bluuebunny/crossref_metadata_2025 huggingface dataset:
Infusion‐fill method versus standard auto‐fill trial of void protocol following a TVT‐exact procedure: A randomised controlled trial
Authors: Mowat Alexandra , Brown Bernadette , Pelecanos Anita , Mowat Victoria , Frazer Malcolm
Published: January 2018

Objective

To establish whether the infusion method trial of void (TOV) after a mid‐urethral sling procedure, in contrast to the standard auto‐fill TOV, permits discharge home from recovery, as these procedures are eminently suited to same day discharge, and the delay in achieving a successful TOV often keeps the patient in hospital overnight.

Method

A randomised controlled trial performed between December 2014 and April 2016 at the University Hospital, enrolling 40 women undergoing a mid‐urethral sling procedure for stress urinary incontinence. The women were randomised to infusion method or auto‐fill method TOV. The primary outcome was discharge home from the recovery area of theatre.

Results

Discharge from recovery was not different between the two groups (odds ratio (OR) 1.3 95% CI: 0.3–5.9, P = 0.71). The rate of TOV being successfully passed in recovery was higher in the infusion‐fill group compared to the standard auto‐fill group (OR 4.5 95% CI 1.2–17.4, P = 0.025). This means that three women will undergo the infusion‐fill to achieve one more successful TOV in recovery.

Conclusions

The infusion method resulted in more women passing their TOV in recovery but this did not translate into more discharges from recovery.
Socio‐demographic predictors of unintended pregnancy and late antenatal booking in Honiara, Solomon Islands
Authors: Kluckow Hannah , Panisi Leeanne , Larui Jessie , Jatobatu Anna , Kim Dukyeon , Hodges Laura , Black Kirsten I.
Published: January 2018

Background

The Solomon Islands is a Pacific nation with a maternal mortality of 114 per 100 000 births. Around 57% of pregnancies are unintended and only 15% of women attend their first antenatal visit in the first 12 weeks as recommended by the World Health Organization.

Aims

We sought to examine the socio‐demographic predictors of unintended pregnancy and late antenatal booking (>18 weeks) among women attending antenatal care in Honiara.

Materials and methods

From January 2014 to May 2015 we undertook a cross‐sectional survey using a structured questionnaire on women presenting to the National Referral Hospital and community clinics in Honiara for antenatal care.

Results

Of 1441 women, 41.0% of pregnancies were intended, 55.7% were ambivalent and 3.3% were fully unintended. Unintended pregnancy was significantly associated with being unemployed (adjusted odds ratio (aOR) 1.45, P = 0.024), being a teenager at first intercourse (aOR 1.53; P = 0.004), shared family planning decision making (aOR 0.54; P = 0.006) living with a husband (aOR 0.31 P < 0.001) and a short interpregnancy interval (OR 4.48, P ≤ 0.001). Late booking occurred in 1168 (84.7%) women and independent predictors of this included ambivalent or unintended pregnancy (aOR 1.74, P = 0.005) and multiparity (aOR 2.05, P = 0.001).

Conclusions

Unintended pregnancy and late antenatal booking remain a challenge to improving maternal health in the Solomon Islands. Investments in family planning could target reproductive health education and post‐partum family planning. Improving the quality of antenatal care as well as addressing social determinants of health, including gender equity, education and employment of women, is required if maternal mortality is to be reduced.
The Sterkfontein Caves after Eighty Years of Paleoanthropological Research: The Journey Continues
Authors: Stratford Dominic Justin
Published: January 2018

The Sterkfontein Caves, the richest Australopithecus‐bearing site in the world, occupies a crucial position in the history of South African scientific inquiry and has been pivotal to the development of the field of paleoanthropology. The site is physically and culturally embedded in the foundations of Johannesburg and is recognized as being one of the world's most important cultural heritage resources. The year 2016 was the eightieth anniversary of the discovery of the first adult Australopithecus by Robert Broom at Sterkfontein in 1936, a find that inspired three generations of paleoanthropological research throughout South Africa's Cradle of Humankind. Since this discovery, through fortune or dedicated research efforts, Sterkfontein has provided some of the most crucial clues to the complexities of our evolutionary past. In an auspicious year, 150 years since Robert Broom's birth, eighty years since Broom's discovery, and fifty years since Tobias's inauguration of a new Sterkfontein research program, this article presents a brief review of the history of research at Sterkfontein and its role in the development of the field of paleoanthropology. In light of this juncture, this article contributes two consolidated resources: a literature archive and a consolidated record of excavation‐diary entries since 1967. [Sterkfontein, Australopithecus, Cradle of Humankind, paleoanthropology, Robert Broom]
What does the world think of ankyloglossia?
Authors: Jin Ruilin R. , Sutcliffe Alastair , Vento Maximo , Miles Claudelle , Travadi Javeed , Kishore Kumar , Suzuki Keiji , Todd David , Wooderson Susanne , Kamar Azanna Ahmad , Ma Li , Smyth John , Oei Ju Lee
Published: January 2018

Aim

The diagnosis of tongue‐tie (or ankyloglossia) has increased more than 10‐fold in some countries. Whether this is a global phenomenon or related to cultural and professional differences is uncertain.

Methods

An online survey in English, Japanese, Chinese and Spanish was disseminated between May and November 2016 via 27 international professional bodies to >30 clinical professions chosen a priori to represent occupations involved in the management of neonatal ankyloglossia.

Results

A total of 1721 responses came from nursing (51%), medical (40%), dental (6%) and allied health (4%) clinicians. Nurses (40%) and allied health (34%) professionals were more likely than doctors (8%) to consider ankyloglossia as important for lactation problems, as were western (83%) compared to Asian (52%) clinicians. Referrals to clinicians for ankyloglossia management originated mainly from parents (38%). Interprofessional referrals were not clearly defined. Frenectomies were most likely to be performed by surgeons (65%) and dentists (35%), who were also less likely to be involved in lactation support. Clinicians performing frenectomies were more likely to consider analgesia as important compared to those not performing frenectomies.

Conclusion

The diagnosis and treatment of ankyloglossia vary considerably around the world and between professions. Efforts to standardise management are required.
Prescriptive birthweight charts can improve the prediction of adverse outcomes in very preterm infants who are small for gestational age
Authors: Hoftiezer Liset , Snijders Renske G. , Hukkelhoven Chantal W.P.M. , van Lingen Richard A. , Hogeveen Marije
Published: January 2018

Aim

We compared three anthropometric charts to determine which provided the best predictions for adverse outcomes in very preterm small for gestational age (SGA) infants to address a lack of consensus on this subject.

Methods

This was a retrospective cohort study of infants born below 32 weeks, who were admitted to two‐level three neonatal intensive care units in The Netherlands from 2008 to 2013. The birthweights of 1720 infants were classified as SGA using a conventional, gender‐specific birthweight chart, based on births in The Netherlands between 2000 and 2007, a prescriptive, gender‐specific birthweight chart, based on the same data but without risk factors for intrauterine growth restriction (IUGR), and a non‐gender‐specific foetal weight chart derived from American ultrasonographic measurements.

Results

The conventional, prescriptive and foetal weight charts classified 126 (7.3%), 494 (28.7%) and 630 (36.6%) infants as SGA. The prescriptive chart, which excluded IUGR, identified 368 SGA infants with significantly increased risks of neonatal mortality and morbidity. The 136 SGA infants just classified by the American foetal weight chart were not at increased risk.

Conclusion

The prescriptive birthweight chart, which excluded infants with IUGR, was the most effective chart when it came to identifying clinically important risk increases in SGA infants.
The preterm infant stomach actively degrades milk proteins with increasing breakdown across digestion time
Authors: Demers‐Mathieu Veronique , Qu Yunyao , Underwood Mark A. , Dallas David C.
Published: January 2018

Aim

This study investigated the effect of time post‐ingestion on gastric digestion and gastric hormones after feeding preterm infants unfortified and fortified human milk.

Methods

Human milk and infant gastric samples were collected from 14 preterm (23–32 weeks birth gestational age) mother‐infant pairs within 7–98 days postnatal age. Gastric samples were collected one, two and three hours after beginning of feeding. Samples were analysed for pH, proteolysis, general protease activity and the concentrations of pepsin, gastrin and gastrin‐releasing peptide (GRP). One‐way ANOVA with repeated measures followed by Tukey's multiple comparisons test was used.

Results

Gastric pH was significantly decreased after each hour in the preterm infant stomach from one to three hours postprandial. Proteolysis increased significantly from human milk to gastric contents at one, two and three hours postprandial (by 62, 131% and 181%, p < 0.05). General protease activity increased significantly by 58% from human milk to the gastric contents at two hours postprandial. GRP was present in human milk, whereas gastrin was produced in the infant stomach.

Conclusion

Although preterm infants may digest human milk proteins to a lesser extent than term infants, we demonstrated that the preterm infant stomach actively degrades milk proteins with increasing breakdown over digestion time.
Body length and occipitofrontal circumference may be good indicators of neurodevelopment in very low birthweight infants – secondary publication
Authors: Watanabe Yoshitaka , Itabashi Kazuo , Taki Motohiro , Miyazawa Tokuo , Nakano Yuya , Murase Masahiko
Published: January 2018

Aim

The aim of this study was to predict the neurological prognosis of very low birthweight (VLBW) infants. We examined the relationship between nutritional status, brain volume measured by magnetic resonance imaging (MRI) and anthropometric measurements of VLBW infants at term‐equivalent age (TEA).

Methods

We evaluated 27 VLBW infants, born at Showa University Hospital in Japan between April 2012 and August 2013, who underwent brain MRI at TEA. Based on their clinical data, we analysed their protein and energy intake.

Results

Median values for the 27 VLBW infants were as follows: gestational age, 29.7 weeks; birthweight 1117 g; protein intake 2.7 g/kg/day and energy intake 97.9 kcal/kg/day. At TEA, the standard deviation scores (SDSs) of body weight, body length and the occipitofrontal circumference (OFC) were −0.8, −1.4 and 0.7, respectively. Multiple regression analysis revealed that the SDSs of body length and the OFC at TEA were significant determinants of white matter volume, but that the SDS of body weight at TEA was not.

Conclusion

Our findings suggest that the SDSs of body length and the OFC at TEA may be better indicators than body weight for predicting the development of the central nervous system in VLBW infants receiving nutritional management.
Randomised controlled trial of diazoxide for small for gestational age neonates with hyperinsulinaemic hypoglycaemia provided early hypoglycaemic control without adverse effects
Authors: Balachandran Binesh , Mukhopadhyay Kanya , Sachdeva Naresh , Walia Rama , Attri Savita Verma
Published: January 2018

Aim

Hyperinsulinaemic hypoglycaemia (HH) is a very common cause of hypoglycaemia in small for gestational age (SGA) neonates. We compared using early oral diazoxide or a placebo for this patient group.

Methods

This was a randomised, double‐blind, placebo‐controlled trial that focused on SGA neonates born at at least 32 weeks of gestation with HH during the first five days of life. Neonates with severe perinatal asphyxia, sepsis or contraindications for oral feeds were excluded. The primary outcome was the hours taken to achieve hypoglycaemic control, with a glucose infusion rate of ≤4 mg/kg/min. The secondary outcomes were the duration of intravenous fluids, sepsis episodes, time to achieve full feeds and mortality.

Results

We screened 490 neonates and 30 neonates were eligible for randomisation and completed the trial. Half received diazoxide and half received a placebo. The median time to achieve hypoglycaemia control (40 vs 71.5 hours, p = 0.015), the total duration of intravenous fluids (114 vs 164 hours, p = 0.04) and time to achieve full feeds (74 vs 124 hours, p = 0.02) were significantly lower in the diazoxide group, with no adverse effects attributed to the drug.

Conclusion

Using oral diazoxide for SGA neonates with HH provided early hypoglycaemic control with no apparent adverse effects.
National data showed that delayed sleep in six‐year‐old children was associated with excessive use of electronic devices at 12 years
Authors: Kato Tsuguhiko , Yorifuji Takashi , Yamakawa Michiyo , Inoue Sachiko
Published: January 2018

Aim

Cross‐sectional studies have shown associations between adolescent sleep problems and the use of electronic devices, such as mobile phones, but longitudinal studies remain scarce. We explored any association between delayed bedtimes at six years old and the excessive use of electronic devices at 12 years of age. Texting was a prime focus.

Methods

We analysed 9607 adolescents who owned mobile phones in 2013 using the Japanese Longitudinal Survey of Newborns in the 21st Century, which started in 2001. The outcomes were daily excessive use of a mobile phone, television (TV) and video games.

Results

Delayed bedtime at the age of six years was associated with excessive texting at weekends. The adjusted odds ratios and 95% confidence intervals obtained from logistic regression analyses were 1.88 (1.14–3.10) for the 10–11 pm group and 1.98 (1.08–3.63) for the after 11 pm group, compared with the before 9 pm group. Later bedtimes were also associated with increased risks of excessive TV viewing and video game use.

Conclusion

Our study indicated that six‐year‐olds who regularly stayed up late at night used electronic devices more frequently, or for longer, at the age of 12. Parents need to be more aware of links between sleep issues and electronic devices.
NONUNION EMPLOYEE REPRESENTATION: THEORY AND THE GERMAN EXPERIENCE WITH MANDATED WORKS COUNCILS
Authors: JIRJAHN Uwe , SMITH Stephen C.
Published: January 2018

Theories of how nonunion employee representation impacts firm performance, affects market equilibria, and generates externalities on labor and society are synthesized. Mandated works councils in Germany provide a particularly strong form of nonunion employee representation. A systematic review of research on the German experience with mandated works councils finds generally positive effects, though these effects depend on a series of moderating factors and some impacts remain ambiguous. Finally, key questions for empirical research on nonunion employee representation, which have previously been little analyzed in the literature, are reviewed.
A clinically relevant decrease in abiraterone exposure associated with carbamazepine use in a patient with castration‐resistant metastatic prostate cancer
Authors: Benoist Guillemette E. , van der Doelen Maarten J. , ter Heine Rob , van Erp Nielka P. , Mehra Niven
Published: January 2018

Adverse Event

Decreased abiraterone exposure after introducing carbamazepine.

Drugs Implicated

Abiraterone acetate and carbamazepine.

The Patient

A 65‐year‐old man with metastatic castration resistant prostate cancer, was treated with abiraterone acetate and prednisolone, and received concomitant carbamazepine for treatment of facial neuropathy.

Evidence that Links the Drug to the Event

The interaction was confirmed by a decrease in abiraterone exposure >2‐fold (area‐under‐the‐curve and trough levels). After discontinuation of carbamazepine therapy, the abiraterone exposure normalized. No alternative causes were found that explain the decrease in abiraterone exposure.

Mechanism

Induction of CYP3A and potentially phase I metabolism (SULT2A1) by carbamazepine.

Implications for Therapy

Clinicians and pharmacists should be aware of this clinically relevant interaction. The national drug–drug interaction checker does not warn for this interaction, whereas both the Lexicomp® and Micromedex® advice to avoid if possible or to increase the abiraterone dose frequency to twice daily. Carbamazepine should not be combined with abiraterone to avoid underexposure and suboptimal therapy. Therapeutic drug monitoring of abiraterone is useful to guide therapy when drug–drug interactions cannot be avoided.
Platelets at the crossroads of thrombosis, inflammation and haemolysis
Authors: Vogel Sebastian , Thein Swee Lay
Published: January 2018

Platelets play a critical role at the interphase of thrombosis and inflammation, key features in haemolysis‐associated disorders. Exercising this role requires expression of pattern recognition receptors by platelets, including toll‐like receptor 4 (TLR4) and nucleotide‐binding domain leucine rich repeat containing protein 3 (NLRP3), the latter forming intraplatelet multiprotein inflammasome complexes. Platelets are a potential target of various damage‐associated molecular pattern (DAMP) molecules, such as free haem, a degradation by‐product of haemoglobin oxidation during haemolysis, and high‐mobility group box 1 (HMGB1), a DNA‐binding protein released by dying or stressed cells and activated platelets. We have recently identified platelet TLR4, NLRP3, and Bruton tyrosine kinase (BTK) as critical regulators of platelet aggregation and thrombus formation, suggesting that the BTK inhibitor ibrutinib is a potential therapeutic target. Increasing evidence suggests that these and other DAMP‐driven signalling mechanisms employed by platelets might be key in mediating inflammation and thrombosis encountered in haemolytic disorders. However, the precise regulatory triggers and their clinical relevance are poorly understood. We provide new insights into these less‐well characterised platelet mechanisms, which are potentially targetable in haemolytic disorders.
Higher level of GGT during mid‐pregnancy is associated with increased risk of gestational diabetes mellitus
Authors: Kong Man , Liu Chaoqun , Guo Yanfang , Gao Qing , Zhong Chunrong , Zhou Xuezhen , Chen Renjuan , Xiong Guoping , Yang Xuefeng , Hao Liping , Yang Nianhong
Published: January 2018

Objective

This study was to explore the link between gamma‐glutamyl transferase (GGT), alanine transaminase (ALT) and aspartate transaminase (AST) levels during early‐middle pregnancy and subsequent risk of gestational diabetes mellitus (GDM).

Methods

In a prospective cohort study, pregnant women enrolled prior to 16 weeks of gestation were followed up until delivery. GGT, AST and ALT levels were tested during weeks 14‐18 of gestation and oral glucose tolerance test was conducted during 24‐28 weeks to screen GDM.

Results

The GDM rate was 8.1% (122/1512). Mean GGT level was higher in GDM than non‐GDM women (18.7 ± 13.0 vs 14.5 ± 7.0, P < .001). The higher GGT level was 26.9~74.0 U/L, which was significantly associated with increased risk of GDM. The adjusted RR (95% CI) comparing higher GGT level versus lower was 5.40 (3.36‐8.68). No significant correlation was found between ALT or AST levels and the risk of GDM.

Conclusions

The results suggest that pregnant women with higher serum GGT during early‐middle pregnancy have higher risk of developing GDM. A GGT level >26.9 U/L may indicate an increased risk of developing GDM later and should be further concerned.
Disclosure of cardiac variants of uncertain significance results in an exome cohort
Authors: Lawal T.A. , Lewis K.L. , Johnston J.J. , Heidlebaugh A.R. , Ng D. , Gaston‐Johansson F.G. , Klein W.M.P. , Biesecker B.B. , Biesecker L.G.
Published: January 2018

This study examined the impact of disclosing subclassifications of genetic variants of uncertain significance (VUS) on behavioral intentions. We studied return of VUS results to 79 individuals with a cardiomyopathy‐associated VUS, subclassified into VUS‐high or VUS‐low. Primary outcomes were perceived risk (absolute and comparative), perceived severity, perceived value of information, self‐efficacy, decision regret, and behavioral intentions to share results and change behaviors. There was no significant difference between the 2 subclasses in overall behavioral intentions (t = 0.023, P = .982) and each of the individual items on the behavioral intentions scale; absolute (t = −1.138, P = .259) or comparative (t = −0.463, P = .645) risk perceptions; perceived value of information (t = 0.582, P = .563) and self‐efficacy (t = −0.733, P = .466). Decision regret was significantly different (t = 2.148, P = .035), with VUS‐low (mean = 17.24, SD = 16.08) reporting greater regret. Combining the subclasses, perceived value of information was the strongest predictor of behavioral intentions (β = 0.524, P < .001). Participants generally understood the meaning of a genetic VUS result classification and reported satisfaction with result disclosure. No differences in behavioral intentions were found, but differences in decision regret suggest participants distinguish subclasses of VUS results. The perceived value of VUS may motivate recipients to pursue health‐related behaviors.
Attractive males produce high‐quality daughters in the bean bugRiptortus pedestris
Authors: Suzaki Yû , Katsuki Masako , Okada Kensuke
Published: January 2018

There are numerous studies on the genetic benefit of female mate choice. Fisherian benefits are detected frequently, in which attractive males benefit females by increasing the mating success of sons. In contrast, good‐genes benefits are relatively small or undetectable, especially as males often face a trade‐off between the expression of secondary sexual traits and viability. In this situation, the effects of good genes might be masked in their sons and, therefore, should be investigated in daughters. A previous study has shown that attractive males produce attractive sons (i.e., Fisherian benefit); the present study aimed to verify the existence of good‐genes benefits by revealing whether attractive males of the bean bugRiptortus pedestris(Fabricius) (Hemiptera: Alydidae) produced high‐quality daughters. Male attractiveness was measured using courtship latency, and the fitness of the females and their offspring was measured based on their lifetime reproductive success as well as the longevity of the daughters. There was no evidence that females directly benefited from mating with attractive males. Whereas male attractiveness (i.e., courtship latency) did not affect nymphal viability or the longevity of daughters, the attractive males with lower courtship latency could produce the daughters with higher lifetime reproductive success. These results suggest that female mating preference inR.pedestrisevolved via Fisherian and good‐genes benefits.
Larval host plant influences male body size and mating success in a tephritid fruit fly
Authors: Shelly Todd E.
Published: January 2018

In phytophagous insects, the larval host plant may have a profound effect on the biology of the adult stage. This influence has been most widely studied in females, where larval diet may affect their fecundity and survival. Males have been less well studied, with focus on host plant effects on (1) male size and the consequences of variable male size on male mating success, ejaculate, and/or nuptial gifts, or (2) male‐produced chemical signals important in sexual communication. The melon fly, Zeugodacus cucurbitae (Coquillett) (Diptera: Tephritidae), is a world‐wide agricultural pest that infests plants of the family Cucurbitaceae primarily but also attacks hosts in other unrelated families. The objective of the present study was to investigate whether larval host influenced female choice in Z. cucurbitae and, in particular, test for random mating using adults (Z flies) whose larvae fed on a cucurbit host (zucchini, Cucurbita pepo L.) and adults (P flies) whose larvae fed on a non‐cucurbit host (papaya, Carica papaya L., Caricaceae). In field tent trials, both Z and P females mated more often with Z males than P males, and in no‐choice laboratory cage trials, mating latency was generally shorter for Z than for P males. Wing vein measurements, made both within and between generations, showed that Z males were consistently larger than P males. Further observations of fly trios — one female plus one large and one small male — revealed that large males dominated in aggressive encounters and exhibited wing fanning (signaling) more often than their smaller counterparts. Although olfactory signals associated with wing fanning were not investigated in the present study, the observed host‐mediated difference in male size is, if not solely responsible, certainly an important determinant of the mating patterns described.
Do facultative symbionts affect fitness of pea aphids in the sexual generation?
Authors: McLean Ailsa H.C. , Ferrari Julia , Godfray H. Charles J.
Published: January 2018

Many aphids carry one or more facultative symbiotic bacteria which can provide a variety of fitness benefits for their hosts. They have chiefly been investigated in asexually reproducing aphids, with studies of the sexual generation limited to investigation of transmission rates and the potential for sex ratio manipulation. The effects of two facultative symbionts on the mating success of pea aphids, Acyrthosiphon pisum Harris (Hemiptera: Aphididae, Macrosiphini), were investigated in a no‐choice experiment. We compared the fitness of aphids with natural infections of either Regiella insecticola Moran et al. or Hamiltonella defensa Moran et al. with that of aphids from genetically identical cured lines. Female fecundity was unaffected by the presence of facultative symbionts. However, females mated to males cured of H. defensa laid fewer eggs on average than females mated to males carrying H. defensa; in one case the percentage of melanized eggs (eggs that were either not fertilized or in which early death occurred) was also smaller with cured compared to naturally infected males. In addition, males with H. defensa suffered higher mortality during the experiment than cured males. Four of the aphid lines used also hosted Spiroplasma infections, a symbiont previously reported to cause male‐killing in pea aphids. Despite this, three of the Spiroplasma‐infected lines produced males, two at high numbers. We conclude that removing a natural symbiont infection may have a negative fitness effect on male aphids in some aphid clones, whereas sexual females from the same clones are largely unaffected.
Chronic lymphoproliferative disorder of NK‐cells: A single‐institution review with emphasis on relative utility of multimodality diagnostic tools
Authors: Kurt Habibe , Jorgensen Jeffrey L. , Amin Hesham M. , Patel Keyur P. , Wang Sa A. , Lin Pei , Kanagal‐Shamanna Rashmi , Loghavi Sanam , Thakral Beenu , Khogeer Haitham A. , Jabbour Elias J. , Li Shaoying , Yin C. Cameron , Medeiros L. Jeffrey , Khoury Joseph D.
Published: January 2018

Background

Chronic lymphoproliferative disorder of NK‐cells (CLPD‐NK) manifests as a persistent increase (≥2 × 109/L, for > 6 months) of mature NK‐cells in peripheral blood with an indolent clinical course. The disease is rare, and only limited case series have been published.

Methods

We retrospectively studied 11 patients with CLPD‐NK diagnosed at our institution between 2005 and 2017.

Results

Patients included 7 men and 4 women with a median age of 60 years (range, 25‐89 years). Ten patients (91%) had cytopenias. Bone marrow involvement by CLPD‐NK ranged from 5‐15%. The most commonly detected antigenic aberrancies by  low cytometry immunophenotyping were as follows: CD7decreased/dim (30%), CD8uniform+ (36%), CD56−/partial (73%), CD94bright (55%), and KIR restriction (100%). JAK/STAT pathway mutations were detected in 8 of 10 (80%) patients and involved STAT3 (n = 7) and JAK3 (n = 1). The presence of mutations tended to correlate with the occurrence of other cytopenias (anemia/thrombocytopenia) and requirement for treatment. Seven patients received single‐agent therapy, with amelioration of symptoms; 4 patients were observed. There were no disease‐associated deaths or progression to more aggressive disease during the follow‐up interval (median, 17 months).

Conclusions

Patients with CLPD‐NK have an indolent clinical course and frequent hematologic manifestations that are responsive to single‐agent therapy. Mutations in STAT3 are common and portend more pronounced clinical manifestations.
Topographic principles of cortical fluid‐attenuated inversion recovery signal in temporal lobe epilepsy
Authors: Adler Sophie , Hong Seok‐Jun , Liu Min , Baldeweg Torsten , Cross J. Helen , Bernasconi Andrea , Bernhardt Boris C. , Bernasconi Neda
Published: January 2018

Objective

In drug‐resistant temporal lobe epilepsy (TLE), relative to the large number of whole‐brain morphological studies, neocortical T2 changes have not been systematically investigated. The aim of this study was to assess the anatomical principles that govern the distribution of neocortical T2‐weighted fluid‐attenuated inversion recovery (FLAIR) signal intensity and uncover its topographic principles.

Methods

Using a surface‐based sampling scheme, we mapped neocortical FLAIR intensity of 61 TLE patients relative to 38 healthy controls imaged at 3 T. To address topographic principles of the susceptibility to FLAIR signal changes in TLE, we assessed associations with normative data on tissue composition using 2 complementary approaches. First, we evaluated whether the degree of TLE‐related FLAIR intensity changes differed across cytoarchitectonic classes as defined by Von Economo‐Koskinas taxonomy. Second, as a proxy to map regions with similar intracortical composition, we carried out a FLAIR intensity covariance paradigm in controls by seeding systematically from all cortical regions, and identified those networks that were the best spatial predictors of the between‐group FLAIR changes.

Results

Increased intensities were observed in bilateral limbic and paralimbic cortices (hippocampus, parahippocampus, cingulate, temporopolar, insular, orbitofrontal). Effect sizes were highest in periallocortical limbic and insular classes as defined by the Von Economo‐Koskinas cytoarchitectonic taxonomy. Furthermore, systematic FLAIR intensity covariance analysis in healthy controls revealed that similarity patterns characteristic of limbic cortices, most notably the hippocampus, served as sensitive predictors for the topography of FLAIR hypersignal in patients. FLAIR intensity findings were robust against correction for morphological confounds. Patients with a history of febrile convulsions showed more marked signal changes in parahippocampal and retrosplenial cortices, known to be strongly connected to the hippocampus.

Significance

FLAIR intensity mapping and covariance analysis provide a model of TLE gray matter pathology based on shared vulnerability of periallocortical and limbic cortices.
Successful surgical management of eosinophilic granuloma on the urethral process of a gelding associated with Habronema spp. infection
Authors: Tyrnenopoulou P. , Diakakis N. , Psalla D. , Traversa D. , Papadopoulos E. , Antonakakis M.
Published: January 2018

Habronemiasis, otherwise known as summer sores, is a parasitic disease of horses, donkeys and other equids, commonly encountered in subtropical and tropical regions. It occurs as a result of nematode infestation of the skin and typically manifests as ulcerative granulating lesions or masses. Habronema muscae, Habronema microstoma and Draschia megastoma are the usual invaders, usually transmitted by house flies, face flies and stable flies. In this case report, an eosinophilic granuloma on the urethral process of a 15‐year‐old gelding is presented, followed by successful surgical excision without further medical treatment. To the authors’ knowledge, equine eosinophilic granuloma on the urethral process associated with habronemiasis has not previously been documented in southern Europe and should be considered as a potential differential diagnosis for penile masses.
The role of glucocerebrosidase in Parkinson disease pathogenesis
Authors: Gegg Matthew E. , Schapira Anthony H. V.
Published: January 2018

GBA encodes the lysosomal enzyme glucocerebrosidase (GCase), an enzyme involved in sphingolipid metabolism. Mutations in the GBA gene are numerically the most important risk factor for developing Parkinson disease (PD) accounting for at least 5% of all PD cases. Furthermore, loss of GCase activity is found in sporadic PD brains. Lysosomal dysfunction is thought to play a principal role in PD pathogenesis and in particular its effect on the metabolism of α‐synuclein. A hallmark of PD is the presence of intraneuronal protein inclusions called Lewy bodies, which are composed mainly of α‐synuclein. Cellular and animal models of GCase deficiency result in lysosomal dysfunction, and in particular the autophagy lysosome pathway, resulting in the accumulation of α‐synuclein. Some forms of mutant GCase unfold in the endoplasmic reticulum activating the unfolded protein response, which might also contribute to PD pathogenesis. It has also been suggested that accumulation of GCase substrates glucosylceramide/glucosylsphingosine may contribute to GBA‐PD pathogenesis. Mitochondrial dysfunction and neuroinflammation are associated with GCase deficiency and have also been implicated in the aetiology of PD. This review discusses these points and highlights potential treatments that might be effective in treating GCase deficiency in PD.
Validation of contralateral premolars as the substrate for endodontic comparison studies
Authors: Johnsen G. F. , Sunde P. T. , Haugen H. J.
Published: January 2018

Aim

To use micro‐CT technology and metrology software to validate the use of contralateral premolars as samples in endodontic comparison studies by comparing them before and after canal instrumentation with one instrumentation system. Furthermore, to determine whether contralateral premolar roots (CPRs) will yield non‐significantly different outcomes regarding shaping ability (volume), degree of twisting and three‐dimensional shape changes. The null‐hypothesis (H0) is that there are no differences between the CPRs pre‐ or post‐instrumentation.

Methodology

Twenty‐eight extracted human contralateral premolars (n = 44 contralateral roots) from 12 donor patients were scanned with microcomputed tomography before and after instrumentation. Root canal lengths (RCLs) were measured visually using a dental‐operating microscope, electronic apex locator and micro‐CT scans. Data were analysed statistically for differences between pre‐ and post‐instrumentation.

Results

Instrumentation increased the volume of the canals significantly (P < 0.05). Degree of twisting for a majority (83%) of the contralateral roots pairs did not change significantly (P > 0.05). There was no significant difference (P > 0.05) in the shape deviation analysis between contralateral pairs. There was no significant difference (P > 0.05) for RCL between the contralateral pairs for any of the three endometric methods.

Conclusion

Contralateral premolar root canals were associated with similar changes in terms of volume, three‐dimensional shape and degree of twisting from pre‐ to post‐instrumentation. There was no difference between the CPR pairs pre‐ and post‐instrumentation, and the study validates contralateral premolars as samples for root canal comparison studies. The null‐hypothesis (H0) could not be rejected.
Histoid leprosy: clinical and histopathological analysis of patients in follow‐up in University Clinical Hospital of endemic country
Authors: Canuto Maria J. M. , Yacoub Carolina R. D. , Trindade Maria A. B. , Avancini Joao , Pagliari Carla , Sotto Mirian N.
Published: January 2018

Background

Histoid leprosy (HL) is a rare form of lepromatous leprosy, characterized by hyperchromic indurated nodules above normal skin. Its main histopathological aspect is spindle cells. Because it may simulate other aspects, such as dermatofibroma and neurofibroma, histoid leprosy poses itself as a diagnostic challenge.

Methods

This is a retrospective study with all patients having been selected from the leprosy clinic of the Hospital das Clínicas da Universidade de São Paulo from 2006 to 2016.

Results

There were 12 patients in this study, eight in the histoid group and four in the lepromatous leprosy group. The prevalence of HL was 1.12% in all leprosy subjects. All individuals from HL group were “de novo” cases, and the histopathological analysis of skin lesions presented spindle cells generating a storiform pattern. Immunohistochemistry for CD68, vimentin, and anti‐BCG were positive in all 12 cases. Factor XIIIa was visualized only in the papillary dermis, and S100 protein was negative in all biopsies. Smooth‐muscle actin was present in 62.5% of the HL samples.

Conclusion

The prevalence of HL was similar to previous reports. However, all histoid patients were “de novo” cases, differing from published studies. Fusocellular macrophage transformation could be explained by the differences in cytoskeleton proteins expressed in histoid lesions in comparison to other leprosy variants, with emphasis on vimentin and smooth muscle actin.
When all other doors are closed: Telenurses' experiences of encountering care seekers with mental illnesses
Authors: Bjorkman Annica , Salzmann‐Erikson Martin
Published: January 2018

The aim of the study was to describe the telephone nurses' experiences of encountering callers with mental illnesses. Telenursing services are solely staffed with telenurses, who with the support of a decision support system (CDSS) independently triage callers based on the severity of the main symptoms presented by the care seeker. The system focuses on somatic symptoms, while information regarding mental health and mental illnesses is limited. Information about telenurses' experiences of encountering care seekers with mental illnesses is scarce, despite the increase in mental illnesses in the population. The study used a descriptive design with a qualitative approach. Twenty telenurses were interviewed, and the data were then analysed using inductive qualitative content analysis. The results are elaborated in the following three categories: (i) Experiences of encountering care seekers with mental illnesses; (ii) Experiences of facing difficulties and challenges; and (iii) Experiences of facing dissatisfaction and threats. Encountering care seekers with mental illnesses is metaphorically addressed as ‘when all other doors are closed’. Encountering care seekers with mental illnesses was perceived as time‐consuming and did not adequately correspond to the resources given by the service. Even though telenurses strive to achieve agreement, there is a collision between human needs and organizational structures. The study pinpoints the lack of resources for and education about mental illnesses and the limitations of the decision system, which needs to be updated in order to provide all care seekers care on equal terms.
Unexpected absence of island endemics: Long‐distance dispersal in higher latitude sub‐Antarctic Siphonaria (Gastropoda: Euthyneura) species
Authors: González‐Wevar Claudio A. , Segovia Nicolás I. , Rosenfeld Sebastián , Ojeda Jaime , Hüne Mathias , Naretto Javier , Saucède Thomas , Brickle Paul , Morley Simon , Féral Jean‐Pierre , Spencer Hamish G. , Poulin Elie
Published: January 2018

Aim

We assess biogeographical patterns, population structure and the range of species in the pulmonate genus Siphonaria across the sub‐Antarctic. We hypothesized that locally endemic cryptic species will be found across the distribution of these direct‐developing limpets in the sub‐Antarctic.

Location

The sub‐Antarctic coasts of the Southern Ocean including South America, the Falkland/Malvinas, South Georgia, Kerguelen and Macquarie Islands.

Methods

Multi‐locus phylogenetic reconstructions, mtDNA time‐calibrated divergence time estimations and population‐based analyses of Siphonaria populations were used at the scale of the Southern Ocean.

Results

We resolve two widely distributed lineages of Siphonaria (S. lateralis and S. fuegiensis) across the sub‐Antarctic. MtDNA divergence time estimates suggest that they were separated around 4.0 Ma (3.0 to 8.0 Ma). Subsequently both species followed different evolutionary pathways across their distributions. Low levels of genetic diversity characterize the populations of both species, reflecting the role of Quaternary glacial cycles during their respective demographic histories, suggesting high levels of dispersal among geographically distant localities.

Main conclusions

Siphonaria lateralis and S. fuegiensis constitute sister and broadly co‐distributed species across the sub‐Antarctic. Unexpected transoceanic similarities and low levels of genetic diversity in both these direct‐developing species imply recurrent recolonization processes through long‐distance dispersal to isolated sub‐Antarctic islands. For such groups of Southern Ocean invertebrates, rafting may be more effective for long‐distance dispersal than a free‐living planktotrophic larval stage. This biogeographical model may explain why many marine species lacking a dispersal phase exhibit broad distributions, low genetic diversity and low population structure over thousands of kilometres.
Incidence and risk factors associated with hepatocellular carcinoma surveillance failure
Authors: Mancebo Alejo , Varela María , González‐Diéguez María Luisa , Navascués Carmen A , Cadahía Valle , Mesa‐Álvarez Alicia , Rodrigo Luis , Rodríguez Manuel
Published: January 2018

Background and Aim

Surveillance for hepatocellular carcinoma (HCC) intends to detect tumors at an early stage to improve survival. The study aims were to assess the frequency and risk factors associated with HCC surveillance failure.

Methods

The study analyzed data from 188 consecutive patients diagnosed with HCC within a surveillance program conducted among 1,242 cirrhotic patients and based on ultrasonography and alpha‐fetoprotein (AFP) testing every 3 or 6 months. Program failure was defined as the detection of HCC exceeding the Milan criteria. Variables recorded at entry into the program, during follow‐up and at HCC diagnosis, were analyzed.

Results

At diagnosis, 50 (26.6%) HCC tumors were beyond the Milan criteria. In univariate analysis, Child‐Pugh B at entry (P = 0.03), development of complications of portal hypertension before tumor diagnosis (P = 0.03), and failure to complete the prior screening round (P = 0.02), Child‐Pugh B/C (P = 0.001) and AFP ≥ 100 ng/mL (P = 0.03) at diagnosis, were associated with failure. In multivariate analysis, only Child‐Pugh B/C (hazard ratio, 3.18; 95% confidence interval, 1.66–6.10, P < 0.001) and AFP ≥ 100 ng/mL, both at diagnosis (hazard ratio, 2.80; 95% confidence interval, 1.37–5.71, P = 0.005), were independently associated with failure. Survival was higher among patients with tumors within the Milan criteria than those with program failure (33.9 vs 7.6 months, P < 0.001).

Conclusions

Approximately 25% of HCC cases diagnosed among patients included in a surveillance program were beyond the Milan criteria. Child‐Pugh B/C and AFP ≥ 100 ng/mL at diagnosis were associated with program failure. However, Child‐Pugh B at entry and development of liver‐related complications during follow‐up can be early predictors of failure.
Benefits and risks of intensive blood‐pressure lowering in advanced chronic kidney disease
Authors: Cheung A. K. , Chertow G. M. , Greene T. , Kimmel P. L. , Rahman M. , Reboussin D. , Rocco M. ,   SPRINT Research Group
Published: January 2018

Click here to view the Letter to the Editor by Dr. Obi et al.
Immediate and delayed loading of fixed dental prostheses supported by single or two splinted implants: A histomorphometric study in dogs
Authors: Cesaretti G. , Lang N. P. , Viganò P. , Bengazi F. , Apaza Alccayhuaman K. A. , Botticelli D.
Published: January 2018

To evaluate presumptive differences in osseointegration at implants supporting crowns that are physiologically loaded either immediately or 3 months after installation. All premolars and first molars were extracted bilaterally in six dogs. After 3 months of healing, three implants were installed on the premolar region and two in the molar region in one side of the mandible. Likewise, after another 3 months, five implants were installed in the contralateral side, and impressions were taken bilaterally. Within 48 hours, two single crowns were screwed bilaterally onto two implants in the premolar region, and two splinted crowns reproducing the shape of the first molar were screwed bilaterally onto the implants in the molar region. The mesial implants were used as no‐loaded controls. Sacrifices were performed after 3 months, and histological analyses were performed. At the premolar sites, mineralised bone‐to‐implant contact (MBIC%) was 78.0 ± 4.0% and 70.9 ± 7.9% at the delayed and immediately loaded sites, respectively. This difference was statistically significant. At the control implants, MBIC% was 61.4 ± 14.7% and 63.1 ± 13.1% at the delayed and the immediately loaded sites, respectively. At the molar sites, MBIC% was 79.2 ± 10.9% and 61.1 ± 10.3% at the delayed and immediately loaded sites, respectively. Applying a delayed loading to fixed dental prostheses supported by single or two splinted implants yielded higher proportions of bone‐to‐implant contact (osseointegration) compared to immediately loaded implants. Moreover, both types of loading protocols yielded a higher rate of osseointegration compared to unloaded implant sites after 3 months following implant installation.
Rapid diagnosis of rice bakanae caused by Fusarium fujikuroi and F. proliferatum using loop‐mediated isothermal amplification assays
Authors: Rong Zhenyang , Yuan Yongtian , Ye Wenwu , Wang Xiaoli , Zheng Xiaobo
Published: January 2018

Rice bakanae is an important disease that causes serious rice production loss worldwide. We describe a new method for rapid diagnosis of rice bakanae caused by Fusarium fujikuroi and F. proliferatum, based on loop‐mediated isothermal amplification (LAMP) assays. After screening, primers were selected to target FusariumDNA sequences, that is, the intergenic spacer (IGS) region of the nuclear ribosomal operon and reductase‐coding region (RED1) in F. fujikuroi and F. proliferatum, respectively. Both LAMP assays efficiently amplified target genes in 70 min at 62°C. A colour change from purple to sky blue (visible to the unaided eye) was observed in the presence of the DNA of the targeted pathogens only, by adding hydroxynaphthol blue to the reaction system prior to amplification. The minimum of genomic DNA needed in the assays was 67 and 346 pg/μl for F. fujikuroi and F. proliferatum, respectively. Using the two assays described here, we successfully and rapidly diagnosed suspected diseased rice plant and seed samples collected from Jiangsu Province.