates of these patients were 100%, 87%, 57% and 52% at 0, 3, 6 and 12 months, respectively. Seventeen patients (28%) suffered side effects. Most commonly these were mild side effects such as erythema and xerosis.

Conclusion

We have demonstrated that nbUVB is a safe, well‐tolerated and efficacious form of treatment for children with atopic eczema. We have shown it to be effective in those with skin phototypes greater than III and shown that they are a group that may derive greater long‐term efficacy. In clinical practice, preference for nbUVB as second‐line treatment, over oral systemics, should always be considered.
Immunopathology and modulation induced by hookworms: From understanding to intervention
Authors: Mourão Dias Magalhães Luisa , Silva Araújo Passos Livia , Toshio Fujiwara Ricardo , Lacerda Bueno Lilian
Published: October 2020

Hookworm infection is considered the most prevalent human soil‐transmitted helminth infection affecting approximately 500 million people and accounting for 3.2 million disability‐adjusted life years lost annually. As with many other neglected tropical diseases, no international surveillance mechanisms that show accurate data on the prevalence of hookworm infection are in place, thus hindering strategies to control parasite transmission. In this review, we unravel the current knowledge in immunopathology and immunoregulation of hookworm infection and present discoveries in drug therapies based on the capability of hookworms to regulate inflammation to treat allergic, inflammatory and metabolic diseases. Additionally, we highlight potential vaccine development and treatments and propose avenues for further inquiry.
Involvement of soluble proteins in growth and metabolic adjustments of drought‐stressed Calligonum mongolicum seedlings under nitrogen addition
Authors: Zhang Z. , Tariq A. , Zeng F. , Chai X. , Graciano C.
Published: October 2020

The planting of seedlings is the most effective measure for vegetation restoration. However, this practice is challenging in desert ecosystems where water and nutrients are scarce. Calligonum mongolicum is a sand‐fixing pioneer shrub species, and its adaptive strategy for nitrogen (N) deposition and drought is poorly understood.

Thus, in a pot experiment, we studied the impacts of four N levels (0, 3, 6, 9 gN·m−2·year−1) under drought or a well‐watered regime on multiple eco‐physiological responses of 1‐year‐old C. mongolicum seedlings.

Compared to well‐watered conditions, drought considerably influenced seedling growth by impairing photosynthesis, osmolyte accumulation and activity of superoxide dismutase and enzymes related to N metabolism. Nitrogen addition improved the productivity of drought‐stressed seedlings, as revealed by increased water use efficiency, enhanced superoxide dismutase and nitrite reductase activity and elevated N and phosphorus (P) levels in seedlings. Nevertheless, the addition of moderate to high levels of N (6–9 gN·m−2·year−1) impaired net photosynthesis, osmolyte accumulation and nitrate reductase activity. N addition and water regimes did not markedly change the N:P ratios of aboveground parts; while more biomass and nutrients were allocated to fine roots to assimilate the insufficient resources. Soluble protein in assimilating shoots might play a vital role in adaptation to the desert environment.

The response of C. mongolicum seedlings to N addtion and drought involved an interdependency between soluble protein and morphological, physiological and biochemical processes. These findings provide an important reference for vegetation restoration in arid lands under global change.