bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of Shortness of Breath in the Acute Patient: A National Study
Authors: Hale Zachariah E. , Singhal Astha , Hsia Renee Y.
Published: May 2018

Background

Dyspnea is a common and ambiguous complaint that results in 3.4 million emergency department (ED) visits annually. While learners may encounter lists of differential diagnoses to consider while in training, often these lists are not empirically based. We sought to establish an evidence‐based differential diagnosis for dyspnea and to determine whether normal vital signs can rule out a life‐threatening diagnosis.

Methods

We analyzed data from the National Hospital Ambulatory Medical Care Survey from 2005 to 2014 for ED visits with a chief complaint of dyspnea and tallied the principal discharge diagnosis. We included 10,170 sampled ED visits by adults with a chief complaint of dyspnea, representing nearly 42 million visits nationally. We then calculated the most common principal discharge diagnoses by age group and the frequency of abnormal respiratory vital signs in cases with life‐threatening diagnoses.

Results

The most represented age group was 45 to 64 years (31.6%). Most visits were discharged directly from the ED (57.5%), while 8.1% required admission to an intensive care unit (ICU). The most common diagnosis in patients aged 18 to 44 was acute asthma exacerbation (14.8%). Obstructive chronic bronchitis was the most common specified diagnosis in both patients ages 45 to 64 (11.1%) and patients ages 65 to 79 (12.4%), while congestive heart failure was the most common for patients ages 80 and over (15.9%). Respiratory vital signs were frequently normal in the 44.6% of visits that resulted in a potentially life‐threatening diagnosis but corresponded to increased ICU utilization when abnormal.

Conclusions

For patients with dyspnea, the high utilization of ICUs highlights the importance of an accurate differential. The frequencies established here can be used as pretest probabilities in Bayesian analysis to improve the accuracy of differential diagnosis lists.
Pathogenesis, diagnosis and treatment of anaemia in immune‐mediated gastrointestinal disorders
Authors: Bergamaschi Gaetano , Di Sabatino Antonio , Corazza Gino R.
Published: May 2018

Immune‐mediated disorders affecting the gastrointestinal (GI) tract may compromise GI integrity, interfere with the absorption of nutrients and cause bleeding and inflammation. All these features contribute to the pathogenesis of anaemia, the most prevalent extra‐intestinal manifestation of immune‐mediated GI disorders. Anaemia is most commonly due to iron deficiency and/or inflammation, but vitamin deficiencies and, more infrequently, autoimmune haemolysis or drug‐induced myelosuppression can be involved. Here we address several issues related to the differential diagnosis and treatment of anaemia in immune‐mediated GI disorders, giving particular relevance to the problem of iron deficiency anaemia associated with inflammation. It is emphasized how, in most cases, anaemias due to iron or vitamin deficiencies are best treated by parenteral administration of the deficient factor(s), and how the available high dose intravenous (IV) iron formulations can reduce ambulatory and social costs of IV iron supplementation, while improving patient's compliance to treatment. Actual and future treatment possibilities for anaemia of inflammation, involving the use of erythropoiesis stimulating agents, biologicals and hepcidin inhibitors are discussed.
Exploring breast cancer and screening awareness among Irish women with intellectual disabilities
Authors: Reidy Mary , Denieffe Suzanne , Foran Sinéad
Published: May 2018

Accessible Summary

We asked women with intellectual disabilities what they knew about breast cancer and screening programmes.

We asked women what would put them off going to see a doctor whether they found something wrong with their breast.

Most of those we asked knew that a lump was a warning sign for breast cancer.

Most of those we asked did not know about the risk factors for breast cancer.

Many women did not know much about the breast screening programme.

Many women said they would be worried about what the doctor might find.

Improving breast cancer and screening awareness is important for women with intellectual disabilities.

Women with intellectual disabilities need to be taught more about breast cancer and screening.

Background

Internationally, it is known that there are gaps in cancer and screening awareness among women with intellectual disabilities. Little is known about this awareness among Irish women with intellectual disabilities. The aim of this study was to explore this awareness among these women.

Materials and Methods

The study design incorporated a cross‐sectional descriptive survey using an accessible version of the Cancer Research UK Cancer Awareness Measure. The questionnaire was administered to women with mild to moderate intellectual disabilities (n = 45, age range 20–59 years) living in the South East of Ireland.

Results

Almost three quarters of the women (77.8%) recognised a breast lump as a breast cancer warning sign. Knowledge about nonlump warning signs was much lower; 40% of the women did not feel confident that they would notice a change in their breast; 80% of the women could not recall a breast cancer risk factor. Overall, there was poor awareness of the national breast screening programme in Ireland. Worry and embarrassment about talking about their breasts would put women off seeking early medical intervention.

Conclusion

There was poor awareness about breast cancer warning signs, risk factors and the breast screening programme among the women. Where women with intellectual disabilities are lacking this knowledge, breast cancer warning may be missed. Carers and intellectual disability services need to ensure that theoretically based cancer and screening education interventions are undertaken which will enable these women to identify warning signs and seek attention promptly.
Cytomegalovirus: an unlikely ally in the fight against blood cancers?
Authors: Bigley A B , Baker F L , Simpson R J
Published: May 2018

Cytomegalovirus (CMV) infection is a potentially fatal complication in patients receiving haematopoietic stem cell transplantation (HSCT), but recent evidence indicates that CMV has strong anti-leukaemia effects due in part to shifts in the composition of natural killer (NK) cell subsets. NK cells are the primary mediators of the anti-leukaemia effect of allogeneic HSCT, and infusion of allogeneic NK cells has shown promise as a means of inducing remission and preventing relapse of several different haematological malignancies. The effectiveness of these treatments is limited, however, when tumours express human leucocyte antigen (HLA)-E, a ligand for the inhibitory receptor NKG2A, which is expressed by the vast majority of post-transplant reconstituted and ex-vivo expanded NK cells. It is possible to enhance NK cell cytotoxicity against HLA-Epos malignancies by increasing the proportion of NK cells expressing NKG2C (the activating receptor for HLA-E) and lacking the corresponding inhibitory receptor NKG2A. The proportion of NKG2Cpos/NKG2Aneg NK cells is typically low in healthy adults, but it can be increased by CMV infection or ex-vivo expansion of NK cells using HLA-E-transfected feeder cells and interleukin (IL)-15. In this review, we will discuss the role of CMV-driven NKG2Cpos/NKG2Aneg NK cell expansion on anti-tumour cytotoxicity and disease progression in the context of haematological malignancies, and explore the possibility of harnessing NKG2Cpos/NKG2Aneg NK cells for cancer immunotherapy.
Parent perspectives of engagement in the strengthening families program: An evidence‐based intervention for families in child welfare and affected by parental substance use
Authors: Akin Becci A. , Johnson‐Motoyama Michelle , Davis Sharah , Paceley Megan , Brook Jody
Published: May 2018

Despite growing use of evidence‐based parenting interventions (EBPIs) in child welfare settings, few qualitative studies have obtained parents' direct views and feedback on these programs. Further, engagement in EBPIs continues to present challenges in a child welfare context, particularly for parents affected by substances. We sought to understand parents' experiences of the supports and barriers to engagement in an EBPI. Semistructured interviews were conducted with a purposive sample of 10 parents who were involved in child welfare and a family drug treatment court, affected by parental substance use, and had recently completed the Strengthening Families Program. Our results indicated that barriers and supports comprised individual, provider, and programmatic factors. A prevalent theme was providers' abilities to build supportive helping relationships and facilitate a dynamic group effectively. Also significant were pragmatic program features that directly assisted families' access and ongoing participation, such as transportation and scheduling.
Generation and Visual Exploration of Medical Flow Data: Survey, Research Trends and Future Challenges
Authors: Oeltze‐Jafra S. , Meuschke M. , Neugebauer M. , Saalfeld S. , Lawonn K. , Janiga G. , Hege H.‐C. , Zachow S. , Preim B.
Published: May 2018

Simulations and measurements of blood and airflow inside the human circulatory and respiratory system play an increasingly important role in personalized medicine for prevention, diagnosis and treatment of diseases. This survey focuses on three main application areas. (1) Computational fluid dynamics (CFD) simulations of blood flow in cerebral aneurysms assist in predicting the outcome of this pathologic process and of therapeutic interventions. (2) CFD simulations of nasal airflow allow for investigating the effects of obstructions and deformities and provide therapy decision support. (3) 4D phase‐contrast (4D PC) magnetic resonance imaging of aortic haemodynamics supports the diagnosis of various vascular and valve pathologies as well as their treatment. An investigation of the complex and often dynamic simulation and measurement data requires the coupling of sophisticated visualization, interaction and data analysis techniques. In this paper, we survey the large body of work that has been conducted within this realm. We extend previous surveys by incorporating nasal airflow, addressing the joint investigation of blood flow and vessel wall properties and providing a more fine‐granular taxonomy of the existing techniques. From the survey, we extract major research trends and identify open problems and future challenges. The survey is intended for researchers interested in medical flow but also more general, in the combined visualization of physiology and anatomy, the extraction of features from flow field data and feature‐based visualization, the visual comparison of different simulation results and the interactive visual analysis of the flow field and derived characteristics.
Time discounting and the decision to protect areas that are near and threatened or remote and cheap to acquire
Authors: Armsworth Paul R.
Published: May 2018

Should conservation organizations focus on protecting habitats that are at imminent risk of being converted but are expensive or more remote areas that are less immediately threatened but where a large amount of land can be set aside? Variants of this trade‐off commonly arise in spatial planning. I used models of land‐use change near a deforestation frontier to examine this trade‐off. The optimal choice of where to protect was determined by how decisions taken today accounted for ecological benefits and economic costs of conservation actions that would occur sometime in the future. I used an ecological and economic discount rate to weight these benefits and costs. A large economic discount rate favored protecting more remote areas, whereas a large, positive ecological discount rate favored protecting habitat near the current deforestation frontier. The decision over where to protect was also affected by the influence economic factors had on landowners' decisions, the rate of technological change, and ecological heterogeneity of the landscape. How benefits and costs through time are accounted for warrants careful consideration when specifying conservation objectives. It may provide a niche axis along which conservation organizations differentiate themselves when competing for donor funding or other support.
The glycaemic benefits of a very‐low‐carbohydrate ketogenic diet in adults with Type 1 diabetes mellitus may be opposed by increased hypoglycaemia risk and dyslipidaemia
Authors: Leow Z. Z. X. , Guelfi K. J. , Davis E. A. , Jones T. W. , Fournier P. A.
Published: May 2018

Aims

To investigate whether very‐low‐carbohydrate high‐fat diets, typical of ketogenic diets, can improve glycaemic control without causing any ill health effects in adults with Type 1 diabetes.

Methods

In this observational study, 11 adults with Type 1 diabetes (seven men, four women, mean ± sd age 36.1± 6.8 years, mean ± sd duration of diabetes 12.8 ± 10.3 years), who followed a ketogenic diet (< 55 g carbohydrate per day) for a mean ± sd of 2.6 ± 3.3 years (β‐hydroxybutyrate 1.6 ± 1.3 mmol/l), underwent sampling and analysis of fasting blood, and were fitted with a blinded continuous glucose monitor for 7 days to measure glycaemic variability.

Results

The mean ± sd HbA1c levels were 35±4 mmol/mol (5.3±0.4%), and participants spent 74±20 and 3±8% of their time in the euglycaemic (4–8 mmol/l) and hyperglycaemic (>10 mmol/l) ranges, respectively, with little daily glycaemic variability (sd 1.5±0.7 mmol/l; coefficient of variation 26±8%). Blood glucose levels were <3.0 mmol/l for 3.6% of the time, and participants experienced a median (range) of 0.9 (0.0–2.0) daily episodes of hypoglycaemia. Total cholesterol, LDL cholesterol, total cholesterol/HDL cholesterol ratio, and triglycerides were above the recommended range in 82%, 82%, 64% and 27% of participants, respectively; however, HDL cholesterol levels were within the recommended range for all participants. Participants displayed no or little evidence of hepatic or renal dysfunction.

Conclusion

This study provides the first evidence that, ketogenic diets in adults with Type 1 diabetes are associated with excellent HbA1c levels and little glycaemic variability, but may also be associated with dyslipidaemia and a high number of hypoglycaemic episodes.
CXCR4, the master regulator of neutrophil trafficking in homeostasis and disease
Authors: De Filippo Katia , Rankin Sara M.
Published: May 2018

Background

Chemokines play a critical role in orchestrating the distribution and trafficking of neutrophils in homeostasis and disease.

Results

The CXCR4/CXCL12 chemokine axis has been identified as a central regulator of these processes.

Conclusion

In this review, we focus on the role of CXCR4/CXCL12 chemokine axis in regulating neutrophil release from the bone marrow and the trafficking of senescent neutrophils back to the bone marrow for clearance under homeostasis and disease. We also discuss the role of CXCR4 in fine‐tuning neutrophil responses in the context of inflammation.
Sensory attenuation of self‐produced signals does not rely on self‐specific motor predictions
Authors: Kaiser Jakob , Schütz‐Bosbach Simone
Published: May 2018

Sensory events produced by ourselves are known to lead to lower neural and perceptual impact than sensory events from other environmental sources. This sensory attenuation is widely assumed to result from control processes that are specific to our own motor actions, potentially helping us to distinguish effects produced by ourselves and others. However, previous research cannot rule out that the putative self‐attenuation in fact reflect actor‐independent, general predictive mechanisms, which, in direct comparison, just highlight external events due to lower predictability of their onset and thus higher surprise. By measuring the auditory‐evoked N1 component, we show that self‐generation of sounds only lead to cortical attenuation when the onset of other‐generated sounds is less predictable due to the absence of any predictive cues. The presence of a cue predicting the onset of auditory stimuli, in contrast, led to a reversal of the attenuation effect, with lower N1 amplitudes for other‐generated sounds in contrast to self‐generated sounds. Thus, contrary to prevalent assumptions sensory attenuation is not bound to self‐generation per se. Rather, it appears to be the result of general mechanisms that does not reliably and selectively attenuate self‐induced stimulation but is determined by a flexible processing of sensory input based on its predictability, contextual relevance and attentional salience.
Proteomic and cellular localisation studies suggest non‐tight junction cytoplasmic and nuclear roles for occludin in astrocytes
Authors: Morgan Sarah V. , Garwood Claire J. , Jennings Luke , Simpson Julie E. , Castelli Lydia M. , Heath Paul R. , Mihaylov Simeon R. , Vaquéz‐Villaseñor Irina , Minshull Thomas C. , Ince Paul G. , Dickman Mark J. , Hautbergue Guillaume M. , Wharton Stephen B.
Published: May 2018

Occludin is a component of tight junctions, which are essential structural components of the blood–brain barrier. However, occludin is expressed in cells without tight junctions, implying additional functions. We determined the expression and localisation of occludin in astrocytes in cell culture and in human brain tissue, and sought novel binding partners using a proteomic approach. Expression was investigated by immunocytochemistry and immunoblotting in the 1321N1 astrocytoma cell line and ScienCell human primary astrocytes, and by immunohistochemistry in human autopsy brain tissue. Recombinant N‐ and C‐terminal occludin was used to pull‐down proteins from 1321N1 cell lysates and protein‐binding partners identified by mass spectrometry analysis. Occludin was expressed in both the cytoplasm and nucleus of astrocytes in vitro and in vivo. Mass spectrometry identified binding to nuclear and cytoplasmic proteins, particularly those related to RNA metabolism and nuclear function. Occludin is expressed in several subcellular compartments of brain cell‐types that do not form tight junctions and the expression patterns in cell culture reflect those in human brain tissue, indicating they are suitable model systems. Proteomic analysis suggests that occludin has novel functions in neuroepithelial cells that are unrelated to tight junction formation. Further research will establish the roles of these functions in both cellular physiology and in disease states.
Selective determination of the catalytic cysteine pKa of two‐cysteine succinic semialdehyde dehydrogenase from Acinetobacter baumannii using burst kinetics and enzyme adduct formation
Authors: Phonbuppha Jittima , Maenpuen Somchart , Munkajohnpong Pobthum , Chaiyen Pimchai , Tinikul Ruchanok
Published: May 2018

Succinic semialdehyde dehydrogenase (SSADH) from Acinetobacter baumannii (Ab) catalyzes the oxidation of succinic semialdehyde (SSA). This enzyme has two conserved cysteines (Cys289 and Cys291) and preferentially uses NADP+ over NAD+ as a hydride acceptor. Steady‐state kinetic analysis showed that AbSSADH has the highest catalytic turnover (137 s−1) and can tolerate SSA inhibition the most (< 500 μm) among all SSADHs reported. Alanine substitutions of the two conserved cysteines indicated that Cys291Ala has ~ 65% activity compared with the wild‐type enzyme while Cys289Ala is inactive, suggesting that Cys289 is the active residue participating in catalysis. Pre‐steady‐state kinetics showed for the first time burst kinetics for NADPH formation in SSADH, indicating that the rate‐limiting step is associated with steps that occur after the hydride transfer. As the magnitude of burst kinetics represents the amount of NADPH formed during the first turnover, it is directly dependent on the amount of the deprotonated form of cysteine. The pKa of Cys289 was calculated from a plot of the burst magnitude vs pH as 7.4 ± 0.2. The Cys289 pKa was also measured based on the ability of AbSSADH to form an NADP–cysteine adduct, which can be detected by the increase of absorbance at ~ 330 nm as 7.9 ± 0.2. The lowering of the catalytic cysteine pKa by 0.6–1 unit renders the catalytic thiol more nucleophilic, which facilitates AbSSADH catalysis under physiological conditions. The methods established herein can specifically measure the active site cysteine pKa without interference from other cysteines. These techniques may be useful for studying ionization state of other cysteine‐containing aldehyde dehydrogenases.

Enzyme

Succinic semialdehyde dehydrogenase, EC1.2.1.24.
Another cause of difficult airway in an elderly patient: Tongue‐base abscess
Authors: Binar Murat , Arslan Fatih , Aydin Umit
Published: May 2018

Objective

An abscess of the tongue base is rare, but it can be a potentially life‐threatening situation in elderly patients.

Case report

A 72‐year‐old male patient presented with mid‐anterior neck swelling, odynophagia, poor oral hygiene and severe dyspnoea. After a difficult intubation, the muscles were dissected via a submental suprahyoid approach and the abscess was drained.

Conclusion

Poor oral hygiene may predispose elderly patients to tongue‐base abscesses. An early decision should be made for surgical drainage due to the risk of airway obstruction.
Posttraumatic Headache: Classification by Symptom‐Based Clinical Profiles
Authors: Lucas Sylvia , Ahn Andrew H.
Published: May 2018

There are currently no accepted therapies for posttraumatic headache (PTH). In order to meet the urgent need for effective therapies for PTH, we must continue to address fundamental gaps in our understanding of the clinical course and impact of PTH. Here we examine the existing schema used to characterize the clinical characteristics of PTH, including the International Classification of Headache Disorders (ICHD). There remain unresolved questions about whether to classify patients based on the extent of brain injury or on clinical symptom profiles. There also remain problematic issues of definition such as continuous headache, and chronic daily headache with features of “embedded” migraine‐type within these headaches, which will need to be studied further. We make the case that a symptom‐based classification is needed to begin an examination of these unresolved questions, and to establish clinically relevant endpoints for research and clinical trials for effective therapies.
Restoration of natural killer cell activity by interferon‐free direct‐acting antiviral combination therapy in chronic hepatitis C patients
Authors: Nakamura Ikuo , Furuichi Yoshihiro , Sugimoto Katsutoshi
Published: May 2018

Aim

Interferon‐free direct‐acting antiviral (DAA) therapy is an effective treatment for chronic hepatitis C (CH(C)) patients. Activity of natural killer (NK) cells was reported to be impaired in patients with hepatitis C virus infection. The aim of this study was to examine whether DAA therapy could restore NK activity in patients with CH(C).

Methods

Direct‐acting antiviral therapy was given to 31 CH(C) patients as asunaprevir/daclatasvir (ASV/DCV) (n = 15), ledipasvir/sofosbuvir (n = 7), ombitasvir/paritaprevir/ritonavir (n = 6), or elbasvir/grazoprevir (n = 3). Prior to therapy (0M), at the completion of the therapy (EOT), and at 24 weeks after completion (AFTER), NK activity and the frequency of CD56dimNK and CD56brightNK cells in peripheral blood were estimated by Cr release assay and flow cytometry. Statistical analysis was carried out by anova and the Mann–Whitney U‐test.

Results

In one of the ASV/DCV‐treated patients, treatment was stopped 12 weeks after initiation of therapy because of viral breakthrough. The anova showed that NK activity significantly improved at EOT (vs. 0M, P < 0.01) and at AFTER (vs. 0M, P < 0.001) in 30 patients with sustained virologic response. It also showed that the frequency of CD56dimNK cells was significantly increased at EOT and at AFTER (vs. 0M, P < 0.05). In addition, the NK activity ratio (AFTER/0M) had no significant difference between patient groups with higher and lower Fibrosis‐4 scores.

Conclusion

Direct‐acting antiviral therapy in CH(C) patients could improve NK activity by increasing the frequency of CD56dimNK cells. Additionally, our results might imply that DAAs therapy could reduce the risk of hepatocarcinogenesis by restoring innate immune responses.
Zinc‐containing compounds for personal care applications
Authors: Abendrot M. , Kalinowska‐Lis U.
Published: May 2018

It is well‐known that zinc ions are widely used in cosmetic products. Their popularity is associated with the multifunctional profile of Zn2+, which is classified as an essential chemical element in the human body. This review examines numerous beneficial biological properties of zinc‐containing compounds and classifies the compounds used in cosmetic products according to their functionality profile: antioxidant, sunscreen, anti‐inflammatory, anti‐pigmentation, anti‐ageing, anti‐acne, antimicrobial, anti‐odour, cleansing or stabilizing activity. It also underlines the significance of zinc in enzymatic processes, which depends on the enzyme type acts as inhibitor or enzymatic stimulator. Moreover, the article describes the chemical nature of the most interesting groups of Zn compounds.
Factors associated with quality of life in facial melasma: a cross‐sectional study
Authors: Pollo C. F. , Miot L. D. B. , Meneguin S. , Miot H. A.
Published: May 2018

Background

Melasma is a common chronic focal hypermelanosis that affects photexposed areas as face, mainly in women at fertile age. It inflicts a significant impact in quality of life; nevertheless, quality of life scores (e.g. MELASQoL) are not strongly correlated with clinical severity (e.g. MASI) in facial melasma, suggesting that different factors can influence the perception of disease beyond the clinical extension or the intensity of pigmentation.

Objectives

To explore clinical and socio‐demographic aspects that influences MELASQoL scores.

Methods

Cross‐sectional study enrolling 155 adults (>18 y.o.) with facial melasma. MELASQoL, MASI, clinical and demographic information were assessed. The associations among factors were explored by multivariable methods.

Results

The mean (SD) age of the participants was 39 (8) years, and 134 (86%) were females. The correlation (Spearman′s rho) between MELASQoL and MASI was 0.35 (P < 0.05). In a multivariate regression, MELASQoL score was associated (P ≤ 0.05) to MASI score (β = 0.6), lower income (β = 6.8), be single (β = 4.2) and low education level (β = 5.0). At multiple correspondence analysis, MASI, sex, marriage, education and income were associated with MELASQoL, as well as MASI was associated to skin phototypes, income and education level.

Conclusion

The perception of life quality impairment in melasma is influenced by low scholarly, low family income, single marital status and greater clinical severity.
External cervical resorption: part 2 – management
Authors: Patel S. , Foschi F. , Condon R. , Pimentel T. , Bhuva B.
Published: May 2018

Effective management of external cervical resorption (ECR) depends on accurate assessment of the true nature and accessibility of ECR; this has been discussed in part 1 of this 2 part article. This aim of this article was firstly, to review the literature in relation to the management of ECR and secondly, based on the available evidence, describe different strategies for the management of ECR. In cases where ECR is supracrestal, superficial and with limited circumferential spread, a surgical repair without root canal treatment is the preferred approach. With more extensive ECR lesions, vital pulp therapy or root canal treatment may also be indicated. Internal repair is indicated where there is limited resorptive damage to the external aspect of the tooth and/or where an external (surgical) approach is not possible due to the inaccessible nature of subcrestal ECR. In these cases, root canal treatment will also need to be carried out. Intentional reimplantation is indicated in cases where a surgical or internal approach is not practical. An atraumatic extraction technique and short extraoral period followed by 2‐week splinting are important prognostic factors. Periodic reviews may be indicated in cases where active management is not pragmatic. Finally, extraction of the affected tooth may be the only option in untreatable cases where there are aesthetic, functional and/or symptomatic issues.
Prevotella strains and lactamic resistance gene distribution in different oral environments of children with pulp necrosis
Authors: de Lima B. R. , Nicoloso G. F. , Fatturi‐Parolo C. C. , Ferreira M. B. C. , Montagner F. , Casagrande L.
Published: May 2018

Aim

To determine the presence of Prevotella species, the cfxA/cfxA2, blaZ and blaTEM genes associated with resistance to lactamic agents in different oral niches of children with pulp necrosis.

Methodology

Children with pulp necrosis in primary teeth had samples of saliva, supragingival, pulp chamber and root canal biofilms collected and tested for Prevotella species (P. intermedia, P. nigrescens, P. tannerae) and for beta‐lactam resistance genes (cfxA/cfxA2, blaZ and blaTEM). The presence of bacterial DNA was examined through PCR, with a specific primer directed to the 16S rRNA gene. Specific primers were used to detect the Prevotella species and beta‐lactam resistance genes. The chi‐square test was used to analyse associations between the presence of bacteria and clinical variables. The Cochran's Q test was used to assess whether the proportion of gene detection is the same between different sites.

Results

Thirty‐two teeth were sampled from 27 patients with a mean age of 5.5 years (±1.76). The total detection rate of Prevotella strains was 29.1%, 25%, 21.8% and 32.29% in saliva, supragingival, pulp chamber and root canal samples, respectively. P. nigrescens was the most commonly detected species in all oral niches. The previous use of antibiotics was associated with detection of P. nigrescens in saliva (P = 0.03). Pain was associated with the presence of P. nigrescens (P = 0.04) and P. tannerae (P = 0.01) in pulp chamber biofilm. blaTEM was detected in the four oral niches, being more frequent (23.8%) in supragingival biofilm (Cochran's Q test, P = 0.04). The presence of P. intermedia in SB and PC was associated with the detection of blaTEM in saliva (P = 0.04). The cfxA/cfxA2 and blaZ genes were not detected in any of the four oral niches.

Conclusions

The oral cavity of children with pulp necrosis had a variable distribution of Prevotella strains in different niches. Saliva, supragingival biofilm, pulp chamber and root canals of primary teeth with necrotic pulps can harbour resistance genes to beta‐lactams agents.
Shared Leadership in Commercial Organizations: A Systematic Review of Definitions, Theoretical Frameworks and Organizational Outcomes
Authors: Sweeney Anne , Clarke Nicholas , Higgs Malcolm
Published: May 2018

The importance of context has been well established in studies of leadership (Bryman, A. and Stephens, M. (1996). The importance of context: qualitative research and the study of leadership. Leadership Quarterly, 7, pp. 353–371; Pettigrew, A. and Whipp, R. (1991). Managing Change for Competitive Success. Oxford: Blackwell). However, recent reviews of shared leadership have tended to merge findings across commercial and non‐commercial settings, disregarding contextual differences in these distinctive domains. Acknowledging that the challenges of leadership may vary in different organizational contexts, this paper argues that a focused review of shared leadership in commercial organizations (COs) is needed. The authors thus systematically review findings from over twenty years of empirical research on the practice of shared leadership in commercial organizations, critically reviewing definitions, theoretical dispositions and measurement approaches adopted in the field, before evaluating the impact of shared leadership on performance in this context. Findings from commercial and non‐ commercial organizations are then compared, highlighting significant differences in the conceptualization of shared leadership in these distinct settings. Contributing to theory in this field, a framework is developed, mapping the landscape of current research in commercial contexts, revealing critical gaps in our present understanding of shared leadership processes. Consequently, a model summarizing a proposed research agenda for future studies is provided, highlighting the need for such research to focus on the interactions of individuals as they share in the leadership of their team.
Effects of lifestyle change interventions for people with intellectual disabilities: Systematic review and meta‐analysis of randomized controlled trials
Authors: Willems Mariël , Waninge Aly , Hilgenkamp Thessa I. M. , van Empelen Pepijn , Krijnen Wim P. , van der Schans Cees P. , Melville Craig A.
Published: May 2018

Background

Promotion of a healthy lifestyle for people with intellectual disabilities is important; however, the effectiveness of lifestyle change interventions is unclear.

Aims

This research will examine the effectiveness of lifestyle change interventions for people with intellectual disabilities.

Methods and Procedures

Randomized controlled trials (RCTs) of lifestyle change interventions for people with intellectual disabilities were included in a systematic review and meta‐analysis. Data on study and intervention characteristics were extracted, as well as data on outcome measures and results. Internal validity of the selected papers was assessed using the Cochrane Collaboration's risk bias tool.

Outcomes and Results

Eight RCTs were included. Multiple outcome measures were used, whereby outcome measures targeting environmental factors and participation were lacking and personal outcome measures were mostly used by a single study. Risks of bias were found for all studies. Meta‐analysis showed some effectiveness for lifestyle change interventions, and a statistically significant decrease was found for waist circumference.

Conclusion and Implications

Some effectiveness was found for lifestyle change interventions for people with intellectual disabilities. However, the effects were only statistically significant for waist circumference, so current lifestyle change interventions may not be optimally tailored to meet the needs of people with intellectual disabilities.
Single nucleotide polymorphisms in long noncoding RNA, ANRIL, are not associated with severe periodontitis but with adverse cardiovascular events among patients with cardiovascular disease
Authors: Schulz S. , Seitter L. , Werdan K. , Hofmann B. , Schaller H.‐G. , Schlitt A. , Reichert S.
Published: May 2018

Background and Objective

Biological plausibility of an association between severe periodontitis and cardiovascular disease (CVD) has been proven. Genetic characteristics play an important role in both complex inflammatory diseases. Polymorphisms (single nucleotide polymorphisms [SNPs]) in the long noncoding RNA, antisense noncoding RNA in the INK4 locus (ANRIL), were shown to play a leading role in both diseases. The primary objectives of the study were to assess, among cardiovascular (CV angiographically proven ≥50% stenosis of a main coronary artery) patients, the impact of ANRIL SNPs rs133049 and rs3217992 on the severity of periodontitis and the previous history of coronary events, as well as on the occurrence of further adverse CV events.

Material and Methods

The prevalence of severe periodontitis was analyzed in 1002 CV patients. ANRIL SNPs rs133049 and rs3217992 were genotyped. The prognostic value of both ANRIL SNPs for combined CV endpoint (stroke/transient ischemic attack [TIA], myocardial infarction, death from a CV‐related event, death from stroke) was evaluated after a 3‐year follow‐up period. Hazard ratios (HRs) were adjusted for established CV risk factors applying Cox regression.

Results

ANRIL SNPs rs133049 and rs3217992 were not associated with severe periodontitis or history of CVD in CV patients. In the Kaplan‐Meier survival curve including the log rank‐test (P = .036) and Cox regression (hazard ratio = 1.684, P = .009) the AA genotype of rs3217992 was shown to be an independent predictor for adverse CV events after 3 years of follow‐up.

Conclusion

SNPs in ANRIL are not risk modulators for severe periodontitis and history of CVD in CV patients. The AA genotype of ANRIL SNPs rs3217992 possesses prognostic power for further CV events within 3 years of follow‐up.
Identification, Characterization, and Evaluation of Polymorphic Microsatellite Markers for Parentage Assignment in Pinctada fucata
Authors: Zhu Kecheng , Yu Wenbo , Zhang Dianchang , Guo Huayang , Zhang Nan , Jiang Shigui
Published: May 2018

Parentage analysis is a useful tool for establishing pedigree relationships in selective breeding. In this study, 31 microsatellite markers were tested, and 13 loci were subsequently used to identify parenthood in Pinctada fucata. According to simulation analysis, the power of nine loci to exclude false parents was 99.94%, and that of 10 loci was 99.95%. Moreover, using 10 loci and known parental and filial information, the cumulative assignment success rate to one true parental pair was as high as 99%. Of the 120 progeny tested, 93.3% were exclusively assigned to their parental pairs in mixed pedigrees. These results suggested that these microsatellite markers can be used for rapid and effective parentage assignment and contribute to the selective breeding of P. fucata.
Sarcopenic obesity in cirrhosis—The confluence of 2 prognostic titans
Authors: Eslamparast Tannaz , Montano‐Loza Aldo J. , Raman Maitreyi , Tandon Puneeta
Published: May 2018

Sarcopenia and obesity are 2 major health conditions with a growing prevalence in cirrhosis. The concordance of these 2 conditions, sarcopenic obesity, is associated with higher rates of mortality and impact on the metabolic profile and physical function than either condition alone. To date, there is little consensus surrounding the diagnostic criteria for sarcopenia, obesity or as a result, sarcopenic obesity in patients with cirrhosis. Cross‐sectional imaging, although the most accurate diagnostic technique, has practical limitations for routine use in clinical practice. Management strategies are focused on increasing muscle mass and strength. The present review provides an overview of the diagnosis, pathophysiology, prognostic implications and management strategies available for sarcopenic obesity in cirrhosis. We also discuss the associated condition myosteatosis, the pathological accumulation of fat in skeletal muscle. Much work needs to be done to advance both clinical care and research in this area. Future directions require consensus definitions for sarcopenia, obesity and sarcopenic obesity, an expansion of our understanding of the complex pathogenesis of the muscle‐liver‐adipose tissue axis in cirrhosis and evidence to support management recommendations for nutrition, exercise and pharmacological therapies.
Transmission electron microscopy of impact‐generated platinum group element alloys from Barberton spherule layers: New clues to their formation
Authors: Mohr‐Westheide T. , Greshake A. , Wirth R. , Reimold W. U.
Published: May 2018

The oldest known large bolide impacts onto Earth are represented by approximately 3.47–3.2 Ga old Archean spherule layers of the Barberton Greenstone Belt (BGB) in South Africa and the Pilbara craton in West Australia. These layers were recognized as impact deposits by their excessively high platinum group element (PGE) contents that are indicative of an extraterrestrial component. This was followed by measurements of extraterrestrial Cr isotopic ratios, in some cases. Recently, the extraterrestrial PGE signature in Archean spherule layers from the BGB was localized and positively associated with the presence of submicrometer PGE alloy micronuggets associated with Ni,Cr‐rich spinel. The actual formation of these platinum group mineral (PGM) phases has, however, not yet been resolved. Primary meteoritic particles from the impacting body, the products of impact melting, or condensation from impact vapor plumes have all been proposed as possible genetic process. Resolving this requires detailed microanalytical investigation of the internal microchemical and microstructural compositions, textural characteristics, and crystallographic relationships between the different phases. Here, we report the results of a first transmission electron microscopy (TEM) study of six such PGE microparticles enclosed in Ni‐Cr spinel or occurring in groundmass of Barberton spherule layers from the BARB5 ICDP drill core and from the CT3 exploration core. Results include a variety of chemical and structural PGM compositions that are difficult to explain by a single process, leading to the conclusion that several processes may have been involved in the formation of PGMs in Archean spherule layers from the BGB. There is evidence supporting formation of these PGMs by exsolution from the spinel host phase, precipitation from a melt phase, and condensation from a gas phase (of the impact vapor plume).
Plasticity and local adaptation explain lizard cold tolerance
Authors: Card Daren C. , Schield Drew R. , Castoe Todd A.
Published: May 2018

How does climate variation limit the range of species and what does it take for species to colonize new regions? In this issue of Molecular Ecology, Campbell‐Staton et al. () address these broad questions by investigating cold tolerance adaptation in the green anole lizard (Anolis carolinensis) across a latitudinal transect. By integrating physiological data, gene expression data and acclimation experiments, the authors disentangle the mechanisms underlying cold adaptation. They first establish that cold tolerance adaptation in Anolis lizards follows the predictions of the oxygen‐ and capacity‐limited thermal tolerance hypothesis, which states that organisms are limited by temperature thresholds at which oxygen supply cannot meet demand. They then explore the drivers of cold tolerance at a finer scale, finding evidence that northern populations are adapted to cooler thermal regimes and that both phenotypic plasticity and heritable genetic variation contribute to cold tolerance. The integration of physiological and gene expression data further highlights the varied mechanisms that drive cold tolerance adaptation in Anolis lizards, including both supply‐side and demand‐side adaptations that improve oxygen economy. Altogether, their work provides new insight into the physiological and genetic mechanisms underlying adaptation to new climatic niches and demonstrates that cold tolerance in northern lizard populations is achieved through the synergy of physiological plasticity and local genetic adaptation for thermal performance.
The Big Breakfast Study: Chrono‐nutrition influence on energy expenditure and bodyweight
Authors: Ruddick‐Collins L. C. , Johnston J. D. , Morgan P. J. , Johnstone A. M.
Published: May 2018

A growing body of evidence highlights the importance of the biological clock as a modulator of energy balance and metabolism. Recent studies in humans have shown that ingested calories are apparently utilised more efficiently in the morning than in the evening and this is manifest through improved weight loss, even under iso‐energetic calorie intake. The mechanisms behind this enhanced morning energy metabolism are not yet clear, although it may result from behavioural adaptations or circadian driven variations in physiology and energy metabolism. A major objective of the newly funded Big Breakfast Study therefore is to investigate the mechanistic basis of this amplified morning thermogenesis leading to enhanced weight loss, by exploring behavioural and physiological adaptations in energy expenditure alongside the underlying circadian biology. This report briefly discusses the current research linking meal timing, circadian rhythms and metabolism; highlights the research gaps; and provides an overview of the studies being undertaken as part of the Medical Research Council‐funded Big Breakfast Study.
Raman spectroscopy quantification of eumelanin subunits in natural unaltered pigments
Authors: Galván Ismael , Araujo‐Andrade Cuauhtemoc , Marro Mónica , Loza‐Alvarez Pablo , Wakamatsu Kazumasa
Published: May 2018

Eumelanins are large polymers composed of 5,6‐dihydroxyindole (DHI) and 5,6‐dihydroxyindole‐2‐carboxylic acid (DHICA). Reactive oxygen species generation is higher during the synthesis of DHI than during the synthesis of DHICA; thus, the production of eumelanins with high relative DHI contents may compromise the viability of cells and organisms. Here, we show that dispersive Raman spectroscopy allows a noninvasive direct detection and quantification of DHI and DHICA in unaltered eumelanins that can be applied to the analysis of natural pigments in biological tissues. Using synthetic eumelanins purely composed of DHI or DHICA, we develop a model to determine the differential contribution of these subunits to the Raman spectra of mixed eumelanins, and exemplify the predictive capacity of the model with natural eumelanins deposited in black and gray feathers of fowl. We found that the wavenumber ranges of 550–1,200 and 1,650–2,300 cm−1 are significant to predict the DHI:DHICA ratio in unknown samples.
Early life origins of the Asthma–COPD Overlap Syndrome?
Authors: Hancox Robert J. , Zhang Xian
Published: May 2018

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Differences Between Florida and the Rest of the United States in Response to Local Transmission of the Zika Virus: Implications for Future Communication Campaigns
Authors: Winneg Kenneth M. , Stryker Jo Ellen , Romer Daniel , Jamieson Kathleen Hall
Published: May 2018

For those at risk for Zika virus infection, prevention requires an approach that includes individual, interpersonal, and community‐level support for behavior change. In August 2016, the announcement of local Zika transmission in Florida provided an opportunity to determine whether Zika‐related knowledge, attitudes, and behaviors might be affected differentially in Florida compared to the rest of the nation. From August 8–October 3, 2016, we conducted nationally representative weekly surveys (N = 12,236), oversampling Florida residents, measuring Zika virus news exposure, knowledge about transmission and prevention of the infection, and attitudes and behaviors toward prevention. We tested two classes of models: those focused on individual Zika risk perceptions (e.g., protection motivation theory) and one focused on community action beyond those directly at risk (social consensus model). Analyses assessed differences between Florida and the rest of the nation by survey week. Consistent with both models, Floridians demonstrated significantly higher levels of perceived susceptibility and knowledge, more positive attitudes toward Zika virus prevention, and higher likelihood of engaging in protective behavior than non‐Floridians. Consistent with theories of individual risk perception, response was greater among respondents who saw themselves at risk of infection. However, consistent with the SCM, irrespective of personal risk, response was greater among Floridians. Nevertheless, more than half of the public took no direct action to prevent the spread of Zika. Communities at increased risk for a novel infection such as Zika may quickly acquire Zika‐related knowledge, attitudes, and behavior, but large‐scale community‐wide response might be difficult without further community‐level public education.