bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of family characteristics with perceptions of care among parents of children with autism
Authors: Sobotka S. A. , Francis A. , Vander Ploeg Booth K.
Published: October 2015

Background

Although autism spectrum disorder (ASD) is an increasingly common chronic disability, primary care provider (PCPs) report deficits in providing primary care for children with ASD, and parents report lapses in receipt of medical home services. In this study, we describe parental experiences with specific medical home components for their children with ASD.

Methods

We analysed data from all children within the National Survey of Children with Special Health Care Needs database with ASD and a usual place for care (n = 2859). We evaluated the receipt of core medical home components: accessible, comprehensive, coordinated, family centred and compassionate and culturally sensitive care.

Results

Children were mean age 10.1 years, and respondents were 75% mothers and 95% reported having a primary care provider (PCP). Seventy‐one percent reported care to be usually comprehensive, over three‐fourths of respondents reported care to be family centred and compassionate and 87% reported care to be culturally sensitive. Of the parents who reported a need for care coordination (n = 1049), only 14% of parents reported usually getting the help they needed. More educated, English‐speaking, non‐Hispanic White mothers of older children supported by private insurance were more likely to report never getting as much help coordinating care as desired. Coordination with education services are especially important for children with ASD, yet 27% of parents reported dissatisfaction with PCPs' communication with schools or early intervention.

Conclusion

Although parents report a high level of access to PCPs and places for care as well as receiving most core components of the medical home, care coordination activities are lacking for children with ASD. More resourced families are particularly likely to report unmet needs.
Cross‐cultural equivalence in translations of the oral health impact profile
Authors: MacEntee Michael I. , Brondani Mario
Published: October 2015

The Oral Health Impact Profile (OHIP) has been translated for comparisons across cultural boundaries. This report on a systematic search of literature published between 1994 and 2014 aims to identify an acceptable method of translating psychometric instruments for cross‐cultural equivalence, and how they were used to translate the OHIP. An electronic search used the keywords ‘cultural adaptation’, ‘validation’, ‘Oral Health Impact Profile’ and ‘OHIP’ in MEDLINE and EMBASE databases supplemented by reference links and grey literature. It included papers on methods of cross‐cultural translation and translations of the OHIP for dentulous adults and adolescents, and excluded papers without translational details or limited to specific disorders. The search identified eight steps to cross‐cultural equivalence, and 36 (plus three supplemental) translations of the OHIP. The steps involve assessment of (i) forward/backward translation by committee, (ii) constructs, (iii) item interpretations, (iv) interval scales, (v) convergent validity, (vi) discriminant validity, (vii) responsiveness to clinical change and (viii) pilot tests. Most (>60%) of the translations involved forward/backward translation by committee, item interpretations, interval scales, convergence, discrimination and pilot tests, but fewer assessed the underlying theory (47%) or responsiveness to clinical change (28%). An acceptable method for translating quality of life‐related psychometric instruments for cross‐cultural equivalence has eight procedural steps, and most of the 36 OHIP translations involved at least five of the steps. Only translations to Saudi Arabian Arabic, Chinese Mandarin, German and Japanese used all eight steps to claim cultural equivalence with the original OHIP.
Features of autosomal recessive non‐syndromic hearing impairment: a review to serve as a reference
Authors: Oonk A.M.M. , Huygen P.L.M. , Kunst H.P.M. , Kremer H. , Pennings R.J.E.
Published: October 2015

Objective

Non‐syndromic sensorineural hearing impairment is inherited in an autosomal recessive fashion in 75–85% of cases. To date, 61 genes with this type of inheritance have been identified as related to hearing impairment, and the genetic heterogeneity is accompanied by a large variety of clinical characteristics.

Adequate counselling on a patient's hearing prognosis and rehabilitation is part of the diagnosis on the genetic cause of hearing impairment and, in addition, is important for the psychological well‐being of the patient.

Type of review

Traditional literature review.

Data source

All articles describing clinical characteristics of the audiovestibular phenotypes of identified genes and related loci have been reviewed.

Conclusion

This review aims to serve as a summary and a reference for counselling purposes when a causative gene has been identified in a patient with a non‐syndromic autosomal recessively inherited sensorineural hearing impairment.
Exploiting Listener Gaze to Improve Situated Communication in Dynamic Virtual Environments
Authors: Garoufi Konstantina , Staudte Maria , Koller Alexander , Crocker Matthew W.
Published: October 2015

Beyond the observation that both speakers and listeners rapidly inspect the visual targets of referring expressions, it has been argued that such gaze may constitute part of the communicative signal. In this study, we investigate whether a speaker may, in principle, exploit listener gaze to improve communicative success. In the context of a virtual environment where listeners follow computer‐generated instructions, we provide two kinds of support for this claim. First, we show that listener gaze provides a reliable real‐time index of understanding even in dynamic and complex environments, and on a per‐utterance basis. Second, we show that a language generation system that uses listener gaze to provide rapid feedback improves overall task performance in comparison with two systems that do not use gaze. Aside from demonstrating the utility of listener gaze in situated communication, our findings open the door to new methods for developing and evaluating multi‐modal models of situated interaction.
The influence of comorbidities on mortality in sarcoidosis: a observational prospective cohort study
Authors: Nowiński Adam , Puścińska Elzbieta , Goljan Anna , Peradzynska Joanna , Bednarek Michal , Korzybski Damian , Kamiński Dariusz , Stokłosa Anna , Czystowska Monika , Śliwiński Pawel , Górecka Dorota
Published: October 2015

Aim

The aim of this study was to identify the frequency and prevalence of comorbidities in sarcoid patients and to assess their influence on overall mortality in the cohort of patients with sarcoidosis.

Materials and methods

A cohort of 557 patients with histologically confirmed sarcoidosis diagnosed between 2007 and 2011 and a group of non‐sarcoid controls were observed. All patients were carefully observed for comorbidities and mortality.

Results

291 males (52.2%) and 266 females (47.8%) with mean age 48.4 ± 12.0 years in sarcoidosis group and a group of 100 controls with mean age (49.25 ± 10.3) were observed. The mean number of comorbidities in both groups was similar (0.9 ± 0.99 vs 0.81 ± 0.84 NS). The frequency of thyroid disease was significantly higher in sarcoidosis group comparing to controls at the time of diagnosis (OR = 3.62 P = 0.0144). During the observation period (median 58.0 months), 16 patients died (2.9%). The mean number of comorbidities was significantly higher in the groups of non‐survivors as compared to survivors (2.8 ± 1.0, vs 0.8 ± 0.9), P < 0.0001.

Conclusion

The comorbidity burden has strong impact on mortality in sarcoidosis. Thyroid diseases are more frequent in sarcoidosis than in non‐sarcoid controls.
Use of polarized light microscopy is essential in the efficient diagnosis of respiratory amyloidosis and could decrease disease prevalence
Authors: Ma Dedong , Lu Hongxiu , Zhang Cuijuan , Ying Yangyang , Xiao Wei
Published: October 2015

Introduction

Primary tracheobronchial amyloidosis (TBA) is a rare disease of unknown etiology, with a high misdiagnosis rate. The current gold standard diagnostic criteria require double‐positive results for Congo red staining and polarized light microscopy examination.

Objectives

The aim of the present report was to examine the diagnostic value of polarized light microscopy in TBA diagnosis in China.

Methods

Thirteen cases from the Shandong University Qilu Hospital were reviewed. Polarized light microscopic examination was conducted after searching for cases with positive Congo red staining.

Results

Among the 13 patients, eight displayed yellow–green birefringence body with polarized light microscopic examination. This result indicated a false‐positive rate of 38.5% with Congo red staining used as the single criteria for TBA diagnosis. After reviewing the Chinese literature and selecting 104 reported cases of TBA in China, we found that diagnosis with the gold standard was confirmed in <30% patients, which may lead to misdiagnosis and delayed treatment.

Conclusion

The universal use of polarized light microscopy in China is currently limited, and there is a big gap from the international diagnosis standards. There is a need to include polarized light microscopy in routine TBA diagnosis to reduce the misdiagnosis rate, and achieve optimal treatment.
Acute severe asthma with thyroid crisis and myasthenia: a case report and literature review
Authors: Gong Pi‐Hua , Dong Xiao‐Song , Li Chun , Bao Jing , Cao Zhao‐Long , Yuan Yun , Zheng Ya‐Li , Gao Zhan‐Cheng
Published: October 2015

Background and Aims: Acute severe asthma, thyroid crisis and acute myasthenia are all medical emergencies that rarely coexistent. Here, we report a young man with severe asthma attack, necessitate invasive mechanical ventilation at the onset, followed by thyroid crisis, rhabdomyolysis, acute kidney injury, thrombocytopenia and progressive myasthenia. The aim of this study is to better understand the relationships among severe asthma, autoimmune thyroiditis and myasthenia.

Methods: The case was presented and former literatures were reviewed.

Results: This is the first case report of a young patient presented with severe asthma and autoimmune thyroiditis, followed by thyroid storm, multiple organ dysfunction and myasthenia. Neither conventional treatment for asthma or thyroid storm was effective separately. The patient's clinical condition did not improve until after plasmapheresis.

Conclusion: Here, we highlighted both the importance of early recognition of thyroid storm and prompt therapies, which likely attenuated organ dysfunction and enabled this patient to recover from the life‐threatening attack. Asthmatic patients should be closely controlled when suspected of thyroid disorders, especially those with high levels of anti‐thyroid antibodies irrespective of thyroid hormones concentrations.
Substance use, health status and service utilisation of older clients attending specialist drug and alcohol services
Authors: Lintzeris Nicholas , Rivas Consuelo , Monds Lauren A. , Leung Stefanie , Withall Adrienne , Draper Brian
Published: October 2015

Introduction and Aims

The number of older clients attending drug and alcohol (D&A) services is increasing, although there is insufficient knowledge regarding service needs for this group. The aim of this study was to document the patterns of substance use, health status, cognition, social conditions, and health service utilisation of older clients in D&A treatment.

Design and Methods

A cross‐sectional observational study of 99 clients aged ≥50 years (M = 55, SD = 4.5; 77% male) attending specialist D&A services (N = 30 alcohol treatment, N = 69 opioid treatment) in Sydney, Australia. Participants completed a confidential research interview. Findings were compared to aggregated data from younger opioid substitution treatment (OST) clients attending the same services (N = 214).

Results

Alcohol (46%), benzodiazepines (40%) and cannabis (38%) were the most commonly reported substances used in the past 4 weeks; 23% reported no recent substance use, and 17% reported using three or more drugs. Participants reported high levels of physical and mental health problems, social isolation, low levels of employment, and a third reported difficulties with daily living activities. Forty percent had been injured in a fall in the past 12 months. The mean Addenbrooke's Cognitive Examination‐R score was 82.4 ± 9.6, with 40% performing at a level consistent with severe cognitive impairment. A significantly higher proportion of older participants used alcohol and benzodiazepines than younger clients, and older participants had significantly poorer psychological health, physical health and quality of life.

Discussion and Conclusions

D&A services will require strategies to address the complex physical, mental, cognitive and social problems of older clients. [Lintzeris N, Rivas C, Monds LA, Leung S, Withall A, Draper B. Substance use, health status and service utilisation of older clients attending specialist drug and alcohol services. Drug Alcohol Rev 2016;35:223–31]
Opening Pandora's bait box: a potent vector for biological invasions of live marine species
Authors: Fowler Amy E. , Blakeslee April M. H. , Canning‐Clode João , Repetto Michele F. , Phillip Anne M. , Carlton James T. , Moser Fredrika C. , Ruiz Gregory M. , Miller A. Whitman
Published: October 2015

Aim

For over 80 years, the Maine baitworm trade has shipped live polychaete worms and packing algae ‘wormweed’ to distributors world‐wide, while also consistently transferring a wide diversity and abundance of hitchhiking organisms of all life stages to numerous recipient communities. Here, we investigate this potent, yet underestimated, invasion vector using an important recipient region (the Mid‐Atlantic) to examine the stepwise species transfer and survival along four stages of the vector.

Location

Maine and Mid‐Atlantic region (New Jersey, Delaware, Maryland, Virginia and North Carolina), USA.

Methods

We quantified taxonomic identities and abundances of organisms associated with packing algae at four stages along the vector pathway during summer 2011: (1) Maine source habitats; (2) bait boxes from Maine distributors; (3) bait boxes from distributors in five Mid‐Atlantic States; and (4) bait bags from retailers in five Mid‐Atlantic States. We also examined functional diversity based on significant physical and life history characteristics and assessed genetic diversity for two common hitchhiking snail species.

Results

We identified 17,798 live macro‐organisms across 58 taxa, including marine macro‐invertebrates, macroalgae, vascular plants and semi‐terrestrial or aquatic invertebrates, present in bait boxes and bags. In all measures of diversity and abundance, we observed decreases of live marine macro‐invertebrates across sequential stages of the vector from source to recipient regions. Significant differences in community composition were also observed between stages and were driven by isopods (taxonomic diversity) and isopods, amphipods and some gastropods (functional diversity).

Main conclusions

The lack of management in the face of the sheer magnitude and diversity of organisms that are transported via the live marine bait trade underscores how this is an underappreciated vector that could be a considerable source of successful invasions globally.
The unpredictable characteristics of the localities where new Iberian species will be discovered
Authors: Payo‐Payo Ana , Lobo Jorge M.
Published: October 2015

Aim

To describe patterns in new species descriptions, examine the spatial distribution and the associated environmental conditions of the localities with newly discovered species, as well as to assess whether protected areas encompass the majority of the occurrences of undescribed species.

Location

Ibero‐Balear region.

Methods

After an exhaustive literature review, the temporal and spatial patterns of the terrestrial animal species described in the Ibero‐Balear region from 1994 to 2012 were mapped. Both linear and asymptotic functions were used to compare the rates of discovered species using Akaike weights. Generalized Linear Models were used to estimate the explanatory capacity of a large set of environmental, land use and distance variables on the presence–absence of newly discovered species and on the variation in the number of new discoveries.

Results

The average annual description rate was 112 species; 99% of the species descriptions were invertebrates. Adjusted discovery curves suggest that we still have an incomplete animal inventory. Environmental variables possess a limited capacity to predict the characteristics of the localities where new species are discovered (≈ 12%).

Main conclusions

Our results indicate that it is not possible to provide an advanced estimation of the environmental and land use characteristics of the Ibero‐Balear regions in which new species will be discovered in the future. Current protected areas are not guaranteed to conserve these undiscovered species, and non‐protected areas should also be considered important reservoirs of unknown biodiversity.
Effects of interventions promoting monitoring of medication use and brief messaging on medication adherence for people with Type 2 diabetes: a systematic review of randomized trials
Authors: Farmer A. J. , McSharry J. , Rowbotham S. , McGowan L. , Ricci‐Cabello I. , French D. P.
Published: October 2015

Aims

To assess the impact of interventions promoting the monitoring of medication use and brief messaging to support medication adherence in patients with Type 2 diabetes mellitus, and to investigate the extent of theory use to guide intervention development.

Methods

We systematically searched for controlled trials, published from 1990 onwards in Medline, Embase, CINAHL, PsycINFO and the Cochrane library, that evaluated interventions based on monitoring and brief messaging to support medication adherence in patients with Type 2 diabetes, to examine the effectiveness of such interventions.

Results

A total of 11 trials, comparing 15 interventions, were identified. Only a small minority presented a low risk of bias. Three interventions were based on delivering brief messages, six were based on monitoring medication adherence, and six used both strategies. Messaging interventions included the use of short message service text messages, web‐based feedback, and messages delivered through monitoring devices. Monitoring interventions included remote self‐reporting of medication and telephone calls with healthcare staff. Improvements in medication adherence were observed in six interventions, although effect sizes were generally moderate. Only two interventions improved both adherence and clinical outcomes. A meta‐analysis of five trials (eight interventions) combining monitoring and messaging strategies showed that the pooled difference in medication adherence between intervention and control was moderate and not statistically significant [standardized mean difference = 0.22 (95% CI −0.05; 0.49)]. Only four trials were based on explicit theoretical frameworks.

Conclusions

Although interventions based on messaging and monitoring have the potential to improve medication adherence in patients with Type 2 diabetes, evidence of their efficacy is limited and additional high‐quality, theory‐based research is needed.
Use of continuous glucose monitoring in patients with diabetes on peritoneal dialysis: poor correlation with HbA1c and high incidence of hypoglycaemia
Authors: Oei E. , Samad N. , Visser A. , Chowdhury T. A. , Fan S. L.
Published: October 2015

Background

Achieving adequate glycaemic control in patients with diabetes on peritoneal dialysis is challenging. Traditional assessment of glycaemia using HbA1c is difficult in such patients because of renal anaemia or carbamylation of haemoglobin, and significant glucose excursions may be masked. We describe three patients with diabetes on peritoneal dialysis with similar HbA1c levels, but with very different glucose profiles shown on continuous glucose monitoring.

Case reports

Patient 1 was treated with gliclazide, and had a number of solutions with high glucose concentration in his dialysis prescription. Continuous glucose monitoring showed glucose levels > 11 mmol/l for > 17 h per day, and < 4 mmol/l for 72 min per day with no symptoms. His HbA1c level was 61 mmol/mol (7.7%). Patient 2 was treated with insulin. Continuous glucose monitoring showed glucose levels > 11 mmol/mol for 3.8 h per day, and < 4 mmol/mol for 3.8 h per day. His HbA1c level was 59 mmol/mol (7.6%). Patient 3 was treated with pioglitazone and gliclazide, and glucose levels were > 11 mmol/l for 8 h per day and < 4 mmol/l for 1.6 h per day. His HbA1c was 62 mmol/mol (7.8%). None of the patients was aware of hypoglycaemia during the periods of low glucose recorded on continuous glucose monitoring.

Conclusion

Despite similar HbA1c levels, our three patients had very different glucose profiles. These cases highlight the fact that HbA1c is frequently inadequate in reflecting glucose control in patients with diabetes on peritoneal dialysis, and we suggest that intermittent continuous glucose monitoring may allow safer management of glycaemia in such patients.
Psychological morbidity among young adults attending primary care: a retrospective study
Authors: Hickey Louise , Hannigan Ailish , O'Regan Andrew , Khalil Sherif , Meagher David , Cullen Walter
Published: October 2015

Aim

Currently, Ireland has the fourth highest rate of youth suicide in the European Union with psychological morbidity ranging from 21% to 27% in young adults. Primary care is ideally situated to address mental health problems and provide direction and support to young adults. This study investigates the prevalence and management of young adults aged 18–25 presenting to their general practitioner with a psychological problem as part of a larger study on all adults.

Methods

A random sample of 100 patients aged 18 and over with a consultation in the previous 2 years was selected from the practice management systems of 40 general practices in Ireland. Clinical records of active patients (excluding temporary visitors to the practice) were examined using a standardized reporting tool to extract information on demographics, prevalence, diagnoses and treatments for psychological problems.

Results

Of the 3845 active patients sampled aged 18 and over, 479 were in the target age group of 18–25. Of the 479 young adults identified (51% female, 60% fee paying), 57 (12%, 95% CI: 9–15%) had a documented psychological problem within the previous 2 years. Those with psychological problems were more likely to be frequent attenders and eligible for free medical care. Depression (23%) and stress and anxiety (23%) were most commonly identified.

Conclusions

The estimated prevalence rate is considerably lower than previous studies which may indicate reluctance among young adults in presenting to primary care or reflect under‐identification of psychological problems. Given the high rate of prescribing, enhancing access to non‐pharmacological treatments in primary care is a priority.
Evaluation of verbal list learning as a predictor of psychosis
Authors: Lindgren Maija , Manninen Marko , Kalska Hely , Mustonen Ulla , Laajasalo Taina , Moilanen Kari , Huttunen Matti O. , Cannon Tyrone D. , Therman Sebastian , Suvisaari Jaana
Published: October 2015

Aim

We explored whether cognitive performance, and verbal learning in particular, predicts psychosis or psychiatric hospitalizations among unselected first‐admission adolescent patients in general psychiatric care.

Methods

Up to 152 adolescents aged 15–18 were interviewed with the SIPS, tested with a cognitive test battery in the beginning of their psychiatric treatment, and followed for a maximum of 9 years (median 4.5 years).

Results

The composite factors of processing speed, verbal performance and visuospatial performance did not predict psychosis (n = 7) or all‐cause psychiatric hospitalizations (n = 26) beyond psychosis risk symptoms. However, those who developed psychosis performed worse on California Verbal Learning Test (CVLT) compared to other adolescents. Lower scores of CVLT immediate recall predicted psychosis (P = .003, HR = 1.13 per CVLT point decrease). However, when general verbal ability was adjusted for, CVLT did not reach significance.

Conclusions

Impaired verbal list learning may predict psychosis also among adolescent psychiatric patients not preselected for psychosis risk suspicion.
Relating belowground microbial composition to the taxonomic, phylogenetic, and functional trait distributions of trees in a tropical forest
Authors: Barberán Albert , McGuire Krista L. , Wolf Jeffrey A. , Jones F. Andrew , Wright Stuart Joseph , Turner Benjamin L. , Essene Adam , Hubbell Stephen P. , Faircloth Brant C. , Fierer Noah
Published: October 2015

The complexities of the relationships between plant and soil microbial communities remain unresolved. We determined the associations between plant aboveground and belowground (root) distributions and the communities of soil fungi and bacteria found across a diverse tropical forest plot. Soil microbial community composition was correlated with the taxonomic and phylogenetic structure of the aboveground plant assemblages even after controlling for differences in soil characteristics, but these relationships were stronger for fungi than for bacteria. In contrast to expectations, the species composition of roots in our soil core samples was a poor predictor of microbial community composition perhaps due to the patchy, ephemeral, and highly overlapping nature of fine root distributions. Our ability to predict soil microbial composition was not improved by incorporating information on plant functional traits suggesting that the most commonly measured plant traits are not particularly useful for predicting the plot‐level variability in belowground microbial communities.
Insertable cardiac monitors after cryptogenic stroke – a risk factor based approach to enhance the detection rate for paroxysmal atrial fibrillation
Authors: Poli S. , Diedler J. , Härtig F. , Götz N. , Bauer A. , Sachse T. , Müller K. , Müller I. , Stimpfle F. , Duckheim M. , Steeg M. , Eick C. , Schreieck J. , Gawaz M. , Ziemann U. , Zuern C. S.
Published: October 2015

Background and purpose

Recently, the CRYSTAL AF trial detected paroxysmal atrial fibrillation (AF) in 12.4% of patients after cryptogenic ischaemic stroke (IS) or cryptogenic transient ischaemic attack (TIA) by an insertable cardiac monitor (ICM) within 1 year of monitoring. Our aim was (i) to assess if an AF risk factor based pre‐selection of ICM candidates would enhance the rate of AF detection and (ii) to determine AF risk factors with significant predictive value for AF detection.

Methods

Seventy‐five patients with cryptogenic IS/TIA were consecutively enrolled if at least one of the following AF risk factors was present: a CHA2DS2‐VASc score ≥4, atrial runs, left atrium (LA) size >45 mm, left atrial appendage (LAA) flow ≤0.2 m/s, or spontaneous echo contrast in the LAA. The electrocardiographic and echocardiographic criteria were chosen as they have been repeatedly reported to predict AF; the same applies for four of the six items of the CHA2DS2‐VASc score. The study end‐point was the detection of one or more episodes of AF (≥2 min).

Results

Seventy‐four patients underwent implantation of an ICM; one patient had AF at the date of implantation. After 6 months, AF was detected in 21/75 patients (28%), after 12 months in 25/75 patients (33.3%). 92% of AF episodes were asymptomatic. LA size >45 mm and the presence of atrial runs were independently associated with AF detection [hazard ratio 3.6 (95% confidence interval 1.6–8.4), P = 0.002, and 2.7 (1.2–6.7), P = 0.023, respectively].

Conclusions

The detection rate of AF is one‐third after 1 year if candidates for an ICM after cryptogenic IS/TIA are selected by AF risk factors. LA dilation and atrial runs independently predict AF.
The cyclic GMP‐AMP synthetase–STING signaling pathway is required for both the innate immune response against HBV and the suppression of HBV assembly
Authors: Dansako Hiromichi , Ueda Youki , Okumura Nobuaki , Satoh Shinya , Sugiyama Masaya , Mizokami Masashi , Ikeda Masanori , Kato Nobuyuki
Published: October 2015

During viral replication, the innate immune response is induced through the recognition of viral replication intermediates by host factor(s). One of these host factors, cyclic GMP‐AMP synthetase (cGAS), was recently reported to be involved in the recognition of viral DNA derived from DNA viruses. However, it is uncertain whether cGAS is involved in the recognition of hepatitis B virus (HBV), which is a hepatotropic DNA virus. In the present study, we demonstrated that HBV genome‐derived double‐stranded DNA induced the innate immune response through cGAS and its adaptor protein, stimulator of interferon genes (STING), in human hepatoma Li23 cells expressing high levels of cGAS. In addition, we demonstrated that HBV infection induced ISG56 through the cGAS–STING signaling pathway. This signaling pathway also showed an antiviral response towards HBV through the suppression of viral assembly. From these results, we conclude that the cGAS–STING signaling pathway is required for not only the innate immune response against HBV but also the suppression of HBV assembly. The cGAS–STING signaling pathway may thus be a novel target for anti‐HBV strategies.
Association of the SEL1L protein transmembrane domain with HRD1 ubiquitin ligase regulates ERAD‐L
Authors: Hosokawa Nobuko , Wada Ikuo
Published: October 2015

Misfolded proteins in the endoplasmic reticulum (ER) are transported to the cytoplasm for degradation by the ubiquitin–proteasome system, a process otherwise known as ER‐associated degradation (ERAD). Mammalian HRD1, an integral membrane ubiquitin ligase that ubiquitinates ERAD substrates, forms a large assembly in the ER membrane including SEL1L, a single‐pass membrane protein, and additional components. The mechanism by which these molecules export misfolded proteins through the ER membrane remains unclear. Unlike Hrd3p, the homologue in Saccharomyces cerevisiae, human SEL1L is an unstable protein, which is restored by the association with HRD1. Here we report that the inherently unstable nature of the human SEL1L protein lies in its transmembrane domain, and that association of HRD1 with the SEL1L transmembrane domain restored its stability. On the other hand, we found that the SEL1L luminal domain escaped degradation, and inhibited the degradation of misfolded α1‐antitrypsin variant null Hong Kong by retaining the misfolded cargo in the ER. Overexpression of HRD1 inhibited the degradation of unfolded secretory cargo, which was restored by the interaction of HRD1 with the SEL1L transmembrane domain. Hence, we propose that SEL1L critically regulates HRD1‐mediated disposal of misfolded cargo through its short membrane spanning stretch.
Mycobacteriophage D29 holin C‐terminal region functionally assists in holin aggregation and bacterial cell death
Authors: Kamilla Soumya , Jain Vikas
Published: October 2015

Holins are phage‐encoded small transmembrane proteins that perforate the bacterial cytoplasmic membrane. In most cases, this process allows the phage‐encoded peptidoglycan hydrolases to act on the cell wall, resulting in host cell lysis and phage release. We report a detailed functional characterization of Mycobacterium phage D29 gp11 coding for a putative holin that, upon expression, rapidly kills both Escherichia coli and Mycobacterium smegmatis. We dissected Gp11 by making several deletions and expressing them in E. coli. The shortening of Gp11 from its C‐terminus results in diminished cytotoxicity and smaller holes. Evidently, the two transmembrane domains (TMDs) present at the N‐terminus of Gp11 are incapable of integrating into the cytoplasmic membrane and do not show toxicity. Interestingly, the fusion of two TMDs and a small C‐terminal region that bears the coiled‐coil motif resulted in restoration of the cell killing ability of the protein. We further show that the second TMD is dispensable in protein toxicity because its deletion does not abolish Gp11‐mediated cell death. We conclude that Gp11 C‐terminal region is necessary but not sufficient for toxicity. These results shed light on a yet undiscovered role of Gp11 C‐terminal region that will help clarify the mechanism of holin‐mediated membrane perforation. Finally, we abolish the toxicity of Gp11 using a specific Gly to Asp substitution in the putative loop region of the protein; the mutant protein may help to clarify how holin functions in mycobacteriophage D29.
Carbon cost of plant nitrogen acquisition: global carbon cycle impact from an improved plant nitrogen cycle in the Community Land Model
Authors: Shi Mingjie , Fisher Joshua B. , Brzostek Edward R. , Phillips Richard P.
Published: October 2015

Plants typically expend a significant portion of their available carbon (C) on nutrient acquisition – C that could otherwise support growth. However, given that most global terrestrial biosphere models (TBMs) do not include the C cost of nutrient acquisition, these models fail to represent current and future constraints to the land C sink. Here, we integrated a plant productivity‐optimized nutrient acquisition model – the Fixation and Uptake of Nitrogen Model – into one of the most widely used TBMs, the Community Land Model. Global plant nitrogen (N) uptake is dynamically simulated in the coupled model based on the C costs of N acquisition from mycorrhizal roots, nonmycorrhizal roots, N‐fixing microbes, and retranslocation (from senescing leaves). We find that at the global scale, plants spend 2.4 Pg C yr−1 to acquire 1.0 Pg N yr−1, and that the C cost of N acquisition leads to a downregulation of global net primary production (NPP) by 13%. Mycorrhizal uptake represented the dominant pathway by which N is acquired, accounting for ~66% of the N uptake by plants. Notably, roots associating with arbuscular mycorrhizal (AM) fungi – generally considered for their role in phosphorus (P) acquisition – are estimated to be the primary source of global plant N uptake owing to the dominance of AM‐associated plants in mid‐ and low‐latitude biomes. Overall, our coupled model improves the representations of NPP downregulation globally and generates spatially explicit patterns of belowground C allocation, soil N uptake, and N retranslocation at the global scale. Such model improvements are critical for predicting how plant responses to altered N availability (owing to N deposition, rising atmospheric CO2, and warming temperatures) may impact the land C sink.
The Impact of Post‐Traumatic Stress Disorder on the Burden of Migraine: Results From the National Comorbidity Survey‐Replication
Authors: Rao Aruna S. , Scher Ann I. , Vieira Rebeca V.A. , Merikangas Kathleen R. , Metti Andrea L. , Peterlin B. Lee
Published: October 2015

Background

Post‐traumatic stress disorder (PTSD) has been linked with migraine in prior studies.

Objective

To evaluate the individual and joint burdens of migraine and PTSD in a population‐based cohort.

Methods

The National Comorbidity Survey‐Replication (NCS‐R) is a general population study conducted in the United States from February 2001–April 2003. PTSD and migraine were assessed, and four groups defined based on their migraine and PTSD status. The four groups included those with no migraine and no PTSD (controls, n=4535), those with migraine and without PTSD (migraine alone, n=236), those with PTSD and without migraine (PTSD alone, n=244), and those with both migraine and PTSD (mig+PTSD, n=68). Logistic and Poisson regression models were used to assess the association between dichotomous/multilevel outcome variables indicating financial, health, and interpersonal burdens and each migraine/PTSD group.

Results

Compared to controls, those with Mig+PTSD were more likely to be in the low poverty index (48% vs 41%, AOR 2.16; CI: 1.10, 4.24) and were less likely to be working for pay or profit in the past week (50% vs 68%, AOR 0.42; CI: 0.24, 0.74) but not those with migraine or PTSD alone. Additionally, the number of days where work quality was cut due to physical or mental health or substance abuse in the past month was greater in all groups compared to controls: (1) migraine alone: mean 2.57 (SEM 0.32) vs mean 1.09 (SEM 0.08) days, ARR=2.39; CI: 2.19, 2.62; (2) PTSD alone: mean 2.43 (SEM 0.33) vs mean 1.09 (SEM 0.08) days, ARR=2.09; CI: 1.91, 2.29; (3) mig+PTSD: mean 8.2 (SEM 0.79) vs 1.09 (SEM 0.08) days, ARR 6.79; CI 6.16, 7.49; and was over 2.5‐fold greater in those mig+PTSD than migraine alone (mean 8.0 [SEM 0.79] vs 2.6 days [SEM 0.72], ARR 2.77; CI: 2.45, 3.14). The likelihood of having difficulty getting along or maintaining a social life was also increased in all groups relative to controls: (1) migraine alone: 21% vs 5.4%, AOR 4.20; CI: 2.62, 6.74; (2) PTSD alone: 18% vs 5.4%, AOR 3.40; CI: 2.40, 4.82; (3) Mig+PTSD: 39% vs 5.4%, AOR 9.95; CI: 5.72, 17.32, and was 2‐fold greater in those with Mig+PTSD as compared to those with migraine alone (AOR 2.32; CI: 1.15, 4.69).

Conclusions

These findings support the need for those who treat migraine patients to be aware of the comorbidity with PTSD, as these patients may be particularly prone to adverse financial, health, and interpersonal disease burdens.
Red Ear and More: Facial and Extrafacial Erythema Accompanying Migraine Attacks
Authors: Velasco Elena Martínez , Mesonero Luis López , Hueso María Isabel Pedraza , Piñero Marina Ruiz , de Lera Alfonso Mercedes , Peral Ángel Luis Guerrero
Published: October 2015

Cutaneous manifestations of migraine are infrequent and their spectrum is reduced to the red ear syndrome (RES) and eyelid disorders. We report a case of a 26‐year‐old woman with migraine accompanied by extensive erythema, which involved right ear and cheek and left hemithorax. She fulfilled proposed criteria of RES. We started preventive therapy with a significant response. This is the first description in the literature of an erythema accompanying migraine attacks broadly exceeding the ear.
Vagus Nerve Stimulation and Headache
Authors: Yuan Hsiangkuo , Silberstein Stephen D.
Published: October 2015

Neuromodulation is an emerging area in headache management. Through neurostimulation, multiple brain areas can be modulated to alleviate pain, hence reducing the pharmacological need. In this review, we discuss the recent development of the vagus nerve stimulation (VNS) for headache management. Early case series from epilepsy and depression cohorts using invasive VNS showed a serendipitous reduction in headache frequency and/or severity. Noninvasive VNS (nVNS), which stimulates the carotid vagus nerve with the use of a personal handheld device, also demonstrated efficacy for acute migraine or cluster headache attacks. Long‐term use of nVNS seemed to exert a prophylactic effect for both chronic migraine and chronic cluster headache. In animal studies, nVNS modulated multiple pain pathways and even lessen cortical spreading depression. Progression in nVNS clinical efficacy over time suggests an underlying disease‐modifying neuromodulation. Noninvasive VNS appears to be as effective as the invasive counterpart for many indications. With an enormous potential therapeutic gain and a high safety profile, further development and application of nVNS is promising.
Presentation of available CTL epitopes that induction of cell‐mediated immune response against HIV‐1 Koran clade B strain using computational technology
Authors: Park H , Chung Y‐S , Yoon C‐H , Lee SH , Kim SS , Kang C , Choi B‐S
Published: October 2015

Objective

Theoretical predicting cytotoxic T lymphocyte (CTL) epitopes are an important tool in vaccine design and CTL therapy for enhancing our understanding of the cellular immune system. We would like to identify available CTL epitopes against HIV‐1 Korean clade B. CTL activity was assessed in freshly isolated peripheral blood mononuclear cells from Korean HIV patients in order to assess whether these CTL epitopes induce a cell‐mediated immune response (CMI).

Methods

NetCTLpan1.1 software, which is the most popular prediction computer software package, and full atom‐based simulation (FABS), which is a 3D modelling system for binding activity between epitopes and human leucocyte antigen (HLA) molecules, were used to predict the peptide‐spanning Env region binding to HLA‐A*24:02, HLA‐A*02:01 and HLA‐B*15:01, which are frequently found in the Korean population. Granzyme B and interferon‐γ ELISPOT assays were used to determine whether identified CTL epitopes induce CMI.

Results

Three HIV‐1 Korean clade B‐specific Env CTL epitopes were identified: Gp41‐RYL and Gp41‐RQG are localized within gp41, and Gp120‐LLQ within gp120. In in vitro assays using granzyme B ELISPOT, Gp120‐LLQ and Gp41‐RQG induced epitope‐specific CTL responses in HLA‐restricted cells. In ex vivo assay using IFN‐γ ELISPOT, cell‐mediated immune responses to Gp41‐RYL were present in 50% of HLA‐matched patients, and responses to Gp120‐LLQ and Gp41‐RQG were found in 33% of HLA‐matched patients.

Conclusion

In this study, we found that a prediction pipeline for CTL epitopes might be based on the most popular computer prediction software and FABS methods. Our results suggest that these CTL epitopes may provide useful tools and information for the development of a therapeutic vaccine against HIV‐1 Korean clade B.
The globalization of whitening: prevalence of skin lighteners (or bleachers) use and its social correlates among university students in 26 countries
Authors: Peltzer Karl , Pengpid Supa , James Caryl
Published: October 2015

Background

The aim of this study was to investigate the use of skin lighteners and its social correlates in university students from 26 low, middle income, and emerging economy countries.

Methods

Using anonymous questionnaires, data were collected from 19,624 undergraduate university students (mean age 20.8, SD 2.8) from 27 universities in 26 countries across Asia, Africa, and the Americas. Multivariate logistic regression analysis was used to identify associations between sociodemographic, social, health risk, mental health and abuse, and the use of skin lighteners.

Results

Overall, the prevalence of previous 12‐month skin lightener use was 24.5, and 16.7% in male and 30.0% in female students. The use of skin lighteners varied by country, ranging from 0% in Turkey to 83.8% in Thailand. In multivariate logistic regression analysis among both men and women, social variables (highly‐organized religious activity and lack of personal mastery) and health variables (inconsistent condom use) were associated with skin lightening use. In addition, male students from a lower income country, having a lack of social support, and a history of childhood sexual abuse were more likely to use skin lighteners, and women aged 20–21 years old, residing on the university campus, being a student of health and welfare, and having a lack of personal control, inadequate physical activity, and depressive symptoms were more likely users of skin‐lightening products.

Conclusion

A high prevalence of skin lightener use was found in this large sample of university students, and social and health‐related risk factors were identified.
Comorbidity as a predictor for drug survival of biologic therapy in patients with psoriasis
Authors: Jacobi Arnd , Rustenbach Stephan J. , Augustin Matthias
Published: October 2015

Background

Psoriasis often requires lifelong therapy, and adherence to treatment is considered a marker for treatment success. Data on the drug survival of biologics in psoriasis patients with comorbidities are lacking.

Objectives

This study was designed to estimate the long‐term drug survival rates of different biologic agents in a cohort of psoriasis patients and to evaluate reasons and predictors for treatment adherence.

Methods

Drug survival rates and outcome parameters in psoriasis patients treated with biologic agents were analyzed.

Results

A total of 125 treatment periods with adalimumab (n = 37), efalizumab (n = 9), etanercept (n = 55), infliximab (n = 13), and ustekinumab (n = 11) were administered to 67 psoriasis patients. Patients with psoriatic arthritis (P = 0.010) and without comorbidity (P = 0.033) demonstrated significantly greater rates of drug survival.

Conclusions

The overall efficacy of biologic agents is reduced with time. Patients with the comorbidity of metabolic syndrome demonstrate a loss of adherence to biologic treatment.
HLA‐C and TNF gene polymorphisms are associated with psoriasis in Brazilian patients
Authors: Cardili Renata N. , Deghaide Neifi S. , Mendes‐Junior Celso T. , Donadi Eduardo A. , Souza Cacilda S.
Published: October 2015

Background

Polymorphisms at the human leukocyte antigens (HLA‐C) and tumor necrosis factor (TNF) genes have been associated with susceptibility to psoriasis in several worldwide populations. In this study, HLA‐C and TNF (–238/–308) polymorphisms were performed in 125 Brazilian patients and 202 healthy controls.

Methods

HLA‐C and TNF promoter region alleles were typed by polymerase chain reaction using sequence‐specific primer‐polymerase chain reaction.

Results

The presence of HLA‐C*06 was associated with psoriasis onset, particularly in younger patients, being more frequent for patients with disease onset before the age of 20 years (P = 0.03), 25 years (P = 0.01), or 30 years (P = 0.03). No association between HLA‐C*06 and psoriasis was observed for patients older than 35 years. Susceptibility to psoriatic arthritis was associated with the TNF –238 G/A genotype (P = 0.02). The TNF –308A allele was overrepresented in patients (P = 0.0061), and the TNF –308 G/A genotype was increased in generalized forms (erythrodermic and generalized pustular psoriasis) compared to plaque psoriasis (P < 0.001). The TNF –238A/HLA‐C*06 haplotype was overrepresented in patients (P = 0.025), while the TNF –238G/HLA‐C*15 haplotype was increased in controls (P = 0.037).

Conclusions

The strong association of HLA‐C*06 allele with disease susceptibility, particularly in early onset psoriasis, indicates that younger ages could be considered to stratify psoriasis into early and late types. TNF –308 polymorphisms can be associated with psoriasis susceptibility and severity. Potential genetic markers of psoriasis in populations with a complex mixture of ethnicities should be investigated.
Primary treatment of female urethral stricture by nurses leads to improved outcomes
Authors: Ranjan Nikhil , Singh Rana Pratap , Kumari Amrita , Upadhyay Rohit
Published: October 2015

Female urethral stricture (FUS) is a distressing disease in the field of urology both for the patient and for the health care provider. It has been treated using various techniques such as urethral dilatation (UD), urethrotomy and urethroplasty. The disease's recurrence after urethral dilation, however, is not uncommon. Female urethroplasty carries the risk of stress urinary incontinence, and long‐term studies on its success are lacking. We present our study of treating FUS by repeated UD in a dedicated cystoscopy and dilation clinic managed by nurses. After the initial cystoscopy and dilation of FUS to 30 Fr, patients were followed up with in the dilation clinic at regular intervals. Over the past 5 years, 190 patients have been treated at our cystoscopy and dilation clinic and at are various stages of follow up. We find that the primary treatment of FUS by nurses at our institute leads to improved outcomes. Nurse‐led cystoscopies have been in vogue in Australia and the UK for some time now. There is an urgent need to expand the conventional indications of nurse‐led surgical interventions in order to allow medical care to reach the community at large.