bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of dysplastic fundic gland polyps in patients with and without familial adenomatous polyposis
Authors: Straub Shana F , Drage Michael G , Gonzalez Raul S
Published: February 2018

Aims

Dysplastic fundic gland polyps (d‐FGPs) typically arise in patients with familial adenomatous polyposis (FAP) but may occur in non‐syndromic patients. They rarely become malignant, but their significance is unclear, especially in non‐syndromic patients. We aimed to compare d‐FGPs in patients with and without FAP, using clinicopathologic findings and β‐catenin immunohistochemistry (IHC).

Methods and results

We identified 124 fundic gland polyps with low‐grade dysplasia (LGD) or high‐grade dysplasia (HGD) or indefinite for dysplasia (IFD) from 66 patients (27 with FAP; 39 non‐syndromic). We recorded patient sex, age at first d‐FGP, time until subsequent d‐FGP (if any), history of non‐gastric cancer (no patients had gastric cancer), proton‐pump inhibitor use, and the presence of Helicobacter pylori. β‐Catenin IHC was performed on cases with available blocks. The mean age at d‐FGP diagnosis was 31 years for FAP patients and 61 years for non‐syndromic patients (P < 0.0001). Sixteen FAP patients (59%) developed at least one subsequent d‐FGP, as compared with 10 (27%) non‐syndromic patients (P = 0.0099). The median time between d‐FGP detection was 11.5 months in FAP patients and 7 months in non‐syndromic patients (P = 0.82). Six FAP patients (22%) and 17 non‐syndromic patients (44%) had non‐gastric malignancies (P = 0.11). β‐Catenin IHC showed nuclear positivity in 14 of 112 (13%) d‐FGPs: 12 of 94 with LGD, two of three with HGD, and none of 15 with IFD polyps.

Conclusions

Familial adenomatous polyposis patients develop d‐FGPs earlier and more often develop additional ones than non‐syndromic patients. d‐FGPs in FAP and non‐syndromic patients have similar low rates of β‐catenin nuclear IHC positivity. FAP and non‐syndromic patients developed non‐gastric cancers at similar rates, suggesting that d‐FGPs may portend a general increased risk of carcinogenesis in non‐syndromic patients.
Homeobox transcriptional factor engrailed homeobox 1 is expressed specifically in normal and neoplastic sweat gland cells
Authors: Miura Keiko , Akashi Takumi , Ando Noboru , Ayabe Shinya , Kayamori Kou , Namiki Takeshi , Eishi Yoshinobu
Published: February 2018

Aims

A number of homeobox transcriptional factors are utilised as organ‐specific markers in the histopathological diagnosis of neoplasms. We have screened a homeobox gene that is expressed specifically in normal sweat gland cells and is useful for the histopathological diagnosis of sweat gland neoplasms.

Methods and results

By screening an open database resource of The Human Protein Atlas, 37 genes among the 235 homeobox transcriptional factors were found to be expressed specifically in the skin. Among those 37 genes, the engrailed homeobox 1 (En1) was expressed in normal eccrine glands but not in the epidermal keratinocytes. Expression of En1 was found throughout the eccrine glands, but not in the apocrine secretory coils, sebaceous glands or hair follicles. Expression of En1 was examined immunohistochemically in 111 cases of cutaneous epithelial neoplasms. All nine cases of poroma, seven cases of spiradenoma and six cases of syringoma, which are considered to differentiate towards eccrine glands, showed positive nuclear staining in most of the tumour cells. Sebaceous gland and hair follicle tumours were immunonegative. En1 was expressed focally in the epidermal neoplasms of seborrheic keratosis and squamous cell carcinoma.

Conclusion

Engrailed homeobox 1 was expressed specifically in normal eccrine glands and was expressed in most of the tumour cells of sweat gland neoplasms with eccrine gland differentiation. En1 was expressed focally in epidermal neoplasms; however, it was absent in sebaceous or hair follicle neoplasms. These findings will help in the histopathological diagnosis as well as understanding of the histogenesis of sweat gland neoplasms.
Protective effects of an extract of the freshwater microalga Scenedesmus rubescens on UV‐irradiated skin cells
Authors: Campiche R. , Sandau P. , Kurth E. , Massironi M. , Imfeld D. , Schuetz R.
Published: February 2018

Background

Skin ageing results from intrinsic but also extrinsic factors of which UV irradiation is a main cause. It is hence of interest to have means to protect skin from UV irradiation‐induced damage. We selected an extract of the freshwater microalga Scenedesmus rubescens and assessed its potential to protect skin from photoageing caused by UV irradiation.

Methods

Skin cells in vitro and ex vivo were analysed for markers of UV irradiation‐induced photodamage such as decreased viability, decreased collagen content, hyperpigmentation and sunburn cells.

Results

We found that a dry extract of the microalga Scenedesmus rubescens was able to suppress cellular signs of ageing induced by UV irradiation. It enhanced dermal fibroblast viability, rescued dermal collagen content, inhibited the formation of sunburn cells and inhibited tyrosinase activity.

Conclusion

An extract of Scenedesmus rubescens showed broad activity against markers of UV irradiation‐induced cutaneous ageing. It may therefore be used as a preventive or regenerative agent for anti‐ageing strategies.
Nursing wound care practices in Haiti: facilitators and barriers to quality care
Authors: Timmins B.A. , Thomas Riché C. , Saint‐Jean M.W. , Tuck J. , Merry L.
Published: February 2018

Aim

To describe the facilitators and barriers for nurses to perform quality wound care in three surgical wards of a hospital in Port‐au‐Prince, Haiti.

Background

Up to a quarter of patients in low‐ and middle‐income countries may acquire at least one infection while hospitalized. There is a paucity of research investigating nursing wound care practices in low‐ and middle‐income countries regarding the prevention of hospital‐acquired infections.

Methods

The design was qualitative descriptive. We observed nursing staff on the general surgery, orthopaedics and maternity units while they performed routine dressing changes (n = 15). We interviewed nursing (n = 13) and medical residents (n = 3) and inquired about their perceptions of facilitators and barriers for nurses to perform quality wound care.

Findings

A number of wound care practices appeared well integrated including using gloves to remove dressings, applying sterile dressings, properly disposing of soiled materials, inspecting wounds for signs of infection and employing comfort and privacy measures. Areas that may need improvement included aseptic technique, hand hygiene, pain assessments, patient education and documentation. We identified four themes related to barriers and facilitators to perform quality wound care: (i) materials and resources; (ii) nurse‐to‐patient ratios, workload and support; (iii) roles and responsibilities of nurses; and (iv) knowledge and training of nurses.

Conclusion

Nursing wound care practices may be optimized by improving nurses’ professional status and working conditions.

Implications for nursing practice and health policy

Greater financial investment in health care and (continuing) education, self‐regulation and development of the nursing role, including more autonomy, are needed to elevate the professional status of nurses in Haiti. Institutional policies should promote best practices, clarify nursing roles and responsibilities and foster interdisciplinary collaboration in patient care.
Methods and Tools for Bayesian Variable Selection and Model Averaging in Normal Linear Regression
Authors: Forte Anabel , Garcia‐Donato Gonzalo , Steel Mark
Published: February 2018

In this paper, we briefly review the main methodological aspects concerned with the application of the Bayesian approach to model choice and model averaging in the context of variable selection in regression models. This includes prior elicitation, summaries of the posterior distribution and computational strategies. We then examine and compare various publicly available R‐packages, summarizing and explaining the differences between packages and giving recommendations for applied users. We find that all packages reviewed (can) lead to very similar results, but there are potentially important differences in flexibility and efficiency of the packages.
Volatility diagram of ZrB2‐SiC‐ZrC system and experimental validation
Authors: Lu Ying , Zou Ji , Xu Fangfang , Zhang Guo‐Jun
Published: February 2018

A volatility diagram of zirconium carbide (ZrC) at 1600, 1930, and 2200°C was calculated in this work. Combining it with the existing volatility diagrams of ZrB2 and SiC, the volatility diagram of a ternary ZrB2‐SiC‐ZrC (ZSZ) system was constructed in order to interpret the oxidation behavior of ZSZ ceramics. Applying this diagram, the formation of ZrC‐corroded and SiC‐depleted layers and the oxidation sequence of each component in ZSZ during oxidation and ablation could be well understood. Most of the predictions from the diagrams are consistent with the experimental observations on the oxidation scale of dense ZrB2‐SiC‐ZrC ceramics/coatings after oxidation at 1600°C or ablation at 1930 and 2200°C. The reasons for the discrepancy are also briefly discussed.
Mobile‐Based micro‐Learning and Assessment: Impact on learning performance and motivation of high school students
Authors: Nikou S.A. , Economides A.A.
Published: February 2018

Mobile‐based micro‐learning has gained a lot of attention lately, especially for work‐based and corporate training. It combines features of mobile learning and micro‐learning to deliver small learning units and short‐term learning activities. The current study uses the lens of the Self‐Determination Theory of motivation and proposes a series of Mobile‐Based micro‐Learning and Assessment (MBmLA) homework activities to improve high school students' motivation and learning performance in science. An experiment was conducted to evaluate the effectiveness of the proposed approach. One hundred and eight students of a senior‐level high school in Europe were randomly assigned into either a control condition (conventional paper‐based homework approach) or an experimental (MBmLA approach) condition. The study carried out for a period of 5 weeks. From the experimental results, it was found that, in comparison to the conventional paper‐based approach, the proposed MBmLA approach enhanced students' basic psychological needs of self‐perceived autonomy, competence, and relatedness and improved students' exam performance in terms of factual knowledge. Moreover, students self‐reported greater learning satisfaction with the mobile‐based microassessment and micro‐learning homework tasks. Implications on educational practices as well as future research are discussed.
Cost effectiveness of focal impulse and rotor modulation guided ablation added to pulmonary vein isolation for atrial fibrillation
Authors: Baykaner Tina , Duff Steve , Hasegawa James T. , Mafilios Michael S. , Turakhia Mintu P.
Published: February 2018

Background

Although ablation with focal impulse and rotor modulation (FIRM), as an adjunct to pulmonary vein isolation (PVI), has been shown to decrease atrial fibrillation (AF) recurrence, cost‐effectiveness has not been assessed.

Objective

We aimed to evaluate the cost effectiveness of FIRM‐guided ablation when added to PVI in a mixed AF population.

Methods and results

We used a Markov model to estimate the costs, quality‐adjusted survival, and cost effectiveness of adding FIRM ablation to PVI. AF recurrence rates were based on 3‐year data from the CONFIRM trial. Model inputs for event probabilities and utilities were obtained from literature review. Costs were based on Medicare reimbursement, wholesale acquisition costs, and literature review.

Three‐year total costs FIRM+PVI versus PVI alone were $27,686 versus $26,924. QALYs were 2.338 versus 2.316, respectively, resulting in an incremental cost‐effectiveness ratio (ICER) of $34,452 per QALY gained. Most of the cost (65–81%) was related to the index ablation procedure. Lower AF recurrence generated cost offsets of $4,266, primarily due to a reduced need for medications and repeat ablation. Probabilistic sensitivity analysis demonstrated ICER below $100,000/QALY in 74% of simulations.

Conclusion

Based on data from the CONFIRM study, the addition of FIRM to PVI does have the potential to be cost‐effective due to higher quality‐adjusted life years and lower follow‐up costs. Value is sensitive to the incremental reduction in AF recurrence, and FIRM may have the greatest economic value in patients with greater AF symptom severity. Results from ongoing randomized trials will provide further clarity.
Shifting the focus – the primary role of IL‐23 in psoriasis and other inflammatory disorders
Authors: Gooderham M.J. , Papp K.A. , Lynde C.W.
Published: February 2018

Insights into the pathophysiology of autoimmune inflammatory diseases including psoriasis have advanced considerably in recent years, and in parallel, so too have the available treatment options. Current clinical paradigms for the treatment of psoriasis have evolved to include targeted biologic therapies, starting with tumour necrosis factor‐alpha (TNF‐α) inhibitors and later, agents targeting interleukin (IL)‐12/23 and IL‐17. The most recent evidence suggests that IL‐23 might be an even more potent target for the effective treatment of psoriasis and other autoimmune inflammatory disorders. This review will describe recent developments leading to the current understanding of the key role of IL‐23 as a ‘master regulator’ of autoimmune inflammation and the clinical evidence for agents that specifically target this modulator in the context of treating psoriasis, spondyloarthropathy and inflammatory bowel disease.
The Complexity of Determining Whether a Nursing Home Transfer Is Avoidable at Time of Transfer
Authors: Unroe Kathleen T. , Carnahan Jennifer L. , Hickman Susan E. , Sachs Greg A. , Hass Zachary , Arling Greg
Published: February 2018

Objectives

To describe the relationship between nursing facility resident risk conditions and signs and symptoms at time of acute transfer and diagnosis of conditions associated with potentially avoidable acute transfers (pneumonia, urinary tract infection, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) or asthma, dehydration, pressure sores).

Design

As part of a demonstration project to reduce potentially avoidable hospital transfers, Optimizing Patient Transfers, Impacting Medical Quality, Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project clinical staff collected data on residents who transferred to the emergency department (ED) or hospital. Cross‐tabulations were used to identify associations between risk conditions or symptoms and hospital diagnoses or death. Mixed‐effects logistic regression models were used to describe the significance of risk conditions, signs, or symptoms as predictors of potentially avoidable hospital diagnoses or death.

Setting

Indiana nursing facilities (N=19).

Participants

Long‐stay nursing facility residents (N=1,174), who experienced 1,931 acute transfers from November 2014 to July 2016.

Measurements

Participant symptoms, transfers, risk factors, and hospital diagnoses.

Results

We found that 44% of acute transfers were associated with 1 of 6 potentially avoidable diagnoses. Symptoms before transfer did not discriminate well among hospital diagnoses. Symptoms mapped into multiple diagnoses and most hospital diagnoses had multiple associated symptoms. For example, more than two‐thirds of acute transfers of residents with a history of CHF and COPD were for reasons other than exacerbations of those two conditions.

Conclusion

Although it is widely recognized that many transfers of nursing facility residents are potentially avoidable, determining “avoidability” at time of transfer is complex. Symptoms and risk conditions were only weakly predictive of hospital diagnoses.
A review of the role of estrogen in dermal aging and facial attractiveness in women
Authors: Lephart Edwin D
Published: February 2018

Estrogens are known to have protective and favorable influences on skin health; conversely, androgens oppose the actions of estrogens. Estrogen's chemical messages are transmitted via the classical nuclear hormone estrogen receptors (ER) alpha and beta and the rapid‐acting G‐coupled membrane estrogen receptor. Androgens [both testosterone and 5α‐dihydrotestosterone (5α‐DHT)] bind the same androgen receptor. Estrogen levels peak in the mid‐ to late 20s in women and then decline by 50% by 50 years of age and dramatically decrease further after menopause. The loss of estrogens with aging contributes to diminished dermal health, whereas estrogen hormone therapy [eg, oral conjugated equine estrogens (CEE)] restores skin health. Several reports suggest positive correlations between the levels of circulating estrogens and: (1) perceived age, (2) attractiveness, (3) enhanced skin health, and (4) facial coloration in women. Based upon a psychological dermato‐endocrine perspective, the positive correspondence of high estrogens levels with perceived age and facial attractiveness in women especially with aging demonstrates the importance of hormonal influences on observed dermal health and youthful appearance.
Fetoscopic laser photocoagulation for twin–twin transfusion syndrome
Authors: Sago Haruhiko , Ishii Keisuke , Sugibayashi Rika , Ozawa Katsusuke , Sumie Masahiro , Wada Seiji
Published: February 2018

The aim of this study was to review fetoscopic laser photocoagulation (FLP), which ablates placental vascular anastomoses to treat twin–twin transfusion syndrome (TTTS). A review of studies reporting on the procedures, outcomes, complications and nonconventional applications of FLP for TTTS was conducted. FLP has been established as the primary treatment for monochorionic twin pregnancy associated with TTTS at 16–26 weeks. FLP is the only therapy that directly addresses the underlying pathophysiology. The recent technique modification of FLP, referred to as the ‘Solomon technique’, induces selective coagulation to connect the anastomoses ablation sites and has been introduced to reduce residual anastomoses. The perinatal survival following FLP improved significantly with advances in the technique after its introduction. The recent survival rates of both twins and at least one twin are 70% and more than 90%, respectively. However, there is still an 11–14% risk of long‐term neurodevelopment impairment. The premature rupture of membranes that leads to preterm labor is a common complication after FLP. FLP is a valuable treatment option for feto‐fetal transfusion syndrome in triplets and for TTTS after 26 weeks. FLP for selective intrauterine growth restriction may be potentially beneficial when accompanied by abnormal Doppler findings and oligohydramnios. FLP is the optimal treatment option for TTTS at 16–26 weeks of gestation. FLP appears to be applicable in triplets, TTTS after 26 weeks and cases of selective intrauterine growth restriction with abnormal Doppler findings and oligohydramnios. FLP is the most common and successful fetal intervention. Improvement in the neurodevelopmental outcomes after FLP is a future focus.
A unified model of melatonin, 6‐sulfatoxymelatonin, and sleep dynamics
Authors: Abeysuriya Romesh G. , Lockley Steven W. , Robinson Peter A. , Postnova Svetlana
Published: February 2018

A biophysical model of the key aspects of melatonin synthesis and excretion has been developed, which is able to predict experimental dynamics of melatonin in plasma and saliva, and of its urinary metabolite 6‐sulfatoxymelatonin (aMT6s). This new model is coupled to an established model of arousal dynamics, which predicts sleep and circadian dynamics based on light exposure and times of wakefulness. The combined model thus predicts melatonin levels over the sleep‐wake/dark‐light cycle and enables prediction of melatonin‐based circadian phase markers, such as dim light melatonin onset (DLMO) and aMT6s acrophase under conditions of normal sleep and circadian misalignment. The model is calibrated and tested against group average data from 10 published experimental studies and is found to reproduce quantitatively the key dynamics of melatonin and aMT6s, including the timing of release and amplitude, as well as response to controlled lighting and shift work.
Melatonin attenuates smoking‐induced hyperglycemia via preserving insulin secretion and hepatic glycogen synthesis in rats
Authors: Li Tianjia , Ni Leng , Zhao Zhewei , Liu Xinnong , Lai Zhichao , Di Xiao , Xie Zhibo , Song Xitao , Wang Xuebin , Zhang Rui , Liu Changwei
Published: February 2018

Epidemiology survey indicated that cigarette smoking is a risk factor of diabetes. However, the precise mechanisms remain to be clarified. In this study, we found that smoking caused metabolic malfunctions on pancreas and liver in experimental animal model. These were indicated by hyperglycemia, increased serum hemoglobin A1c level and decreased insulin secretion, inhibition of liver glycogen synthase (LGS), and hepatic glycogen synthesis. Mechanistic studies revealed that all these alterations were caused by the inflammatory reaction and reactive oxygen species (ROS) induced by the smoking. Melatonin treatment significantly preserved the functions of both pancreas and liver by reducing β cell apoptosis, CD68‐cell infiltration, ROS production, and caspase‐3 expression. The siRNA‐knockdown model identified that the protective effects of melatonin were mediated by melatonin receptor‐2 (MT2). This study uncovered potentially underlying mechanisms related to the association between smoking and diabetes. In addition, it is, for first time, to report that melatonin effectively protects against smoking‐induced glucose metabolic alterations and the signal transduction pathway of melatonin is mainly mediated by its MT2 receptor. These observations provide solid evidence for the clinically use of melatonin to reduce smoking‐related diabetes, and the therapeutic regimens are absent currently.
Sympathy between disciplines
Authors: Gurton‐Wachter Lily
Published: February 2018

This essay surveys some of the recent scholarship about sympathy (as fellow feeling between people) and the natural sympathies (as physiological or occult affinities or attractions, known now as “action at a distance”) to reconsider the shifting relation between the two. Though Michael Foucault famously tells the story of an early modern conception of “space governed by sympathy and antipathy, which are ceaselessly drawing things together and holding them apart” (28) that ends abruptly with the seventeenth century, recent interdisciplinary research into early modern and eighteenth‐century histories of the natural sympathies and antipathies suggests that the shift from sympathy as a physical “principle of mobility” to an ethical attitude was neither as clear nor as decisive as it once may have seemed. For Romanticists, this revision prompts us to rethink the now familiar history of fellow feeling and start to take into account the forgotten relationship between the movement of both emotion and matter.
Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein
Authors: Kim Jin Hyoung , Shim Ju Hyun , Yoon Hyun‐Ki , Ko Heung‐Kyu , Kim Jong Woo , Gwon Dong Il
Published: February 2018

Background & Aims

We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT.

Methods

From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as a first‐line treatment for HCC with segmental PVTT.

Results

After TACE, the median survival of the whole cohort was 10.7 months, and the 1‐year, 3‐year and 5‐year survival rates were 44.9%, 16% and 12% respectively. Objective tumour response after TACE was achieved in 53.8% of patients. Multivariable Cox regression analyses confirmed that up‐to‐11 criteria, extrahepatic metastasis, Child–Pugh class, and tumour response to TACE were independent prognostic factors for patient survival. The expected median survival times among patients with 0, 1 and 2‐4 risk factors were 29.1, 15.1 and 5.3 months respectively. The 30‐day mortality and major complications rates after TACE were 0.9% and 5.4% respectively.

Conclusions

TACE was well‐tolerated and effective in selected patients with HCC with segmental PVTT. We found that four risk factors were associated with decreased length of patient survival after TACE: a major tumour burden (up‐to‐11 criteria out), extrahepatic spread, Child–Pugh class B liver function and nonregression to TACE. TACE may not be recommended for HCC patients with segmental PVTT with 2‐4 risk factors because of poor survival outcome.
LytM factor Alr3353 affects filament morphology and cell–cell communication in the multicellular cyanobacterium Anabaena sp. PCC 7120
Authors: Bornikoel Jan , Staiger Julia , Madlung Johannes , Forchhammer Karl , Maldener Iris
Published: February 2018

Heterocyst‐forming cyanobacteria are organized as multicellular filaments of tightly interacting, functionally specialized cells. N2‐fixing heterocysts differentiate from vegetative cells under nitrogen limitation in a semi‐regular pattern along the filament. Diazotrophic growth requires metabolite exchange between neighboring cells within the filament. This exchange occurs via cell–cell junction complexes that span the gap between the plasma membranes and thereby cross the septal peptidoglycan through an array of uniform nanopores formed by AmiC‐type cell wall hydrolases. We investigated how the lytic hydrolase AmiC1 (Alr0092) from Anabaena sp. PCC 7120, whose activity needs to be tightly controlled to avoid cell lysis, is regulated by the LytM factor Alr3353. Inactivation of alr3353 resulted in significantly fewer nanopores and as a consequence, a lower rate of fluorescent tracer exchange between cells. The mutant was not able to grow with N2 as sole nitrogen source, although heterocysts were formed. Alr3353 localized mainly to fully developed intercellular septa of vegetative cells. The purified protein bound to peptidoglycan and enhanced the hydrolytic activity of AmiC1 in vitro. Our data show that the LytM factor Alr3353 regulates nanopore formation and cell–cell communication by directly interacting with AmiC1.
Nutraceuticals and skin appearance: Is there any evidence to support this growing trend?
Authors: Spiro A. , Lockyer S.
Published: February 2018

The rise of the nutraceutical market, specifically oral nutrition supplements claiming to improve skin appearance, is striking. This paper aims to examine the published scientific evidence for beneficial effects of nutraceuticals on skin appearance. An overview of skin physiology and intrinsic and extrinsic ageing is provided which underlies the potential physiological processes nutraceuticals purport to counter. Common ingredients used are explored. Some of these (vitamins A, C, B2, B3, B7, copper, iodine, zinc) have authorised skin‐related health claims, but many do not. Current evidence for those without existing authorised claims (e.g. green tea extract, pomegranate extract, carotenoids, evening primrose oil, borage oil, fish oil, collagen and co‐enzyme Q10) is reviewed, focussing primarily on evidence from randomised controlled trials where available, in relation to skin parameters including wrinkles and hydration. Issues of safety are also considered, and the postulated mechanisms for some emerging ingredients, such as cocoa flavanols and probiotics, are explored. Evidence from high quality human trials demonstrating clear benefit is required by regulatory authorities in order for foods and nutrition supplements to carry a health or beauty claim. To date, the evidence for many ingredients in relation to skin appearance is limited, not sufficiently robust and/or inconsistent. Although there are a small number of human studies suggesting a potential benefit and some plausible biological mechanisms, much of the evidence to date comes from animal and in vitro studies. There are simply not enough good quality randomised controlled trials in this area to draw firm conclusions about the benefit of nutraceuticals to skin appearance.
Rising food bank use in the UK: Sign of a new public health emergency?
Authors: Loopstra R.
Published: February 2018

The provision of food aid through food banks has recently expanded in the UK. By providing free bags of food to people experiencing financial shortfalls, food banks aim to prevent individuals and families from going without food. A growing body of research has sought to understand this type of provisioning, from what it indicates about social security in the UK to what it indicates about the problem of food insecurity. Here, recent research on the characteristics of people receiving help from food banks is reviewed, highlighting that they serve the most financially vulnerable groups in the UK: people with disabilities, people receiving out‐of‐work benefits and lone parents. The severity and chronicity of food insecurity observed in this population is a public health concern, as is evidence of high rates of poor mental health. Food banks have largely gone unevaluated for how well they do at meeting the needs of people using them, but focusing on building better food banks may also serve to further entrench voluntary and charitable food assistance as part of the social safety net in the UK. Given evidence that policy interventions such as pensions and income transfers reduce food insecurity, the importance of restoring strong social safety nets for reducing the need for food banks and food insecurity is discussed.
British eggs: Back on the menu for all
Authors: Gray J.
Published: February 2018

This article updates the latest guidance and research on the suitability of eggs as a good source of nutrition for particular population groups. This follows the publication of two important UK government reports: revised advice for vulnerable groups from the Food Standards Agency and a draft report about infant feeding from the Scientific Advisory Committee on Nutrition (SACN), as well as a recent review on egg consumption and cardiovascular disease risk in people with type 2 diabetes. The Food Standards Agency now advises that raw or lightly cooked British eggs are safe to eat for vulnerable groups, such as pregnant women, babies, toddlers and older people, provided that the eggs bear the Lion mark. This indicates that they have been produced under the British Lion Code of Practice, a scheme that includes more than 700 auditable criteria, of which vaccination of laying hens against Salmonella is a key aspect. The draft SACN report Feeding in the First Year of Life recommends that first complementary foods should be introduced from around 6 months of age and that there is no need to differentiate hens’ egg from other foods in this respect. There is also a warning that the deliberate exclusion or delayed introduction of allergenic foods including egg may increase the risk of allergy to these foods later in childhood. As regards people with type 2 diabetes, despite earlier concerns from epidemiological studies that higher egg intake might increase cardiovascular disease risk, more recent high‐quality intervention studies indicate that, provided eggs are consumed as part of a healthy, energy‐controlled diet, there is no need for concern. Eggs provide a wide range of important nutrients, including several that are found in only a limited number of other foods, such as vitamin D, iodine and the long‐chain omega‐3 fatty acid, docosahexaenoic acid. They are therefore a useful and versatile ingredient for pregnant women, infants and children, and older people.
Clinicians’ attitudes and approaches to evaluating the potential living kidney donor‐recipient relationship: An interview study
Authors: Ralph Angelique F. , Butow Phyllis , Craig Jonathan C. , Chapman Jeremy R. , Gill John S. , Kanellis John , Tong Allison
Published: February 2018

Aim

Careful assessment of the potential donor‐recipient relationship is recommended by guidelines to prevent undue coercion, and to ensure realistic expectations and genuine motivations. However, relationships are complex, nuanced and value‐laden, and can be challenging to evaluate in living kidney donation. We aimed to describe the attitudes and approaches of transplant clinicians towards assessing the relationship between potential living kidney donors and their recipients.

Methods

Semi‐structured interviews were conducted with 54 transplant clinicians (nephrologists, surgeons, coordinators, social workers, psychiatrists and psychologists) from 32 transplant centres across nine countries including Australia, United States, Canada and New Zealand. Transcripts were analyzed thematically.

Results

Four themes were identified: protecting against vulnerability and premature decisions (ensuring genuine motivation, uncovering precarious dynamics and pre‐empting conflict, shared accountability, relying on specialty psychosocial expertise, trusting intimate bonds, tempering emotional impulsivity); safeguarding against coercion (discerning power imbalance, justified inquiry, awareness of impression management); minimizing potential threat to relationships (preserving the bond, giving equitable attention to donors and recipients, ensuring realistic expectations); and ambiguities in making judgments (adjudicating appropriateness and authenticity of relationships, questioning professional intervening, uncertainties in subjective and emotional assessments).

Conclusions

Clinicians felt ethically compelled to minimize the risk of undue coercion and to protect donors and recipients when evaluating the donor‐recipient relationship. However, disentangling voluntariness and altruism from potential undisclosed pressures to enact societal and family duty, making decisions within this complex, multi‐stakeholder context, and avoiding the imposition of undue paternalism and donor autonomy, were challenging. Multidisciplinary expertise and practical strategies for managing uncertainties are required.
Chemocoding as an identification tool where morphological‐ andDNA‐based methods fall short:Ingaas a case study
Authors: Endara María‐José , Coley Phyllis D. , Wiggins Natasha L. , Forrister Dale L. , Younkin Gordon C. , Nicholls James A. , Pennington R. Toby , Dexter Kyle G. , Kidner Catherine A. , Stone Graham N. , Kursar Thomas A.
Published: February 2018

The need for species identification and taxonomic discovery has led to the development of innovative technologies for large‐scale plant identification.DNAbarcoding has been useful, but fails to distinguish among many species in species‐rich plant genera, particularly in tropical regions. Here, we show that chemical fingerprinting, or ‘chemocoding’, has great potential for plant identification in challenging tropical biomes.

Using untargeted metabolomics in combination with multivariate analysis, we constructed species‐level fingerprints, which we define as chemocoding. We evaluated the utility of chemocoding with species that were defined morphologically and subject to next‐generationDNAsequencing in the diverse and recently radiated neotropical genusInga(Leguminosae), both at single study sites and across broad geographic scales.

Our results show that chemocoding is a robust method for distinguishing morphologically similar species at a single site and for identifying widespread species across continental‐scale ranges.

Given that species are the fundamental unit of analysis for conservation and biodiversity research, the development of accurate identification methods is essential. We suggest that chemocoding will be a valuable additional source of data for a quick identification of plants, especially for groups where other methods fall short.
Mesophyll conductance does not contribute to greater photosynthetic rate per unit nitrogen in temperate compared with tropical evergreen wet‐forest tree leaves
Authors: Bahar Nur H. A. , Hayes Lucy , Scafaro Andrew P. , Atkin Owen K. , Evans John R.
Published: February 2018

Globally, trees originating from high‐rainfall tropical regions typically exhibit lower rates of light‐saturated net CO2 assimilation (A) compared with those from high‐rainfall temperate environments, when measured at a common temperature. One factor that has been suggested to contribute towards lower rates of A is lower mesophyll conductance.

Using a combination of leaf gas exchange and carbon isotope discrimination measurements, we estimated mesophyll conductance (gm) of several Australian tropical and temperate wet‐forest trees, grown in a common environment. Maximum Rubisco carboxylation capacity, Vcmax, was obtained from CO2 response curves.

gm and the drawdown of CO2 across the mesophyll were both relatively constant. Vcmax estimated on the basis of intercellular CO2 partial pressure, Ci, was equivalent to that estimated using chloroplastic CO2 partial pressure, Cc, using ‘apparent’ and ‘true’ Rubisco Michaelis–Menten constants, respectively

Having ruled out gm as a possible factor in distorting variations in A between these tropical and temperate trees, attention now needs to be focused on obtaining more detailed information about Rubisco in these species.
In situ mycorrhizal function – knowledge gaps and future directions
Authors: Lekberg Ylva , Helgason Thorunn
Published: February 2018

We know a lot about the potential functions of mycorrhizas, but whether or not these are realized in the field where plants simultaneously experience a range of biotic interactions and fluctuating abiotic conditions is more or less unknown. In this Viewpoint, we present findings from a literature survey of papers on mycorrhizal function published in New Phytologist during the past 30 years. This survey showed that most functional studies are still conducted under controlled conditions, target mostly arbuscular and ectomycorrhizas, and focus on nutrient and carbon dynamics of the symbiosis. We also share discussions from a workshop, ‘In situ mycorrhizal function: how do we get relevant data from a messy world?’, held at the 9th International Conference on Mycorrhiza (ICOM9) in August 2017. In this workshop, we examined possibilities and limitations of old and new techniques for field research, and participants expressed the need to learn more about fungal traits and how they may relate to function. We argue that moving mycorrhizal experiments into the field will allow us not only to quantify realized functions, but also to revisit old paradigms and possibly discover new functions.
Hodges–Lehmann Detection of Structural Shocks – An Analysis of Macroeconomic Dynamics in the Euro Area
Authors: Herwartz Helmut
Published: February 2018

Structural shocks in multivariate dynamic systems are hidden and often identified with reference to a priori economic reasoning. Based on a non‐Gaussian framework of independent shocks, this work provides an approach to discriminate between alternative identifying assumptions on the basis of dependence diagnostics. Relying on principles of Hodges–Lehmann estimation, we suggest a decomposition of reduced form covariance matrices that yields implied least dependent (structural) shocks. A Monte Carlo study underlines the discriminatory strength of the proposed identification strategy. Applying the approach to a stylized model of the Euro Area economy, independent shocks conform with features of demand, supply and monetary policy shocks.
GCH1 attenuates cardiac autonomic nervous remodeling in canines with atrial‐tachypacing via tetrahydrobiopterin pathway regulated by microRNA‐206
Authors: Wei Jinqiu , Zhang Yujiao , Li Zhan , Wang Ximin , Chen Linlin , Du Juanjuan , Liu Jing , Liu Ju , Hou Yinglong
Published: February 2018

Background/aims

Cardiac autonomic nerve remodeling (ANR) is an important mechanism of atrial fibrillation (AF). GTP cyclohydrolase I, encoded by GCH1, is the rate‐limiting enzyme in de novo synthesis of tetrahydrobiopterin (BH4), an essential cofactor for nitric oxide (NO) synthesis. Previous studies reported that increased BH4 and NO content negatively regulated nerve regeneration. This study investigated the effects of GCH1 on ANR via BH4 pathway, regulated by microRNA‐206 (miR‐206).

Methods and results

In canines, atrial tachypacing (A‐TP), together with miR‐206 overexpression, increased PGP9.5 level and inhibited GCH1 expression by quantitative real‐time polymerase chain reaction and western blot analysis. GCH1 was validated to be a direct target of miR‐206 by luciferase assays. Meanwhile, miR‐206 overexpression by lentiviruses infection into right superior pulmonary vein fat pad decreased GCH1 expression to ∼40% and further reduced BH4 and NO content compared with the control canines. After infection of GCH1 overexpression lentiviruses for two weeks, atrial effective refractory period was increased compared with the control group (105.8 ± 1.537 ms vs 99.17 ± 2.007 ms, P < 0.05). Moreover, GCH1 overexpression attenuated canines’ atrial PGP9.5 level to ∼56% of the controls. In myocardial cells, transfection of GCH1 overexpression lentiviruses also decreased PGP9.5 expression to 26% of the control group. In patients, plasma was collected and miR‐206 expression was upregulated in AF patients (n = 18) than the controls (n = 12).

Conclusions

Our findings suggested that GCH1 downregulation exacerbated ANR by decreasing atrial BH4 and NO content modulated by miR‐206 in A‐TP canines. This indicates that GCH1 may prevent the initiation of AF through inhibiting ANR.
Vagus nerve injury symptoms after catheter ablation for atrial fibrillation
Authors: Jacobs Victoria , May Heidi T. , Crandall Brian G. , Ballantyne Becca , Chisum Ben , Johnson Dave , Graves Kevin G. , Cutler Michael , Day John D. , Mallender Charles , Osborn Jeffrey S. , Weiss J. Peter , Bunch T. Jared
Published: February 2018

Background

Vagus nerve injury during catheter ablation for atrial fibrillation can significantly impact quality of life and result in lingering gastrointestinal symptoms. This study was designed to define risk factors of vagus nerve injury, symptoms, prevalence, and temporal resolution.

Methods

A total of 100 patients undergoing radiofrequency catheter ablation (RFCA) were enrolled and consented to participate in the study. Patients completed a 22‐item questionnaire that included questions specific to vagus nerve injury symptomatology during their baseline visit and at 1 and 3 months post‐RFCA.

Results

The average age of the population was 63 ± 10.6 years and 68% were male. A total of 100 patients completed their baseline questionnaire (90 patients completed the 1‐month questionnaires and 85 patients completed the 3‐month questionnaires). Symptoms rated as moderate were prevalent at baseline (trouble swallowing 13%, bloating 26%, feeling full 20%), and increased in all categories analyzed at 1 month and with the exception of trouble swallowing returned to the preablation percentages at 3 months (heartburn 22.4%, trouble swallowing 18.8%, bloating 16.5%, nausea 8.2%, vomiting 3.5%, constipation 18.8%, diarrhea 16.4%, feeling full 15.3%). Severe rated symptoms of trouble swallowing (2–5.5%), bloating (5–7.6%), and early satiety (5–9.8%) increased at 1 month and bloating and early satiety percentages remained approximately two times higher at 3 months (trouble swallowing 2.4%, bloating 8.2%, early satiety 7.1%).

Conclusion

The majority of symptoms were resolved by 3 months, although those patients who rate bloating and early satiety at a severe rating may have persistent symptoms.
Incidence and factors contributing to postdischarge nausea and vomiting in pediatric ambulatory surgical cases
Authors: Efune Proshad N. , Minhajuddin Abu , Szmuk Peter
Published: February 2018

Background

Little is known regarding the incidence and contributing factors of postdischarge nausea and vomiting in children.

Aims

The aim of this study was to determine the incidence of postdischarge nausea and vomiting in day surgery patients and to identify demographic, intraoperative, and postoperative variables that influence the risk.

Methods

In this prospective observational study, a postdischarge questionnaire was administered to parents of ambulatory patients who received anesthesia and the electronic records were reviewed.

Results

Of 1041 ambulatory patients who received general anesthesia, 143 (14%) experienced postdischarge nausea and vomiting. Patients who did not receive intraoperative opioids had a lower incidence (8%) than those who received short‐acting opioids (14%) (difference of 6%, 95% CI 1.9%‐10.2%, P < .001) or long‐acting opioids (24%) (difference of 16%, 95% CI 8.1%‐24.3%, P < .001). Patients who received short‐acting opioids also had a lower incidence than those who received long‐acting opioids (difference of 10%, 95% CI 2.2%‐18.1%, P < .001). The incidence also differed between those patients who received postdischarge opioids at home (29%) and those who did not (13%) (difference of 16%, 95% CI 7.5%‐27.6%, P < .001). There was no association with age, gender, airway management, nitrous oxide use, amount of intravenous fluids, duration of anesthesia, intraoperative antiemetic administration or dosage, length of time from recovery room discharge to first oral intake, or length of ride home from the hospital. Multivariate generalized linear regression analysis confirmed intraoperative (short‐acting opioids odds ratio 1.686, 95% CI 1.020‐2.787; long‐acting opioids odds ratio 3.093, 95% CI 1.634‐5.874) and postdischarge (odds ratio 2.037 95% CI 1.142‐3.632) opioids to be independent risk factors for postdischarge nausea and vomiting.

Conclusion

We found an incidence of postdischarge nausea and vomiting of 14%. Intraoperative and postdischarge opioids increase the risk, with long‐acting intraoperative opioids further accentuating the risk.
Congenital Langerhans cell histiocytosis presenting in a 27‐week‐gestation neonate
Authors: Dennin Margaret H. , Roman Carly J. , Stein Sarah L.
Published: February 2018

Langerhans cell histiocytosis is exceedingly rare in premature infants, and the few cases reported suggest a poor prognosis with systemic involvement. We present a case of Langerhans cell histiocytosis limited to a single cutaneous lesion, presenting in a 27‐week‐gestation infant, which is the youngest gestational age of reported Langerhans cell histiocytosis cases. The lesion showed spontaneous resolution by 41 weeks corrected gestational age, and systemic involvement was absent, demonstrating a mild course of skin‐only Langerhans cell histiocytosis in a premature infant.
Geographic tonguelike presentation in a child with pityriasis rosea: Case report and review of oral manifestations of pityriasis rosea
Authors: Alzahrani Nouf A. , AlJasser  Mohammed I.
Published: February 2018

Oral lesions are rarely reported in patients with pityriasis rosea. We report a case of a 3‐year‐old boy with clinical evidence of generalized pityriasis rosea who developed asymptomatic oral lesions similar in appearance to geographic tongue. The generalized eruption and tongue lesions resolved simultaneously within 4 weeks. We also review the literature on the oral manifestations of Pityriasis rosea.
Bascule syndrome associated with syncopal episodes
Authors: Martín José M. , Torres Catalina , Cordero Pilar , Sánchez Sara , Terradez Liria , Ramón Dolores
Published: February 2018

Bascule syndrome is a recently described benign vasomotor dermatosis characterized by Bier anemic spots, cyanosis, and urticaria‐like eruption. We report a case of a 13‐year‐old girl with cutaneous lesions consistent with Bascule syndrome who had had three exercise‐related syncopal episodes. It would be recommended to exclude orthostatic intolerance or postural orthostatic tachycardia syndrome when evaluating patients with Bascule syndrome.