bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac chloroma or cardiac myeloid sarcoma: Case Report
Authors: Abdelnabi Mahmoud H. , Almaghraby Abdallah , Saleh Yehia , ElSharkawy Eman
Published: August 2019

Chloroma or myeloid sarcoma is rare extramedullary tumor composed of immature myeloid cells that may occur in association with or during or even before the course of adult myelodysplastic or myeloproliferative diseases. It may involve different organs including the orbit, skin, lymph nodes, bone, gastrointestinal tract, breast, central nervous system, and lung. Cardiac involvement with MS is an exceedingly rare finding. We report a very rare case of left ventricular cardiac chloroma accidentally discovered by transthoracic echocardiography (TTE) and confirmed by cardiac magnetic resonance (CMR) in an old aged male patient with acute myeloid leukemia (AML) French‐American‐British (FAB)‐class M5. Unfortunately, shortly after a prompt start of AML palliative chemotherapy protocols, the patient died due to massive intracranial hemorrhage (ICH).
Serumd‐ andl‐lactate, pyruvate and glucose levels in individuals with at‐risk mental state and correlations with clinical symptoms
Authors: Onozato Mayu , Umino Maho , Shoji Ayako , Ichiba Hideaki , Tsujino Naohisa , Funatogawa Tomoyuki , Tagata Hiromi , Nemoto Takahiro , Mizuno Masafumi , Fukushima Takeshi
Published: August 2019

Aim

Little information exists on the peripheral metabolite levels in individuals with at‐risk mental state who meet the criteria for a high‐risk state of psychosis. Here, we aimed to investigate serum levels of glucose, pyruvate andd‐ andl‐lactate, which may act as a signalling molecule for learning and memory in neuronal cells.

Methods

High performance liquid chromatography or commercial kits were used to assess serum metabolites in individuals with attenuated psychosis symptoms of at‐risk mental state (n = 24, men = 12) who were not receiving antipsychotics. The metabolite levels of these individuals were compared with those of age‐ and sex‐matched healthy individuals (controls, n = 23, men = 11). Correlations between the metabolites and clinical symptoms of at‐risk mental state were also examined.

Results

Individuals with at‐risk mental state had higher serum glucose levels than did controls (P= 2.18 × 10−3), while no significant difference in pyruvate levels were observed between the groups. Individuals with at‐risk mental state had significantly lower seruml‐lactate levels than did controls (P= 6.31 × 10−5), while no differences ind‐lactate levels were observed. Furthermore, a negative correlation was identified between seruml‐lactate levels and Positive and Negative Syndrome Scale negative symptoms scores (r= −0.5651,P= 4.01 × 10−3) in individuals with at‐risk mental state.

Conclusions

We found that, compared with controls, individuals with at‐risk mental state have reduced seruml‐lactate levels, which may predate psychosis onset, and may be involved in the related negative symptoms.
Infertility, impaired fecundity, and live birth/pregnancy ratio in women with epilepsy in the USA: Findings of the Epilepsy Birth Control Registry
Authors: MacEachern Devon B. , Mandle Hannah B. , Herzog Andrew G.
Published: August 2019

Objective

To determine the current risks of infertility and impaired fecundity as well as the live birth/pregnancy ratio among women with epilepsy (WWE) in the USA and whether antiepileptic drug (AED) use is a factor.

Methods

These retrospective survey data come from the 2010‐2014 Epilepsy Birth Control Registry (EBCR) Web‐based survey of 1000 WWE in the USA, aged 18‐47 years, who provided demographic, epilepsy, AED, reproductive, and contraceptive data. We report risks of infertility and impaired fecundity, live birth/pregnancy ratio, and whether outcomes differ by AED use or category versus No AED.

Results

A total of 978 of the 1000 USA WWE reported reproductive data; 373 WWE had 724 pregnancies and 445 births. An additional 38 WWE (9.2%, 95% confidence interval [CI] = 6.7‐12.4%) tried to conceive but were infertile. A total of 72.5% had a live birth outcome for their first pregnancy, 89.0% had at least one live birth for their first two pregnancies, and 61.6% had two live births for their first two pregnancies. Eighty‐four of 406 WWE (20.7%, 95% CI = 17.0‐2.9%) had impaired fecundity. The risk of impaired fecundity trended higher on AED polytherapy than on No AED (risk ratio [RR] = 1.79, 95% CI = 0.94‐3.11, P = .08). The ratio of live birth/unaborted pregnancy (445/594, 74.9%) was similar among WWE on No AED (71.3%), AED monotherapy (71.8%), and polytherapy (69.7%). None of the AED categories differed significantly from No AED. Note that glucuronidated AED (lamotrigine), which had the highest ratio of live birth/pregnancy (89.1%), compared favorably to enzyme‐inhibiting AED (valproate), which had the lowest (63.3%; RR = 1.41, 95% CI = 1.05‐1.88, P = .02).

Significance

The EBCR finds 9.2% infertility risk and 20.7% impaired fecundity risk among WWE in the USA. Impaired fecundity trended higher on AED polytherapy than on No AED. Live birth/pregnancy ratio was higher with the use of lamotrigine than valproate. These findings may provide WWE a more objective basis for pregnancy planning.
The effects of endometrial damage on placental and fetal development in a mare
Authors: Wilsher S. , De Rijck M. , Rigali F. , Allen W. R.
Published: August 2019

A 13‐year‐old ex‐polo pony maiden mare with an extensively damaged endometrium was initially used as an embryo donor in a research herd. Embryos recovered from the mare were of normal morphology and size. Subsequently, the mare was inseminated and left pregnant. Early conceptus development was normal and she foaled a small (22 kg) but healthy filly after a gestation of 360 days. Examination of the placenta showed that development of the microcotyledons accurately reflected the damage to the uterus. Plasma progestagen profiles throughout gestation also provided evidence for placental pathology and fetal stress.
A method for fatigue testing of equine McIII subchondral bone under a simulated fast workout training programme
Authors: Shaktivesh  , Malekipour F. , Whitton C. , Lee P. V. S.
Published: August 2019

Background

Standard fatigue testing of bone uses a single load and frequency applied until failure. However, in situ, the subchondral bone of Thoroughbred racehorses is subjected to a combination (or a spectrum) of loads and frequencies during training and racing.

Objective

To investigate the use of a fatigue testing method for equine third metacarpal (McIII) subchondral bone under a spectrum of loading conditions which a racehorse is likely to experience during a fast workout.

Study design

In vitro biomechanical experimental study.

Methods

McIII subchondral bone specimens (n = 12) of racehorses were harvested from left and right medial condyles. A novel fatigue loading protocol was developed based upon a standard sequence of gaits during a typical fast workout protocol. This loading pattern, or loading loop, was repeated until the failure of the specimen.

Results

The mean ± standard deviation for all specimens for total time‐to‐failure was 76,393 ± 64,243 s (equivalent to 18.3 ± 15.7 fast workouts). Ten of twelve specimens withstood at least one complete loop equivalent to a fast workout. All specimens failed during simulated gallop loading.

Main limitations

The resting time between loops was much shorter than in vivo resting time and specimens were unconfined during compressive testing.

Conclusions

This novel fatigue loading protocol more closely mimics in vivo fatigue loading of McIII subchondral bone and demonstrates the importance of the highest speeds in the development of subchondral bone injury.
The control, content, and consequences of edTPA: World language teacher educators’ perceptions
Authors: Hildebrandt Susan A. , Swanson Pete
Published: August 2019

Implemented in almost 900 teacher education programs across 41 states and the District of Columbia, edTPA is marketed as a content‐specific, standardized portfolio assessment of beginning teacher performance. However, concerns about edTPA and its content specificity are pervasive. To that end, the researchers surveyed teacher educators with World Language (WL) edTPA experience (N = 88) to ascertain their perceptions of the assessment, including its impact on teacher candidates, teacher education programs, and clinical placements as well as the resources required, support experienced, and consequences perceived as a result of its implementation. Using a framework of teacher education accountability, the researchers explored issues of control, content, and consequences related to power relationships and the WL edTPA, centering on the assessment's intended content specificity, while recounting an ACTFL task force's efforts in 2016 to influence the assessment's content.
Addition of low dose acetazolamide as an adjunct in patients undergoing high dose methotrexate is safe and beneficial
Authors: Ku Matthew , Bazargan Ali , Tam Constantine
Published: August 2019

Background

High‐dose methotrexate (HDMTx) is utilised in central nervous system lymphoma and acute lymphoblastic leukaemia due to its ability to penetrate the blood–brain barrier. Despite its efficacy, nephrotoxicity is a potentially serious toxicity that could also exacerbate other methotrexate‐related toxicities and compromise dose intensity. Acetazolamide (AZL) is a carbonic anhydrase inhibitor that causes an increase in bicarbonate excretion and consequently urine alkalinisation. Following occurrences of HDMTx‐induced acute kidney injury (AKI) due to inadequate urine alkalinisation at our institution, routine AZL was administered to appropriate patients from 2010 onwards.

Aims

To analyse the addition of AZL to routine renoprotective measures, given that inadequate urinary alkalinisation is the major risk factor for methotrexate crystal precipitation and prolonged excretion. In addition, since fluid overload is a common consequence of HDMTx treatment, the effect of AZL on fluid balance was also examined.

Methods

This is a retrospective, single‐centred cohort study examining the mitigation of HDMTx‐induced toxicities by AZL in 92 patients over a 6‐year period.

Results

AZL showed a strong trend of preventing either AKI (as per CTCAE version 4.03) or delayed methotrexate elimination (>5 days), especially in males. Furthermore, AZL also resulted in reduced weight gain and fewer episodes of urinary pH <7.0.

Conclusion

AZL appeared to diminish the incidence of HDMTx‐induced toxicities, including reducing oedema‐related weight gain. With mild, preventable hypokalaemia as the only noteworthy toxicity, AZL could be considered as an adjunct to HDMTx patient care.
Inducible T‐cell co‐stimulator: Signaling mechanisms in T follicular helper cells and beyond
Authors: Panneton Vincent , Chang Jinsam , Witalis Mariko , Li Joanna , Suh Woong‐Kyung
Published: August 2019

Human patients with homozygous null mutations in the ICOS gene suffer from recurrent infections due to humoral immune defects. Studies on human patients and mouse models have shown that inducible T‐cell co‐stimulator (ICOS)‐deficient individuals cannot form T follicular helper (Tfh) cells, a group of CD4 T cells that migrate into B cell follicles and facilitate germinal center (GC) reactions. ICOS‐induced phosphoinositide 3‐kinase signaling pathways have been shown to play critical roles in Tfh programming, migration of Tfh cells into the GC, and delivery of T cell help during Tfh‐GC B cell conjugation. These processes are also assisted by ICOS‐mediated intracellular calcium mobilization and TANK‐binding kinase 1 signaling. However, ICOS signaling also has stimulatory roles in T regulatory cells and innate lymphoid cells (ILCs), providing another layer of complexity. In this review, we discuss cell‐type‐specific signaling mechanisms utilized by ICOS in Tfh cells, T regulatory cells, and ILCs. Whenever relevant, we compare the roles and signaling pathways of ICOS and CD28. Understanding ICOS signal transduction mechanisms used by distinct immune subsets at different stages of immune responses or disease progression may help improve vaccination protocols, treat autoimmune diseases, and enhance cancer immunotherapy.
Regulation of immune system development and function by Cbl‐mediated ubiquitination
Authors: Li Xin , Gong Liying , Gu Hua
Published: August 2019

Ubiquitination is a form of posttranslational protein modification that affects the activity of target proteins by regulating their intracellular degradation, trafficking, localization, and association with other regulators. Recent studies have placed protein ubiquitination as an important regulatory mode to control immune system development, function, and pathogenesis. In this review, we will mainly update the research progress from our laboratory on the roles of the Cbl family of E3 ubiquitin ligases in the development and function of lymphocytes and non‐lymphoid cells. In addition, we will highlight our current understanding of the mechanisms used by this family of proteins, especially Cbl and Cbl‐b, to co‐ordinately regulate the function of various receptors and transcription factors in the context of immune regulation and diseases.
A prolonged QTc‐interval at the emergency department: Should we always be prepared for the worst?
Authors: Vandenberk Bert , Siau Caroline , Vandael Eline , Puype Laura , Branders Jordi , Dewolf Philippe , Foulon Veerle , Willems Rik , Verelst Sandra
Published: August 2019

Introduction

QTc‐interval prolongation is associated with ventricular arrhythmias and mortality in a general population. Bazett's correction formula (QTcB) is routinely used despite its overcorrection at high heart rates. Recently, we proposed a patient‐specific QT correcting algorithm (QTcA) resulting in improved rate correction and predictive value in a general population. We hypothesize risk stratification at the Emergency Department (ED) could be improved using QTcA.

Methods and Results

A retrospective case‐control study including a randomized age‐ and sex‐matched control population was performed at a tertiary care ED. A total of 1930 patients were included in the analysis (63.0% males, age 71.5 ± 15.6 years). Patient characteristics, history, and test results at the time of the electrocardiogram were collected. QTc was dichotomized as prolonged (>450 millisecond for men, >470 millisecond for women) or severely prolonged (>500 millisecond). Implementation of QTcA would reduce the number of patients considered to have a prolonged QTc by 65.2%, for severely prolonged QTc 79.6%. Multivariate regression was performed for in‐hospital mortality, cardiovascular endpoints, and hospital admission. Neither a prolonged QTcB (HR 1.04; 95% CI, 0.64‐1.69) nor QTcA (HR 0.76; 95% CI, 0.42‐1.38) was an independent predictor of in‐hospital mortality. A severely prolonged QTcA (OR, 2.54; 95% CI, 1.04‐6.23) was an independent predictor of cardiovascular events. Both a prolonged QTcA (OR, 1.52; 95% CI, 1.06‐2.18) and a prolonged QTcB (OR, 1.37; 95% CI, 1.05‐1.79) were associated with higher hospitalization rates.

Conclusions

QTcA reduced the number of patients considered at risk. Neither QTcB nor QTcA were predictors of in‐hospital mortality. A severely prolonged QTcA was associated with cardiovascular events.
The German Federal Courts Dataset 1950–2019: From Paper Archives to Linked Open Data
Authors: Hamann Hanjo
Published: August 2019

Various reasons explain why Europe lags behind the United States in empirical legal studies. One of them is a scarcity of available data on judicial decision making, even at the highest levels of adjudication. By institutional design, civil‐law judges have lower personal profiles than their common‐law counterparts. Hence very few empirical data are available on how courts are composed and how that composition changes over time. The present project remedies that by easing access to such data and lowering the threshold for empirical studies on judicial behavior. This paper introduces the German Federal Courts Dataset (GFCD) as a resource for empirical legal scholars, with the objective of inspiring more European lawyers to engage with empirical aspects of civil‐law adjudication. To that end, several thousand pages of German court documentation were digitized, transcribed into machine‐readable tables (ready to be imported into statistics software), and published online (www.richter-im-internet.de). To simultaneously explore innovative ways of sharing public‐domain datasets, the data were modeled as linked open data and imported into the Wikidata repository for use in any computational application.
Integrating Race, Racism, and Critical Consciousness in Black Parents' Engagement With Schools
Authors: Marchand Aixa D. , Vassar Rema Reynolds , Diemer Matthew A. , Rowley Stephanie J.
Published: August 2019

Although decades of research document the positive benefits of parent involvement in schools, Black parents are not always welcomed in schooling spaces. Black parents have sometimes been perceived as uncaring about their children's education, and often racism has precluded their full inclusion and meaningful participation. This article uses critical race theory to understand the ways that racism influences Black parents' experiences in schools. We propose a novel form of parent involvement—critical parent engagement—which we define as parents' recognition of issues related to race and racism in schools that informs the actions they take to ensure their children's academic success. This new conceptualization of parent involvement relies on critical race theory and critical consciousness theory to provide a conceptual framework to understand how Black parents critically analyze issues that are present in the schools and how they subsequently engage in action. We conclude with suggestions for future research and practice.
Different Definitions of Elder Mistreatment and Mortality: A Prospective Cohort Study From 2011 to 2017
Authors: Li Mengting , Liang Ying , Dong XinQi
Published: August 2019

OBJECTIVES

To investigate the relationship between different definitions and subtypes of elder mistreatment (EM) and yearly mortality.

DESIGN

Population‐based epidemiological study.

SETTING

Greater Chicago area.

PARTICIPANTS

Chinese Americans aged 60 and older (N=3,157).

MEASUREMENTS

Data were collected from 2011 to 2017, with mortality data collected over the subsequent 4 years. Face‐to‐face in‐home interviews were conducted. EM was measured using a brief screening tool (10 items) and a detailed assessment (56 items) and defined using different criteria for overall and specific subtypes of EM. Mortality was ascertained during follow‐up. Cox proportional hazards models were used.

RESULTS

Four hundred seventy‐five (15.2%) participants reported EM. Severe and moderate EM were associated with greater risk of 1‐year (hazard ratio (HR)=2.51, 95% confidence interval (CI)=1.04–6.03; HR=2.55, 95% CI=1.08–6.03), 2‐year (HR=1.68, 95% CI=1.01–2.78; HR=1.69, 95% CI=1.04–2.74), 3‐year (HR=1.73, 95% CI=1.17–2.55; HR=1.73, 95% CI=1.19–2.51) and 4‐year (HR=1.51, 95% CI=1.08–2.10; HR=1.48, 95% CI=1.08–2.04) mortality. A broad definition of EM was associated with greater risk of 3‐year and 4‐year mortality. With respect to subtypes of EM, psychological mistreatment and caregiver neglect were associated with greater mortality risk, whereas the relationships between psychological mistreatment, caregiver neglect and mortality risk varied according to definitional criteria.

DISCUSSION

Different definitions and subtypes of EM had different associations with mortality in Chinese‐American older adults. This study challenges assumptions about consequences of EM and calls for customized interventions for EM in minority populations. J Am Geriatr Soc 67:S506–S512, 2019.
Sex Differences in the Prevalence and Incidence of Cognitive Impairment: Does Immigration Matter?
Authors: Tang Fengyan , Chi Iris , Dong XinQi
Published: August 2019

OBJECTIVES

We aimed to examine the associations between immigration‐related factors and prevalent and incident cognitive impairment (CI) and whether the associations varied by sex among US Chinese older adults.

DESIGN

Two‐wave prospective study.

SETTING

The greater Chicago area.

PARTICIPANTS

Community‐dwelling adults aged 60 and older who self‐identified as Chinese, who were interviewed at two time points during 2011‐2013 (N = 3157) and 2013‐2015 (N = 2713).

MEASUREMENTS

CI was assessed by the 30‐item Chinese Mini‐Mental State Examination (C‐MMSE). CI prevalence was determined by the percentage of respondents whose C‐MMSE score was below 18 at baseline (N = 3033), and CI incidence was determined by the percentage of the respondents whose score was 18 or above at baseline (N = 2443) but dropped below 18 at wave 2. Immigration‐related factors included age at migration, immigration reasons, and acculturation.

RESULTS

The CI prevalence rate was 7.62% at baseline, and the incidence rate was 5.12% at wave 2. Women were more likely than men to have CI, consisting of 77.06% and 75.20% among persons with CI at the time points. None of the immigration‐related factors were related to CI prevalence and incidence. Older age, fewer years of education, and more instrumental activities of daily living limitations were risk factors of CI in the whole, male, and female samples.

CONCLUSION

Older Chinese women were generally disadvantaged in cognition and overall health as compared with older Chinese men. Yet immigration experience does not link to CI for both men and women after equalizing the well‐established effects of age and education on cognition. Future research needs to investigate whether the risk of CI in late life is related to the biological and contextual factors earlier in the life course. Decreasing sex disparities in the risk of dementia may focus on reducing educational and health disparities in the early life stage. J Am Geriatr Soc 67:S513–S518, 2019.
Sense of Filial Obligation and Caregiving Burdens Among Chinese Immigrants in the United States
Authors: Guo Man , Kim Sohyun , Dong XinQi
Published: August 2019

BACKGROUND/OBJECTIVES

Focusing on Chinese immigrants, this study examined (1) whether filial obligation, the core social norm in the Chinese culture, is related to caregiving burdens; and (2) whether level of acculturation of the caregivers moderates the above relationships.

DESIGN

Cross‐sectional.

SETTING

Chicago, Illinois.

PARTICIPANTS

A purposive sample of 393 Chinese adult immigrants who were primary caregivers of parents aged 60 years or older.

MEASURES

Sense of filial obligation was captured by felt responsibility toward parents in six domains (respect, make happy, care, greet, obey, and provide financial support). Caregiving burdens were measured by the Caregiver Burden Inventory. Acculturation was measured by 12 questions about respondents' language preference in different settings and ethnicity of individuals they interact with.

RESULTS

A stronger sense of filial obligation was significantly associated with lower levels of developmental (β = −.15), emotional (β = −.18), social (β = −.20), and physical (β = −.10) burdens. For subjective burdens (developmental, social burdens), such a protective effect of filial obligation was stronger among caregivers with lower acculturation levels. For more objective burdens (time‐dependent, physical burdens), stronger filial obligation was actually associated with greater burdens among caregivers with higher acculturation levels.

CONCLUSION

Programs focusing on celebrating the cultural heritage of immigrants and improving the relationship between the parents and children may be helpful to reduce caregiving burdens. Intervention programs that help Chinese immigrant caregivers to find the most appropriate way to balance traditional and new social norms are important to provide successful care to aging Chinese immigrants. J Am Geriatr Soc 67:S564–S570, 2019.
The Impact of Intergenerational Relationship on Health and Well‐Being of Older Chinese Americans
Authors: Lai Daniel W.L. , Lee Vincent W.P. , Li Jia , Dong XinQi
Published: August 2019

BACKGROUND/OBJECTIVES

Among older adults, intergenerational support can help to improve well‐being. This study examines the correlation between intergenerational relationships and the subjective well‐being among older Chinese immigrants in the United States.

DESIGN

Hierarchical multiple regression analyses were applied to test the association between intergenerational relationships and self‐rated well‐being. The mediating effects of sense of control and the moderation effects of support from friends were also tested.

SAMPLE

A cross‐sectional sample of 2717 older Chinese immigrants, aged 60 years and older, with children and grandchildren was drawn from the Population Study of Chinese Elderly.

MEASUREMENTS

Study measures included four items concerning intergenerational relationships: the Pearlin Mastery Scale, two items on seeking support from friends, and single items measuring self‐rated health status and quality of life.

RESULTS

Only the feeling of closeness with children was positively linked with subjective well‐being, while coresidence and frequency of talking were not. Support from friends moderated the association with self‐rated health status, while sense of control partially mediated the association between feeling of closeness and both self‐rated health status and quality of life.

CONCLUSION

A stronger sense of closeness with children correlates to self‐rated health status and quality of life among older Chinese immigrants. The effects of sociocultural changes affecting Chinese American families, and potential implications for older adults' health, could be addressed through strategies to develop emotional closeness with their families and to support sense of control and well‐being among older Chinese adults. J Am Geriatr Soc 67:S557–S563, 2019.
Oral lesions and associated factors in breast cancer survivors
Authors: Jardim Luísa Comerlato , Flores Priscila Trindade , de Araújo Sensever Felipe , Araújo Maria do Carmo dos Santos , de Moraes Cristina Machado Bragança , Chiesa Juares , Antoniazzi Raquel Pippi
Published: August 2019

Aim

To evaluate the prevalence of oral lesions (OL) and associated factors among survivors of breast cancer (BC).

Methods

A cross‐sectional study involving 150 BC survivors was conducted at a public hospital in southern Brazil. Data were collected on socioeconomic aspects, treatment characteristics and oral problems. The decayed, missing and filled teeth index and the occurrence of OL were evaluated. Logistic regression was performed to determine independent variables associated with the outcome.

Results

24% of the women had at least 1 OL and 33.3% of these had more than one lesion. Melanotic macule was the most prevalent lesion. Duration of tamoxifen use, radiotherapy, missing teeth and xerostomia were associated with the occurrence of OL (P < .05). In the adjusted analysis, women with more than 13 missing teeth and xerostomia had 2.39‐fold (95% confidence interval [CI], 1.06‐5.40) and 2.71‐fold (95% CI, 1.14‐6.42), respectively, greater odds of exhibiting OL.

Conclusion

Approximately 1/4 of the BC survivors exhibited OL, which were associated with tooth loss and xerostomia. These findings could assist in the establishment of oral health strategies for women with BC.
Telomere shortening in the oral epithelium in relation to alcohol intake, alcohol dehydrogenase (ADH‐1B), and acetaldehyde dehydrogenase (ALDH‐2) genotypes and clinicopathologic features
Authors: Aida Junko , Yokoyama Akira , Hara Sachiko , Ishizaki Tatsuro , Fujiwara Mutsunori , Arai Tomio , Ishiwata Toshiyuki , Takubo Kaiyo
Published: August 2019

Background

Progressive telomere shortening with age or chronic inflammation may lead to genomic instability that characterizes the early stage of carcinogenesis. Certain risk factors, such as drinking alcoholic beverages or smoking, predispose the oral mucosa to squamous cell carcinoma. The ADH1B and ALDH2 genotypes can influence the risk of cancer due to alcohol drinking. In the present study, we analyzed chromosomal instability due to telomere shortening in the oral mucosa in relation to cancer risk factors.

Design

Using our quantitative fluorescence in situ hybridization (Q‐FISH) technique, we estimated telomere lengths (TL) in the background mucosa from 23 cases of mucosal carcinoma, 12 cases of oral epithelial dysplasia, and 21 non‐neoplasia cases. ALDH2 and ADH1B genotypes were determined using DNA extracted from paraffin sections. We analyzed TL in relation to alcohol drinking, smoking, and cancer multiplicity.

Results

Telomeres in the backgrounds of dysplasia and mucosal carcinoma were significantly shorter than in controls. In comparison with adult controls, telomeres were significantly (P = .038) shorter in the ADH1B less‐active type (ADH1B*1/*1), but not (P = .841) in the ALDH2 inactive type (ALDH2*1/*2 or *2/*2). Cancer multiplicity and smoking had no significant relationship with TL.

Conclusion

Telomeres in the oral epithelium are shorter in cases of oral dysplasia or mucosal carcinoma than in non‐neoplasia. Unlike the esophageal epithelium of alcoholics, they are also shorter in individuals with the less‐active rather than the active ADH1B gene. Telomeres in the oral epithelium may be directly affected by alcohol drinking.
Carbohydrate and PepO control bimodality in competence development by Streptococcus mutans
Authors: Underhill Simon A. M. , Shields Robert C. , Burne Robert A. , Hagen Stephen J.
Published: August 2019

In Streptococcus mutans, the alternative sigma factor ComX controls entry into genetic competence. Competence stimulating peptide (CSP) induces bimodal expression of comX, with only a fraction of the population becoming transformable. Curiously, the bimodality of comX is affected by peptides in the growth medium and by carbohydrate source. CSP elicits bimodal expression of comX in media rich in small peptides, but CSP elicits no response in defined media lacking small peptides. In addition, growth on certain sugars increases the proportion of the population that activates comX in response to CSP. By investigating the connection between media and comX bimodality, we find evidence for two mechanisms that modulate transcriptional positive feedback in the ComRS system, where comX bimodality originates. We find that the endopeptidase PepO suppresses the ComRS feedback loop, most likely by degrading the XIP/ComS feedback signal. Deletion of pepO eliminates comX bimodality, leading to a unimodal comX response to CSP in both defined and complex media. We also find that CSP stimulates the ComRS feedback system by upregulating comR in a carbohydrate source‐dependent fashion. Our data provide mechanistic insight into how S. mutans regulates bimodality and explain the puzzle of growth medium effects on competence induction by CSP.
Neuroblastoma rat sarcoma mutated melanoma: That’s what we got so far
Authors: Bertoli Elisa , Giavarra Marco , Vitale Maria Grazia , Minisini Alessandro Marco
Published: August 2019

Neuroblastoma rat sarcoma (NRAS) mutation, occurring in about 20%–30% of cutaneous melanomas, leads to activation of RAS‐RAF‐MAPK cascade and represents a clear distinct clinicopathological entity in melanoma. In contrast with BRAF mutant melanoma, no specific target therapies are available outside the setting of clinical trials. In the field of immunoncology, the predictive role of NRAS mutation with respect to checkpoint inhibitors treatment has not clearly established and deserves further investigation. At present, the standard treatment is the same as for BRAF wild type melanoma. Ongoing trials are exploring novel combination strategies among patients with advanced NRAS mutant melanoma.
Body site‐specific genetic effects influence naevus count distribution in women
Authors: Visconti Alessia , Ribero Simone , Sanna Marianna , Spector Tim D. , Bataille Veronique , Falchi Mario
Published: August 2019

Body site is highly relevant for melanoma: it affects prognosis and varies according to the patient's sex. The distribution of naevi, a major risk factor for melanoma, at different body sites also varies according to sex in childhood. Using naevus counts at different body sites in 492 unrelated adults from both sexes, we observed that women have an increased number of naevi on the lower limbs compared to men (p = 8.5 × 10−5), showing that a high naevus count on this site persists from childhood throughout life. Then, using data from 3,232 twins, we observed, in women, the lowest naevus count heritability on the trunk (26%), and the highest on the lower limbs (69%). Finally, we showed that, in 2,864 women, six genomic loci previously associated with both naevus count and melanoma risk (IRF4, DOCK8, MTAP, 9q31.2, KITLG and PLA2G6) have an effect on naevus count that is body site‐specific, but whose effect sizes are predominantly stronger on the lower limbs. Sex‐specific genetic influence on naevus count at different sites may explain differences in site‐specific melanoma incidence as well as prognosis between sexes.
Immunologic benefit of maternal donors in pediatric living donor liver transplantation
Authors: Kim Michelle H. , Akbari Omid , Genyk Yuri , Kohli Rohit , Emamaullee Juliet
Published: August 2019

Purpose of review

Long‐term follow‐up has suggested that pediatric LDLT may have superior outcomes compared to deceased donor recipients. In this review, we describe the subset of LDLT recipients with maternal donors that have lower reported rates of rejection and improved allograft survival.

Recent findings

Pediatric LDLT recipients, particularly those with a primary diagnosis of biliary atresia who receive grafts from their mothers, have been reported to have lower rates of acute cellular rejection post‐transplant and graft failure. Maternal‐fetal microchimerism and the persistence of regulatory T cells may be related to improved outcomes observed in recipients with maternal donors. Further, recent studies have shown that up to 60% of pediatric LDLT recipients can undergo intentional withdrawal of immunosuppression and achieve long‐term operational tolerance. The impact of graft type on operational tolerance has not been thoroughly investigated; however, investigation of tolerant pediatric LDLT patients with maternal donors may provide key insights into the mechanisms of immune tolerance.

While excellent outcomes can be achieved in pediatric LDLT, there is still a measurable decrease in graft and patient survival over time post‐transplant. Recipients of maternal donor liver transplants are a subset of patients who may be advantaged toward improved outcomes by means of immune tolerance.
The Norwegian version of the five factor narcissism inventory for vulnerable narcissism and the grandiose narcissism subscale of indifference: Psychometric properties of the long‐ and short‐form versions
Authors: Prendergast Claire Nicole , Haahjem Eftedal Nikolai , Fredriksen Ikonomeas Alexander Gustav , Brun Aurora , Huth Håkon , Bredesen Marit
Published: August 2019

In recent years, narcissism has been reconceptualized as a multi‐dimensional feature of human psychology. The Five Factor Narcissism Inventory (FFNI) has been proposed as a measure for two distinguishable dimensions of narcissism: Vulnerable and Grandiose (Glover, Miller, Lynam, Crego & Widiger, 2012). To investigate the role that some of these factors may have in moderating responses to cues of social exclusion, implemented in a connected laboratory experiment, we translated the subscales for Vulnerable Narcissism and the Grandiose Narcissism subscale of Indifference from English into Norwegian and included them in an online survey that was used to recruit and pre‐screen participants for the laboratory experiment. In this paper, we test the psychometric properties of these translated self‐report measures, in what amounted to be a diverse sample of the Norwegian population. We perform reliability tests and confirmatory factor analysis on the long‐ and short‐form versions of FFNI Vulnerable Narcissism and the Grandiose Narcissism subscale of Indifference. We further test the criterion validity of these measures by way of correlational analyses with other theoretically relevant measures. We conclude that the Norwegian short‐form versions of FFNI Vulnerable Narcissism and Grandiose Narcissism subscale of Indifference exhibit good psychometric properties in our data and propose that the translated scales can now be used to explore these constructs in clinical and non‐clinical populations in Norway, and can be easily adapted for use in other Scandinavian countries.
Incidence, risk factors, and outcome of pulmonary invasive fungal disease after respiratory virus infection in allogeneic hematopoietic stem cell transplantation recipients
Authors: Piñana José Luis , Gómez María Dolores , Montoro Juan , Lorenzo Ignacio , Pérez Ariadna , Giménez Estela , González‐Barberá Eva María , Carretero Carlos , Guerreiro Manuel , Salavert Miguel , Sanz Guillermo , Hernández‐Boluda Juan Carlos , Borrás Rafael , Sanz Jaime , Solano Carlos , Navarro David
Published: August 2019

Background

There is growing evidence that community‐acquired respiratory virus (CARV) increases the risk of pulmonary invasive fungal disease (IFD) in the allogeneic hematopoietic stem cell transplantation (allo‐HSCT) setting. To date, there is a lack of knowledge regarding the risk factors (RFs), as well as the most critical period for subsequent onset of IFD after CARV infections in allo‐HSCT recipients.

Methods

In this prospective longitudinal observational CARV survey, we analyzed the effect of CARV on subsequent IFD development in 287 adult allo‐HSCT recipients diagnosed with 597 CARV episodes from December 2013 to December 2018. Multiplex PCR panel assays were used to test CARVs in respiratory specimens.

Findings

Twenty‐nine out of 287 allo‐HSCT recipients (10%) developed IFD after a CARV episode. The median time of IFD onset was 21 days (range, 0‐158 days) from day of the first CARV detection. Generalized estimating equation model identified 4 risk factors for IFD: ATG‐based conditioning regimen [odds ratio (OR) 2.34, 95% confidence interval (CI) 1.05‐5.2, P = .038], CARV lower respiratory tract disease (OR 10.6, 95% CI 3.7‐30.8, P < .0001), CARV infection during the first year after transplant (OR 5.34, 95% CI 1.3‐21.8, P = .014), and corticosteroids during CARV (OR 2.6, 95% CI 1.1‐6.3, P = .03).

Conclusion

Allo‐HSCT recipients conditioned with ATG and under corticosteroid therapy at the time of CARV LRTD during the first year after transplant may require close monitoring for subsequent IFD.
Urban political ecologies of heritage: Integrating cultural and natural landscapes in Penang, Malaysia
Authors: Connolly Creighton
Published: August 2019

Over the past few decades, there have been numerous studies examining the interface between cultural heritage conservation and urban (re)development, particularly in rapidly developing regions. On the other hand, scholars have also examined nature conservation movements in the context of encroaching (urban) development. However, this body of research has, with a few exceptions, not considered the interrelationship between natural and cultural heritage in urban settings. The paper argues that a renewed understanding of urban heritage – consisting of both cultural and natural elements – is required for effective and socio‐ecologically sustainable approaches to heritage conservation and urban development. To illustrate this argument, the paper draws on an empirical examination of Penang Hill, which is a culturally and ecologically significant area of Penang Island, Malaysia. In conceptualising this relationship, the paper draws on the urban political ecologies of landscape, which is useful in examining the urbanisation of nature and problematising distinctions between urban/rural and natural/cultural. As I will demonstrate, invocations of Penang's rich natural heritage are often framed alongside urban and cultural heritage in local resistance to these developments, which relate to the particular socio‐environmental sensibilities of local stakeholders. The analysis is based on discursive analysis of primary written sources and original interviews with local residents and civil society activists, which helps to demonstrate the crucial role of local communities in achieving more socio‐ecologically just forms of heritage management.
Use of perioperative variables to determine the requirement for repeat celiotomy in horses with postoperative reflux after small intestinal surgery
Authors: Jacobs Carrie C. , Stefanovski Darko , Southwood Louise L.
Published: August 2019

Objective

To determine whether perioperative variables can be used to differentiate a medical vs a surgical reason for postoperative reflux (POR) after small intestinal (SI) surgery in horses.

Study design

Retrospective study.

Sample population

Horses >1 year of age that recovered from SI surgery and had POR.

Methods

Medical records of horses that underwent SI surgery and developed POR from 2009‐2015 were reviewed. Surgical reasons for POR were defined as an anastomosis complication, mechanical obstruction, or nonviable intestine identified at repeat celiotomy/necropsy. A medical reason for POR was presumed when the POR improved with medical treatment or when no surgical reasons were identified at repeat celiotomy/necropsy. Perioperative variables were analyzed and used to develop a logistic regression model.

Results

Fifty‐one horses had POR after SI surgery. After initial SI surgery, 14 horses had surgical reasons for POR diagnosed at repeat celiotomy or necropsy. Thirty‐seven horses were considered to have medical reasons for POR because their POR resolved with medical management or functional ileus was diagnosed at repeat celiotomy/necropsy. A greater volume and a greater duration of POR were not associated with a surgical reason for POR. Rather, a postoperative (PO) fever and the timing of colic in the PO period were associated with a surgical reason for POR.

Conclusion

Horses that developed a fever and colic in the PO period after SI surgery were more likely to have a surgical reason for POR.

Clinical significance

These findings may provide guidance for clinicians when they are making decisions about repeat celiotomy in horses with POR after SI surgery.
Implementing the Richmond Agitation-Sedation Scale in a respiratory critical care unit: a best practice implementation project
Authors: Su Jui-Yuan , Lockwood Craig , Tsou Yi-Chen , Mu Pei-Fan , Liao Shu-Chen , Chen Wei-Chih
Published: August 2019

Introduction:

Adequate sedation can lead to patient-ventilator synchrony, facilitation of treatment, and decreased physical and psychological discomfort for patients with respiratory failure in the intensive care unit (ICU). The Richmond Agitation-Sedation Scale (RASS) is considered to be the most appropriate tool in sedation assessment.

Objectives:

This aim of this project was to implement evidence-based recommendations for sedation assessment using the RASS in mechanically ventilated patients in the ICU.

Methods:

This implementation project was conducted in an ICU at a tertiary medical center in Taiwan. Using the JBI Practical Application of Clinical Evidence System software, a baseline audit was conducted in the ICU, followed by an identification of barriers of RASS assessment and an implementation of management of strategies to improve the consistency of sedation assessment.

Results:

Results of the baseline audit showed that four of the six selected criteria had 0% compliance. Following the implementation of the strategies, which included education, visual management and development of a “RASS Reminder Card”, there was an improvement in all the criteria audited, with each criterion achieving 83–100% of compliance.

Conclusion:

The project successfully improved the implementation of RASS assessment in the respiratory ICU. Following the development and implementation of evidence-based resources, a high level of compliance was achieved for nurses using the RASS in the ICU to assess sedation in patients with a ventilator.
Experiences of transgender men in seeking gynecological and reproductive health care: a qualitative systematic review protocol
Authors: Sbragia Julia D. , Vottero Beth
Published: August 2019

Objective:

The purpose of this review is to synthesize the existing qualitative literature examining the experiences of transgender men seeking gynecological and reproductive health in all healthcare settings globally.

Introduction:

Existing literature clearly identifies that fear of mistreatment and discrimination is an ongoing concern among the transgender community. Transgender men face challenges and barriers when seeking health care. When female reproductive organs and genitalia are retained, transgender men will need to access reproductive and gynecological health care and screening examinations. Synthesis of the literature examining those experiences is the focus of this review.

Inclusion criteria:

This review will consider all qualitative studies that include natal females who identify as transgender, genderqueer, non-binary or gender expressive and their experiences when seeking and receiving care related to gynecological or reproductive care. All studies on this type of care in any setting will be included.

Methods:

CINAHL Complete and PubMed will be searched and eligible studies published in English after 1979 will be included. Titles and abstracts will be screened by two independent reviewers for assessment against the inclusion criteria. The full text of articles will be assessed for inclusion and all potential articles will then be appraised for methodological quality using standardized critical appraisal tools. Data will be extracted by two independent reviewers. Findings will be pooled with a meta-aggregation approach to categorize findings. These synthesized findings will be graded to establish confidence in the output.
Scattering and radiation force dependence on properties of empty elastic spherical shells: Low-frequency phase-shift derivation
Authors: Marston Philip L.
Published: August 2019

It is helpful to evaluate scattering and acoustic radiation forces on spheres for idealized cases in which the effects of energy dissipation are ignorable. Let x denote the product of the acoustic wave number and the sphere's radius. Previously expansions were obtained for fluid and solid spheres involving powers of x and algebraic expressions containing material properties. The present analysis concerns the case of empty elastic shells and reveals how expansion coefficients also depend on shell thickness. Incident waves considered are plane traveling and standing waves, though relevance to Bessel wave-fields is also noted. The expansions give leading-order corrections to the usual Rayleigh scattering approximation.
Shock and Early Death in Hematologic Patients with Febrile Neutropenia
Authors: Guarana Mariana , Nucci Marcio , Nouér Simone A.
Published: August 2019

Empirical antibiotic therapy with a beta-lactam is the standard of care in febrile neutropenia (FN) and is given to prevent early death. The addition of vancomycin is recommended in certain circumstances, but the quality of evidence is low, reflecting the lack of clinical data.
Picornaviruses and RNA Metabolism: Local and Global Effects of Infection
Authors: Holmes Autumn C. , Semler Bert L.
Published: August 2019

Due to the limiting coding capacity for members of the
Picornavirida
e family of positive-strand RNA viruses, their successful replication cycles require complex interactions with host cell functions.