bluuebunny/crossref_metadata_2025 huggingface dataset:
Host‐related volatile cues used by a parasitoid wasp during foraging for its woodboring host
Authors: Fischbein D. , Villacide J.M. , López B. , Corley J.C. , Martínez A.S.
Published: October 2018

Parasitoids rely mainly on infochemicals to search for their herbivore hosts to oviposit on. Megarhyssa nortoni (Cresson) (Hymenoptera: Ichneumonidae) is a parasitoid of siricid wasp larvae which are concealed inside tree stems of several coniferous tree species. This parasitoid is used as a biological control agent against the global pine pest Sirex noctilio Fabricius (Hymenoptera: Siricidae), which engages in an obligate nutritional symbiosis with the fungus Amylostereum areolatum (Chaillet ex Fr.) Boidin (Russulales). We explore the chemical cues that could be used by M. nortoni females while foraging for hosts on the two pine species most commonly planted in commercial forests in Patagonia, Argentina, Pinus contorta Douglas ex Loudon var. latifolia Engelm. ex S Watson and Pinus ponderosa Douglas ex C Lawson (Pinaceae). Behavioural assays were conducted in an olfactometer and the following odour sources were tested in pairwise combinations: (1) P. contorta, (2) P. ponderosa, (3) P. contorta with host fungal symbiont, (4) P. ponderosa with host fungal symbiont, and (5) air (control). Megarhyssa nortoni females discriminated the odours of infested wood (host fungal symbiont‐pine complex) from those of healthy trees, irrespective of the pine species. Additionally, when offered both pine species infested with the fungal symbiont, the parasitoids displayed a bias towards P. contorta. Even though the identity of the compounds responsible for the behavioural bias towards the symbiont was not established at this stage, our findings emphasize the relevance of chemical information derived from the fungal symbiont‐pine complex during parasitoids that forage for woodboring insect hosts.
The arundo wasp, Tetramesa romana, does not control giant river reed, Arundo donax, in Texas, USA
Authors: Showler Allan T. , Osbrink Weste L.A.
Published: October 2018

Giant river reed, Arundo donax L. (Poaceae), native to the Mediterranean basin and east to the Indus River region of Afghanistan and Pakistan, has become widespread in temperate and subtropical regions worldwide. It is regarded as being deleterious for clogging waterways and for choking out natural riparian plant communities. In the USA efforts to control the pest have included the release of exotic herbivorous insects. One of them, the arundo wasp, Tetramesa romana Walker (Hymenoptera: Eurytomidae), has been reported to utilize primary A. donax stalks for oviposition, stunting and killing the plant. In our study, stands of A. donax in natural habitats of Kerr County (TX, USA) were sampled at monthly intervals for 2 years and small plots of A. donax at annual intervals for five consecutive years. Parasitism of stalks, regardless of plant age, was rare or non‐existent. Arundo donax in natural habitats and freshly planted A. donax grew in dense stands and proliferated regardless of being infested by T. romana. We determined that parasitized culms can serve as plant propagules by growing roots and stems, hence, the wasp does not impede the ability of A. donax to propagate and proliferate from broken off plant parts. The wasp utilizes A. donax culm stems growing from hardening ≥1st‐year stalks for development in the winter and early summer when the larvae pupate and emerge as adults. We found that appreciable T. romana parasitism of an A. donax plant only occurs for 8.3–16.7% of the plant's 2‐year lifespan. Adult exit holes remain on the culms during summer. Under field conditions T. romana is a parasite that is well‐adapted to A. donax by not killing stalks, reducing stand density, and hindering propagation. Hence, the exotic wasp is ineffective as a biological control agent against A. donax.
Overexpression of striatal D2 receptors reduces motivation thereby decreasing food anticipatory activity
Authors: LeSauter Joseph , Balsam Peter D. , Simpson Eleanor H. , Silver Rae
Published: October 2018

Dopamine has been implicated in circadian timing underlying the food entrainable oscillator (FEO) circuitry and overexpression of the dopamine D2 receptor (D2R) in the striatum has been reported to reduce motivation to obtain food rewards in operant tasks. In the present study, we explored both of these mechanisms by examining food anticipatory activity (FAA) in dopamine D2 receptor‐overexpressing (D2R‐OE) mice under various durations of food availability. First, we noted that at baseline, there were no differences between D2R‐OE mice and their littermates in activity level, food intake, and body weight or in circadian activity. Under conditions of very restricted food availability (4 or 6 hr), both genotypes displayed FAA. In contrast, under 8‐hr food availability, control mice showed FAA, but D2R‐OE mice did not. Normalization of D2R by administration of doxycycline, a tetracycline analogue, rescued FAA under 8‐hr restricted food. We next tested for circadian regulation of FAA. When given ad libitum access to food, neither D2R‐OE nor controls were active during the daytime. However, after an interval of food restriction, all mice showed elevated locomotor activity at the time of previous food availability in the day, indicating circadian timing of anticipatory activity. In summary, motivation is reduced in D2R‐OE mice but circadian timing behavior is not affected. We conclude that an increase in striatal D2R reduces FAA by modulating motivation and not by acting on a clock mechanism.
Detectability of stop‐signal determines magnitude of deceleration in saccade planning
Authors: Indrajeet Indrajeet , Ray Supriya
Published: October 2018

An inhibitory control is exerted when the context in which a movement has been planned changes abruptly making the impending movement inappropriate. Neurons in the frontal eye field and superior colliculus steadily increase activity before a saccadic eye movement, but cease the rise below a threshold when an impending saccade is withheld in response to an unexpected stop‐signal. This type of neural modulation has been majorly considered as an outcome of a race between preparatory and inhibitory processes ramping up to reach a decision criterion. An alternative model claims that the rate of saccade planning is diminished exclusively when the stop‐signal is detected within a stipulated period. However, due to a dearth of empirical evidence in support of the latter model, it remains unclear how the detectability of the stop‐signal influences saccade inhibition. In our study, human participants selected a visual target to look at by discriminating a go‐cue. Infrequently they cancelled saccade and reported whether they saw the stop‐signal. The go‐cue and stop‐signal both were embedded in a stream of irrelevant stimuli presented in rapid succession. Participants exhibited difficulty in detection of the stop‐signal when presented almost immediately after the go‐cue. We found a robust relationship between the detectability of the stop‐signal and the odds of saccade inhibition. Saccade latency increased exponentially with the maximum time available for processing the stop‐signal before gaze shifted. A model in which the stop‐signal onset spontaneously decelerated progressive saccade planning with the magnitude proportional to its detectability accounted for the data.
Diagnostic value of the 2017 McDonald criteria in patients with a first demyelinating event suggestive of relapsing–remitting multiple sclerosis
Authors: Lee D.‐H. , Peschke M. , Utz K. S. , Linker R. A.
Published: October 2018

Background and purpose

For the diagnosis of relapsing–remitting multiple sclerosis (RRMS), the revised 2017 McDonald criteria include cerebrospinal fluid specific oligoclonal bands as a new criterion for dissemination in time. Amongst other things, one expectation of the new criteria is to marginalize the diagnosis of clinically isolated syndrome (CIS), thus allowing for a faster and at the same time still reliable diagnosis of RRMS.

Methods

In this study, data from an unselected patient cohort with a typical CIS and dissemination in space at a large German Multiple Sclerosis Center from 2013 to 2016 were re‐analysed to compare differences in diagnosing RRMS with the 2017 versus 2010 McDonald criteria in everyday practice.

Results

Out of a cohort of 290 patients presenting with a typical first demyelinating event, 52% (152 patients) with the diagnosis of RRMS and 48% (138 patients) with the diagnosis of CIS according to the 2010 McDonald criteria were identified. The application of the 2017 McDonald criteria in the same patients increased the number of definite RRMS to 94% (273), thus leaving only 6% of patients with the diagnosis of CIS. The reason for this shift was the presence of cerebrospinal fluid specific oligoclonal bands which was found in 92.7% of the total population and in all patients with 2017 McDonald RRMS. Over a mean follow‐up of 1.5 years, 50% of patients formerly diagnosed with CIS who are now RRMS also fulfilled the 2010 McDonald criteria.

Conclusions

Our data support the use of the 2017 McDonald criteria for a more sensitive, but not that specific, diagnosis of RRMS in everyday practice.
Higher intake of medications for digestive disorders in children prenatally exposed to drugs with atropinic properties
Authors: Benevent Justine , Hurault‐Delarue Caroline , Araujo Mélanie , Montastruc François , Montastruc Jean‐Louis , Lacroix Isabelle , Damase‐Michel Christine
Published: October 2018

Childhood digestive disorders are a common occurrence and are sometimes unexplained. Maternal medication during the development of the foetus' digestive system may contribute to the increase in childhood digestive disorders, especially with drugs acting on the cholinergic system. This study investigated the association between prenatal exposure to drugs with atropinic properties and the use of digestive disorder medications in childhood (0–3 years). Children from POMME (PrescriptiOn Médicaments Mères Enfants), a French database of reimbursed drugs for pregnant women and their children, were included (N = 8 372). Each drug prescribed during antenatal life was assigned an atropinic score (0 = null, 1 = low, 3 = strong). The prenatal atropinic burden was calculated as the sum of atropinic scores of drugs prescribed. More than 30% (N = 2 652) of the children were prenatally exposed to atropinic drugs. They used significantly more digestive disorder medications than unexposed children (RRa = 1.11 [1.06; 1.16]). The strength of the association increased with the prenatal atropinic burden. Our results suggest long‐term digestive effects after prenatal exposure to atropinic drugs.
Shedding light on IRIS: from Pathophysiology to Treatment of Cryptococcal Meningitis and Immune Reconstitution Inflammatory Syndrome in HIV‐Infected Individuals
Authors: Balasko A , Keynan Y
Published: October 2018

Objectives

The aim of this work was to review current treatment options and propose alternatives for immune reconstitution inflammatory syndrome (IRIS) in HIV‐infected individuals with cryptococcal meningitis (CM) (termed ‘HIV‐CM IRIS’). As a consequence of the immunocompromised state of these individuals, the initial immune response to CM is predominantly type 2 T helper (Th2) /Th17 rather than Th1, leading to inefficient fungal clearance at the time of antiretroviral initiation, and a subsequent overexaggeration of the Th1 response and life‐threatening IRIS development.

Methods

An article‐based and clinical trial‐based search was conducted to investigate HIV‐CM IRIS pathophysiology and current treatment practices.

Results

Guidelines for CM treatment, based on the Cryptococcal Optimal Antiretroviral Timing (COAT) trial, recommend delayed antiretroviral therapy (ART) following antifungal treatment. The approach aims to decrease fungal burden and allow immune balance restoration prior to ART initiation. If the initial immune balance is not restored, the fungal burden is not sufficiently reduced and there is a risk of developing IRIS post‐ART, highlighted by a Th1 immune overcompensation, leading to increased mortality. The mainstay treatment for Th1‐biased IRIS is corticosteroids; however, this treatment has been shown to correlate with increased mortality and significant associated adverse events. We emphasize targeting a more specific Th1 mechanism via the tumour necrosis factor (TNF)‐α cytokine antagonist thalidomide, as it is the only TNF‐α antagonist currently approved for use in infectious disease settings and has been shown to decrease Th1 overreaction, restoring immune balance in HIV‐CM IRIS.

Conclusions

Although the side effects and limitations of thalidomide must be considered, it is currently being successfully used in infectious disease settings and warrants mainstream application as a therapeutic option for treatment of IRIS in HIV‐infected patients with CM.
Heterogeneity of virological suppression in the national antiretroviral programme of Cameroon (ANRS 12288 EVOLCAM)
Authors: Liégeois F , Eymard‐Duvernay S , Boyer S , Maradan G , Kouanfack C , Domyeum J , Boyer V , Mpoudi‐Ngolé E , Spire B , Delaporte E , Vidal L , Kuaban C , Laurent C ,   the EVOLCAM study group
Published: October 2018

Objectives

In terms of HIV infection, western and central Africa is the second most affected region world‐wide, and the gap between the regional figures for the testing and treatment cascade and the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90–90–90 targets is particularly worrying. We assessed the prevalence of virological suppression in patients routinely treated in 19 hospitals in Cameroon.

Methods

A cross‐sectional survey was performed in adult patients receiving antiretroviral therapy (ART) in the Centre and Littoral regions. The prevalences of virological suppression (<1000 HIV‐1 RNA copies/mL) were compared among all 19 hospitals using the χ2 test. Potential individual and health care‐related determinants of virological suppression were assessed using multivariate logistic regression models.

Results

A total of 1700 patients (74% women; median age 41 years; median time on ART 3.7 years) were included in the study. The prevalence of virological suppression was 82.4% overall (95% confidence interval 80.5–84.2%). It ranged from 57.1 to 97.4% according to the individual hospital (P < 0.001). After adjustment, virological suppression was associated with age, CD4 cell count at ART initiation, disclosure of HIV status to family members, interruption of ART for more than two consecutive days, and location of patient's residence and hospital (rural/urban). These factors did not explain the heterogeneity of virological suppression between the study hospitals (P < 0.001).

Conclusions

The overall prevalence of virological suppression was reassuring. Nevertheless, the heterogeneity of virological suppression among hospitals highlights that, in addition to programme‐level data, health facility‐level data are crucial in order to tailor the national AIDS programme's interventions with a view to achieving the third UNAIDS 90 target.
Influence of plant growth regulators on key‐coding genes expression associated with phytochemicals biosynthesis and antioxidant activity in soybean (Glycine max (L.) Merr) sprouts
Authors: Guo Xinbo , Wang Linzhen , Chang Xiaoxiao , Li Quan , Abbasi Arshad Mehmood
Published: October 2018

The present study was aimed to investigate the effect of plant growth regulators (PGRs) on phytochemicals biosynthesis and antioxidant activity in soybean sprouts. GmVTC2, GmDHAR and GmGLDH were investigated for the biosynthesis of vitamin C. GmPAL, GmCHS and GmIFS were investigated for the biosynthesis of phenolics, flavonoids and isoflavones. Our results revealed that 6‐benzylaminopurine (6‐BA) treatment significantly affected the expression levels of those major genes, followed by Gibberellin (GA3) and Naphthaleneacetic acid (NAA). Moreover, the highest levels of vitamin C, polyphenolics and antioxidant activity in 6‐BA and GA3 treated groups indicate the synergistic and antagonistic role of growth regulators in the biosynthesis of phytochemicals. Overall, 6‐BA seems the key contributor in genes’ expression involve in the biosynthesis secondary metabolites and their antioxidant activity. Therefore, it could be the most suitable option to enhance nutritional quantity and health benefits of soybean sprouts.
Microbiological, chemical and sensory aspects of bread supplemented with different percentages of the culinary mushroom Pleurotus eryngii in powder form
Authors: Gaglio Raimondo , Guarcello Rosa , Venturella Giuseppe , Palazzolo Eristanna , Francesca Nicola , Moschetti Giancarlo , Settanni Luca , Saporita Paola , Gargano Maria Letizia
Published: October 2018

Pleurotus eryngii (DC.) Quél. powder was used in bread production. Three dough trials (0, 5 and 10% of mushroom) were obtained with commercial baker's yeast. P. eryngii powder was first tested against several yeast species; 10% P. eryngii trial was characterised by the highest pH and total titratable acidity. P. eryngii did not influence negatively the fermentation process, since all trials reached yeast levels of 108 CFU g−1. Mushroom powder decreased bread height and softness, increased crust redness and crumb void fraction and cell density and, although the breads were scored diverse, the overall assessment was comparable. The final breads provided higher concentrations of thiamin, riboflavin and pantothenic acid than control breads and, mostly importantly, supplied biotin, cobalamin and cholecalciferol generally absent in wheat bread. P. eryngii can be cultivated on food residues. Thus, its inclusion in functional bread production represents an optimal strategy for the valorisation of food processing by‐products.
Effect of audiovisual distraction on the management of dental anxiety in children: A systematic review
Authors: Liu Yunkun , Gu Zhiyu , Wang Yan , Wu Qi , Chen Vivian , Xu Xin , Zhou Xuedong
Published: October 2018

Background

Audiovisual distraction, a non‐pharmacological intervention, has been used to manage dental anxiety in prior clinical trials.

Aim

Synthesize the available evidences to evaluate the efficacy of audiovisual distraction techniques on the management of dental anxiety in children.

Design

Electronic databases (PubMed, Cochrane Central Register of Controlled Trials, and Embase) were searched. We included randomized controlled trials (RCTs), and methodological quality of included trials was assessed using the Cochrane Collaboration's criteria. Information on reported anxiety, pain, behaviors, vital signs (including blood pressure, oxygen saturation, and pulse rate), and children satisfaction was analyzed.

Results

Nine studies were included for a systematic review, and none of them had low risk of bias. Significant differences in anxiety were found. According to the study, a majority of results indicated a significant difference in pain and behavior between the audiovisual and control group. Three studies reported children in the audiovisual group preferred usage of an audiovisual device for future dental visits. No significant differences could be found regarding blood pressure.

Conclusions

There is some low‐quality evidence suggesting that the usage of audiovisual distraction during dental treatment may relieve children's dental anxiety.
Climate suggests environment‐dependent selection on lizard colour morphs
Authors: Pérez i de Lanuza Guillem , Sillero Neftalí , Carretero Miguel Ángel
Published: October 2018

Aim

The maintenance of polymorphisms is often explained by sexual selection. However, natural selection may also constrain morphs to particular locations, causing geographical variation in morph diversity. In many well‐known polymorphic organisms in which the relevance of sexual selection on the maintenance of polymorphisms is widely supported, the role of environmental factors has been poorly studied. Here, we adopted a population‐level approach to assess the extent to which geographical variation in climate explains morph composition in a colour polymorphic lizard. We predict that rare morphs are more environmentally constrained than common morphs.

Location

Eastern Pyrenees, Western Europe.

Taxon

Podarcis muralis (Lacertidae). The species shows up to five discrete colour morphs: white (W), orange (O), white‐orange (WO), yellow (Y) and yellow‐orange (YO). Populations strongly vary in morph composition.

Methods

We modelled the realised niche of each morph and the whole species with Maxent, Bioclim, and Domain, considering 110 localities over a relatively small but environmentally heterogeneous area. Morph ranges were compared to identify differences among their realised niches and local morph frequencies were interpolated to detect intra‐morph geographical variations beyond the mere presence of morphs.

Results

Differences between morph distributions were mainly associated to temperature seasonality and annual precipitation. While W, O, and WO morphs were found along the whole environmental range of the species, Y and YO morphs were restricted to a subset of the environmental conditions suitable for the species, namely high temperature seasonality and relatively high precipitation. Local frequencies of common morphs also differ among localities, the W morph being more frequent at lower altitudes than the O and WO morphs, which are more locally abundant at higher altitudes.

Main conclusions

We found a remarkable geographical relationship between climate and local morph composition that suggests environmentally dependent selection acting in a different way on common and rare morphs, most likely in interaction with sexual selection.
Swallow (deglutition) syncope: An evaluation of swallowing‐induced heart rate and hemodynamic changes in affected patients and control subjects
Authors: Kohno Ritsuko , Adkisson Wayne O. , Detloff Barry L. S. , Sakaguchi Scott , Benditt David G.
Published: October 2018

Background

Syncope triggered by swallowing is a well‐known but uncommon condition that has been the focus of case reports but is otherwise largely unstudied. To better understand swallow syncope we examined heart rate (HR) and blood pressure (BP) changes during swallowing in clinically suspected swallow syncope patients and asymptomatic control subjects.

Methods

The study population comprised four individuals with a history suggesting swallow syncope (three men, 53 ± 14.9 years) and 15 (nine men, 46 ± 17.1 years, P = NS vs patients) asymptomatic volunteer control subjects. Studies in all individuals comprised noninvasive beat‐to‐beat HR and BP measurement during swallowing 150 mL of cold liquid while standing. Additional tests in swallow syncope patients included: active standing, Valsalva maneuver, carotid sinus massage (CSM), and head‐up tilt (HUT).

Results

Swallowing resulted in a greater decrease of both HR (−22 ± 22.1 vs −3 ± 11.7 beats/minute [bpm]; P = 0.045) and BP (−22 ± 17.4 vs − 2 ± 11.8; P = 0.036) in swallow syncope patients than in controls. Further, in swallow syncope patients the time to lowest HR and BP differed (9 ± 5.5 vs 19 ± 7.2 seconds; P = 0.02), suggesting that both cardioinhibitory (CI) and vasodepressor (VD) mechanisms are present but operate independently. Other autonomic studies were normal in swallow syncope patients except for CSM pause more than 3 seconds in two patients.

Conclusion

Swallow syncope is associated with transient and temporally independent CI and VD features, consistent with reflex syncope. Potentially, a swallowing test during autonomic evaluation may be useful to unmask relative magnitudes of CI and VD responses, thereby facilitating treatment strategy decisions.
Association between plasma homocysteine and hypertension: Results from a cross‐sectional and longitudinal analysis in Beijing’s adult population from 2012 to 2017
Authors: Tao Li‐Xin , Yang Kun , Wu Jie , Mahara Gehendra , Zhang Jie , Zhang Jing‐Bo , Ping Zhao , Guo Xiuhua
Published: October 2018

Plasma homocysteine (Hcy) levels are associated with elevated blood pressure. However, the causal association between Hcy levels and the risk of hypertension remains ambiguous. Taking the study design effect into consideration, this study aimed to investigate this issue through a cross‐sectional and longitudinal analysis. Data were obtained from the Beijing Health Management Cohort study, which conducted routine health check‐ups from 2012 to 2017. Multivariate logistic regression was used for the cross‐sectional analysis, and a quadratic inference function approach was performed for the longitudinal analysis. A total of 30 376 subjects (mean age = 50.0 years) were included in the cross‐sectional analysis, and a subgroup of 3913 subjects without hypertension at baseline was included in the longitudinal analysis. After adjusting for potential confounders, the risk of hypertension increased with Hcy levels in the cross‐sectional analysis using the traditional definition of hypertension (OR = 1.262, 95% CI: 1.155‐1.378, Q2 vs Q1; OR = 1.458, 95% CI: 1.335‐1.593, Q3 vs Q1; OR = 1.520, 95% CI: 1.388‐1.664, Q4 vs Q1) and the 2017 hypertension definition (OR = 1.159, 95% CI: 1.067‐1.259, Q2 vs Q1; OR = 1.328, 95% CI: 1.221‐1.445, Q3 vs Q1; OR = 1.328, 95% CI: 1.217‐1.449, Q4 vs Q1). The longitudinal analysis showed that hypertension risk increased in the third quartile of Hcy (OR = 1.268, 95% CI: 1.030‐1.560, Q3 vs Q1). Elevated total plasma Hcy may be used as a predictive biomarker for hypertension. Attention should be paid to gender‐specific mechanisms when issuing precise precautions.
Why Do Farm Animal Welfare Regulations Vary Between EU Member States? A Comparative Analysis of Societal and Party Political Determinants in France, Germany, Italy, Spain and the UK
Authors: Vogeler Colette S.
Published: October 2018

In the field of agricultural policy, farm animal welfare is gaining importance. At the European Union level, animal welfare policies have been developing since the 1970s. However, national regulations vary considerably between member states. The study provides a systematic comparison of farm animal welfare regulations in France, Germany, Italy, Spain and the UK and explores the factors that influence differences by applying theories from comparative policy analysis. Firstly, in four of the five countries the level of societal concern influences animal welfare policies. Secondly, a connection between the level of societal concern and the emphasis of political parties on farm animal welfare is identified. The findings contribute to the exploration of a hitherto under‐researched area in public policy, the field of farm animal welfare.
Meta‐analysis of randomized clinical trials comparing clinical and patient‐reported outcomes between extra‐short (≤6 mm) and longer (≥10 mm) implants
Authors: Ravidà Andrea , Wang I‐Ching , Barootchi Shayan , Askar Houssam , Tavelli Lorenzo , Gargallo‐Albiol Jordi , Wang Hom‐Lay
Published: October 2018

Aim

To compare the clinical outcomes of ≤6 mm extra‐short implants (test group) versus ≥10 mm long implants (control group), with and without bone augmentation procedures.

Materials and Methods

A systemic literature search of randomized clinical trials was performed using the PubMed (MEDLINE) and EMBASE databases. A quantitative meta‐analysis was conducted to compare all the outcome variables. Meta‐regression analysis determined the effect of bone augmentation procedures and the influence of other clinical covariates on the results.

Results

Eighteen studies comprising 1,612 implants (793 extra‐short and 820 long implants) were selected for the meta‐analysis. No statistically significant difference in the survival rate was observed at 1 and 3 years (p > 0.05). Extra‐short implants displayed less marginal bone loss (MBL) from both implant placement time points (1 and 3 years) and prosthetic placement (1 year), as well as less biological complications, surgical time and treatment cost (p < 0.05). Contrarily, a statistically significant small number of prosthetic complications were reported with long implants (p < 0.05).

Conclusions

Placement of extra‐short implants (≤6 mm) presented as an equivalent option in the treatment of patients with an atrophic posterior arch up to 3‐year follow‐up. However, the long‐term effectiveness of extra‐short dental implants remains to be further studied.
Periodontal disease and incident venous thromboembolism: The Atherosclerosis Risk in Communities study
Authors: Cowan Logan T. , Lakshminarayan Kamakshi , Lutsey Pamela L. , Folsom Aaron R. , Beck James , Offenbacher Steven , Pankow James S.
Published: October 2018

Aim

Periodontal disease is a cardiovascular disease (CVD) risk factor but few studies have considered the relationship between periodontal disease and venous thromboembolism (VTE). We hypothesized that periodontal disease is independently associated with increased risk of incident VTE.

Materials and methods

We used data from 8,092 participants of the Atherosclerosis Risk in Communities (ARIC) study to examine periodontal disease in 1996–1998 and incident VTE through 2011. Periodontal disease was determined using self‐reported tooth loss due to gum disease and dental examinations. Cox proportional hazards regression models were used to estimate hazard ratios for VTE and 95% confidence intervals adjusted for relevant confounders.

Results and conclusions

Participants were on average 62.7 years old at baseline and 13.9% self‐reported tooth loss from gum disease. Over a mean of 12.9 years of follow‐up, there were 313 incident VTE events. Self‐reported tooth loss due to gum disease was associated with 30% higher VTE risk (HR = 1.29 (0.96, 1.73) after adjusting demographic factors, SES, periodontal risk factors, oral hygiene, and access to dental care variables. No statistically significant associations between clinical measures of periodontitis and VTE were observed after adjustment. Further research is needed to elucidate whether a relationship between periodontal disease and VTE exists.
Dietary therapy and non‐surgical periodontal treatment in obese patients with chronic periodontitis
Authors: Martinez‐Herrera Mayte , López‐Domènech Sandra , Silvestre Francisco Javier , Silvestre‐Rangil Javier , Bañuls Celia , Hernández‐Mijares Antonio , Rocha Milagros
Published: October 2018

Aim

The effect of dietary weight loss intervention on periodontal therapy is unknown. Therefore, we aimed to evaluate whether weight loss improves the response of obese subjects to non‐surgical periodontal treatment.

Materials and methods

This interventional study in obese patients was conducted at the University Hospital Dr. Peset (Valencia, Spain). Patients were divided into two groups with and without dietary therapy. All participants received non‐surgical periodontal treatment. Periodontal, anthropometric and biochemical parameters were assessed at baseline and 12 weeks.

Results

A total of 78 patients were re‐evaluated after intervention. All periodontal parameters improved in both groups after periodontal treatment, but the reductions in mean probing depth (PD) (0.23 mm vs. 0.12 mm) and in percentage of sites with PD 4–5 mm (10.4% vs. 5.89%) were significantly higher in the dietary group. Additionally, complement component 3 (C3) and tumour necrosis factor alpha (TNFα) decreased in the dietary group after intervention. Percentage of change in mean PD correlated with change in C3 (r = 0.233, p = 0.043), and percentage of change in sites with PD 4–5 mm correlated with change in TNFα (r = 0.414, p = 0.012).

Conclusions

This study suggests that dietary weight loss intervention causes a greater reduction in systemic inflammation, which may enhance the response to periodontal treatment.
Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either collagen matrix or subepithelial connective tissue graft: A randomized clinical study
Authors: Pietruska Małgorzata , Skurska Anna , Podlewski Łukasz , Milewski Robert , Pietruski Jan
Published: October 2018

Aim

To compare outcomes of modified coronally advanced tunnel technique (MCAT) combined with either collagen matrix (CM) or subepithelial connective tissue graft (SCTG) in the treatment of Miller class I and II multiple gingival recessions in the mandible.

Materials and methods

The study encompassed 91 recessions in 29 patients for whom MCAT was combined with CM on one side of the mandible and SCTG on the contralateral one. The following clinical parameters were measured: gingival recession height (GR) and width (RW), probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (KT), gingival thickness (GT), mean (MRC) and complete root coverage (CRC) and Root Coverage Esthetic Score (RES).

Results

The MRC proportions on the CM‐ and SCTG‐treated sides were 53.20% and 83.10%, respectively. CRC was achieved in 9 out of 45 (20%) gingival defects treated with CM and 31 out of 46 (67%) treated with SCTG. There were statistically significant differences in MRC, CRC, GR, RW, KT, GT and RES between CM‐ and CTG‐treated sides.

Conclusions

Modified coronally advanced tunnel technique leads to reduction in gingival recession both when combined CM and SCTG, of which the latter is more efficient as far as root coverage and aesthetic parameters are concerned.
Periodontitis as a risk indicator and predictor of poor outcome for lacunar infarct
Authors: Leira Yago , Rodríguez‐Yáñez Manuel , Arias Susana , López‐Dequidt Iria , Campos Francisco , Sobrino Tomás , D'Aiuto Francesco , Castillo José , Blanco Juan
Published: October 2018

Aim

To investigate the association between periodontitis (PD) and lacunar infarct (LI) as well as to analyse whether PD could be a predictor of poor functional prognosis in patients with LI.

Material and Methods

Full‐mouth periodontal examination was done in 120 cases (patients with LI) and 157 healthy controls. Demographic, clinical, medical and neurological information were collected from all of them. In addition, a measure of periodontal inflammation and disease activity, namely the periodontal inflamed surface area (PISA), was also calculated for each patient. Poor functional outcome was considered as a modified Rankin Scale >2 at 3 months.

Results

PD was independently associated with the presence of LI (OR = 3.3, p < 0.001). Poor outcome was observed in 31 patients with LI (25.8%), of which 90.3% had PD. A PISA value ≥727 mm2 was an independent predictor of poor prognosis, after adjusting for clinical confounders (OR = 6.5, p = 0.001).

Conclusions

PD and LI were associated. Active moderate to severe PD predicted poor prognosis in patients with LI. Further evidence is warranted to confirm our results and investigate potential mechanisms behind this association.
Cost analysis of mobile radiography services for nursing home residents in Southeast Norway
Authors: Kjelle Elin , Kleven Linn , Olerud Hilde Merete , Melberg Hans Olav
Published: October 2018

Rationale, aims, and objective

Telemedicine applications, such as a mobile radiography service, provide a new way of organizing healthcare services. In order to provide safe and personalised care for nursing home residents during X‐ray examinations, mobile radiography services have been implemented. The objective of this study was to analyse the costs of X‐ray examinations and treatments for nursing home residents when comparing hospital‐based imaging with a combination of hospital‐based imaging and a mobile radiography service in Southeast Norway.

Methods

A decision model was developed using the software TreeAge Pro. The model included two alternatives: the mobile radiography service in combination with hospital‐based imaging and hospital‐based imaging alone. The treatment needed based on the examination results could be given either in the nursing home or at the hospital. Probabilities and costs in the model were derived from previous research, various reports, and hospital data from the Southeast region of Norway. Monte Carlo simulations of 1000 residents were run through the model, and statistical analyses were applied.

Results

The analysis showed a mean cost of €2790 per resident for the hospital‐based service alone. For mobile and hospital‐based services combined, the mean cost was €1946 per resident, including examinations and the immediate treatment given. This difference in costs was significant (p < 0.001).

Conclusion

A mobile radiography service in nursing homes provides a safe, high quality health care service. The result of this study showed there was a 30% cost‐reduction by implementing the mobile radiography service
What Is a Falls Risk Factor? Factors Associated with Falls per Time or per Step in Individuals with Glaucoma
Authors: Ramulu Pradeep Y. , Mihailovic Aleksandra , West Sheila K. , Friedman David S. , Gitlin Laura N.
Published: October 2018

Objectives

To determine whether visual field (VF) damage or other factors confer a similar risk of falling when falls are ascertained as a rate over time (falls/year) as when ascertained over activity (falls/step).

Design

Prospective, observational cohort study.

Setting

Clinic‐based recruitment with real‐world monitoring of falls and physical activity.

Particpants

Individuals with glaucoma or suspected glaucoma (N=230).

Measurements

Participants recorded falls using daily calendars, with injuries identified in a follow‐up questionnaire. Annual 1‐week accelerometer trials were used to estimate steps. VF results from both eyes were merged to determine integrated VF sensitivity, with lower sensitivity indicating greater VF damage. Other potential risk factors for falls (age, sex, race, comorbid illness, polypharmacy) were determined using questionnaires.

Results

The cumulative probability of falls was 45.2% at 12 months and 61.6% at 24 months; cumulative probability of injurious falls was 23.3% at 12 months and 40.0% at 24 months. Greater VF damage was associated with higher rates of falls/steps (incident rate ratio = 1.40/5 dB decrement in sensitivity; p = .004) but not with more falls/year (incident rate ratio = 1.25/5 dB decrement in sensitivity; p = .07). Several additional variables (older age, female sex, more comorbid disease) were also associated with a higher rate of falls/step (p < .02 for all) but not with falls/year (p > 0.10). Black participants had fewer falls/year than whites (p = .002) but did not differ in falls/step (p = .07). Similar results were obtained when injurious falls were analyzed.

Conclusions

Risk factors associated with frequent falls when walking (falls/step) are not properly identified when analyzing falls as a rate over time (falls/year). Given the clinical importance of preventing falls while preserving physical activity, falls assessment integrated with activity measurement is recommended when determining whether a risk factor is associated with falls. J Am Geriatr Soc 67:87–92, 2019.
Thirty years of neuroendocrinology: Technological advances pave the way for molecular discovery
Authors: Stubbs Felicity E. , Conway‐Campbell Becky L. , Lightman Stafford L.
Published: October 2018

Since the 1950s, the systems level interactions between the hypothalamus, pituitary and end organs such as the adrenal, thyroid and gonads have been well known; however, it is only over the last three decades that advances in molecular biology and information technology have provided a tremendous expansion of knowledge at the molecular level. Neuroendocrinology has benefitted from developments in molecular genetics, epigenetics and epigenomics, and most recently optogenetics and pharmacogenetics. This has enabled a new understanding of gene regulation, transcription, translation and post‐translational regulation, which should help direct the development of drugs to treat neuroendocrine‐related diseases.
Interaction between angiotensin II and glucose sensing at the subfornical organ
Authors: Paes‐Leme Bruno , Dos‐Santos Raoni C. , Mecawi André S. , Ferguson Alastair V.
Published: October 2018

The subfornical organ (SFO) lacks the normal blood‐brain barrier and senses the concentrations of many different circulating signals, including glucose and angiotensin II (ANG II). ANG II has recently been implicated in the control of food intake and body weight gain. The present study assessed whether single SFO neurones sense changes in glucose and ANG II, and also whether changes in glucose concentration alter the responsiveness of these neurones to ANG II. SFO neurones dissociated from male Sprague‐Dawley rats (100‐175 g) were used. We first examined whether glucose concentration modulates AT1 receptor expression. Similar AT1a mRNA expression levels were found at glucose concentrations of 1, 5 and 10 mmol L‐1 in dissociated SFO neurones. Glucose responsiveness of SFO neurones was assessed using perforated current‐clamp recordings and switching between 5 and 10 mmol L‐1 glucose artificial cerebrospinal fluid to classify single neurones as nonresponsive (nGS), glucose‐excited (GE) or glucose‐inhibited (GI). In total, 26.7% of the SFO neurones were GI (n = 24 of 90), 21.1% were GE (n = 19 of 90) and 52.2% were nGS (n = 47 of 90). Once classified, the effects of 10 nmol L‐1 ANG II on the excitability of these neurones were tested, with 52% of GE (n = 10 of 19), 71% of GI (n = 17 of 24) and 43% of nGS (n = 20 of 47) neurones being ANG II sensitive. Finally, we tested whether acute changes in glucose concentration modified the response to ANG II and showed that some neurones (4/17) only respond to ANG II at 10 mmol L‐1 glucose. Our data demonstrate that the same SFO neurone can sense glucose and ANG II and that acute changes in glucose concentration may change ANG II responsiveness.
Use of calcium hydroxylapatite in the upper third of the face: Retrospective analysis of techniques, dilutions and adverse events
Authors: Van Loghem Jani A. J.
Published: October 2018

Calcium hydroxylapatite (CaHA) is a commonly used soft tissue filler for aesthetic facial improvement, in particular for the lower and mid‐face. The golden standard for upper facial filler indications is hyaluronic acid (HA) injection. In this report we investigate the safety, efficacy and complication rates after injections of CaHA to the upper third of the face using a variety of different techniques. This was a retrospective analysis performed on patients who had received CaHA in 2016 and 2017 at various dilutions in the upper third of the face (frontal area, eyebrows and temporal hollows) using a number of injection techniques and both blunt‐tipped cannulas as well as sharp needles. Records of adverse events and side effects were studied. Seventy patients had been injected with CaHA in the upper third of the face. There were 36 treatments to the frontal area, most with a cannula in the subgaleal space with standard dilution of CaHA (16.7% lidocaine containing epinephrine). There were 13 treatments to the brow, mostly with a cannula and multilevel technique, and 66 treatments to the temporal hollows, mostly with a cannula in the interfascial space with standard CaHA dilution. No serious complications were recorded. CaHA was effective and well‐tolerated for a range of upper‐face indications. More (prospective) research is required to further determine the value of CaHA treatments in these areas.
Exploring the early‐stage implementation of a patient engagement support intervention in an integrated‐care context—A qualitative study of a participatory process
Authors: Menichetti Julia , Pitacco Giuliana , Graffigna Guendalina
Published: October 2018

Aims and objectives

To explore: (a) the usual patient education in different care services of an integrated‐care organisation, (b) the healthcare professionals’ experiences with adding a patient engagement support intervention called PHEinAction in the patient education practice and (c) the co‐designed activities to assist the implementation.

Background

Including individual support for engaging patients in care into patient education practice is a key effort of integrated‐care organisations. However, there is a paucity of studies exploring the implementation of similar efforts.

Design and methods

We conducted a qualitative study of a participatory process with 26 healthcare professionals—mostly nurses (n = 22) with leading roles (n = 12)—of different care services in one Italian integrated‐care organisation. Data were collected through multiple sources (observations and shadowing; interviews; documents/artefacts; workshops) during the first 6 months of the implementation of PHEinAction. A thematic analysis using a hybrid approach was performed. COREQ guidelines were followed.

Results

The existing patient education practice of hospital, ambulatory and community healthcare services of the organisation differed in contents, perceived responsibility and focus area. These key aspects of patient education influenced the healthcare professionals’ experiences with the implementation. The experiences informed the activities enacted during the participatory process to assist the implementation, from the co‐creation of artefacts to the deployment of peer group supervision.

Conclusion

The implementation of a brief intervention for patient engagement support required a process of adjustment to the single settings and a continuous support to healthcare professionals. It also required performing complementary activities to assist the implementation and its adoption in new care services.

Relevance to clinical practice

This qualitative study contributes to the understanding of the pitfalls and strategies that may surround embedding patient engagement support in the educational practice of complex organisations, potentially facilitating the deployment to other care settings.
Self‐awareness in nursing: A scoping review
Authors: Rasheed Subia P. , Younas Ahtisham , Sundus Amara
Published: October 2018

Aims and objectives

To outline and examine the literature about self‐awareness in nursing and to identify areas for future research and practice.

Background

Self‐awareness is important for the personal and professional development of nurses, for developing an effective nurse–patient relationship and for improving nursing abilities. Despite its importance in nursing and therapeutic nurse–patient relationship and its evolving nature, the knowledge base for self‐awareness in nursing remains under‐examined.

Design

A scoping review using PRISMA guidelines.

Methods

A five‐step approach: (a) identification of research question; (b) identification of relevant studies using a three‐step search: keywords search within PubMed and CINAHL, literature search within PubMed, CINAHL, ERIC, PsycINFO, Science Direct and Google Scholar, and literature search of references lists; (c) study selection; (d) data extraction and charting; (e) data collation, summarisation and reporting, was used.

Findings

Of 1,531 identified sources, 76 full‐text sources were read and 29 English language sources, published from January 1980 until January 2018, which included nurses or nursing students, were reviewed. Two themes: perspectives on self‐awareness and strategies for enhancing self‐awareness emerged. Under these themes, conceptualisation of self‐awareness; its antecedents and value; and theory‐based, educational and personal strategies for its enhancement were described. There is sufficient literature regarding self‐awareness conceptualisation and theory‐based strategies for its enhancement, but inconclusive evidence regarding value of self‐awareness, and educational and personal strategies for its improvement.

Conclusion

There is limited research on self‐awareness. Most of the literature comprises of theoretical discussions and opinions which adequately provide a conceptual understanding of self‐awareness. However, more empirical and applied research is needed to apply the available theoretical knowledge in practice.

Relevance to clinical practice

This review delineated theoretical, educational and personal strategies for nurses to improve their self‐awareness and indicated that engagement in self‐awareness at relational and contextual levels is essential for developing nurse–patient relationship.