bluuebunny/crossref_metadata_2025 huggingface dataset:
Integration of albumin–bilirubin (ALBI) score into Barcelona Clinic Liver Cancer (BCLC) system for hepatocellular carcinoma
Authors: Chan Anthony W H , Kumada Takshi , Toyoda Hidenori , Tada Toshifumi , Chong Charing C N , Mo Frankie K F , Yeo Winnie , Johnson Philip J , Lai Paul B S , Chan Anthony T C , To Ka‐Fai , Chan Stephen L
Published: January 2016

Background and Aims

The albumin–bilirubin (ALBI) grade is a recently reported, simpler, more objective, and evidence‐based alternative to the Child–Pugh (CP) score for hepatocellular carcinoma (HCC). We aimed to study whether ALBI grade could substitute for CP score in Barcelona Clinic Liver Cancer (BCLC) for HCC.

Methods

An international multicentre cohort (n = 3696) was accrued to compare the prognostic performance of the CP‐based and ALBI‐based BCLC system, in terms of homogeneity, discriminatory ability, and monotonicity of gradients that were numerically reflected by homogeneity likelihood, linear trend chi‐squares, and c‐indices, respectively.

Results

The ALBI grade performed as well as CP score when integrated into the BCLC staging system in terms of predicting clinical outcome of HCC regardless of regions, etiology, and treatment options. CP‐based and ALBI‐based BCLC systems were highly concordant with weighted kappa value of 0.917. All restaged patients showed significantly different clinical outcomes compared with their original stage classification. In particular, ALBI‐based BCLC upstaged 83 (2.2%) patients from lower CP‐based BC LC stages to ALBI‐based BCLC stage D, whose median overall survival was only 3 months.

Conclusions

The overall prognostic performance of ALBI‐based and CP‐based BCLC systems was similar. It also potentially allows more precise patient selection for clinical trials on systemic agents.
In vitro behavior of poly‐lactic‐co‐glycolic acid microspheres containing minocycline, metronidazole, and ciprofloxacin
Authors: Torshabi Maryam , Nojehdehian Hanieh , Tabatabaei Fahimeh S.
Published: January 2016

Aim

In the present study, we aimed to fabricate poly‐lactic‐co‐glycolic acid (PLGA) microspheres containing a mixture of three antibiotics—minocycline, metronidazole, and ciprofloxacin (MMC)—to assess their efficacy and properties.

Methods

MMC were loaded onto PLGA biopolymer microspheres at a 1:1:1 ratio using the double emulsion technique. The morphology of microspheres was observed by a (SEM). The controlled release of antibiotics was evaluated over an 18‐day period. The antibacterial efficacy of released antibiotics against Aggregatibacter actinomycetemcomitans was evaluated by measuring the diameter of the growth‐inhibition zone. The cytotoxicity of MMC‐containing microspheres was also evaluated and compared using 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide assay. One‐way anova was used for the data analysis.

Results

SEM micrographs confirmed the spherical shape and smooth surface of microspheres. The adequate release of antibiotics was observed from the microspheres within the desired time period of 16–18 days. The MMC‐containing microspheres showed antibacterial activity for 11 days. Moreover, MMC‐containing microspheres showed superior cell biocompatibility compared to the free mixture of the three antibiotics (P < 0.05).

Conclusion

Microspheres containing triple antibiotics showed good release, antibacterial activity for 11 days, and similar cell biocompatibility compared to the empty microspheres.
Influence of surface sealing on color stability and roughness of composite submitted to ultraviolet‐accelerated aging
Authors: Catelan Anderson , Suzuki Thaís Yumi Umeda , Becker Francisco , Briso André Luiz Fraga , dos Santos Paulo Henrique
Published: January 2016

Aim

In the present study, we evaluated the influence of surface sealing on color stability and surface roughness of a composite resin after accelerated artificial aging.

Methods

Thirty‐two specimens of a composite were prepared. After 24 h, the specimens were polished and divided into four groups (n = 8), according to the surface sealant used, including the control, which had no sealant application. Baseline color was measured according to the CIELab system using a reflection spectrophotometer. Surface roughness was determined using a profilometer with a cut‐off of 0.25 mm. After these tests, specimens were aged for 252 h in an ultraviolet (UV)‐accelerated aging chamber. Color stability was determined by difference between coordinates obtained before and after the aging procedure. Data of color change and roughness were evaluated by anova and Fisher's exact test (α = 0.05).

Results

The results showed that the unsealed group had the highest color change compared to other groups (P = 0.0289), and there was no significant difference between groups sealed with surface sealant (P > 0.05). The artificial aging caused an increase in roughness values independent of the experimental group studied (P = 0.0015).

Conclusion

The sealed composites showed lower color change after UV aging, but all groups showed clinically‐acceptable color change, and only liquid polish decreased roughness.
Effect of preheating and shade on surface microhardness of silorane‐based composites
Authors: Theodoridis Marios , Dionysopoulos Dimitrios , Koliniotou‐Koumpia Eugenia , Dionysopoulos Pavlos , Gerasimou Paris
Published: January 2016

Aim

The aim of the present study was to evaluate the effect of preheating and shade on the surface microhardness of silorane‐based composites.

Methods

Three shades of two different types of composites were evaluated: a silorane‐based composite and a methacrylate‐based composite. The composites were tested at 23°C, and after preheating at 55°C. Five specimens were prepared for each experimental group. The top surface of the specimens was irradiated for 20 s using an LED unit. Vickers microhardness test was used to evaluate both top and bottom surfaces of the specimens, followed by 24‐h storage in the dark. Statistical analysis was performed using one‐way anova and Tukey's post‐hoc test at a level of significance of α = 0.05.

Results

There was a significant rise in microhardness as the temperature increased from 23 to 55°C for both the top and bottom surfaces of the tested composites (P < 0.05). The C2 shade of both composites exhibited the lowest microhardness (P < 0.05), while the A2 and A3 shades did not show significant differences compared to each other (P > 0.05) Filtek Silorane presented significantly lower microhardness than Filtek Z250 (P < 0.05), regardless of the temperature, shade, or depth of measurement.

Conclusions

Preheating, shade, and composition of the tested composite resins affected their surface microhardness.
Effect of fiber reinforcement on microleakage of class II cavities restored with a novel G‐ænial posterior composite, silorane composite, and nanohybrid composite: an in vitro comparative study
Authors: Agrawal Vineet , Kapoor Sonali
Published: January 2016

Aim

The aim of the present study was to compare G‐ænial, silorane, and nanoceramic composites and the effect of polyethylene fiber inserts in reducing gingival microleakage in class II composite restorations placed apical to the cementoenamel junction.

Methods

Standardized class II cavities were prepared on extracted molars and randomly divided into six groups (n = 20 each): group 1, Ceram X mono; group 2, Ceram X mono + Ribbond; group 3, Filtek P90; group 4, Filtek P90 + Ribbond; group 5, G‐ænial posterior; and group 6, G‐ænial posterior + Ribbond. All specimens were subjected to a thermocycling regime, immersed in 2% methylene blue dye for 24 h, sectioned longitudinally, and examined under a stereomicroscope to assess dye penetration on a six‐point scale. The score data were subjected to statistical analysis, whereby the Kruskal–Wallis analysis of variance was used for multiple group comparisons and the Mann–Whitney test for groupwise comparisons at a significance level of P ≤ 0.05.

Results

A statistically‐significant decrease in microleakage was found when Ribbond fiber was used: group 2 vs group 1 (P < 0.001), group 4 vs group 3 (P < 0.001), and group 6 vs group 5 (P < 0.001). A significant decrease in microleakage scores was found in the silorane and G‐ænial posterior composites when compared to the nanoceramic composite (P < 0.001).

Conclusion

The use of polyethylene fiber, silorane composite, and G‐ænial posterior composite reduces microleakage in class II composite restorations with gingival margins below the cementoenamel junction.
Systematic review of literature: functional outcomes of implant‐prosthetic treatment in patients with surgical resection for oral cavity tumors
Authors: Said Mohamed Moustafa , Otomaru Takafumi , Sumita Yuka , Leung Katherine C.M. , Khan Zafrulla , Taniguchi Hisashi
Published: January 2016

The current systematic review was performed to assess the functional outcomes of implant‐prosthetic treatment on patients who have had surgical resection of oral cavity tumors. The assessment of function, satisfaction, or quality of life (QoL) were the major outcomes that evaluated preoperative and/or before and after implant‐prosthetic treatment. Only eight published studies fulfilled the inclusion criteria. Three publications evaluated chewing ability, masticatory performance, and neuromuscular function, and the other five publications used questionnaire as a method of assessment. These publications mainly reported on implant‐prosthetic treatment in mandibulectomy patients. It was found that implant‐retained prosthesis had a beneficial effect on masticatory performance and masseter muscle activity on the defect side, but not on the non‐defect side. Swallowing threshold performance and jaw movement parameters showed no significant differences between non‐implant‐retained prosthesis and implant‐retained prosthesis. Significant improvement in prosthesis and patients' satisfaction with implant‐retained prosthesis compared to non‐implant‐retained prosthesis was observed. However, general improvement in patients' QoL was not observed after implant‐prosthetic treatment. Patients with intraoral resection might benefit from implant‐retained prosthesis with regard to masticatory function and satisfaction. However, future clinical trials with an adequate sample size are needed to identify the group of patients who are likely to benefit from the implant‐prosthetic treatment modality.
Sympathetic Nervous System Synchrony in Couple Therapy
Authors: Karvonen Anu , Kykyri Virpi‐Liisa , Kaartinen Jukka , Penttonen Markku , Seikkula Jaakko
Published: January 2016

The aim of this study was to test whether there is statistically significant sympathetic nervous system (SNS) synchrony between participants in couple therapy. To our knowledge, this is the first study to measure psychophysiological synchrony during therapy in a multiactor setting. The study focuses on electrodermal activity (EDA) in the second couple therapy session from 10 different cases (20 clients, 10 therapists working in pairs). The EDA concordance index was used as a measure of SNS synchrony between dyads, and synchrony was found in 85% of all the dyads. Surprisingly, co‐therapists exhibited the highest levels of synchrony, whereas couples exhibited the lowest synchrony. The client–therapist synchrony was lower than that of the co‐therapists, but higher than that of the couples.

A Video Abstract is available next to the online version of this article on the JMFT web site.
Crustal reworking in a shear zone: transformation of metagranite to migmatite
Authors: Carvalho B. B. , Sawyer E. W. , Janasi V. A.
Published: January 2016

This study uses field, microstructural and geochemical data to investigate the processes contributing to the petrological diversity that arises when granitic continental crust is reworked. The Kinawa migmatite formed when Archean TTG crust in the São Francisco Craton, Brazil was reworked by partial melting at ~730 °C and 5–6 kbar in a regional‐scale shear zone. As a result, a relatively uniform leucogranodiorite protolith produced compositionally and microstructurally diverse diatexites and leucosomes. All outcrops of migmatite display either a magmatic foliation, flow banding or transposed leucosomes and indicate strong, melt‐present shearing. There are three types of diatexite. Grey diatexites are interpreted to be residuum, although melt segregation was incomplete in some samples. Biotite stable, H2O‐fluxed melting is inferred via the reaction Pl + Kfs + Qz + H2O = melt and geochemical modelling indicates 0.35–0.40 partial melting. Schlieren diatexites are extremely heterogeneous; residuum‐rich domains alternate with leucocratic quartzofeldspathic domains. Homogeneous diatexites have the highest SiO2 and K2O contents and are coarse‐grained, leucocratic rocks. Homogeneous diatexites, quartzofeldspathic domains from the schlieren diatexites and the leucosomes contain both plagioclase‐dominated and K‐feldspar‐dominated feldspar framework microstructures and hence were melt‐derived rocks. Both types of feldspar frameworks show evidence of tectonic compaction. Modelling the crystallization of an initial anatectic melt shows plagioclase appears first; K‐feldspar appears after ~40% crystallization. In the active shear zone setting, shear‐enhanced compaction provided an essentially continuous driving force for segregation. Thus, Kinawa migmatites with plagioclase frameworks are interpreted to have formed by shear‐enhanced compaction early in the crystallization of anatectic melt, whereas those with K‐feldspar frameworks formed later from the expelled fractionated melt. Trace element abundances in some biotite and plagioclase from the fractionated melt‐derived rocks indicate that these entrained minerals were derived from the wall rocks. Results from the Kinawa migmatites indicate that the key factor in generating petrological diversity during crustal reworking is that shear‐enhanced compaction drove melt segregation throughout the period that melt was present in the rocks. Segregation of melt during melting produced residuum and anatectic melt and their mixtures, whereas segregation during crystallization resulted in crystal fractionation and generated diverse plagioclase‐rich rocks and fractionated melts.
Validation of soluble amyloid‐β precursor protein assays as diagnostic CSF biomarkers for neurodegenerative diseases
Authors: van Waalwijk van Doorn Linda J.C. , Koel‐Simmelink Marleen J. , Haußmann Ute , Klafki Hans , Struyfs Hanne , Linning Philipp , Knölker Hans‐Joachim , Twaalfhoven Harry , Kuiperij H. Bea , Engelborghs Sebastiaan , Scheltens Philip , Verbeek Marcel M. , Vanmechelen Eugeen , Wiltfang Jens , Teunissen Charlotte E.
Published: January 2016

Analytical validation of a biomarker assay is essential before implementation in clinical practice can occur. In this study, we analytically validated the performance of assays detecting soluble amyloid‐β precursor protein (sAPP) α and β in CSF in two laboratories according to previously standard operating procedures serving this goal. sAPPα and sAPPβ ELISA assays from two vendors (IBL‐international, Meso Scale Diagnostics) were validated. The performance parameters included precision, sensitivity, dilutional linearity, recovery, and parallelism. Inter‐laboratory variation, biomarker comparison (sAPPα vs. sAPPβ) and clinical performance was determined in three laboratories using 60 samples of patients with subjective memory complaints, Alzheimer's disease, or frontotemporal dementia. All performance parameters of the assays were similar between labs and within predefined acceptance criteria. The only exceptions were minor out‐of‐range results for recovery at low concentrations and, despite being within predefined acceptance criteria, non‐comparability of the results for evaluation of the dilutional linearity and hook‐effect. Based on the inter‐laboratory correlation between Lab #1 and Lab #2, the IBL‐international assays were more robust (sAPPα: r2 = 0.92, sAPPβ: r2 = 0.94) than the Meso Scale Diagnostics (MSD) assay (sAPPα: r2 = 0.70, sAPPβ: r2 = 0.80). Specificity of assays was confirmed using assay‐specific peptide competitors. Clinical validation showed consistent results across the clinical groups in the different laboratories for all assays. The validated sAPP assays appear to be of sufficient technical quality and perform well. Moreover, the study shows that the newly developed standard operating procedures provide highly useful tools for the validation of new biomarker assays. A recommendation was made for renewed instructions to evaluate the dilutional linearity and hook‐effect.

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We analytically validated the performance of assays detecting soluble amyloid‐β precursor protein (sAPP) α and β in CSF according to SOPs in agreement with ISO15189 guidelines. The validated sAPP assays appear to be of sufficient technical quality and perform well. Moreover, this study proofs that the newly developed SOPs, with a minor modification, provide highly useful tools for the validation of new biomarker assays.
Acute selective serotonin reuptake inhibitors regulate the dorsal raphe nucleus causing amplification of terminal serotonin release
Authors: Dankoski Elyse C. , Carroll Susan , Wightman Robert Mark
Published: January 2016

Selective serotonin reuptake inhibitors (SSRIs) were designed to treat depression by increasing serotonin levels throughout the brain via inhibition of clearance from the extracellular space. Although increases in serotonin levels are observed after acute SSRI exposure, 3–6 weeks of continuous use is required for relief from the symptoms of depression. Thus, it is now believed that plasticity in multiple brain systems that are downstream of serotonergic inputs contributes to the therapeutic efficacy of SSRIs. The onset of antidepressant effects also coincides with desensitization of somatodendritic serotonin autoreceptors in the dorsal raphe nucleus (DRN), suggesting that disrupting inhibitory feedback within the serotonin system may contribute to the therapeutic effects of SSRIs. Previously, we showed that chronic SSRI treatment caused a frequency‐dependent facilitation of serotonin signaling that persisted in the absence of uptake inhibition. In this work, we use in vivo fast‐scan cyclic voltammetry in mice to investigate a similar facilitation after a single treatment of the SSRI citalopram hydrobromide. Acute citalopram hydrobromide treatment resulted in frequency‐dependent increases of evoked serotonin release in the substantia nigra pars reticulata. These increases were independent of changes in uptake velocity, but required SERT expression. Using microinjections, we show that the frequency‐dependent enhancement in release is because of SERT inhibition in the DRN, demonstrating that SSRIs can enhance serotonin release by inhibiting uptake in a location distal to the terminal release site. The novel finding that SERT inhibition can disrupt modulatory mechanisms at the level of the DRN to facilitate serotonin release will help future studies investigate serotonin's role in depression and motivated behavior.

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In this work, stimulations of the dorsal raphe nucleus (DRN) evoke serotonin release that is recorded in the substantia nigra pars reticulata (SNpr) using in vivo fast‐scan cyclic voltammetry. Systemic administration of a selective serotonin reuptake inhibitor (SSRI) causes both an increase in t1/2 and an increase in [5‐HT]max in the SNpr. Local application of SSRI to the DRN recapitulates the increase in [5‐HT]max observed in the SNpr without affecting uptake. Thus, SSRIs increase serotonin signaling via two distinct SERT‐mediated mechanisms.
Therapeutic approaches in Parkinson's disease and related disorders
Authors: Valera Elvira , Masliah Eliezer
Published: January 2016

The lack of effective therapies for neurodegenerative disorders is one of the most relevant challenges of this century, considering that, as the global population ages, the incidence of these type of diseases is quickly on the rise. Among these disorders, synucleinopathies, which are characterized by the abnormal accumulation and spreading of the synaptic protein alpha‐synuclein in the brain, already constitute the second leading cause of parkinsonism and dementia in the elderly population. Disorders with alpha‐synuclein accumulation include Parkinson's disease, dementia with Lewy bodies and multiple system atrophy. Numerous therapeutic alternatives for synucleinopathies are being tested in pre‐clinical models and in the clinic; however, only palliative treatments addressing the dopaminergic deficits are approved to date, and no disease‐modifying options are available yet. In this article, we provide a brief overview of therapeutic approaches currently being explored for synucleinopathies, and suggest possible explanations to the clinical trials outcomes. Finally, we propose that a deeper understanding of the pathophysiology of synucleinopathies, together with a combination of therapies tailored to each disease stage, may lead to better therapeutic outcomes in synucleinopathy patients.

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Synucleinopathies, neurodegenerative disorders characterized by the abnormal accumulation of the protein alpha‐synuclein, constitute the second leading cause of parkinsonism and dementia in the elderly population, however, no disease‐modifying options are available yet. In this review, we summarize the therapeutic approaches currently being explored for synucleinopathies, suggest possible explanations to the clinical outcomes, and propose areas of further therapeutic improvement.

This article is part of a special issue on Parkinson disease.
Mechanisms of Stress‐Induced Visceral Pain: Implications in Irritable Bowel Syndrome
Authors: Greenwood‐Van Meerveld B. , Moloney R. D. , Johnson A. C. , Vicario M.
Published: January 2016

Visceral pain is a term describing pain originating from the internal organs of the body and is a common feature of many disorders, including irritable bowel syndrome (IBS). Stress is implicated in the development and exacerbation of many visceral pain disorders. Recent evidence suggests that stress and the gut microbiota can interact through complementary or opposing factors to influence visceral nociceptive behaviours. The Young Investigator Forum at the International Society of Psychoneuroendocrinology (ISPNE) annual meeting reported experimental evidence suggesting the gut microbiota can affect the stress response to affect visceral pain. Building upon human imaging data showing abnormalities in the central processing of visceral stimuli in patients with IBS and knowledge that the amygdala plays a pivotal role in facilitating the stress axis, the latest experimental evidence supporting amygdala‐mediated mechanisms in stress‐induced visceral pain was reviewed. The final part of the session at ISPNE reviewed experimental evidence suggesting that visceral pain in IBS may be a result, at least in part, of afferent nerve sensitisation following increases in epithelial permeability and mucosal immune activation.
Salsolinol Up‐Regulates Oxytocin Expression and Release During Lactation in Sheep
Authors: Górski K. , Marciniak E. , Zielińska‐Górska M. , Misztal T.
Published: January 2016

Salsolinol (1‐methyl‐6,7‐dihydroxy‐1,2,3,4‐tetrahydroisoquinoline) is a dopamine‐derived compound present in the central nervous system and pituitary gland. Several previous studies on lactating sheep and rats have reported that salsolinol plays a crucial role in the regulation of prolactin secretion. The present study investigated the effects of salsolinol, which was infused into the third ventricle of the brain, on oxytocin expression and release in lactating sheep, 48 h after weaning of 8‐week‐old lambs. Serial 30‐min infusions of salsolinol and vehicle were performed at 30‐min intervals from 10.00 to 15.00 h. Blood samples were collected every 10 min. The supraoptic nucleus (SON), paraventricular nucleus (PVN) and posterior pituitary were collected immediately after the experiment. Expression levels ofmRNAs for oxytocin and peptidylglycine α‐amidating monooxygenase (PAM), the terminal enzyme in the oxytocin synthesis pathway, were measured using a real‐time polymerase chain reaction. Oxytocin peptide content in the posterior pituitary was measured by an enzyme‐linked immunosorbent assay, and plasma oxytocin concentration was measured by radioimmunoassay. Salsolinol treatment significantly up‐regulated oxytocin andPAMgene expression in theSON(P < 0.01 and P < 0.05, respectively),PVN(P < 0.01 and P < 0.05, respectively) and posterior pituitary (P < 0.05 and P < 0.05, respectively). Oxytocin peptide content in the posterior pituitary and the area under the response curve of plasma oxytocin were significantly (P < 0.05 and P < 0.01, respectively) higher in salsolinol‐treated sheep than in control animals. The present study shows for the first time that salsolinol stimulates oxytocin secretion during lactation in sheep.
Long‐term efficacy of rituximab in IgM anti‐myelin‐associated glycoprotein neuropathy: RIMAG follow‐up study
Authors: Iancu Ferfoglia Ruxandra , Guimarães‐Costa Raquel , Viala Karine , Musset Lucile , Neil Jean , Marin Benoit , Léger Jean‐Marc
Published: January 2016

The Rituximab vs. Placebo in Polyneuropathy Associated With Anti‐MAG IgM Monoclonal Gammopathy (RIMAG) study showed no improvement using the inflammatory neuropathy cause and treatment sensory score (ISS) as primary outcome in patients with IgM anti‐myelin‐associated glycoprotein neuropathy (IgM anti‐MAG neuropathy) treated with rituximab, when compared with placebo. However, some secondary outcomes seemed to improve in the per protocol analysis. Patients from one participating center in the RIMAG study underwent a new evaluation after a median follow‐up of 6 (interquartile range (IQR) 4.9; 6.5) years, using the same outcome measures used in the original study. Data were recorded in seven rituximab patients (group 1) and in eight placebo patients (group 2). In group 2, six of eight patients received immunotherapy during follow‐up, while only two of seven did in group 1. No significant change was observed in either the ISS or the secondary outcomes in both groups, with the exception of worsening in the 10‐m walk time in group 2 (p = 0.016). The RIMAG follow‐up study failed to find any significant change in most outcome measures in patients from the RIMAG study, some of them having received new immunotherapies. This study stresses the lack of useful clinical scales sensitive enough to capture small, even meaningful, improvement in IgM anti‐MAG neuropathy.
Cerebrospinal fluid profile and seroprevalence of antiganglioside reactivity in patients with neuralgic amyotrophy
Authors: Stich Oliver , Glos Daniela , Brendle Marie , Dersch Rick , Rauer Sebastian
Published: January 2016

Neuralgic amyotrophy (NA), also known as acute brachial plexitis, is postulated as an autoimmune pathogenesis. In a well‐defined cohort of patients with NA, we analyzed the cerebrospinal fluid (CSF) profile and the prevalence of antiganglioside antibodies. Patients with Varicella zoster‐associated radiculitis and healthy blood donors served as controls. An abnormal routine laboratory CSF profile was found in 29% of those with NA, mostly showing a disruption of the blood–brain barrier. Antibodies predominantly from the immunoglobulin M (IgM) isotype against at least one human ganglioside were detected in 36% of sera from patients with NA but in only 2% of controls. An NA‐specific reactivity pattern was not detected, and there was no significant association with clinical or CSF parameters. This suggests that the seroprevalence of antiganglioside autoantibodies in patients with NA is nonspecific.
Three‐dimensional reconstruction of Haversian systems in human cortical bone using synchrotron radiation‐based micro‐CT: morphology and quantification of branching and transverse connections across age
Authors: Maggiano Isabel S. , Maggiano Corey M. , Clement John G. , Thomas C. David L. , Carter Yasmin , Cooper David M. L.
Published: January 2016

This study uses synchrotron radiation‐based micro‐computed tomography (CT) scans to reconstruct three‐dimensional networks of Haversian systems in human cortical bone in order to observe and analyse interconnectivity of Haversian systems and the development of total Haversian networks across different ages. A better knowledge of how Haversian systems interact with each other is essential to improve understanding of remodeling mechanisms and bone maintenance; however, previous methodological approaches (e.g. serial sections) did not reveal enough detail to follow the specific morphology of Haversian branching, for example. Accordingly, the aim of the present study was to identify the morphological diversity of branching patterns and transverse connections, and to understand how they change with age. Two types of branching morphologies were identified: lateral branching, resulting in small osteon branches bifurcating off of larger Haversian canals; and dichotomous branching, the formation of two new osteonal branches from one. The reconstructions in this study also suggest that Haversian systems frequently target previously existing systems as a path for their course, resulting in a cross‐sectional morphology frequently referred to as ‘type II osteons’. Transverse connections were diverse in their course from linear to oblique to curvy. Quantitative assessment of age‐related trends indicates that while in younger human individuals transverse connections were most common, in older individuals more evidence of connections resulting from Haversian systems growing inside previously existing systems was found. Despite these changes in morphological characteristics, a relatively constant degree of overall interconnectivity is maintained throughout life. Altogether, the present study reveals important details about Haversian systems and their relation to each other that can be used towards a better understanding of cortical bone remodeling as well as a more accurate interpretation of morphological variants of osteons in cross‐sectional microscopy. Permitting visibility of reversal lines, synchrotron radiation‐based micro‐CT is a valuable tool for the reconstruction of Haversian systems, and future analyses have the potential to further improve understanding of various important aspects of bone growth, maintenance and health.
Combined autologous platelet‐rich plasma with microneedling verses microneedling with distilled water in the treatment of atrophic acne scars: a concurrent split‐face study
Authors: Asif Mohd , Kanodia Sanjay , Singh Kishor
Published: January 2016

Background

Acne scarring causes cosmetic discomfort, depression, low self‐esteem and reduced quality of life. Microneedling is an established treatment for scars, although the efficacy of platelet‐rich plasma (PRP) has not been explored much.

Objective

The objective of this study was to evaluate the efficacy and safety of platelet‐rich plasma (PRP) combined with microneedling for the treatment of atrophic acne scars.

Methods

Fifty patients of 17–32 years of age with atrophic acne scars were enrolled. Microneedling was performed on both halves of the face. Intradermal injections as well as topical application of PRP was given on right half of the face, while the left half of the face was treated with intradermal administration of distilled water. Three treatment sessions were given at an interval of 1 month consecutively. Goodman's Quantitative scale and Quantitative scale were used for the final evaluation of results.

Results

Right and left halves showed 62.20% and 45.84% improvement, respectively, on Goodman's Quantitative scale. Goodman's Qualitative scale showed excellent response in 20 (40%) patients and good response in 30 (60%) patients over right half of the face, while the left half of the face showed excellent response in 5 (10%) patients, good response in 42 (6%) patients and poor response in three patients.

Conclusion

We conclude that PRP has efficacy in the management of atrophic acne scars. It can be combined with microneedling to enhance the final clinical outcomes in comparison with microneedling alone.
Medication administration errors from a nursing viewpoint: a formal consensus of definition and scenarios using a Delphi technique
Authors: Shawahna Ramzi , Masri Dina , Al‐Gharabeh Rawan , Deek Rawan , Al‐Thayba Lama , Halaweh Masa
Published: January 2016

Aims and objectives

To develop and achieve formal consensus on a definition of medication administration errors and scenarios that should or should not be considered as medication administration errors in hospitalised patient settings.

Background

Medication administration errors occur frequently in hospitalised patient settings. Currently, there is no formal consensus on a definition of medication administration errors or scenarios that should or should not be considered as medication administration errors.

Design

This was a descriptive study using Delphi technique.

Methods

A panel of experts (n = 50) recruited from major hospitals, nursing schools and universities in Palestine took part in the study. Three Delphi rounds were followed to achieve consensus on a proposed definition of medication administration errors and a series of 61 scenarios representing potential medication administration error situations formulated into a questionnaire.

Results

In the first Delphi round, key contact nurses’ views on medication administration errors were explored. In the second Delphi round, consensus was achieved to accept the proposed definition of medication administration errors and to include 36 (59%) scenarios and exclude 1 (1·6%) as medication administration errors. In the third Delphi round, consensus was achieved to consider further 14 (23%) and exclude 2 (3·3%) as medication administration errors while the remaining eight (13·1%) were considered equivocal. Of the 61 scenarios included in the Delphi process, experts decided to include 50 scenarios as medication administration errors, exclude three scenarios and include or exclude eight scenarios depending on the individual clinical situation.

Conclusion

Consensus on a definition and scenarios representing medication administration errors can be achieved using formal consensus techniques.

Relevance to clinical practice

Researchers should be aware that using different definitions of medication administration errors, inclusion or exclusion of medication administration error situations could significantly affect the rate of medication administration errors reported in their studies. Consensual definitions and medication administration error situations can be used in future epidemiology studies investigating medication administration errors in hospitalised patient settings which may permit and promote direct comparisons of different studies.
Making time and space: the impact of mindfulness training on nursing and midwifery practice. A critical interpretative synthesis
Authors: Hunter Louise
Published: January 2016

Aims and objectives

To explore qualitative literature to ascertain whether and how nurses and midwives perceive that mindfulness impacts on their practice, particularly their interactions with patients.

Background

Stress and burnout, which negatively impact patient care, are widely reported among nurses and midwives, who face unique stressors as professionals who often hold little organisational power, but are expected to shoulder the burden of resource cuts and an increasingly complex workload. Mindfulness is recommended as a tool to decrease stress and burnout in health professionals, and may also increase practitioner compassion and improve patient interactions.

Design

A critical interpretative synthesis.

Methods

A systematic search was undertaken to identify qualitative studies where the majority of participants were qualified nurses and/or midwives who had attended mindfulness training. Retrieved literature was read and reread to identify relevant material, which was then coded into themes. Related themes were grouped into synthetic constructs, and a synthetic argument was produced to illustrate the relationships between these.

Results

Five relevant papers were identified. Findings indicate that mindfulness training enables nurses and midwives to gain some control over their thoughts and stress levels. This then creates a quiet mental space giving them agency and perspective and leading to improved caring, including a more patient‐centred focus and increased presence and listening. Mindfulness appears to alter the way nurses and midwives operate within a stressful work environment, thereby changing the way the environment is experienced by themselves and, potentially, the people in their care.

Conclusions

Further research is needed, but current qualitative research suggests mindfulness may enable nurses and midwives to work with compassion in stressful and demanding work environments.

Relevance to clinical practice

Mindfulness may offer an enabling way of coping with stress, in contrast to long‐standing strategies such as task‐orientation and depersonalisation.
Circulating calcium concentrations, vascular disease and mortality: a systematic review
Authors: Reid I. R. , Gamble G. D. , Bolland M. J.
Published: January 2016

Associations between serum calcium and vascular disease have been reported, but the consistency of these findings is unknown. We conducted a systematic review to determine whether circulating calcium concentrations are associated with risks of cardiovascular disease and death in normocalcaemic populations. We conducted PubMed searches up to 18 December 2014 and scrutinized reference lists of papers. Eligible studies related serum calcium to mortality or cardiovascular events in humans. A follow‐up of at least one year was required for longitudinal studies. Studies in populations selected on the basis of renal disease or abnormal serum calcium were excluded. Two investigators performed independent data extraction. The results were tabulated and, where possible, meta‐analysed. Five of 11 studies reported a statistically significant positive association between serum calcium and mortality. Meta‐analysis of eight of these studies showed a hazard ratio of death of 1.13 (1.09, 1.18) per standard deviation of serum calcium. Eight of 13 studies reported a statistically significant positive association between serum calcium and cardiovascular disease. Meta‐analysis of eight studies showed a hazard ratio of cardiovascular disease of 1.08 (1.04, 1.13) per standard deviation of serum calcium. For two studies reporting odds ratios, the pooled odds ratio per standard deviation was 1.22 (1.11, 1.32). When hazard ratios adjusted for cardiovascular risk factors were meta‐analysed, the pooled hazard ratio was 1.04 (1.01, 1.08). Other studies demonstrated associations between serum calcium and stroke and between serum calcium and direct measurements of arterial disease and calcification. These observational data indicate that serum calcium is associated with vascular disease and death, but they cannot determine causality.
The glycocalyx and its significance in human medicine
Authors: Tarbell J. M. , Cancel L. M.
Published: January 2016

Cells are covered by a surface layer of glycans that is referred to as the ‘glycocalyx’. In this review, we focus on the role of the glycocalyx in vascular diseases (atherosclerosis, stroke, hypertension, kidney disease and sepsis) and cancer. The glycocalyx and its principal glycosaminoglycans [heparan sulphate (HS) and hyaluronic acid (HA)] and core proteins (syndecans and glypicans) are degraded in vascular diseases, leading to a breakdown of the vascular permeability barrier, enhanced access of leucocytes to the arterial intima that propagate inflammation and alteration of endothelial mechanotransduction mechanisms that protect against disease. By contrast, the glycocalyx on cancer cells is generally robust, promoting integrin clustering and growth factor signalling, and mechanotransduction of interstitial flow shear stress that is elevated in tumours to upregulate matrix metalloproteinase release which enhances cell motility and metastasis. HS and HA are consistently elevated on cancer cells and are associated with tumour growth and metastasis. Later, we will review the agents that might be used to enhance or protect the glycocalyx to combat vascular disease, as well as a different set of compounds that can degrade the cancer cell glycocalyx to suppress cell growth and metastasis. It is clear that what is beneficial for either vascular disease or cancer will not be so for the other. The overarching conclusions are that (i) the importance of the glycocalyx in human medicine is only beginning to be recognized, and (ii) more detailed studies of glycocalyx involvement in vascular diseases and cancer will lead to novel treatment modalities.
The immune system and cancer evasion strategies: therapeutic concepts
Authors: Muenst S. , Läubli H. , Soysal S. D. , Zippelius A. , Tzankov A. , Hoeller S.
Published: January 2016

The complicated interplay between cancer and the host immune system has been studied for decades. New insights into the human immune system as well as the mechanisms by which tumours evade immune control have led to the new and innovative therapeutic strategies that are considered amongst the medical breakthroughs of the last few years. Here, we will review the current understanding of cancer immunology in general, including immune surveillance and immunoediting, with a detailed look at immune cells (T cells, B cells, natural killer cells, macrophages and dendritic cells), immune checkpoints and regulators, sialic acid‐binding immunoglobulin‐like lectins (Siglecs) and other mechanisms. We will also present examples of new immune therapies able to reverse immune evasion strategies of tumour cells. Finally, we will focus on therapies that are already used in daily oncological practice such as the blockade of immune checkpoints cytotoxic T‐lymphocyte antigen 4 (CTLA‐4) and programmed death‐1 (PD‐1) in patients with metastatic melanoma or advanced lung cancer, or therapies currently being tested in clinical trials such as adoptive T‐cell transfer.
How Social Entrepreneurs Facilitate the Adoption of New Industry Practices
Authors: Waldron Theodore L. , Fisher Greg , Pfarrer Michael
Published: January 2016

This paper explores how social entrepreneurs use rhetoric to facilitate the pervasive adoption of new, socially focused, industry practices. Our conceptualization proposes that the nature of social entrepreneurs’ rhetoric hinges on perceptions of their relationships to the industry members they seek to influence. We develop a framework that explains the effects of two cognitive structures – identity and power – on social entrepreneurs’ perceptions of industry members and, in turn, the social entrepreneurs’ rhetorical strategies for persuading the industry members to adopt new practices. Our framework specifies mechanisms through which social entrepreneurs facilitate systemic social change and, in doing so, informs theory at the intersection of social entrepreneurship, sustainable social change, and rhetoric.
Tongue pressure production during swallowing in patients with mandibular prognathism
Authors: Sakaue K. , Fukui T. , Sasakura C. , Hori K. , Ono T. , Saito I.
Published: January 2016

Abnormalities of swallowing in patients with mandibular prognathism have not been evaluated quantitatively. The aim of this study was to compare tongue pressure production for bolus transfer between volunteers with normal occlusion and patients with mandibular prognathism. The control group had 10 female volunteers with normal occlusion, and the patient group had 10 women with mandibular prognathism. Tongue pressure was measured by a palatal sensor sheet at five sites on swallowing 4 mL of a tasteless and odourless jelly. Results: The tongue pressure waveform differed between the control and patient groups. The incidence of a double‐peak tongue pressure waveform was more frequent in the patient group. In both groups, the exertion of tongue pressure began at the anterior point of the sensor sheet, followed by the peripheral parts. Although the order of expression of tongue pressure was the same for the two groups, maximum tongue pressure at all parts of the sensor sheet was lower in the patient group than in the control group. Furthermore, swallowing time was longer in the patient group than in the control group at the peripheral parts of the palate. These results clearly show the difference in tongue pressure production during swallowing between patients with mandibular prognathism and volunteers with normal occlusion. The current findings suggest that maxillofacial morphology may affect tongue movement during swallowing.
Effect of temporomandibular disorder therapy on otologic signs and symptoms: a systematic review
Authors: Stechman‐Neto J. , Porporatti A. L. , Porto de Toledo I. , Costa Y. M. , Conti P. C. R. , De Luca Canto G. , Mezzomo L. A.
Published: January 2016

The most common temporomandibular disorders (TMD) signs and symptoms are related to muscle sensitivity through palpation, restricted mouth opening, asymmetric mandibular movements, joint sounds, pain and otologic signs and symptoms. To date, counselling, occlusal splints, exercises, biofeedback and acupuncture are examples of conservative modalities proposed for TMD therapy. The aim of this systematic review was to investigate the effect of these conservative therapies for TMD on otologic signs and symptoms. The authors searched the following electronic databases published up to 1st May 2015: PubMed, LILACS, Scopus, Web of Science and Science Direct with no time or language limitations. Using a two‐phase selection process, the authors identified 08 articles and used them to conduct a qualitative analysis. Methodological quality of each article was performed with the aid of ‘Quality Assessment of a Cohort Study’ and ‘Quality Assessment of a Randomized Clinical Trial’, developed by the Dutch Cochrane Centre, a centre of the Cochrane Collaboration. This systematic review showed in seven of the eight studies included that a total or partial resolution of otologic complains occurred after counselling, exercise therapies and occlusal splint therapy. Upon the limitations of the studies included in this systematic review, the present outcomes suggested that there is insufficient evidence in favour or against the conservative therapies for TMD on changes in otologic signs and symptoms. Thus, further studies with a higher level of evidence and more representative samples should be conducted to better understand the relationship of TMD therapy changes on otologic complains.
NURSES’ BEREAVEMENT NEEDS AND ATTITUDES TOWARDS PATIENT DEATH: A QUALITATIVE DESCRIPTIVE STUDY OF NURSES IN A DIALYSIS UNIT
Authors: Tranter Shelley , Josland Elizabeth , Turner Kylie
Published: January 2016

Background

Dialysis nurses have a unique relationship with their patients and often require bereavement support should a patient death occur. This study was conducted in 2014 and aimed to explore the attitudes of dialysis nurses to death and dying and to identify suitable bereavement strategies following a death of a patient.

Methods

A purposeful, convenience sample of all nurses employed in the dialysis service completed a demographic profile and The Death Attitudes Profile Revisited (DAP_R) survey.

Results

There were 52 responses to the survey (98% response rate). The mean age of the participants was 45 years ± 8.0 years; 87% had >10 years nursing experience. Nurses suggest that debriefing and the use of a counsellor would support them in their grieving process while new graduate nurses appear to require extra support following a patient death. Analysis of the death attitude profile‐revised (DAP‐R) showed significant relationships between fear of death/death avoidance as well as fear of death/neutral acceptance. Spirituality and religion correlate strongly with ‘Approach Acceptance’ in this study group. Forty‐four percent people who ‘approach acceptance’ of death can be explained by the strength of religious beliefs.

Conclusions

Many dialysis nurses appear to have strong religious or spiritual belief systems and this contributes to their acceptance of death, although there also appears to be a degree of death avoidance. The study has highlighted the need to provide adequate bereavement support for dialysis nurses.