bluuebunny/crossref_metadata_2025 huggingface dataset:
Rain‐induced deep‐seated catastrophic rockslides controlled by a thrust fault and river incision in an accretionary complex in the Shimanto Belt, Japan
Authors: Arai Noriyuki , Chigira Masahiro
Published: March 2018

To clarify the geological causes of rockslides induced by rainstorms in accretionary complexes, the geology and geomorphology of two large rockslides (volumes > 106 m3) induced by the heavy rainfall of Typhoon Talas in the Shimanto Belt, Kii Mountains, Japan in 2011 are investigated. Our analysis reveals that thrusts with brittle crush zones controlled the occurrence of the rockslides. The properties and distribution of thrusts were poorly constrained before this study. Flooding during the rainstorm removed surface materials along rivers, allowing thorough geological mapping to be performed. Gravitationally deformed slopes were studied using GIS analysis of 1 m digital elevation models (DEMs) and fieldwork, and X‐ray diffraction (XRD) analysis, permeability, and direct shear tests were used to characterize the mineralogy and geotechnical properties of fault gouge. The Kawarabi thrust has a brittle crush zone up to 6 m thick and acts as the sliding surface for both landslides. The thrust dips 34° downslope and is cut by high‐angle faults and joints along one or both sides of each landslide body. Prior to failure, the upper part of the slope contained small scarps, suggesting that the slopes were already gravitationally deformed. The slope instability can be attributed to long‐term river erosion, which has undercut the slope and exposed the thrust at the base of the slope. The groundwater level, monitored in boreholes, suggests that the Kawarabi thrust is a barrier to groundwater flow. The weak and impermeable nature of the thrust played an essential role in the generation of gravitational slope deformation and catastrophic failure during periods of increased rainfall. Thrusts are a common feature of accretionary complexes, including in the Shimanto Belt, and the mechanism of slope failure stated above can be typical of rockslides in accretionary complexes and provide new insights into landslide disaster mitigation.
A multilevel analysis of perceived intergenerational mobility and welfare state preferences
Authors: Gugushvili Alexi
Published: March 2018

Previous scholarship suggests that the effect of perceived intergenerational mobility on attitudes related to social justice, inequality and redistribution is more salient than the effect of individuals' objective intergenerational mobility. However, virtually no studies have attempted to link individuals' perception of experiencing intergenerational mobility and their support for different welfare state programmes. In my study using nationally representative and comparative survey data for 33 Western European welfare democracies and post‐socialist transition societies, I found that perceived intergenerational mobility is associated with support for certain welfare state programmes. Results from multilevel linear probability models indicate that subjectively downwardly mobile individuals are less likely to support education and healthcare expenditure and more likely to prefer targeted assistance of the poor, while subjectively upwardly mobile individuals oppose extra spending on housing and old‐age pensions. The described associations are more vividly manifested in post‐socialist societies than in the analysed Western European democracies.
Aged neutrophils accumulate in lymphoid tissues from healthy elderly mice and infiltrate T‐ and B‐cell zones
Authors: Tomay Federica , Wells Kelsi , Duong Lelinh , Tsu Jean Wei , Dye Danielle E , Radley‐Crabb Hannah G , Grounds Miranda D , Shavlakadze Tea , Metharom Pat , Nelson Delia J , Jackaman Connie
Published: March 2018

The average age of the human population is rising, leading to an increasing burden of age‐related diseases, including increased susceptibility to infection. However, immune function can decrease with age which could impact on processes that require a functional immune system. Aging is also characterized by chronic low‐grade inflammation which could further impact immune cell function. While changes to neutrophils in blood during aging have been described, little is known in aging lymphoid organs. This study used female C57BL/6J mice comparing bone marrow (BM), spleen and lymph nodes from young mice aged 2–3 months (equivalent to 18 human years) with healthy elderly mice aged 22–24 months (equivalent to 60–70 human years). Neutrophil proportions increased in BM and secondary lymphoid organs of elderly mice relative to their younger counterparts and presented an atypical phenotype. Interestingly, neutrophils from elderly spleen and lymph nodes were long lived (with decreased apoptosis via Annexin V staining and increased proportion of BrdUneg mature cells) with splenic neutrophils also demonstrating a hypersegmented morphology. Furthermore, splenic neutrophils of elderly mice expressed a mixed phenotype with increased expression of activation markers, CD11b and ICAM‐1, increased proinflammatory TNFα, yet increased anti‐inflammatory transforming growth factor‐beta. Elderly splenic architecture was compromised, as the marginal zone (required for clearing infections) was contracted. Moreover, neutrophils from elderly but not young mice accumulated in lymph node and splenic T‐ and B‐cell zones. Overall, the expansion of functionally compromised neutrophils could contribute to increased susceptibility to infection observed in the elderly.
Utility of the Hospital Admission Risk Programme diabetes risk calculator in identifying patients with type 2 diabetes at risk of unplanned hospital presentations
Authors: McGrath Rachel T. , Dryden Justin C. , Newlyn Neroli , Pamplona Elline , O'Dea Judy , Hocking Samantha L. , Glastras Sarah J. , Fulcher Gregory R.
Published: March 2018

Background

Prevention of hospitalisation is an important aspect of type 2 diabetes (T2D) management.

Aims

We retrospectively determined the utility of the Hospital Admission Risk Programme (HARP) diabetes risk calculator (HARP tool) in identifying patients with T2D more likely to have unplanned hospital presentations.

Methods

The HARP tool includes a clinical assessment score (Part A) and a psychosocial and self‐management impact score (Part B), and categorises patients into low, medium, high or urgent risk of acute hospitalisation. It was completed for T2D patients attending Royal North Shore Hospital, Sydney, in 2013.

Results

Within the cohort of 278 patients (age 65.3 ± 10.5 years; 62.9% male; diabetes duration 10.7 ± 6.6 years), 67.3% were classified as low risk, 32.7% as medium risk and none as high or urgent risk. Following adjustment for confounders, a medium HARP score was associated with a 3.1‐fold increased risk of unplanned hospital presentations in the subsequent 12 months (95% confidence interval: 1.35–7.31; P = 0.008). Part A scores were significantly higher for patients that presented to hospital compared to those that did not (14.2 ± 6.8 vs 11.4 ± 5.5; P = 0.034), whereas there was no difference in Part B scores (P = 0.860).

Conclusions

In patients with low and medium HARP scores, clinical features were more predictive of hospital presentations than certain psychosocial or self‐management factors in the present cohort. Further studies are required to characterise unplanned hospitalisation in patients with higher HARP scores, or whether additional psychosocial assessments could improve the tool's predictability.
Contact sensitivity in patients with venous leg ulcer: A multi‐centric Indian study
Authors: Rai Reena , Shenoy Manjunath M. , Viswanath Vishalakshi , Sarma Nilendu , Majid Imran , Dogra Sunil
Published: March 2018

Venous leg ulcers are the most common form of non‐healing leg ulcers. They are subjected to treatments such as topical medications, dressings, and compression therapies. This can lead to exposure to a number of allergens with subsequent sensitisation and contact dermatitis of the regional skin. This may contribute to the poor ulcer healing. To detect the various contact sensitisers in patients with venous leg ulcers through patch testing, patients from 6 centres across India with venous leg ulcers of longer than 6 weeks duration were enrolled for the study. They were patch tested using a special parch test kit with 27 antigens. A total of 172 patients were included in the study; 82 (48.2%) tested positive for at least 1 antigen. Among them, polyvalent sensitisation was noted in 71% of patients. Wood tar mix (10.4%) and the framycetin (8.7%) were the most common allergens. There is a high frequency of allergic sensitisation to various ingredients of topical therapies used in the venous ulcer management, which may interfere with wound healing. Avoiding them can help obtain a better therapeutic outcome.
Effect of dilute concentrations of Sm on the temperature‐dependent electrical and dielectric properties of ZnO
Authors: Arora Deepawali , Asokan Kandasami , Kumar Sunil , Kaur Simranpreet , Kaur Parvinder , Singh Gurinder Pal , Mahajan Aman , Kalia Sameer , Kalia Neerja , Seth Kriti , Kaur Puneet , Singh Davinder P.
Published: March 2018

Compounds of undoped and samarium (Sm) doped ZnO have been prepared by standard solid‐state reaction method. X‐ray diffraction (XRD), Williamson‐Hall (W‐H) analysis, Transmission Electron Microscopy (TEM), temperature‐dependent electrical and dielectric studies have been done to characterize these materials. Inclusion of Sm as dopant in hexagonal wurtzite ZnO changes the lattice parameters to a small extent with some Sm aggregation at higher concentration. Also, the mean particle sizes of ZnO:Sm compounds showed an inter‐correlation with the Scherrer method, W‐H analysis as well as with TEM results. The electrical resistivity depicts an exponential decay and metal‐semiconductor transition (MST) at ~300 K for the pristine sample whereas there is large decrement in the resistivity with Sm doping. The analysis of σac of ZnO suggests that the power law is obeyed and indicated an increase in the ac conductivity with Sm content. The mechanism behind this type of conductivity is elucidated by small polaron tunneling (SPT) model of conductivity. The dependence of ln dc on the temperature inverse shows that the traps of electrons are thermally activated such that low and high temperature activation energies confirm the presence of vacancies and interstitials of both O and Zn ions. Thus, a high value of dielectric constant makes these materials suitable for high frequency and charge storage device applications.
The experiences and preparedness of family carers for best interest decision‐making of a relative living with advanced dementia: A qualitative study
Authors: Carter Gillian , McLaughlin Dorry , Kernohan W. George , Hudson Peter , Clarke Mike , Froggatt Katherine , Passmore Peter , Brazil Kevin
Published: March 2018

Aim

To explore the experience and the preparedness of family carers in their caregiving role as best interest decision‐makers of a relative living with advanced dementia.

Background

The prevalence of dementia is a global issue. The role of being a carer of a relative living with dementia does not necessarily lessen once they are admitted to a nursing home. Best interest decision‐making including end‐of‐life care decisions need to be made and reaching these choices can be challenging. The preparedness of family carers in this role needs greater understanding.

Design

Descriptive qualitative study.

Methods

During 2015 twenty semi‐structured interviews were conducted of family carers of nursing home residents living with advanced dementia, then analysed using Braun and Clarke's thematic analysis.

Results

Three themes were identified: (1) Caring for someone living with dementia. The impact on the carer's holistic well‐being and their experience of being a best interest decision‐maker; (2) Accessing support. The influential nature of formal and informal networks; (3) Perceived knowledge and understanding of the dementia trajectory of carers and nursing staff.

Conclusion

The experiences and preparedness of informal carers is a reflection of their personal response, but the distress experienced highlights the significant need of adequate support availability and of enhancing nursing staffs’ dementia expertise to maximize their role in facilitating best interest decision‐making. This has significant implications for nursing practice and for service user and nursing staff education. Considering the global impact of dementia, our findings have international relevance to similar nursing homes across the world.
Occupational mobility among individuals in entry‐level healthcare jobs in the USA
Authors: Snyder Cyndy R. , Dahal Arati , Frogner Bianca K.
Published: March 2018

Aims

The aim of this study was to explore career transitions among individuals in select entry‐level healthcare occupations.

Background

Entry‐level healthcare occupations are among the fastest growing occupations in the USA. Public perception is that the healthcare industry provides an opportunity for upward career mobility given the low education requirements to enter many healthcare occupations. The assumption that entry‐level healthcare occupations, such as nursing assistant, lead to higher‐skilled occupations, such as Registered Nurse, is under‐explored.

Design

We analysed data from the Panel Study of Income Dynamics, which is a nationally representative and publicly available longitudinal survey of US households.

Methods

Using longitudinal survey data, we examined the job transitions and associated characteristics among individuals in five entry‐level occupations at the aide/assistant level over 10 years timeline (2003–2013) to determine whether they stayed in health care and/or moved up in occupational level over time.

Results/Findings

This study found limited evidence of career progression in health care in that only a few of the individuals in entry‐level healthcare occupations moved into occupations such as nursing that required higher education. While many individuals remained in their occupations throughout the study period, we found that 28% of our sample moved out of these entry‐level occupations and into another occupation. The most common “other” occupation categories were “office/administrative” and “personal care/services occupations.” Whether these moves helped individuals advance their careers remains unclear.

Conclusion

Employers and educational institutions should consider efforts to help clarify pathways to advance the careers of individuals in entry‐level healthcare occupations.
Crafting messages to promote water conservation: Using time‐framed messages to boost conservation actions in the United States and China
Authors: Zhuang Jie , Lapinski Maria Knight , Peng Wei
Published: March 2018

Grounded in construal‐level theory (CLT), this experiment examines how messages with different temporal frames (i.e., present‐ vs. future‐framed) influence individuals' perceptions of, and reactions to, water conservation. One hundred ninety‐three participants, 99 from China and 94 from the United States, participated in this study. Results indicated that a present‐framed message results in more positive attitudes toward water conservation than the future‐framed message. Participants who scored higher on individual future‐time orientation show stronger behavioral intention to conserve water than participants who scored lower. A significant interaction between temporal message framing and country emerged such that the future‐framed message resulted in greater behavioral intention for Chinese participants than their U.S. counterparts whereas the present‐framed message did not differentially influence Chinese and U.S. participants. Implications of findings for theory‐building and application are discussed.
Bayesian analyses detect a history of both vicariance and geodispersal in Neotropical freshwater fishes
Authors: Machado Carolina Barros , Galetti Pedro Manoel , Carnaval Ana Carolina
Published: March 2018

Aim

Among the main biogeographical hypotheses explaining the remarkable diversity of fishes in the Neotropics is the “palaeogeographical hypothesis”, focusing on vicariance, and the “hydrogeological hypothesis”, focusing on geodispersal. Yet while reflecting different processes, they may result in similar biogeographical patterns. We employed a model‐based Bayesian approach to test these alternative hypotheses and determine which shaped the phylogeographical patterns observed in a group of Neotropical fishes.

Location

South America.

Taxon

Salminus.

Methods

We used mitochondrial and nuclear markers to infer phylogenetic relationships and estimate divergence times among Salminus species, associating the results with known geological events. We then employed approximate Bayesian computation (ABC) to explore changes in population size over time, asking whether vicariance or geodispersal events best explain the phylogeographical signature observed in the data. Because geodispersal captures a few individuals from a parental population, which can then expand and lead to a new lineage, we expect to find genetic signatures of a founder event following population expansion under this scenario, but not under vicariance.

Results

The analyses suggest that the diversification process in Salminus began in Upper Miocene, and ABC indicates that it involved both vicariance and geodispersal events: while a vicariance event better explains the phylogeographical structure within S. brasiliensis and the genetic patterns of differentiation between S. sp. Amazon and S. sp. Araguaia, geodispersal appears to have been the most important event structuring lineages of Salminus hilarii.

Main Conclusions

Both vicariance and geodispersal signatures were detected in our biological model, inferring a complex yet realistic demographic history of Salminus lineages. The correspondence between the ABC results and traditional phylogeographical interpretations provide further confidence in the models drawn and tested. This study reinforces the value of applying an ABC framework in phylogeographical studies, particularly for those interested in testing alternative and biologically plausible processes underlying similar biogeographical patterns.
Analysing successful massive open online courses using the community of inquiry model as perceived by students
Authors: Cohen A. , Holstein S.
Published: March 2018

This research examines the characteristics that contributed to the success of massive open online courses (MOOCs) in the fields of software, sciences, and management using data mining and semantic analysis together with content analysis. A total of 3,460 reviews regarding 5 different MOOCs that received a 5/5 grade were extracted from the CourseTalk website and analysed according to the community of inquiry model. It was found that, as well as in academic online courses, the characteristics that contributed to MOOCs' success were distributed between all 3 presence elements according to the community of inquiry model: teaching (36%), social (23%), and cognitive (36%; and technological [5%]). This is contrary to the perception that MOOCs mostly contain teaching presence elements. The four leading characteristics were teacher, exercise, atmosphere, and workload. Cluster analysis resulted in 5 types of students with similar presence element preferences. This shows that successful MOOCs enable students with different preferences to consume content and activities according to their individual preferences. These findings could be the base of future research on the subject of adapting MOOC activities and content to students' varied preferences, as well as further understanding the characteristics that contribute to successful MOOCs or other fully online courses.
Challenges and limitations in the diagnosis of atrioesophageal fistula
Authors: Ha Francis J. , Han Hui‐Chen , Sanders Prashanthan , Teh Andrew W. , O'Donnell David , Farouque Omar , Lim Han S.
Published: March 2018

Introduction

Atrioesophageal fistula (AEF) is a dire complication of atrial fibrillation ablation. The diagnostic yield of computed tomography (CT) chest, the role and timing of repeat testing, and the value of other investigations in the diagnosis of AEF is uncertain.

Methods

We systematically reviewed published AEF cases to evaluate radiological, bedside, and biochemical investigations for AEF (registered on PROSPERO [CRD42017077493]).

Results

Eighty‐seven articles with 126 patients (median age, 59 years; male, 71%) were included in the analysis. CT chest was performed in 88% (111/126) and was abnormal in 87%. A clear diagnosis of AEF (fistula/perforation) was only detected in 35% (34/97). Other major findings included free air in mediastinum (26%), left atrium (LA), or LA wall (24%). In 11 patients with normal/nonspecific initial CT chest, major abnormalities were detected in 91% (10/11) of repeat CT chest performed 6 days (median; range, 4–22) after initial scan. Initial CT head was normal in 51%; diffuse air emboli was identified in 79% (22/28). Initial transthoracic echocardiography was normal in 61% of cases. The spectrum of radiological abnormalities included Air (mediastinum/LA), Effusion (pleural/pericardial), Fistula/Perforation, and Thickening (esophagus/LA) ‐ “AEF‐Tests.” Esophagram demonstrated contrast extravasation in 87% (13/15). Blood culture was consistently positive (100%; 28/28), particularly for streptococcus species (93%; 26/28).

Conclusion

The diagnosis of AEF remains challenging. Clinicians should be aware of the limitations in the yield of CT chest, the variety of major abnormalities reported, the need for repeat testing, unique brain imaging findings, and the importance of positive blood cultures and raised inflammatory markers.
Skin temperature in youth soccer players with functional equinus and non‐equinus condition after running
Authors: Rodriguez‐Sanz D. , Losa‐Iglesias M.E. , Becerro de Bengoa‐Vallejo R. , Palomo‐Lopez P. , Beltran‐Alacreu H. , Calvo‐Lobo C. , Navarro‐Flores E. , Lopez‐Lopez D.
Published: March 2018

Objectives

To check how a thermal IR camera can check skin temperature in gastrocnemius‐soleus equinus condition and non‐gastrocnemius‐soleus condition in youth soccer players and thus detect association between the extensibility of the triceps surae (with gastrocnemius‐soleus equinus and non‐gastrocnemius‐soleus equinus) and the muscle temperature pattern.

Design

A cross‐sectional study secondary level of care.

Methods

Sample from an elite soccer academy in Madrid (Spain) 35 healthy male subjects (youth soccer players) age 12.82 ± 1.07 years, height 158.68 ± 10.79 cm, weight 49.19 ± 9.45 kg, body mass index 19.41 ± 2.25. The exclusion criteria were the presence of musculoskeletal and joint injuries, pelvic pain, ankle sprains, low back pain and use of drugs in the previous week, and scoliosis.

Results

Temperature value for gastrocnemius muscles and Achilles tendon were assessed in 35 youth soccer players from an academia before and after training in both 12 gastrocnemius‐soleus equinus and 23 non‐gastrocnemius‐soleus equinus soccer players conditions. State absolute for gastrocnemius soleus condition obtained a 0.34 value (0.19–0.5); we found a significant increase in temperature among these conditions for the gastrocnemius (P = 0.028) and the Achilles tendon (P = 0.007) (confidence interval 95%). The temperature of gastrocnemius‐soleus equinus for gastrocnemius and Achilles tendon was increased more than non‐gastrocnemius‐soleus equinus in youth soccer players.

Conclusions

IR imaging captured temperature is associated with muscle pattern activation for lower limb. Based on our findings, we propose that infrared thermography evaluation of the gastrocnemius and Achilles tendon is suitable to differ gastrocnemius‐soleus equinus and non‐gastrocnemius‐soleus equinus conditions in youth soccer players.
Bedside reasoning on causes and mechanisms of diseases in the era of precision medicine: a timeless story?
Authors: Lipsker D.
Published: March 2018

This is a short reflection about bedside reasoning in clinical medicine, emphasizing the importance of distinguishing between causes and mechanisms of diseases. All complex/sporadic diseases result from interactions between a genetic predisposition and environmental factors. The main disease mechanisms resulting in clinical signs involve inflammation, insult of vessels or nerves, pharmacological or hormonal dysfunction, altered metabolism and overload, tumoral proliferations, intrinsic dysfunction, malformation and traumatism. Different mechanisms can occur during the same disease process. The practical consequences of identifying causes and mechanisms of diseases are illustrated. As a unifying concept, a very simple diagnostic flow chart that puts the patient, and not the disease, into centre of reflection and that bridges the gap between basic knowledge and patient care is provided. This diagnostic flow chart helps both the experienced physician and the medical student to perform a complete diagnostic process, addressing the specificities of the clinical findings, the pathogenesis and the causative factors, an aim that has become possible in the era of precision medicine. Two examples of patients with a dermatologic presentation highlight this diagnostic process, which paves the way to rational therapy and to translational research.
Précising definitions as a way to combat overdiagnosis
Authors: Rogers Wendy A. , Walker Mary J.
Published: March 2018

Roughly, overdiagnosis (ODx) occurs when people are harmed by receiving diagnoses (often accompanied by interventions) that do not benefit them, usually because the diagnosed conditions do not pose a threat to their health. ODx is a theoretical as well as a practical problem as it relates to definitions of disease. Elsewhere, it has been argued that disease is a vague concept and that this vagueness may contribute to ODx. In response, we develop a stipulative or précising definition of disease, for the specific purpose of decreasing or preventing ODx. We call this diseaseODx, aimed at distinguishing cases where it would be beneficial to identify (and treat the condition) from those where diagnosis is more likely to harm than benefit. A preliminary definition of diseaseODx is that X is a diseaseODx iff there is dysfunction that has a significant risk of causing severe harm.

This paper examines the 3 concepts in this definition, using a naturalistic account of function, a Feinbergian account of comparative harm, and a probabilistic understanding of risk. We then test the utility of this approach using examples of clinical conditions that are currently overdiagnosed.
Multimorbidity and Functional Limitation in Individuals with Heart Failure: A Prospective Community Study
Authors: Manemann Sheila M. , Chamberlain Alanna M. , Roger Véronique L. , Boyd Cynthia , Cheville Andrea , Dunlay Shannon M. , Weston Susan A. , Jiang Ruoxiang , Rutten Lila J. Finney
Published: March 2018

Objectives

To characterize the individual and combined effects of multimorbidity and functional limitation on healthcare use and mortality in a large, community cohort of individuals with heart failure (HF).

Design

Prospective cohort study.

Setting

Eleven southeastern Minnesota counties.

Participants

Individuals (mean age 74, 54% male) with a first‐ever HF code (International Classification of Diseases, Ninth Revision code 428 or Tenth Revision code I50) between January 1, 2013 and March 31, 2016 (N=2,692).

Measurements

Eight activities of daily living measured using a survey on a Likert scale (1=without any difficulty, 5=unable to do; median=8). Participants with a score greater than 8 were categorized as having functional limitation. Multimorbidity was defined as having 2 or more noncardiac comorbidities.

Results

Twenty‐five percent of participants had neither multimorbidity nor functional limitation, 35% had multimorbidity, 9% had functional limitation, and 31% had both. After adjustment, participants with multimorbidity and functional limitation had greater risks of all outcomes (death: hazard ratio (HR)=4.92, 95% confidence interval (CI)=3.03–8.00; emergency department (ED) visit: HR=3.67, 95% CI=2.94–4.59; hospitalization: HR=3.66, 95% CI=2.85–4.70; outpatient visit: HR=1.73, 95% CI=1.52–1.96) than those with neither. Participants with functional limitation alone had greater risks of death (HR=4.84, 95% CI=2.78–8.43), ED visits (HR=2.35, 95% CI=1.75–3.16), and hospitalizations (HR=2.10, 95% CI=1.52–2.88) but not outpatient visits. Those with multimorbidity alone had similar risks of ED visits and hospitalizations as those with functional limitation alone but were more likely to have outpatient visits (HR=1.50, 95% CI=1.34–1.67).

Conclusion

Individuals with both multimorbidity and functional limitation have the highest risk of death and healthcare use. Individuals with only functional limitation have similar rates of hospitalizations and ED visits as those with only multimorbidity, underscoring the need to consider both when managing individuals with HF.
Oral Candida colonization and plaque type psoriasis: Is there any relationship?
Authors: Lesan Simin , Toosi Roja , Aliakbarzadeh Reza , Daneshpazhooh Maryam , Mahmoudi Leila , Tavakolpour Soheil , Mahmoudi Hamidreza
Published: March 2018

Aim

The potential role of superantigens derived from microbial agents could be considered in the pathogenesis of psoriasis, but the association between Candida albicans and psoriasis severity is still controversial. The present study was designed to compare the prevalence of oral candidiasis in a group of psoriatic patients and healthy patients, and its correlation with psoriasis severity.

Methods

Seventy psoriatic patients with no history of systemic treatment and 70 closely‐matched control patients underwent oral examination. Scraping of oral mucosa to detect Candida species was done using a sterile cytobrush.

Results

Candida was detected in the oral cavity of 20% of patients with psoriasis and 2.8% of control cases (P = .002), but none had clinical features of oral candidiasis. Candida albicans was the only species isolated from the oral cavity of both groups. No correlation was found between sex, age, phototherapy, and presence of oral candidiasis. There was a positive correlation between psoriasis severity and colony count (P < .001).

Conclusions

The prevalence of oral candidiasis is higher in psoriatic patients and is associated with disease severity. It is not exactly clear whether oral candidiasis can aggravate psoriasis or if psoriasis can predispose patients to oral candidiasis.
Change of salivary fluoride level with intake of fluoride releasing lozenges: A pilot study
Authors: Rechmann Peter , Rechmann Beate M. T. , Kinsel Richard , Featherstone John D. B.
Published: March 2018

Aim

Long‐term, low‐level fluoride concentrations in saliva are highly effective in caries prevention and remineralization. The aim of the present two‐phased study was to test whether fluoride‐releasing lozenges compared to placebo significantly raise salivary fluoride levels above baseline achieved by 1100 ppm fluoride toothpaste in a double‐blind, crossover pilot study.

Methods

In phase 1, a four‐arm crossover basic study, four participants used one dissolvable lozenge with .25, 0.5, 1 or 1.5 mg fluoride for 1 hour. In phase 2, the three‐arm crossover main study, 11 participants used three lozenges per day for 1 hour for 1 week, establishing long‐term salivary fluoride levels dissolving 0 (control), 0.5 and 1.5 mg fluoride lozenges. Saliva was collected at baseline; during lozenge use; 5, 15, 30, and 60 minutes later; and early the next morning. Salivary fluoride levels were determined by laboratory diffusion analysis.

Results

In phase 1, 5 minutes after using one lozenge, salivary fluoride levels were above baseline (0.03 ppm), reaching 0.13 ± 0.19 ppm for the 0.25 mg and 0.73 ± 0.75 ppm for the 1.5 mg fluoride lozenge, dropping to baseline after 60 minutes. In phase 2, after 1 week use of 0.5 and 1.5 mg lozenges, respectively, for the 0.5 mg lozenge for 15 minutes and the 1.5 mg lozenge 30 minutes after use, the salivary levels were significantly higher than baseline/control (0.02 ppm). During 1‐hour lozenge use, fluoride levels >0.1 ppm were consistently achieved.

Conclusions

Fluoride lozenges achieved elevated salivary fluoride levels during use, but only for short periods after use.
Prevalence of temporomandibular disorders among a cohort of university undergraduates in Australia
Authors: Lung Jeremy , Bell Laura , Heslop Molly , Cuming Sophie , Ariyawardana Anura
Published: March 2018

Aim

The aim of the present study was to determine the prevalence of temporomandibular disorder (TMD) symptoms among dentistry students at James Cook University in Australia, and to determine the associations of TMD symptoms with demographic parameters and compare the prevalence to that of the Australian general population.

Methods

The study was conducted at the School of Dentistry, James Cook University. Axis I symptom questionnaire of diagnostic criteria for TMD was used to assess the prevalence of TMD symptoms. Additional questions were included to gather demographic information on the participants. Data were collected anonymously via the online survey tool, SurveyMonkey.

Results

The overall prevalence of TMD symptoms in this cohort was 77.2%. The most common TMD symptoms were pain (48.5%) and joint noises (48.5%). Females reported a significantly higher prevalence of TMD symptoms than males, with 73 of 88 female respondents (83%) and 32 of 48 male respondents (66.7%) reporting at least one symptom of TMD (P = .030).

Conclusions

The overall prevalence of TMD symptoms in the population studied was 77.2%, with female preponderance of TMD symptoms (83%). This is higher than the estimated prevalence (23%) in the Australian general population.
Significance of an amorphous SiO2 phase in a pseudomorph after coesite enclosed in garnet from ultrahigh‐pressure eclogite, Su–Lu Belt, eastern China
Authors: Taguchi Tomoki , Miyake Akira , Enami Masaki , Igami Yohei
Published: March 2018

Here, we report the first discovery of an amorphous SiO2 phase (APSI phase) in a pseudomorph after coesite included in garnet from an ultrahigh‐pressure (UHP) eclogite from the Su–Lu metamorphic belt, eastern China. Using transmission electron microscopy, Raman spectroscopy and selected area electron diffraction, we show that the internal structure of the pseudomorph consists of an APSI phase with nano/submicrocrystalline particles of quartz and a polycrystalline K‐bearing fibrous sheet‐silicate phase (KFSS phase). The APSI phase‐bearing aggregates included in the garnet might have formed by reactions involving a supercritical fluid during exhumation by the following processes: (1) the development of radial cracks within the host garnet by the phase transition of coesite to quartz; (2) the decomposition of a part of the pseudomorph following infiltration of supercritical fluid; (3) the precipitation of the KFSS phase from the fluid phase during subsequent exhumation and cooling, which was likely promoted by a change in the metamorphic fluid from supercritical and/or subcritical to aqueous fluid; and (4) the rapid precipitation of the APSI phase under a metastable (non‐equilibrium) state, such as quenching, during a later stage of the exhumation. Whether the APSI phase generally formed during exhumation and survived widely throughout the Su‐Lu terrane is unknown. However, the presence of the APSI phase in a UHP eclogite provides new insight into the geodynamic phenomena occurring at continental collision zones.
Glucocorticoid withdrawal affects stress‐induced changes in urocortin 2 gene expression in the rat adrenal medulla and brain
Authors: Tillinger A. , Horváthová Ľ. , Nostramo R. , Serova L. I. , Kvetňanský R. , Sabban E. L. , Mravec B.
Published: March 2018

Corticotrophin‐releasing factor is a well known activator of the hypothalamic‐pituitary‐adrenocortical axis, which represents a crucial system participating in the stress response of an organism. Urocortins are members of the corticotrophin‐releasing factor family of peptides with proposed effects on neuroendocrine and behavioural stress response mechanisms. Urocortin 2, which is one of three known urocortins, is present in the central and peripheral stress response system and its expression can be augmented by glucocorticoids. In the present study we examined how glucocorticoid withdrawal affects urocortin 2 gene expression after acute immobilisation in the adrenal medulla and selected brain areas in rats. We used pharmacological adrenalectomy to block the synthesis of corticosterone. The results obtained show that the immobilisation‐induced rise in urocortin 2 mRNA levels in the rat adrenal medulla was not inhibited by glucocorticoid withdrawal. By contrast, observed changes in the brain indicate that the effect of stress and pharmacological adrenalectomy on urocortin 2 gene expression is site‐specific. In the paraventricular nucleus and locus coeruleus, the immobilisation‐induced rise of urocortin 2 was not inhibited by pharmacological adrenalectomy, whereas it was in the arcuate nucleus and central amygdala. Moreover, we have seen a significant depletion of urocortin 2 plasma levels after immobilisation. The immobilisation induced a rise of urocortin 2 gene expression in the rat adrenal medulla and brain areas regulating stress response pathways and the preservation of its induction after adrenalectomy suggests a role for urocortin 2 in the neuroendocrine stress response of an organism.
Optimizing outcomes with polymethylmethacrylate fillers
Authors: Gold Michael H , Sadick Neil S
Published: March 2018

Introduction

The ideal filler should be long‐lasting, biocompatible, chemically inert, soft and easy to use, and have a long history of safety. This review focuses on the evolution and development of the PMMA‐collagen gel, Bellafill, and the 10 years of postmarketing experience of Bellafill since it received premarket approval (PMA) from the FDA as Artefill in 2006. Artefill was rebranded to Bellafill in 2015.

Methods

The authors conducted a literature search on PubMed for key articles describing the steps in which Arteplast, a PMMA filler developed in 1989, led to the development of Bellafill, the only PMMA filler approved by the US FDA for the treatment of nasolabial folds and acne scar correction. The factors governing efficacy and safety were also evaluated for the major PMMA fillers available in the world.

Results

The process of manufacturing and purifying PMMA has played a major role in minimizing adverse events for Bellafill. Postmarketing surveillance data for the 2007‐2016 period show that for more than 530 000 Bellafill syringes distributed worldwide, 11 confirmed granulomas (excluding clinical trial data) (0.002% of syringes sold) have been reported. Data on other PMMA fillers are limited and inconsistent. The authors suggest that adverse events are often attributable to lack of proficiency in treatment technique and other factors.

Conclusion

Bellafill has demonstrated an excellent safety and effectiveness profile in multiple clinical studies, customer feedback, and 10 years of postmarketing surveillance experience. Adverse events occur with all fillers for a variety of reasons. In addition to quality of the product, injector skill and technique are critical to ensuring good clinical outcomes.
Utilisation of hepatocellular carcinoma screening in Australians at risk of hepatitis B virus‐related carcinoma and prescribed anti‐viral therapy
Authors: Sheppard‐Law Suzanne , Zablotska‐Manos Iryna , Kermeen Melissa , Holdaway Susan , Lee Alice , George Jacob , Zekry Amany , Maher Lisa
Published: March 2018

Aims and objectives

To investigate hepatocellular carcinoma screening utilisation and factors associated with utilisation among patients prescribed hepatitis B virus anti‐viral therapy and at risk of hepatocellular carcinoma.

Background

The incidence of hepatocellular carcinoma has increased in Australia over the past three decades with chronic hepatitis B virus infection a major contributor. hepatocellular carcinoma surveillance programs aim to detect cancers early enabling curative treatment options, longer survival and longer times to recurrence.

Design

Multi‐site cross‐sectional survey.

Methods

An online study questionnaire was administered to eligible participants attending three Sydney tertiary hospitals. Data were grouped into six mutually exclusive hepatocellular carcinoma risk factor categories as per American Association for the Study of Liver Diseases guidelines. All analyses were undertaken in STATA. Logistic regression was used to assess the associations between covariates and screening utilisation. Multivariate models described were assessed using the Hosmer–Lemeshow goodness of fit.

Results

Of the 177 participants, 137 (77.4%) self‐reported that US had been performed in the last six months. Awareness that screening should be performed and knowing the correct frequency of US screening were independently associated with screening utilisation. Participants who knew that screening should be undertaken were three times more likely to have had pretreatment education or were prescribed hepatitis B virus anti‐viral treatment for >4 years. Participants reporting a family history of hepatocellular carcinoma were less likely to know that screening should be undertaken every 6 months.

Conclusion

While utilisation of hepatocellular carcinoma surveillance programs was higher in this study than in previous reports, strategies to further improve surveillance remain necessary.

Relevance to clinical practice

Findings from this research form the basis for proposing strategies to improve utilisation of hepatocellular carcinoma screening, inform hepatitis B virus‐related clinical practice and for the delivery of care and nursing education to people receiving hepatitis B virus anti‐viral therapy and at risk of developing hepatocellular carcinoma.
“There Is No Perfect School”: The Complexity of School Decision‐Making Among Lesbian and Gay Adoptive Parents
Authors: Goldberg Abbie E. , Allen Katherine R. , Black Kaitlin A. , Frost Reihonna L. , Manley Melissa H.
Published: March 2018

Parents influence their children's educational experiences in part via school selection. This process is particularly complex for families with multiple minority, potentially stigmatized, statuses. This qualitative study examines middle‐class lesbian and gay (LG) adoptive parents' school decision‐making. Parents' economic resources provided the foundation for how parents weighed child/family identities (children's race, LG‐parent family structure, child's special needs) and school‐related concerns (e.g., academic rigor). For White gay male‐headed families in affluent urban communities, financial resources muted racial and sexual orientation consciousness in favor of competitive academic environments. Lesbian mothers of modest economic means prioritized racial diversity more centrally. Racial diversity overrode gay‐friendliness as a consideration in lesbian‐mother families; gay‐friendliness was prioritized over racial diversity among families in conservative communities; and special needs overrode all other child and family identity considerations. For LG adoptive parent families, school decision‐making has the potential for greater tensions amidst multiple intersecting identities and fewer economic resources.
Calcium‐/calmodulin‐dependent protein kinase II in occlusion‐induced degenerative cartilage of rat mandibular condyle
Authors: Liu Q. , Yang H.‐x. , Wan X.‐h. , Zhang M. , Zhang J. , Lu L. , Xie M. , Ren H.‐t. , Yu S.‐b. , Liu X.‐d. , Wang M.
Published: March 2018

Activated calcium‐/calmodulin‐dependent protein kinaseII (CaMKII) is important to promote chondrocytes from proliferative to pre‐hypertrophic state, which probably plays a role in osteoarthritis (OA), a widespread degeneration disease with enhanced aberrant chondrocyte differentiation. Our aim was to detect the role of CaMKII, and its relationship with the feedback loop of Indian hedgehog (Ihh) and Parathyroid‐related peptide (PTHrP) in the temporomandibular joints (TMJs) OA. KN93, the competitive inhibitor of CaMKII, was added to the culture medium in vitro and was locally injected to rats TMJs (n = 54, female) every other day for 4 weeks from the beginning of the 5th and 9th week after installing of unilateral anterior crossbite (UAC), termed as 4 wk+4 wk and 8 wk+4 wk, accordingly. The RNA expression of CaMKII α (1.49 ± 0.09), CaMKII β (3.36 ± 0.20), Ihh (1.88 ± 0.06) and PTHrP (1.87 ± 0.12) was all enhanced, especially at 24 dyn/cm2 in vitro (all P < .05), accompanied with downregulated expression of cartilage matrix, but upregulated markers of chondrocytes differentiation (all P < 0.05). Similarity was observed in the 4 wk+4 wk group in vivo. In the 8 wk+4 wk group, UAC upregulated the RNA expression of CaMKII α (1.81 ± 0.24), CaMKII β (1.36 ± 0.07) and Ihh (1.70 ± 0.21), however, down‐regulated PTHrP (0.53 ± 0.04) (all P < .05), in consonance with the protein expression. All these changes were attenuated by KN93 (all P < .05). In conclusion, CaMKII took a role, via Ihh and PTHrP pathways, in promoting biomechanically induced TMJ chondrocytes differentiation, the initiation issue of UAC stimulated osteoarthritic changes in rodent TMJs. Inhibiting CaMKII is helpful to rescue the biomechanically stimulated cartilage degradation and prospective to be a target treatment of OA.
Salivary flow and xerostomia in patients with type 2 diabetes
Authors: Carramolino‐Cuéllar Esther , Lauritano Dorina , Silvestre Francisco‐Javier , Carinci Francesco , Lucchese Alberta , Silvestre‐Rangil Javier
Published: March 2018

Background

Saliva is secreted by the major and minor salivary glands. There are a number of physiological factors that can reduce this secretion such as age, sex, body weight, number of teeth present in the mouth or time of day. This decrease may also be caused by the use of certain drugs, radiotherapy for head and neck cancer, chronic rheumatic diseases such as Sjögren's syndrome and other systemic disorders such as diabetes mellitus (DM). Objective of this study was to investigate the effect of type 2 DM on salivary secretion and its relation to the sensation of xerostomia.

Methods

Forty‐seven patients with type 2 DM and 46 healthy individuals, aged 40‐80, participated in the study. Samples of saliva were collected, at rest and after stimulation, at baseline and after the administration of a meal. A questionnaire of 10 items was used to define the patients’ sensations of xerostomia. For statistical analysis, the Mann‐Whitney test was used to assess the difference in salivary flow between the two groups and the relationship between the response to each of the questions and salivary flow levels. The degree of the patients’ sensation of xerostomia was analysed by the Fisher test.

Results and Conclusions

There was a significant decrease in total saliva levels at rest in patients with type 2 DM compared to the control group. The study group also experienced higher levels of dryness at night and on waking as well as a greater sensation of lingual burning compared to the control group.