bluuebunny/crossref_metadata_2025 huggingface dataset:
Police legitimacy, trustworthiness, and associations with intimate partner violence
Authors: Fedina Lisa , Backes Bethany L. , Jun Hyun-Jin , DeVylder Jordan , Barth Richard P.
Published: September 2019

Purpose

The purpose of this paper is to understand the relationship among police legitimacy/trust and experiences of intimate partner violence (IPV), including victims’ decisions to report IPV to police and police responses to IPV.

Design/methodology/approach

Data were drawn from the 2017 Survey of Police–Public Encounters II – a cross-sectional, general population survey of adults from New York City and Baltimore (n=1,000). Regression analyses were used to examine associations among police legitimacy/trust, IPV exposure, police reporting of IPV, and perceived police responses to IPV and interaction effects.

Findings

Higher levels of IPV exposure were significantly associated with lower levels of police legitimacy/trust; however, this relationship was stronger among African–American participants than non-African–American participants. Higher levels of police legitimacy/trust were significantly associated with more positive police responses to IPV and this relationship was stronger among heterosexual participants than sexual minority participants.

Research limitations/implications

Future research should examine prospective relationships to understand causal mechanisms linking individual perceptions of police legitimacy/trust, experiences with IPV and victims’ interactions with police.

Practical implications

Low levels of legitimacy/trust between police and citizens may result, in part, if police are engaged in negative or inadequate responses to reports of IPV. Police–social work partnerships can enhance effective police responses to IPV, particularly to racial/ethnic and sexual minority individuals.

Originality/value

This study provides empirical evidence linking police legitimacy/trust to the experiences of IPV and perceived police responses to reports of IPV, including important group differences among victims based on race/ethnicity and sexual orientation.
Public response to community engagement patrols in high crime areas
Authors: Kahn Kimberly Barsamian , Henning Kris , Stewart Greg , Renauer Brian C. , Peterson Christian , Mitchell Renée Jean , Labissiere Yves , Sothern Sean
Published: September 2019

Purpose

The purpose of this paper is to evaluate an experiment to improve residents’ opinions of the police in Portland, Oregon. Officers conducted community engagement patrols (CEPs) in 60 high-crime areas. The CEPs prioritized non-investigative contacts with community members to build trust and promote positive police–community interactions in designated high-crime locations. It is hypothesized that community members living in/near intervention sites would report greater exposure to officers, more positive interactions and feel more positively about police than residents in control areas.

Design/methodology/approach

In total, 90 crime hot spots were identified using crime reports and calls for service. Locations were randomized into three groups: 2 CEPs/day (n=30), 4 CEPs/day (n=30), and control (i.e. no supplemental patrols,n=30). Officers were dispatched to treatment locations via the computer-aided dispatch system for 90 consecutive days, resulting in 16,200 scheduled CEPs. Surveys were mailed to 11,760 households immediately after the intervention ended and 1,537 were returned (13.1 percent).

Findings

Residents from intervention areas reported a higher number of positive police contacts, whereas contacts that residents perceived as negative did not differ between the three conditions. Community attitudes, including perceived police legitimacy, were generally unaffected by CEP dosage.

Originality/value

This paper documents the outcomes of a large-scale field experiment seeking to improve public attitudes toward police using directed CEPs in crime hot spots. Whereas the intervention succeeded in providing more opportunities for positive contact with police, attitude change may necessitate longer-term strategies.
Conceptualization and development of event experience scale: lessons from India
Authors: Rai Shivam , Nayak Jogendra Kumar
Published: September 2019

Purpose

The purpose of this paper is to conceptualize and develop an event experience scale in the business event (trade shows) context.

Design/methodology/approach

Data were gathered from domestic and foreign exhibitors and visitors of the six countries from the international trade show events organized in the emerging economy of India.

Findings

An event experience scale comprised five dimensions (affective, cognitive, unique, physical and well-being association) associated with experiences emerged. Findings propose that event participants see trade shows as a business event to fulfil their meaningful goals as well as a platform that addresses their subjective pleasure.

Practical implications

Existing experiential practices in the trade show industry can be enhanced by improvising the dimensions found in the study. Practitioners may use the outcomes to enhance the effectiveness of trade shows.

Originality/value

The event literature on trade show experiences is still in its developing stage. To the best of the authors’ knowledge, this research is one of the first attempts to conceptualize and develop a trade show event experience scale. This research conceptualizes trade shows as a tourism destination and adds a new unexplored dimension to business event literature.
Reduction of peak viremia by an integration‐defective SIV proviral DNA vaccine in rhesus macaques
Authors: Wang Chu , Gao Nan , Song Yanan , Duan Sizhu , Wang Wei , Cong Zhe , Qin Chuan , Jiang Chunlai , Yu Xianghui , Gao Feng
Published: September 2019

An integrase‐defective SIV (idSIV) vaccine delivered by a DNA prime and viral particle boost approach can suppress viral loads (VLs) during the acute infection stage after intravenous SIVmac239 challenge. This study investigated how idSIV DNA and viral particle immunization alone contributed to the suppression of VLs in Chinese rhesus macaques after SIV challenge. Two macaques were immunized with idSIV DNA five times and two macaques were immunized with idSIV viral particles three times. Cellular and humoral immune responses were measured in the vaccinated macaques after immunization. The VLs and CD4+ T cell counts were monitored for 28 weeks after the intravenous SIVmac239 challenge. The SIV‐specific T cell responses were only detected in the DNA‐vaccinated macaques. However, binding and neutralizing antibodies against autologous and heterologous viruses were moderately better in macaques immunized with viral particles than in macaques immunized with DNA. After the challenge, the mean peak viremia in the DNA group was 2.3 logs lower than that in the control group, while they were similar between the viral particle immunization and control groups. Similar CD4+ T cell counts were observed among all groups. These results suggest that idSIV DNA immunization alone reduces VLs during acute infection after SIV challenge in macaques and may serve as a key component in combination with other immunogens as prophylactic vaccines.
Sensory Profiling and Consumer Acceptance of Pasta, Bread, and Granola Bar Fortified with Dried Olive Pomace (Pâté): A Byproduct from Virgin Olive Oil Production
Authors: Cecchi Lorenzo , Schuster Noah , Flynn Dan , Bechtel Rose , Bellumori Maria , Innocenti Marzia , Mulinacci Nadia , Guinard Jean‐Xavier
Published: September 2019

An olive pomace (pâté) obtained from virgin olive oil production, was used for the fortification of pasta, bread, and granola bar. For each food, a control (without pâté) and a fortified sample (with pâté, 7% in pasta and 5% in bread and granola bar) were manufactured. Descriptive analysis showed that pâté strongly affected the appearance of pasta and bread and increased the bitterness of bread and granola bar but not pasta. Granola bar was less affected in general, likely because of its higher ingredient complexity. In a central location test with 175 Californian consumers, both the control and the fortified samples of all three foods were well accepted overall, with only the mean liking of the appearance of the fortified pasta falling below the “neither like nor dislike” mark. Approximately 30% of consumers preferred the fortified sample over the control for each food and 50% were willing to pay more for the fortified products. The percentage of phenols from pâté recovered in the prepared samples was such that 63 g of pasta, 18 g of bread, and 12 g of granola bar would be sufficient to meet the EFSA health claim for olive oil phenols. This study demonstrates that pâté can be used for fortification of foods for human consumption, thus adding potential economic value to the virgin olive oil production chain and allowing for a higher daily intake of phenols from Olea europaea L., whose beneficial health properties are well recognized.

Practical Application

The dried olive oil pomace (pâté) that we developed and tested in this research can be used to fortify pasta, bread, and granola bars with health‐beneficial phenols with only slight alterations of their sensory profiles and slight reduction in consumer acceptance. Virgin olive oil producers can use this byproduct and gain further economic value from olive oil production.
Impact of Natural and Artificial Sweeteners Compounds in the Sensory Profile and Preference Drivers Applied to Traditional, Lactose‐Free, and Vegan Frozen Desserts of Chocolate Flavor
Authors: de Medeiros Alessandra Cazelatto , Filho Elson Rogério Tavares , Bolini Helena Maria André
Published: September 2019

The study developed traditional and light chocolate‐flavor frozen dessert formulations, aimed at the general public, lactose intolerants, and vegans, and evaluated influences on quantitative sensory profiles and consumer acceptance with the replacement of sucrose by sweeteners in low‐calorie versions. Twelve samples with different matrices were studied, sweetened with sucrose, sucralose, and stevia. The ideal concentration of sucrose (9%: dairy samples and 15%: vegan samples) was determined by the JAR scale. The sweetness equivalence was determined by the magnitude estimation method. The physical–chemical parameters were evaluated: pH, overrun, melting, and texture. The sensory profile evaluated through Quantitative Descriptive Analysis (QDA). The QDA data were correlated with acceptance data by partial least squares regression (PLS). The results showed that the substitution of traditional milk by lactose‐free milk in the formulation did not change the characteristics of the chocolate ice cream. The use of sweeteners presented differences for milk flavor, bitter taste, bitter residual, and melting. The use of stevia extract was characterized by the presence of bitter taste, residual sweet and bitter that inhibited the perception of milk flavor, but not directly impacting the acceptance by consumers. The sucralose presented a profile closer to the sucrose, presenting lower intensity for the undesirable attributes such as bitter taste and residual bitter. There was no significant difference in the use of soy or rice protein in vegan versions, however, the use of sweeteners and body agents negatively impacted consumers' acceptance by attenuating the flavor of vegetable protein and raising gummy coating during the melting.

Practical Application

This study shows the development and sensory profile of frozen chocolate desserts. Traditional and modified samples have also been produced for consumers with dietary restrictions such as vegans, vegetarians, lactose intolerants, and diabetics. Throughout the sensory and statistical analysis, it was identified how to replace sucrose by the natural glycoside sweetener of steviol, as well as the impact on the sensory profile and the acceptance of the different formulations. The results found may provide important information for researchers in food industries who need to produce frozen chocolate desserts for vegans, vegetarians, lactose intolerant, and diabetic consumers. Stevia and sucralose were good substitutes for sucrose in the formulation of frozen desserts without lactose, but not in vegan versions (with rice and soy protein).
Percutaneous transhepatic laser lithotripsy for intrahepatic cholelithiasis: A technical report
Authors: Lamanna Anthony , Maingard Julian , Bates Davina , Ranatunga Dinesh , Goodwin Mark
Published: September 2019

Advances in interventional radiology have seen the adaptation of urological endoscopic laser techniques to treat biliary tract calculi. Percutaneous transhepatic biliary laser lithotripsy provides an effective alternative procedure for the management of intrahepatic or conventionally refractory choledocholithiasis which would otherwise require invasive and high‐risk surgical intervention. Several small studies have validated the procedure for management in this subset of patients, with most achieving 100% calculi clearance with minimal complications. Most patients are suitable for percutaneous transhepatic biliary laser lithotripsy. Preprocedural imaging is useful for evaluating stone burden and planning percutaneous access. Holmium lasers are commonly used and act by vaporising water particles on and in the calculi, fragmenting the stone via thermal expansion. A series of catheters, wires, sheaths and dilators are used to allow introduction of the choledochoscope and laser so that calculi can be targeted. Percutaneous transhepatic biliary laser lithotripsy is often used in conjunction with balloon dredging and biliary stricture dilatation. Only experienced interventionalists should perform this procedure, and users should be aware of associated hazards. Repeat percutaneous transhepatic cholangiography is routinely performed to confirm eradication of stones. Treatment of biliary calculi and obstruction is important in preventing diseases such as cholangitis and cirrhosis. For patients unsuitable for conventional treatment, percutaneous transhepatic laser lithotripsy is a safe and effective alternative when performed by experienced interventional radiologists. Preprocedural planning is imperative to procedure success.
DEX‐2‐TKA—DEXamethasone twice for pain treatment after Total Knee Arthroplasty: A protocol for a randomized, blinded, three‐group multicentre clinical trial
Authors: Gasbjerg Kasper S. , Hägi‐Pedersen Daniel , Lunn Troels H. , Jakobsen Janus C. , Overgaard Søren , Pedersen Niels A. , Bagger Jens , Lindholm Peter , Brorson Stig , Schrøder Henrik M. , Thybo Kasper H. , Mathiesen Ole
Published: September 2019

Background

Multimodal analgesia is considered the leading principle for post‐operative pain treatment, but no gold standard after total knee arthroplasty (TKA) exists.

Aim

To investigate the beneficial and harmful effects of one or two doses of 24 mg intravenous dexamethasone (DXM) as part of a multimodal analgesic regimen (paracetamol, NSAID and perioperative local infiltration analgesia) after TKA. We hypothesize that addition of DXM will reduce post‐operative opioid consumption.

Methods

DEXamethasone twice for pain treatment after TKA is a randomized, blinded, three‐group multicentre clinical trial. Participants will be randomized to one of three groups: placebo, single dose of DXM or two consecutive doses of DXM. Participants, treatment providers and investigators will be blinded to the allocated intervention. The primary outcome is total opioid consumption (units of morphine equivalents) 0‐48 hours post‐operatively. Inclusion criteria: unilateral, primary TKA; age ≥18 years; American Society of Anesthesiologists‐Score 1‐3; Body Mass Index ≥18 and ≤40; for women—not pregnant; and written informed consent. Exclusion criteria: allergy or contraindications against trial medication; daily use of high dose opioid and/or use of methadone/transdermal opioids; daily use of systemic glucocorticoids; dysregulated diabetes; and patients suffering from alcohol and/or drug abuse. Four‐hundred‐and‐eighty‐six eligible participants are needed to detect or discard a difference of 10 mg morphine equivalents 0‐48 hours post‐operatively maintaining a familywise error rate of 0.05 and a power of 90% for the three possible pairwise comparisons.

Discussion

Recruiting is planned to commence September 2018 and expected to finish March 2020.

Trial Registration

EudraCT: 2018‐001099‐39 (08/06‐18); ClinicalTrials.gov: NCT03506789 (24/04‐2019).

Editorial Comment

This is the protocol for the largest randomized clinical trial investigating the effect of one or two doses of dexamethasones on pain treatment after total knee arthroplasty. Due to the pragmatic and rigerous design this study will deliver results of high quality and external validity.
Exposure to risperidone versus other antipsychotics and risk of osteoporosis‐related fractures: a population‐based study
Authors: Clapham E. , Bodén R. , Reutfors J. , Svensson T. , Ramcharran D. , Qiu H. , Kieler H. , Bahmanyar S.
Published: September 2019

Objective

Antipsychotics may increase serum prolactin, which has particularly been observed with risperidone. Further, hyperprolactinemia has been linked to osteoporosis‐related fractures. Therefore, we investigated fracture risk in a nationwide cohort exposed to antipsychotics.

Methods

Swedish registers were used to identify adults with two consecutive dispensations of risperidone (n = 38 211), other atypical antipsychotics not including paliperidone (n = 60 691), or typical antipsychotics (n = 17 445) within three months between 2006 and 2013. An osteoporosis‐related fracture was defined as a non‐open hip/femur fracture in primary analyses. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

Risperidone users were on average older (mean age of 68, 44, and 63 years for risperidone, other atypical antipsychotics, and typical antipsychotics respectively). Compared with other atypical antipsychotics, there was no association between risperidone and osteoporosis‐related fractures in the overall (HR = 1.04, CI: 0.91–1.19) or age‐stratified analyses. A significantly increased risk of typical antipsychotics (HR = 1.24, CI: 1.07–1.45) compared with other atypical antipsychotics remained for ages >45 years.

Conclusion

Risperidone does not appear to be associated with an increased risk of osteoporosis‐related fracture compared with other atypical antipsychotic agents as a group. For typical antipsychotics, a moderately elevated risk of hip fractures was noted compared with other atypical antipsychotics, possibly because of residual confounding.
Amphibian chytrid fungus in Africa – realigning hypotheses and the research paradigm
Authors: Doherty‐Bone T. M. , Cunningham A. A. , Fisher M. C. , Garner T. W. J. , Ghosh P. , Gower D. J. , Verster R. , Weldon C.
Published: September 2019

The amphibian chytrid fungus Batrachochytrium dendrobatidis (Bd), responsible for numerous amphibian declines and extinctions, was previously thought to originate from the African continent. This was based on infected museum specimens from early 20th century South Africa, Cameroon and Uganda. Further research on archived specimens from other continents eventually revealed early 20th century records also in Brazil and Japan. Recent robust analysis of genomic diversity and phylogeny of Bd has shown origin from Asia to be more plausible. This raises the issue that the threat of Bd for African amphibians as a novel pathogen has been underestimated. There are now cases where dramatic amphibian declines in disparate mountains on the continent could be attributed to Bd, and this necessitates an urgent realigning of hypotheses and the research agenda for amphibian conservation on the continent. Notably, hotspots of amphibian host naivety include West Africa where this pathogen has so far not been detected. We discuss research gaps that amphibian conservationists might focus on, notably more genomic sequencing of the BdCAPE (the less virulent) lineage to determine its date of emergence, and assessing the susceptibility of different amphibian species to infection, disease and decline to better prioritize conservation actions.
Regional restructuring of industrial sport: The case of elite hockey player production in British Columbia
Authors: Decosse Stefan , Norcliffe Glen
Published: September 2019

Although ice hockey has been characterized as a “people's sport,” since the 1980s neoliberalism has stimulated elite hockey to take on industrial characteristics, driven by: the commodification of sport; a growing scale of hockey performance; the branding of teams and cities; a strategic coupling with media; and the privatization of training and facilities. In British Columbia, elite hockey players are being produced in new regional settings. Formerly, many elite players came from smaller resource‐hinterland towns offering strong local support. With neoliberal commodification of the sport, the Lower Mainland has emerged as the main centre of elite player production in British Columbia. This has occurred very rapidly as costly private training programs located mostly in larger metropolitan areas have become the main source of young players aspiring to elite status. High‐performance training companies and private hockey academies offer costly routes to elite player status, with new class relations that exclude low‐income families. A range of internal and external scale economies lead to these new facilities being concentrated in larger conurbations, particularly in Greater Vancouver.
Sex matching does not impact the outcome after simultaneous pancreas‐kidney transplantation
Authors: Messner Franka , Etra Joanna W. , Haugen Christine E. , Bösmüller Claudia , Maglione Manuel , Hackl Hubert , Riedmann Marina , Oberhuber Rupert , Cardini Benno , Resch Thomas , Scheidl Stefan , Margreiter Raimund , Öfner Dietmar , Schneeberger Stefan , Margreiter Christian
Published: September 2019

Background

Several studies in solid organ transplantation have shown a correlation between donor and recipient sex mismatch and risk of graft loss. In this study, we aimed to analyze the impact of donor and recipient sex matching on patient and pancreas graft survival in a large single‐center cohort.

Methods

We retrospectively analyzed all first simultaneous pancreas‐kidney transplants performed between 1979 and 2017 at the Medical University of Innsbruck.

Results

Of 452 patients, 54.6% (247) received a sex‐matched transplant. Patient survival (P = .86), death‐censored pancreas graft survival (dcPGS, P = .26), and death‐censored kidney graft survival (dcKGS, P = .24) were similar between the sex‐matched and sex‐mismatched groups. Patient survival and dcPGS at 1, 5, and 15 years were 95.9%, 90.0%, and 62.1% and 86.1%, 77.1%, and 56.7% in the sex‐matched group and 93.6%, 86.2%, and 62.4% and 83.1%, 73.3%, and 54.3% in the sex‐mismatched group. Sex matching led to a lower odds of severe postoperative complications (41.2% vs 49.0%; OR 0.57, 95%CI 0.33‐0.97; P = .038); however, no increased odds of other adverse postoperative outcomes was detected.

Conclusion

Our study demonstrates that sex matching reduced the odds of postoperative complications but did not impact other early and late outcome parameters in our cohort.
Continuous glucose monitoring to assess glycemic control in the first 6 weeks after pancreas transplantation
Authors: Dadlani Vikash , Kaur Ravinder Jeet , Stegall Mark , Xyda Souzana‐Eirini , Kumari Kanchan , Bonner Keisha , Smith Byron , Thapa Prabin , Dean Patrick G. , Kudva Yogish C.
Published: September 2019

Background

Current therapy for Type 1 diabetes (T1D) is characterized by significant glucose variability (GV). Pancreas transplantation (PT) is performed in certain T1D patients with and without end‐stage renal disease. To date, GV has been examined to a limited extent after PT.

Methods

We investigated GV using continuous glucose monitoring (CGM) 3‐6 weeks after PT.

Results

Eleven patients had simultaneous kidney pancreas transplantation (SPK), nine pancreas after kidney (PAK), and six pancreas transplantation alone (PTA). Mean CGM showed no difference between SPK, 126.5 ± 13.9, PAK 119.9 ± 12.8, and PTA 131.1 ± 29 mg/dL (P value .6). Percentage of time in range (TIR, 70‐180 mg/dL) was 92% for SPK, 93.4% in PAK, and 88.5% in PTA with only 0.3%, 1.5%, and 0.3% of time <70 mg/dL. Percentage >180 mg/dL was 7.9% for SPK, 4.9% PAK, and 11% in PTA. Other measures of GV were similar in the three cohorts. In six patients, CGM was performed before and after PT and improved significantly. GV was also better compared with a matched cohort of T1D patients.

Conclusions

All 3 types of PT resulted in excellent glucose control 3‐6 weeks post‐procedure. CGM outcomes represent an important objective outcome after PT.
Local surgical treatment of cutaneous squamous cell carcinoma: deficits and controversies in the literature
Authors: Breuninger Helmut , Eigentler Thomas , Häfner Hans‐Martin , Leiter Ulrike
Published: September 2019

The prognostic impact of primary excision in the treatment of cutaneous squamous cell carcinoma depends on certain tumor characteristics (risk factors), the surgical approach chosen and the subsequent histological examination.

For the development of the AWMF (Association of Scientific Medical Societies in Germany) guidelines for squamous cell carcinoma, the most conclusive guidelines available were evaluated using the DELBI tool (German Instrument for the Methodological Appraisal of Guidelines). These were the Scottish and Canadian guidelines as well as the joint guidelines published by EDF, EADO and EORTC. The primary literature on the aforementioned topics that was used for these guidelines included 49 studies and 9 reviews. None of the studies had a prospective, randomized design; 19 studies contained prospective data; 30 studies provided retrospective data. Overall, the results were heterogeneous. Not only were there discrepancies in terms of the validity of the various risk factors for locoregional disease progression – such as dedifferentiation, desmoplasia and perineural invasion – but also with respect to tumor thickness and surgical consequences. Differences were also found regarding the histological processing method used. In general, there are two such methods: conventional histology (bread loaf technique) and complete histological assessment of excision margins. The latter was found to be associated both with low recurrence rates and low metastatic rates, possibly due to the fact that patients treated with the latter method had lower‐risk tumors. Publications on bread loaf histology lacked precise information as to how the tissue was actually processed. Likewise, there was a lack of usable data in terms of the surgical margins used in the primary excision.

Conclusion: The current literature is inconsistent and insufficient with regard to the various prognostic factors and the surgical approach to cutaneous squamous cell carcinoma.
Endoscopy opens the door to a new era of autoimmune gastritis research
Authors: Hirata Yoshihiro
Published: September 2019

This Editorial refers to the article by Terao et al., p 364–372 of this issue.
Normal ranges for automatic measurements of tissue Doppler indices of mitral annular motion by echocardiography. Data from the HUNT3 Study
Authors: Grue Jahn Frederik , Storve Sigurd , Støylen Asbjørn , Torp Hans , Haugen Bjørn Olav , Mølmen Harald Edvard , Dalen Håvard
Published: September 2019

Background

Automatic quantification of left ventricular (LV) function could enhance workflow for cardiologists and assist inexperienced clinicians who perform focused cardiac ultrasound. We have developed an algorithm for automatic measurements of the mitral annular plane systolic excursion (MAPSE) and peak velocities in systole (S′) and early (e′) and late (a′) diastole. We aimed to establish normal reference values for the automatic measurements and to compare them with manual measurements.

Methods and Results

Healthy participants (n = 1157, 52.5% women) from the HUNT3 cross‐sectional population study in Norway were included. The mean age ± standard deviation (SD) was 49 ± 14 (range: 19–89) years. The algorithm measured MAPSE, S′, e′, and a′ from apical 4‐chamber color tissue Doppler imaging (cTDI) recordings. The manual measurements were obtained by two echocardiographers, who measured MAPSE by M‐mode and the velocities by cTDI. For men and women, age‐specific reference values were created for groups (mean ± 1.96SD) and by linear regression (mean, 95% prediction interval). Age was negatively correlated with MAPSE, S′, and e′ and positively correlated with a′. There were small differences between genders. Normal reference ranges were created. The coefficients of variation between automatic and manual measurements ranged from 5.5% (S′) to 11.7% (MAPSE).

Conclusion

Normal reference values for automatic measurements of LV function indices are provided. The automatic measurements were in line with the manual measurements. Implementing automatic measurements and comparison with normal ranges in ultrasound scanners can allow for quick and precise interpretation of LV function.
Obesity in pregnancy causes a volume overload in third trimester
Authors: Vonck Sharona , Lanssens Dorien , Staelens Anneleen Simone , Tomsin Kathleen , Oben Jolien , Bruckers Liesbeth , Gyselaers Wilfried
Published: September 2019

Background

Obesity is a major risk factor for cardiovascular diseases. In this study, we aimed to investigate the maternal circulatory differences during pregnancy between obese and normal weight women.

Materials and methods

The functioning of the maternal circulation (arteries, veins, heart and body fluid) was assessed by ECG‐Doppler ultrasound, impedance cardiography (ICG) and bio‐impedance during pregnancy in obese women (BMI ≥30 kg/m2) and normal weight, nonobese women (BMI 20‐25 kg/m2). In this observational study, 232 assessments were performed in the obese group, whereas 919 assessments were performed in the nonobese group.

Results

Relative to nonobese women, the overall cardiovascular function in obese women during first and second trimester is consistent with a high volume/low‐resistance circulation. In third trimester, cardiac output of obese women decreases from 9.2 (8.2‐10.7) L/min to 8.5 (7.6‐9.6) L/min (P = .037) whereas this is not true in the nonobese women (from 7.8 (7‐8.5) L/min to 7.8 (6.8‐8.9) L/min, P = .536). Simultaneously, the persistently lower peripheral vascular resistance in obese vs nonobese women disappears (880 (761‐1060) dyn.sec/cm5 vs 928 (780‐1067).

Conclusions

The circulatory gestational adaptations between nonobese and obese women were generally similar. The findings in the third trimester suggest that a pregnancy in obese women start as a state of high volume/low resistance, gradually shifting to a volume overload with decrease of cardiac output and disappearance of low vascular resistance. This evolution makes obese women vulnerable for gestational hypertensive diseases.
Disclosure strategies in adults with epilepsy when telling, “I have epilepsy”: The How2tell study
Authors: Elliott Naomi , Pembroke Sinead , Quirke Mary , Pender Niall , Higgins Agnes
Published: September 2019

Objective

To generate evidence‐based knowledge about the strategies that adult people with epilepsy (PWEs) use in the process of telling others about their epilepsy.

Methods

In‐depth, one‐to‐one interviews explored PWEs’ first‐hand experiences of self‐disclosure (or not), and grounded theory methods of inductive‐deductive analysis were used to identify strategies used in disclosing. Interviews were audio‐recorded, transcribed, coded, and independently recoded by two researchers using a coding framework specifically developed in this study. To account for maximum variation, PWEs (aged 18+ years) with different life experiences and situations relating to (1) gender, (2) age, (3) employment status, (4) personal relationships, (5) family relationship, (6) support group involvement, and (7) seizure frequency were included. Given the many variables and psychosocial issues associated with epilepsy, demographic details and validated measures including Quality of Life in Epilepsy‐10‐P, Coping Inventory of Stressful Situations‐Adult, and Patient Health Questionnaire‐9 were used to describe the characteristics of participants and to contextualize the results.

Results

Forty‐nine adults with epilepsy participated. Data analysis revealed six interrelated categories (with subcategories) of the strategies that PWEs reported using in the process of disclosure: (1) concerns about disclosing; (2) weighing up who and when to tell; (3) opportunities for telling; (4) moment of disclosure—how to construct the message; (5) tailoring the message to audience needs—altering the message when telling family members, partner, friends, children, or employer and workplace colleagues; and (6) managing reactions by making it ordinary.

Significance

People with epilepsy use a range of different strategies during the process of disclosing their epilepsy. These strategies were used to inform the development of the How2tell multimedia self‐management resource for PWEs on self‐disclosure in everyday social and life situations. How2tell is designed to benefit PWEs by empowering them with practical information about the process of telling another person, “I have epilepsy.”
P38α MAPK coordinates the activities of several metabolic pathways that together induce atrophy of denervated muscles
Authors: Odeh Maali , Tamir‐Livne Yael , Haas Tali , Bengal Eyal
Published: September 2019

Physiological or pathological muscle disuse/inactivity or loss of the neural‐muscular junction cause muscle atrophy. Atrophy‐inducing conditions cause metabolic oxidative stress in the muscle tissue, activation of the ubiquitin‐proteasome and of the autophagosome‐lysosome systems, enhanced removal of the damaged proteins and organelles, and loss of muscle mass and strength. The signaling pathways that control these catabolic processes are only partially known. In this study, we systematically analyzed the role of p38α mitogen‐activated protein kinase (MAPK) in denervation‐mediated atrophy. Mice with attenuated activity of p38α (p38AF) are partially protected from muscle damage and atrophy. Denervated (Den) muscles of these mutant mice exhibit reduced signs of oxidative stress, decreased unfolded protein response and lower levels of ubiquitinated proteins relative to Den muscles of control mice. Further, whereas autopahagy flux is inhibited in Den muscles of control mice, Den muscles of p38AF mice maintain normal level of autophagy flux. Last, muscle denervation affects differently the energy metabolism of muscles in normal and mutant mice; whereas denervation appears to increase mitochondrial oxidative metabolism in control mice, it elevates anaerobic glycolytic metabolism in p38AF mice. Our results indicate, therefore, that attenuation of p38α activity in mice protects Den muscles by reducing oxidative stress, lowering protein damage and improving the clearance of damaged mitochondria by autophagy.
Formulation of survival acceptor medium able to maintain the viability of skin explants over in vitro dermal experiments
Authors: Tarnowska M. , Briançon S. , de Azevedo J. Resende , Chevalier Y. , Barratier C. , Pourcher T. , Bolzinger M.‐A.
Published: September 2019

Objective

In vitro assessments of skin absorption of xenobiotics are essential for toxicological evaluations and bioavailability studies of cosmetic and pharmaceutical ingredients. Since skin metabolism can greatly contribute to xenobiotic absorption, experiments need to be performed with skin explants kept viable in suitable survival media. Existing protocols for non‐viable skin are modified to consider those conditions. The objective was to design a survival medium used as an acceptor fluid in Franz cells for testing cutaneous penetration of hydrophilic or lipophilic molecules. Their metabolism inside skin may be investigated under the same conditions. The determining factors involved in survival mechanisms in vitro are discussed. The consequences of short‐term skin preservation at 4°C were also evaluated.

Methods

The metabolic activity of fresh skin samples mounted in Franz cells was studied by measurement of lactate release over 24 h in order to assess the impacts of pH, buffering, osmolality, ionic strength, initial glucose supply and the addition of ethanol or non‐ionic surfactant in the acceptor part of Franz cells.

Conclusion

Survival media must maintain physiological pH (>5.5) be isotonic with skin cells (300 mOsm kg−1) and contain at least 0.5 g L−1 glucose. Several compositions able to preserve skin metabolism are reported. Storage of skin explants overnight at 4°C impairs skin metabolic activity. The present work provides guidelines for designing survival media according to constraints related to the scientific requirements of the experiments.
Clinical and epidemiological characteristics of childhood vitiligo: a study of 701 patients from Brazil
Authors: Martins Clarissa Pereira dos Santos , Hertz Amanda , Luzio Paulo , Paludo Patricia , Azulay‐Abulafia Luna
Published: September 2019

Background

Vitiligo is an acquired pigmentary disorder that affects approximately 0.5–2% of the world's population, and 25% of cases begin before 10 years of age. Although prevalent, there are few studies on the characterization of childhood vitiligo.

Objective

To evaluate the clinical and epidemiological characteristics of childhood vitiligo.

Methods

Transverse study conducted by reviewing data records of patients under the age of 18 in which disease onset occurred before 13 years of age.

Results

Predominance of females (62%). The most common subtype was generalized vitiligo (53.8%). The average age of disease onset was 5.9 years. The most affected initial site was head/neck (44.22%). The Koebner phenomenon was present in 38.2%, emotional triggering factors in 67.0% of the patients, halo nevus in 17.4%, and associated autoimmune disease in 6.5% of the patients. Family history of vitiligo was observed in 16.9% of the patients, and stability was reported by 20.1% of patients. The presence of positive family history did not significantly influence the age of onset. We found a significant difference between segmental vitiligo (SV) and nonsegmental vitiligo (NSV) regarding the age of onset, Koebner phenomenon, hypothyroidism, anti‐TPO antibodies, family history of psoriasis, and halo nevus.

Conclusion

Childhood vitiligo has its own characteristics. Vitiligo different subtypes have distinct characteristics. Our study presents a great number of patients, helping to elucidate the peculiarities of childhood vitiligo in the Brazilian population.
Tamponade effect of resorbable biological barrier in quality of obturation in primary molar
Authors: Kakade Adesh , Shetty Heeresh , Santosh Anitha , Mali Sayali , Badnaware Sheetal , Deshmukh Bhagyashree , Banthiya Karun
Published: September 2019

Aim

Physical properties of obturating materials have a direct effect on the quality of obturation; less viscous material will tend to extrude beyond the apex. We hypothesize that the use of absorbable gelatin sponge (AGS) can prevent the extrusion of these materials. This study aimed to evaluate the quality of obturation in root canals filled with iodoform‐calcium hydroxide (Metapex) premixed paste and Metapex withAGS(MAGS) in primary molars.

Methods

This in vivo study comprised 60 primary mandibular molars which after instrumentation were divided into 2 groups according to the obturation material used, Metapex andMAGS, followed by radiographic evaluation to assess the quality of the obturation. The χ2‐test was applied for statistical analysis.

Results

There was a statistically significant difference between Metapex andMAGSgroups in achieving optimum obturation (P < .001). Metapex andMAGSexhibited 86.65% and 38.88% optimum obturation respectively. The overfilling of root canals effectively reduced from 38.88% to 4.44%.

Conclusion

The addition ofAGSto Metapex causes a “tamponade effect”, which reduces the tendency of Metapex to extrude beyond the root apex. Root canal obturation using a modified filling paste likeMAGSis effective in obtaining optimum obturation in primary teeth.
Risk assessments in orthodontic patients developing white spot lesions
Authors: Leeper Danielle K. , Noureldin Amal , Julien Katie , Campbell Phillip M. , Buschang Peter H.
Published: September 2019

Aim

To determine whether caries risk factors, including cariogenic bacterial levels and salivary function, can be used to identify orthodontic patients who develop white spot lesions (WSL).

Methods

This prospective case‐control study comprised 50 patients 11‐17 years of age, including 25 controls and 25 cases who developed new WSL during treatment. WSL, oral hygiene and fluorosis were evaluated from intraoral photographs. The biofilm was assessed with bacterial cultures and adenosine triphosphate (ATP) bioluminescence. Salivary analyses were performed to determine the pH of saliva and flow rates. A survey was used to assess snacking frequency, oral hygiene and fluoride utilization.

Results

There were no between‐group pretreatment differences in WSL. Cases reported eating sugary foods significantly more often than the controls. There was a significant decline in oral hygiene during treatment, with no significant between‐group difference. There also were no statistically significant between‐group differences in the amount of saliva, buffer, ATP bioluminescence and bacterial levels. Both groups showed lower than normal buffer capacity and high bacterial levels.

Conclusion

Cases had greater sugar intake between meals than controls. ATP bioluminescence, Streptococcus mutans levels with Saliva Check Mutans, and salivary factors do not identify patients who develop WSL.
Genetic contribution of ABCC2 to Dubin‐Johnson syndrome and inherited cholestatic disorders
Authors: Corpechot Christophe , Barbu Véronique , Chazouillères Olivier , Broué Pierre , Girard Muriel , Roquelaure Bertrand , Chrétien Yves , Dong Catherine , Lascols Olivier , Housset Chantal , Jéru Isabelle
Published: September 2019

Background and Aims

The ABCC2 gene is implicated in Dubin‐Johnson syndrome (DJS), a rare autosomal recessive liver disorder. The primary aim of this study was to determine the diagnostic value of ABCC2 genetic testing in the largest cohort of DJS reported to date. The high number of patients with cholestatic manifestations in this series prompted us to evaluate the genetic contribution of rare, potentially pathogenic ABCC2 variants to other inherited cholestatic disorders.

Methods

The cohort study included 32 patients with clinical DJS diagnosis, and 372 patients referred for the following disorders: low phospholipid‐associated cholelithiasis (LPAC) syndrome, intrahepatic cholestasis of pregnancy (ICP) and benign recurrent intrahepatic cholestasis (BRIC). ABCC2 was screened by next‐generation sequencing.

Results

Most patients with clinical DJS had positive genetic diagnosis (n = 30; 94%), with a great diversity of point mutations and copy number variations in ABCC2. Strikingly, eight (27%) of these patients showed transient cholestatic features at presentation: four neonatal cholestasis, two ICP, one contraceptive‐induced cholestasis and one sporadic cholestasis. Conversely, the frequency of rare, heterozygous, potentially pathogenic ABCC2 variants in patients with LPAC, ICP or BRIC did not differ significantly from that of the general population.

Conclusions

This large series reveals that DJS is a highly homogeneous Mendelian disorder involving a large spectrum of ABCC2 variants. Genetic testing is crucial to establish early DJS diagnosis in patients with atypical presentations, such as neonatal cholestasis. This study also provides no evidence for the contribution of rare, potentially pathogenic ABCC2 variants to other inherited cholestatic disorders.
Combining imaging and tumour biopsy improves the diagnosis of combined hepatocellular‐cholangiocarcinoma
Authors: Gigante Elia , Ronot Maxime , Bertin Caroline , Ciolina Maria , Bouattour Mohamed , Dondero Federica , Cauchy François , Soubrane Olivier , Vilgrain Valérie , Paradis Valérie
Published: September 2019

Background & Aims

Combined hepatocellular‐cholangiocarcinoma (cHCC‐CCA) is by definition a highly heterogeneous tumour, which significantly impacts its diagnosis. The aim of the study was to evaluate the diagnostic performance of imaging using computed tomography and/or magnetic resonance (MR) and biopsy for the diagnosis of cHCC‐CCA.

Methods

cHCC‐CCA resected between December 2006 and April 2017 with available pre‐operative imaging and tumour biopsy were retrospectively included. cHCC‐CCA diagnosis was based on morphological and immunophenotypical features. A total of 21 cHCC‐CCA were compared to 21 intrahepatic cholangiocarcinoma (iCCA) as controls. All biopsies were reviewed. Two radiologists reviewed the cases and classified tumours into four patterns (type 1 [progressive enhancement of the entire lesion, iCCA type], type 2 [arterial enhancement with washout, HCC type], type 3 [mixed pattern with combinations of 1, 2 and 4] and type 4 [atypical pattern, areas of arterial enhancement without washout and/or hypovascular]).

Results

The presence of a type 3 pattern at imaging had a 48% sensitivity and 81% specificity for cHCC‐CCA diagnosis. The initial diagnosis performed on biopsy was cHCC‐CCA in 8/21 patients (38%). After reviewing and including immunophenotypical markers, two more cases were diagnosed as cHCC‐CCA (48% sensibility, 100% specificity). When either imaging or biopsy suggested the diagnosis of cHCC‐CCA, the sensitivity and specificity were 60% and 82% respectively.

Conclusions

We showed that a two‐step strategy combining imaging as the first step and biopsy as the second step improved the diagnostic performance of cHCC‐CCA.
An integrative correlation of myopathology, phenotype and genotype in late onset Pompe disease
Authors: Kulessa M. , Weyer‐Menkhoff I. , Viergutz L. , Kornblum C. , Claeys K. G. , Schneider I. , Plöckinger U. , Young P. , Boentert M. , Vielhaber S. , Mawrin C. , Bergmann M. , Weis J. , Ziagaki A. , Stenzel W. , Deschauer M. , Nolte D. , Hahn A. , Schoser B. , Schänzer A.
Published: September 2019

Aims

Pompe disease is caused by pathogenic mutations in the alpha 1,4‐glucosidase (GAA) gene and in patients with late onset Pome disease (LOPD), genotype–phenotype correlations are unpredictable. Skeletal muscle pathology includes glycogen accumulation and altered autophagy of various degrees. A correlation of the muscle morphology with clinical features and the genetic background in GAA may contribute to the understanding of the phenotypic variability.

Methods

Muscle biopsies taken before enzyme replacement therapy were analysed from 53 patients with LOPD. On resin sections, glycogen accumulation, fibrosis, autophagic vacuoles and the degree of muscle damage (morphology‐score) were analysed and the results were compared with clinical findings. Additional autophagy markers microtubule‐associated protein 1A/1B‐light chain 3, p62 and Bcl2‐associated athanogene 3 were analysed on cryosections from 22 LOPD biopsies.

Results

The myopathology showed a high variability with, in most patients, a moderate glycogen accumulation and a low morphology‐score. High morphology‐scores were associated with increased fibrosis and autophagy highlighting the role of autophagy in severe stages of skeletal muscle damage. The morphology‐score did not correlate with the patient's age at biopsy, disease duration, nor with the residual GAA enzyme activity or creatine‐kinase levels. In 37 patients with LOPD, genetic analysis identified the most frequent mutation, c.‐32‐13T>G, in 95%, most commonly in combination with c.525delT (19%). No significant correlation was found between the different GAA genotypes and muscle morphology type.

Conclusions

Muscle morphology in LOPD patients shows a high variability with, in most cases, moderate pathology. Increased pathology is associated with more fibrosis and autophagy.
Transcript accumulation in a trifold interaction gives insight into mechanisms of biocontrol
Authors: Franken Philipp , Takken Frank L. W. , Rep Martijn
Published: September 2019

This article is a Commentary on Sarkar et al., 224: 886–901.