bluuebunny/crossref_metadata_2025 huggingface dataset:
Independent predictors of mortality in adolescents ascertained for conduct disorder and substance use problems, their siblings and community controls
Authors: Border Richard , Corley Robin P. , Brown Sandra A. , Hewitt John K. , Hopfer Christian J. , McWilliams Shannon K. , Rhea Sally Ann , Shriver Christen L. , Stallings Michael C. , Wall Tamara L. , Woodward Kerri E. , Rhee Soo Hyun
Published: August 2018

Background and aims

Adolescents with conduct and substance use problems are at increased risk for premature mortality, but the extent to which these risk factors reflect family‐ or individual‐level differences and account for shared or unique variance is unknown. This study examined common and independent contributions to mortality hazard in adolescents ascertained for conduct disorder (CD) and substance use disorder (SUD), their siblings and community controls, hypothesizing that individual differences in CD and SUD severity would explain unique variation in mortality risk beyond that due to clinical/control status and demographic factors.

Design

Mortality analysis in a prospective study (Genetics of Antisocial Drug Dependence Study) that began in 1993.

Setting

Multi‐site sample recruited in San Diego, California and Denver, Colorado, USA.

Participants

A total of 1463 clinical probands were recruited through the juvenile correctional system, court‐mandated substance abuse treatment programs and correctional schools, along with 1399 of their siblings, and 904 controls.

Measurements

Mortality and cause‐of‐death were assessed via National Death Index search (released October, 2017).

Findings

There were 104 deaths documented among 3766 (1168 female) adolescents and young adults (average age 16.79 years at assessment, 32.69 years at death/censoring). Mortality hazard for clinical probands and their siblings was 4.99 times greater than that of controls (95% confidence interval = 2.40–10.40; P < 0.001). After accounting for demographic characteristics, site, clinical status, familial dependence and shared contributions of CD and SUD, CD independently predicted mortality hazard, whereas SUD severity did not.

Conclusions

In the United States, youth with conduct and substance use disorders and their siblings face far greater risk of premature death than demographically similar community controls. In contrast to substance use disorder severity, conduct disorder is a robust predictor of unique variance in all‐cause mortality hazard beyond other risk factors.
TexNN: Fast Texture Encoding Using Neural Networks
Authors: Pratapa S. , Olson T. , Chalfin A. , Manocha D.
Published: August 2018

We present a novel deep learning‐based method for fast encoding of textures into current texture compression formats. Our approach uses state‐of‐the‐art neural network methods to compute the appropriate encoding configurations for fast compression. A key bottleneck in the current encoding algorithms is the search step, and we reduce that computation to a classification problem. We use a trained neural network approximation to quickly compute the encoding configuration for a given texture. We have evaluated our approach for compressing the textures for the widely used adaptive scalable texture compression format and evaluate the performance for different block sizes corresponding to 4 × 4, 6 × 6 and 8 × 8. Overall, our method (TexNN) speeds up the encoding computation up to an order of magnitude compared to prior compression algorithms with very little or no loss in the visual quality.
Influence of soft tissue grafting, orofacial implant position, and angulation on facial hard and soft tissue thickness at immediately inserted and provisionalized implants in the anterior maxilla
Authors: Noelken Robert , Geier Jannik , Kunkel Martin , Jepsen Søren , Wagner Wilfried
Published: August 2018

Background

Resorption of hard and soft tissues following immediate implant insertion is frequently reported. Data regarding the influencing factors on facial tissue thickness are rare.

Purpose

This retrospective study investigated the impact of connective tissue grafting, the orofacial angulation and position of immediately inserted and provisionalized implants on the facial hard and soft tissue thickness in the anterior maxilla within a 1‐ to 5‐year follow‐up.

Material and Methods

Implants with the prerequisite of having preoperative and postoperative cone beam computed tomography (CBCT) and a follow‐up of 1 to 5 years were included. Facial bone deficiencies were grafted flaplessly with autogenous bone in all sites. In a subgroup of implants additional connective tissue grafting was performed, whereas the remaining implants were not grafted with soft tissue. The orofacial tooth and implant angulation, the change of horizontal position and the facial bone thickness were measured by CBCT, the facial mucosa thickness by an ultrasonic device.

Results

In total, 76 implants were placed in 55 patients. Sixty‐nine sites showed a facial bone defect. Thirty‐eight received a connective tissue graft additionally. All implants were still in function after a mean follow‐up of 36 months. The mean thickness of the facial mucosa was 1.72 mm at 1 mm, 1.63 mm at 4 mm, 1.52 mm at 6 mm, and 1.66 mm at 9 mm apically to mucosal margin. The bone thickness was 0.02, 0.25, and 0.36 mm initially and 1.32, 1.26, and 1.11 mm finally at 1, 3, and 6 mm apically to implant shoulder level. Mixed model analysis revealed an impact of the preoperative bone status on the facial bone increase. The facial soft tissue thickness was significantly influenced by the gingival biotype.

Conclusions

The results indicate that an initial severe hard tissue defect allows for significant bone regeneration. The facial soft tissue thickness is primarily influenced by the gingival biotype.
Radiological parameters related to success of the round window approach in cochlear implantation: A retrospective study
Authors: Kang Jae‐Yoon , Chung Jee‐Hye , Park Hee‐Sung , Park Yong‐Ho , Choi Jin Woong
Published: August 2018

Objectives

To evaluate the radiologic parameters related to success of round window (RW) approach for cochlear implantation (CI).

Design

A retrospective cohort study.

Setting

Academic‐tertiary centre.

Participants

Eighty‐four consecutive patients without inner ear anomaly who underwent CI with the intent of the RW approach were included. The RW approach was performed through the facial recess after posterior tympanotomy (RW group). When the RW approach was not possible despite maximum effort to expose the RW, promontory cochleostomy (PC) was performed (PC group).

Main outcome measures

The following radiologic parameters were compared between the two groups: (a) Width of the facial recess, (b) oblique distance between the cochlear basal turn (CBT) and facial nerve (FN), (c) anteroposterior distance between the posterior margin of the RW and FN and (d) angle between the EAC and CBT.

Results

Seventy patients (83.3%) were implanted using the RW approach, and 14 patients (16.7%) underwent the PC approach for CI. The anteroposterior distance between the posterior margin of the RW and FN and the angle between the EAC and CBT in the RW group were significantly longer and wider than those in the PC group (P < 0.001 and P = 0.001, respectively). Multivariate analysis revealed that these two parameters were independent parameters for success of the RW approach.

Conclusions

The distance between the posterior margin of the RW and FN and the angle between the EAC and CBT are associated with success of RW approach. Therefore, preoperative radiologic analysis of the two parameters might help CI surgeons to select RW approach.
Linagliptin as add‐on to empagliflozin in a fixed‐dose combination in Japanese patients with type 2 diabetes: Glycaemic efficacy and safety profile in a two‐part, randomized, placebo‐controlled trial
Authors: Kaku Kohei , Haneda Masakazu , Tanaka Yuko , Lee Ganghyuck , Shiki Kosuke , Miyamoto Yuki , Solimando Fernando , Lee Jisoo , Lee Christopher , George Jyothis
Published: August 2018

Aims

This two‐part, double‐blind, double‐dummy, randomized, placebo‐controlled trial (83 sites) evaluated the efficacy and safety of empagliflozin (Empa) 10 or 25 mg and linagliptin (Lina) 5 mg fixed‐dose combinations (FDCs) in Japanese patients with type 2 diabetes mellitus (T2DM) who were poorly controlled with Empa.

Materials and methods

Patients (previously drug‐naive or using one oral antidiabetic drug for ≥ 12 weeks) entered an open‐label stabilization period (16 weeks, Empa 10 mg [Part A] or Empa 25 mg [Part B]). Subsequently, they received Empa 10 mg plus placebo (Plc) for Empa/Lina10/5 (Empa/Plc 10/5; Part A) or Empa 25 mg plus Plc for Empa/Lina 25/5 (Empa/Plc 25/5; Part B) for 2 weeks. Patients with HbA1c 7.5–10.0% were randomized (1:1) to a 24‐week regimen of once‐daily Empa/Lina 10/5 (n = 107) or Empa/Plc 10/5 (n = 108) in Part A, or to Empa/Lina 25/5 (n = 116) or Empa/Plc 25/5 (n = 116) in Part B, with a 28‐week extension period in Part B.

Results

Change from baseline in HbA1c at Week 24 was greater (P < 0.0001) with Empa/Lina than with Empa/Plc (primary outcome, Empa/Lina 10/5: −0.94 vs −0.12%; adjusted mean difference, −0.82%; Empa/Lina 25/5: −0.91 vs −0.33%; adjusted mean difference, −0.59%). Over 24‐ and 52‐week periods, higher proportions of patients achieved HbA1c < 7.0% and greater decreases in fasting plasma glucose were observed with Empa/Lina compared with Empa/Plc. Empa/Lina was well tolerated, with no unexpected adverse events or diabetic ketoacidosis. One case of confirmed hypoglycaemia with Empa/Plc 25/5 was reported.

Conclusions

These results support Empa/Lina FDC as a potential option for Japanese patients with T2DM who require combination therapy. ClinicalTrials.gov NCT02489968.
Mortality in heart failure with atrial fibrillation: Role of digoxin and diuretics
Authors: Gonzalez‐Loyola Felipe , Abellana Rosa , Verdú‐Rotellar José‐ Maria , Bustamante Rangel Alejandro , Clua‐Espuny Josep Lluís , Muñoz Miguel‐Angel
Published: August 2018

Background

The impact of atrial fibrillation (AF) on mortality of patients with heart failure (HF) has been established. Nevertheless, the effect of some factors in mortality, such as digoxin or diuretic use, remains controversial. This study aims at assessing mortality in community‐dwelling patients with stable HF related to AF and determines the relation of these drugs with prognosis.

Materials and methods

Community‐based cohort study of HF patients diagnosed between January 2010 and December 2014 attended at any one of the 279 primary healthcare centres of the Catalan Institute of Health (Spain). Follow‐up ended on December 31, 2015, and the main outcome was mortality for all causes. The effect of clinical and demographic characteristics on survival was assessed by Cox proportional hazards model.

Results

A total of 13 334 HF patients were included. Mean age was 78.7 years (SD 10.1), and 36.8% had AF. Mean follow‐up was 26.9 months (SD 14.0). At the end of the study, 25.8% patients had died, and mortality was higher when AF was present (28.8% vs 24.1%, P < 0.001, respectively). Multivariate model confirmed the higher risk of death for AF patients (HR 1.10 95%, CI 1.02‐1.19). Digoxin and diuretics were not associated with higher mortality in AF patients (HR 1.04 95% CI 0.92‐1.18 and HR 1.04 95% CI 0.85‐1.26, respectively).

Conclusions

An excess of mortality in HF patients with AF was found in a large retrospective community‐based cohort. Digoxin and diuretics did not affect mortality in HF patients with AF.
Behavioral responses of the small hive beetle, Aethina tumida, to odors of three meliponine bee species and honey bees, Apis mellifera scutellata
Authors: Bobadoye Bridget O. , Fombong Ayuka T. , Kiatoko Nkoba , Suresh Raina , Teal Peter E. A. , Salifu Daisy , Torto Baldwyn
Published: August 2018

Recent studies have shown that honey bees, bumble bees, and some meliponine bee species of the genera Trigona, Meliponula, and Dactylurina are hosts of the small hive beetle (SHB) Aethina tumidaMurray (Coleoptera: Nitidulidae), a pest of honey bee colonies in various regions of the world. Olfaction has been implicated in SHB infestations of honey bee and bumble bee colonies. We used olfactometer bioassays to investigate responses of adult male and female SHBs to odors from intact colonies and separate hive components (pot honey, pot pollen, cerumen, and propolis) of three African meliponine bee species, Meliponula ferruginea (Lepeletier) (black morphospecies), M. ferruginea (reddish brown morphospecies), and Meliponula bocandei (Spinola) (Hymenoptera: Apidae). Although both sexes of the beetle strongly preferred intact colony, pot honey, and pot pollen odors, there was no evidence of attraction to propolis and cerumen odors from the three meliponine bee species. Both sexes of SHB also strongly preferred odors from honey bees, Apis mellifera L. (Hymenoptera: Apidae), over odors from the three meliponine bee species. Our results provide substantial evidence of the host potential of African meliponine bees for the SHB, and we discuss this complex association of the SHB with species within the Apidae family.
Impact of performance status and transfusion dependency on outcome of patients with myelodysplastic syndrome, acute myeloid leukemia and chronic myelomonocytic leukemia treated with azacitidine (PIAZA study)
Authors: Wehmeyer Jürgen , Zaiss Matthias , Losem Christoph , Schmitz Stephan , Niemeier Beate , Harde Johanna , Hannig Carla Verena , Harich Hanns‐Detlev , Müller Judith , Klausmann Martine , Tessen Hans Werner , Potthoff Karin
Published: August 2018

Objective

Azacitidine (Vidaza®) is the standard treatment for patients with higher‐risk myelodysplastic syndromes (MDS) not eligible for allogeneic stem cell transplantation. In the noninterventional study PIAZA, we evaluated the effectiveness and safety of azacitidine treatment in 149 patients with higher‐risk MDS, chronic myelomonocytic leukemia (CMML) and acute myeloid leukemia (AML) in routine clinical practice.

Method

Patients were treated according to physician's discretion. Besides evaluation of safety and effectiveness, impact of covariates on progression‐free survival (PFS) was assessed.

Results

Median age of patients was 75 years. 61.1% of patients were diagnosed with MDS, 31.5% with AML and 7.4% with CMML. Patients were treated with azacitidine for a median of seven cycles. Median PFS was 10.9 months. Median OS was 14.1 months. Two‐year survival rate was 28.9%. 45.9% of patients showed CR or PR. Stable and progressive disease were observed in 37.2% and 8% of patients, respectively. Transfusion independence was reported in 64 of 89 patients. Eastern cooperative oncology group (ECOG) performance status (PS) and red blood cell (RBC) transfusion before azacitidine therapy were identified as predictive factors for PFS.

Conclusion

In conclusion, we estimated the duration of PFS in a real‐world setting and identified ECOG PS and RBC transfusion as predictive factors for PFS. The safety of azacitidine showed a similar profile as demonstrated in the pivotal clinical trials.
Equine viral arteritis (EVA): A potential trapdoor for the practicing veterinary surgeon in the United Kingdom
Authors: Crabtree J. R. , Newton J. R.
Published: August 2018

Equine viral arteritis (EVA) is a notifiable disease in the UK with potentially serious consequences for horse owners and breeders. Legislation exists under ‘The Equine Viral Arteritis Order 1995’ to protect the UK from this contagious equine disease. The UK is at risk of introduction of EVA through importation of infected horses or semen. There is however much misunderstanding regarding the importance of EVA and occasionally misinterpretation, specifically on how to protect and manage stallions with vaccination. Issues with changing vaccine datasheet recommendations and vaccine availability have resulted in stallions being inappropriately vaccinated or vaccinations lapsing. This article is aimed at the practicing veterinary surgeon, to update them as to the current status of EVA vaccination and disease screening in horses in the UK and how to avoid some common pitfalls.
MRGPRX2 is negatively targeted by SCF and IL‐4 to diminish pseudo‐allergic stimulation of skin mast cells in culture
Authors: Babina Magda , Wang Zhao , Artuc Metin , Guhl Sven , Zuberbier Torsten
Published: August 2018

MRGPRX2 was recently uncovered as the “missing link” in clinically relevant mast cell (MC) activation explaining previously puzzling phenomena. It is the receptor for various endogenous ligands and exogenous compounds alike, whose binding evokes rapid degranulation much like allergen‐mediated exocytosis. While the perceivable outcomes are similar, the two activation routes differ regarding mechanism and regulation. We recently reported that acute SCF administration curbs responses evoked by MRGPRX2 in human skin MCs. Maintenance of MCs in culture requires the presence of MC supportive factors and renders the cells functionally and molecularly unequal to ex vivo counterparts. Here, we asked whether expansion in culture impacts the pseudo‐allergic route, and if so, what contribution SCF and IL‐4 play in this scenario. We report that the in vitro micromilieu dampens (but does not erase) pseudo‐allergic responses and that this is accompanied by strongly reduced MRGPRX2 expression. Withdrawal of SCF or IL‐4 individually, but most potently of both collectively, partially reinstates the MRGPRX2 pathway, revealing that SCF and IL‐4 make negative adjustments to the pseudo‐allergic pathway. Under all conditions, the FcεRI‐triggered route showed the inverse pattern of regulation, substantiating that allergic and pseudo‐allergic MC activation can obey opposite rules, hinting at possible competition between them.
LGI3 promotes human keratinocyte differentiation via the Akt pathway
Authors: Kim In Wook , Jeong Hyo‐Soon , Kwon Nyoun Soo , Baek Kwang Jin , Yun Hye‐Young , Kim Dong‐Seok
Published: August 2018

Leucine‐rich repeat LGI family member 3 (LGI3), a member of the LGI family, is a secreted protein that is expressed not only in the brain and adipose tissues, but also in various skin cells. We previously reported that LGI3 was secreted after exposure to ultraviolet B and promoted the migration of HaCaT human keratinocytes. In the present study, we investigated whether LGI3 influences the differentiation of keratinocytes. The results show that the expression of involucrin, a keratinocyte differentiation marker, was reduced in tissue from LGI3‐knockout mice. Those results indicate that LGI3 plays an important role in keratinocyte differentiation. Therefore, we treated HaCaT cells with LGI3 to examine its effect on keratinocyte differentiation. Protein levels of various differentiation markers were enhanced by treatment with LGI3. Furthermore, expression of differentiation markers was inhibited when keratinocytes were transfected with an siRNA for LGI3. LGI3 strongly activated Akt, whereas it had no apparent effect on extracellular signal‐regulated kinase, p38 mitogen‐activated protein kinase, or the c‐Jun N‐terminal kinase. A specific inhibitor of phosphoinositide 3‐kinase, LY294002, reduced LGI3‐induced expression of differentiation markers in HaCaT cells. Taken together, these results suggest that LGI3 promotes keratinocyte differentiation and could be used as a therapeutic agent to recover skin barrier function in epidermal barrier disruption.
Altered fire regimes cause long‐term lichen diversity losses
Authors: Miller Jesse E. D. , Root Heather T. , Safford Hugh D.
Published: August 2018

Many global ecosystems have undergone shifts in fire regimes in recent decades, such as changes in fire size, frequency, and/or severity. Recent research shows that increases in fire size, frequency, and severity can lead to long‐persisting deforestation, but the consequences of shifting fire regimes for biodiversity of other vegetative organisms (such as understory plants, fungi, and lichens) remain poorly understood. Understanding lichen responses to wildfire is particularly important because lichens play crucial roles in nutrient cycling and supporting wildlife in many ecosystems. Lichen responses to fire have been little studied, and most previous research has been limited to small geographic areas (e.g. studies of a single fire), making it difficult to establish generalizable patterns. To investigate long‐term effects of fire severity on lichen communities, we sampled epiphytic lichen communities in 104 study plots across California's greater Sierra Nevada region in areas that burned in five wildfires, ranging from 4 to 16 years prior to sampling. The conifer forest ecosystems we studied have undergone a notable increase in fire severity in recent decades, and we sample across the full gradient of fire severity to infer how shifting fire regimes may influence landscape‐level biodiversity. We find that low‐severity fire has little to no effect on lichen communities. Areas that burned at moderate and high severities, however, have significantly and progressively lower lichen richness and abundance. Importantly, we observe very little postfire lichen recolonization on burned substrates even more than 15 years after fire. Our multivariate model suggests that the hotter, drier microclimates that occur after fire removes forest canopies may prevent lichen reestablishment, meaning that lichens are not likely to recolonize until mature trees regenerate. These findings suggest that altered fire regimes may cause broad and long‐persisting landscape‐scale biodiversity losses that could ultimately impact multiple trophic levels.
Spring temperature, migration chronology, and nutrient allocation to eggs in three species of arctic‐nesting geese: Implications for resilience to climate warming
Authors: Hupp Jerry W. , Ward David H. , Soto David X. , Hobson Keith A.
Published: August 2018

The macronutrients that Arctic herbivores invest in their offspring are derived from endogenous reserves of fat and protein (capital) that females build prior to the period of investment or from foods they consume concurrently with investment (income). The relative contribution from each source can be influenced by temporal and environmental constraints on a female's ability to forage on Arctic breeding areas. Warming temperatures and advancing Arctic phenology may alter those constraints. From 2011 to 2014, we examined relationships among spring temperature, timing of migration and reproduction, and the sources of nutrients females deposited in eggs for three sympatric species of geese that nested in northern Alaska. Compared to lesser snow geese (Anser caerulescens caerulescens) and greater white‐fronted geese (Anser albifrons frontalis), black brant (Branta bernicla nigricans) were more likely to initiate follicle development during migration, resulting in fewer days between their arrival in the Arctic and the onset of incubation and requiring a relatively greater capital investment in eggs. Delaying follicle development until after their arrival in the Arctic provided snow geese and white‐fronted geese an opportunity to forage near their nesting area and to deposit exogenous nutrients in eggs. With warmer spring temperatures, brant invested more capital in eggs, but snow geese invested less capital. Brant likely used capital to meet costs associated with earlier onset of follicle development when phenology was advanced, whereas snow geese used capital to compensate for poor foraging conditions during colder Arctic springs. Global warming is likely to reduce the quality of lower latitude marine habitats where brant acquire endogenous reserves and advancing Arctic phenology may increase their reliance on those reserves during reproduction. Near‐term warming in northern Alaska may improve foraging conditions and favor the reproductive strategies of some herbivores such as snow geese and white‐fronted geese that mainly invest Arctic nutrients in their offspring.
Enhancer function regulated by combinations of transcription factors and cofactors
Authors: Nakagawa Takeya , Yoneda Mitsuhiro , Higashi Miki , Ohkuma Yoshiaki , Ito Takashi
Published: August 2018

Regulation of the expression of diverse genes is essential for making possible the complexity of higher organisms, and the temporal and spatial regulation of gene expression allows for the alteration of cell types and growth patterns. A critical component of this regulation is the DNA sequence‐specific binding of transcription factors (TFs). However, most TFs do not independently participate in gene transcriptional regulation, because they lack an effector function. Instead, TFs are thought to work by recruiting cofactors, including Mediator complex (Mediator), chromatin‐remodeling complexes (CRCs), and histone‐modifying complexes (HMCs). Mediator associates with the majority of transcribed genes and acts as an integrator of multiple signals. On the other hand, CRCs and HMCs are selectively recruited by TFs. Although all the pairings between TFs and CRCs or HMCs are not fully known, there are a growing number of established TF–CRC and TF–HMC combinations. In this review, we focused on the most important of these pairings and discuss how they control gene expression.
The Role of Fault‐Zone Architectural Elements on Pore Pressure Propagation and Induced Seismicity
Authors: Ortiz John P. , Person Mark A. , Mozley Peter S. , Evans James P. , Bilek Susan L.
Published: August 2018

We used hydrogeologic models to assess how fault‐zone properties promote or inhibit the downward propagation of fluid overpressures from a basal reservoir injection well (150 m from fault zone, Q = 5000 m3/day) into the underlying crystalline basement rocks. We varied the permeability of the fault‐zone architectural components and a crystalline basement weathered layer as part of a numerical sensitivity study. Realistic conduit‐barrier style fault zones effectively transmit elevated pore pressures associated with 4 years of continuous injection to depths of approximately 2.5 km within the crystalline basement while compartmentalizing fluid flow within the injection reservoir. The presence of a laterally continuous, relatively low‐permeability altered/weathered basement horizon (kaltered layer = 0.1 × kbasement) can limit the penetration depth of the pressure front to approximately 500 m. On the other hand, the presence of a discontinuous altered/weathered horizon that partially confines the injection reservoir without blocking the fault fluid conduit promotes downward propagation of pressures. Permeability enhancement via hydromechanical failure was found to increase the depth of early‐time pressure front migration by a factor of 1.3 to 1.85. Dynamic permeability models may help explain seismicity at depths of greater than 10 km such as is observed within the Permian Basin, NM.
Real‐world comparative analysis of bleeding complications and health‐related quality of life in patients with haemophilia A and haemophilia B
Authors: Booth Jason , Oladapo Abiola , Walsh Shaun , O'Hara Jamie , Carroll Liz , Garcia Diego Daniel‐Anibal , O'Mahony Brian
Published: August 2018

Introduction

Clinical severity and impact of haemophilia on quality of life have been generally considered to be lower for haemophilia B (HB) compared with haemophilia A (HA) patients.

Aims

To compare annual bleeding rate (ABR), target joint development and health‐related quality of life (HRQoL) between adult (≥18 years) severe HA and HB patients using recent data from the Cost of Haemophilia in Europe: a Socioeconomic Survey (CHESS) study.

Methods

Multivariate generalized linear models (GLM) were constructed to assess the relationship between haemophilia type, ABR, HRQoL (derived from EQ‐5D index scores) and the presence of target joints while controlling for covariates.

Results

Of the 1225 patients included, 77% (n = 949) had HA and 23% (n = 278) had HB. Of the 514 patients who completed the EQ‐5D, 78% (n = 405) had HA, and 22% (n = 110) had HB. Unadjusted mean ABR was 3.79 in HA and 4.60 in HB. The presence of ≥1 target joint was reported in 59% and 54% of patients with HA and HB, respectively. Unadjusted mean EQ‐5D index score was 0.78 in HA and 0.76 in HB. Haemophilia type was not a significant predictor of ABR, target joints or HRQoL when adjusted for confounding factors such as BMI, age and replacement therapy regimen.

Conclusion

Data suggest comparable ABR, incidence of target joints and HRQoL between patients with HB and HA indicating comparable clinical severity and disease impact on patient quality of life.
Immunological profile of teeth with inflammatory periapical disease from chronic liver disease patients
Authors: Braga Diniz J. M. , Espaladori M. C. , Souza e Silva M. E. , Brito L. C. N. , Vieira L. Q. , Ribeiro Sobrinho A. P.
Published: August 2018

Aim

To evaluate the mRNA expression levels of the cytokines interferon‐γ, tumour necrosis factor‐α, interleukin (IL)‐1β, IL‐10, IL‐6, VEGF, and AGT and the chemokine CCL2/MCP‐1 in periapical interstitial fluid associated with root canal infections before and after the reduction of the bacterial load using a cleaning procedure.

Methodology

The case group included 11 patients with chronic liver disease, and the control group included 11 healthy patients. Clinical samples were taken from teeth with pulp necrosis. After cleaning and drying the canal, three paper points were introduced into the root canal and passed through the root apex (2 mm) into the periapical tissues for 1 min. The samples were collected immediately after root canal cleaning and 7 days later to characterize those gene expression levels using real‐time PCR. The data were subjected to the Shapiro–Wilk and the Wilcoxon tests.

Results

In the control group, significantly increased expression of the pro‐inflammatory cytokines IFN‐γ and TNF‐α was observed in teeth with restrained bacterial loads (day 7) (P < 0.05). Similarly, increased TNF‐α expression was found on day 7 in the liver group (P < 0.05). No differences were observed in the expression levels of the IL‐1β, IL‐10 and, IL‐6, MCP‐1/CCL‐2 and VEGF between the first collection (day 0) and second collection (day 7), over time in either group.

Conclusion

Chronic liver disease patients exhibited sufficient immunologic ability showing relatively similar expression levels of cytokines, chemokines and angiogenic factors in periapical samples compared with the responses from no‐chronic liver disease patients. The outcomes of this study suggest that liver impairment did not compromise the periapical immune response.
Outcome of hospital outpatient treatment of functional gastrointestinal disorders
Authors: Basnayake Chamara , Kamm Michael A. , Salzberg Michael , Stanley Annalise , Khera Angela , Burrell Kathryn , Wilson‐O’Brien Amy , Hebbard Geoffrey , Thompson Alexander J.
Published: August 2018

Background

Functional gastrointestinal disorders (FGID) are the commonest conditions observed in gastrointestinal (GI) practice, yet the outcomes of their outpatient care are not known.

Aim

To evaluate the outcome for patients with FGID attending a specialist GI clinic.

Methods

Consecutive, newly referred patients with a FGID attending a specialist GI clinic in a tertiary hospital, over a 1‐year period were reviewed and then completed a phone survey to assess current symptoms.

Results

Of 102 patients, 57% had irritable bowel syndrome, 28% functional dyspepsia and 15% other functional disorders. At interview, a median of 402 days after the last consultation 38% expressed symptom improvement, but 64% remained concerned about their condition despite 62% having been reassured. After treatment, 50% of employed patients took time off work because of gut symptoms. Functional dyspepsia patients were less likely to be symptomatically improved than other FGID (21% vs 45%, P = 0.02). Patients given a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols were more likely than others to achieve symptom improvement (53% vs 31%, P = 0.03); PPI‐treated patients were less likely to experience improvement (22% vs 44%, P = 0.05); other treatments did not predict outcome. Number of visits, seniority of clinician, duration of care and comorbidities did not predict outcome.

Conclusion

One year after attending a specialist GI clinic a minority of patients with FGID were symptomatically improved. Failure to benefit by many patients may relate to the nature of patients and conditions being treated or the limited nature and range of treatments offered. Different models of care, including more diverse multidisciplinary models, should be explored.
Hepatitis C treatment for difficult to access populations: can telementoring (as distinct from telemedicine) help?
Authors: Mohsen Waled , Chan Patrick , Whelan Michelle , Glass Ann , Mouton Marlize , Young Ernest , Tran Quyen , Arora Sanjeev , Davison Scott , Lama Tenzin , Cobrador Cherry , Levy Miriam
Published: August 2018

Background

Although hepatitis C virus (HCV) infection is curable, treatment of difficult to access populations (DTAP) presents unique challenges. Project ECHO (PE) (Extension for Community Healthcare Outcomes) is a telementoring programme adopted to support clinicians treating DTAP.

Aims

To determine if the PE model supports primary care clinicians treating HCV and to compare cohort of PE patients with those in a tertiary liver clinic (TLC).

Methods

Weekly PE group video conferences were conducted. Clinical information, laboratory indices, psychosocial elements and treatment outcomes, including sustained virological response (SVR) data were recorded in the first 100 consecutive cases and retrospectively compared to 100 consecutive patients seen at a TLC from July 2016 to April 2017.

Results

Some patient characteristics were similar between PE and TLC: gender (72% vs 75% male; P = 0.23), median age (45 vs 50; P = 0.344) and the proportion of treatment naïve patients (95.0% vs 90.9%). Treatment for HCV was commenced in 78% of the PE patients and 81% of the TLC patients; 67/68 of the TLC patients and 60/61 PE patients with virological follow up who completed treatment and attended follow up have confirmed SVR. PE patients are more likely to have ongoing substance use (44% vs 17% P < 0.001), be active intravenous drug users (32% vs 17%; P < 0.001) and polysubstance abusers (26% vs 7%; P < 0.001) and were more likely to be taking opioid substitution therapy (74% vs 20%; P < 0.001). Indigenous patients were three times more greatly represented in PE (15% vs 5%; P = 0.018).

Conclusion

PE is an effective model to support primary healthcare providers treating HCV in DTAP with similar rates of treatment uptake and SVR compared to patients in TLC.
Inpatient palliative care of people dying in New South Wales hospitals or soon after discharge
Authors: Stubbs Joanne M. , Assareh Hassan , Achat Helen M. , Jalaludin Bin
Published: August 2018

Background

Palliative care can benefit all patients with life‐limiting diseases.

Aim

To describe hospital use in the final year of life, timing of palliative care and variations by age and disease for patients receiving inpatient palliative care.

Methods

Retrospective cohort study of all New South Wales residents aged 50 years and older who died (decedents) between July 2010 and June 2015 in hospital or within 30 days of discharge. Care type and diagnosis codes identified decedents who received inpatient palliative care.

Results

Of 150 770 decedents, 34.4% received palliative care a median of 10 days before death. Decedents were more likely to receive palliative care if they had cancer (64.7% vs 13.3% for those without chronic conditions) or were younger (46.3% vs 25.0% of the oldest decedents). In their last year of life, palliated decedents, on average, had three emergency department presentations and four hospital admissions – one involving surgery and one where palliation was the intent of care. Of the 30.1 days spent in hospital, 8.7 days involved palliative care. Older age and non‐cancer diagnoses were associated with fewer days of inpatient palliation and shorter time between first palliative admission and death. Decedents dying out of hospital started palliative care 18 days earlier than those dying in hospital.

Conclusion

Most decedents did not receive palliative care during hospital admission, and even then only very late in life, limiting its benefits. Improved recognition of palliative need, including earlier identification regardless of age and disease, will enhance the quality of care for the dying.
Outcomes of patients admitted to hospital medical units with back pain
Authors: Kyi Leo , Kandane‐Rathnayake Rangi , Morand Eric , Roberts Lynden J.
Published: August 2018

Background

Hospital admissions for patients with back pain are increasing. Despite their significant contribution to the healthcare burden, they remain largely unstudied.

Aim

To investigate the management and clinical outcomes of patients with acute back pain admitted to hospital under general medicine units when compared to a rheumatology unit.

Methods

A 36‐month retrospective, observational study on patients presenting to the emergency department with back pain who were subsequently admitted to one of three general medicine units (GM) or a rheumatology unit (RU). Differences in patient demographics, management and clinical outcomes were assessed using Chi‐squared tests for categorical variables and Kruskall–Wallis tests for continuous variables. Multivariate associations of two primary outcomes, length of stay (LOS) and complications were examined using generalised estimating equations.

Results

Data from 712 admissions from 594 patients across the four inpatient units were used for this study. Common discharge diagnoses were musculoskeletal/non‐specific back pain (41%), disc‐related illness (22%), vertebral fracture (14%) and sciatica (14%). Non‐English speaking background (NESB), age ≥ 80 years, disc‐related disease, vertebral fracture and sciatica were statistically significantly associated with both increased LOS and complications. The presence of comorbidities was associated with more complications. GM admission was associated with a longer LOS and more complications than RU admission.

Conclusion

Multiple factors associated with an increased LOS and complications were identified, including older patients and patients of NESB. Given the observed variations in back pain management between general and specialty units, strategies to standardise care should be considered.
Ferroelectric and piezoelectric properties of Ba0.85Ca0.15Ti0.90Zr0.10O3 films in 200 nm thickness range
Authors: Reddy Seelam Rangaswamy , Bhanu Prasad Velidandla Venkata , Bysakh Sandip , Shanker Vishnu , Joardar Joydip , Roy Subir K.
Published: August 2018

Lead‐free piezoelectric Ba0.85Ca0.15Ti0.90Zr0.10O3 (BCZT) thin films were fabricated on Si/SiO2/TiO2/Pt (100) substrates following chemical solution deposition technique. Microstructure of the nano‐sized BCZT particles crystallized in the thin film was thoroughly characterized. Ferroelectric, dielectric and piezoelectric properties of the films were investigated in detail. The BCZT films annealed at 800°C temperature exhibited high remanent polarization of 25 ± 1 μC/cm2, energy density of 17 J/cm3, dielectric constant of 1550 ± 50 and dielectric tunability of 50%. Converse piezoelectric coefficients (d33) obtained from piezo‐response force microscopy (PFM) measurements on BCZT grains of different grain size (20‐100 nm) distributed on the BCZT 700 film varied widely from 90 to 230 pm/V. The same for BCZT 800 measured on different grain size (30‐130 nm) varied from 120 to 295 pm/V. These BCZT thin films with high dielectric, ferroelectric, and piezoelectric properties might be good alternative to the PZT films for thin film piezoelectric device applications.
Local coordination, electronic structure, and thermal quenching of Ce3+ in isostructural Sr2GdAlO5 and Sr3AlO4F phosphors
Authors: Ji Haipeng , Xu Jian , Asami Kazuki , Ueda Jumpei , Brik Mikhail G. , Tanabe Setsuhisa
Published: August 2018

Sr2GdAlO5:Ce and Sr3AlO4F:Ce are isostructural phosphors in which the Ce3+ 4f‐5d1 transition can be efficiently excited by a photon with energy lower than 3.1 eV. Herein, we analyze the crystal chemistry of the Ce3+ local coordination, compare the thermal quenching behavior and construct the electronic structure of Ce3+ in them. The Rietveld refinement on two occupancy models suggests that Gd3+ only occupies the 8h site in Sr2GdAlO5; this provides a hint on the preferred occupancy of dopant Ce3+ in this site. The large crystal filed splitting of Ce8h is mainly due to the fact that the 8h site is bonded to two oxygen with relatively short dSr/Gd‐O and forms a quasi‐square antiprism which experiences a large distortion. The Ce3+ 5d‐4f luminescence in Sr3AlO4F is much more stable against thermal quenching than that in Sr2GdAlO5, as evidenced by the temperature‐dependent luminescence intensity and luminescence decay studies. The energy of the O2−‐Eu3+/2+ and O2−‐Ce4+/3+ charge transfer as well as bandgap were estimated and the electronic structure of Ce3+ were constructed. A larger energy barrier ΔEdC between the Ce3+ 5d1 level and the conduction band bottom in Sr3AlO4F is seen from the Vacuum Referred Binding Energy (VRBE) diagrams which explains the higher thermal quenching temperature by thermal ionization model.
Boro/carbothermal reduction synthesis of uranium tetraboride and its oxidation behavior in dry air
Authors: Guo Hangxu , Wang Jieru , Chen Denglei , Tian Wei , Cao Shiwei , Chen Desheng , Tan Cunmin , Deng Qihuang , Qin Zhi
Published: August 2018

Uranium tetraboride (UB4) was successfully synthesized by boro/carbothermal reduction of UO2 with B4C and carbon as combined reduction agents under flowing argon. The effects of processing temperature and mole ratios of starting materials on phase evolution were studied. XRD results demonstrated that UB4 was obtained with 3.75 mol% B4C in excess based on the UO2/B4C/C molar ratios of 1:1:1 at 1500°C. SEM observation revealed that submicrometer‐sized quasi‐spherical UB4 particles cemented together to be an aggregate. The laser particle size analysis showed that the particle size was in the range of 1‐10 μm. The oxidation behavior of UB4 was also investigated by TG and XRD. The oxidation of UB4 started at about 500°C and it showed better oxidation resistance than other basic uranium nuclear fuels (UO2, UC, UN and U3Si2). The oxidation chemical process of UB4 was presented as a three‐step process: (a) the formation of U3O8 and B2O3 oxidation products; (b) the formation of UB2O6 intermediate product by the interaction of U3O8 and B2O3; (c) the decomposition of UB2O6 to get U3O8.
Lysosome biogenesis in health and disease
Authors: Bajaj Lakshya , Lotfi Parisa , Pal Rituraj , Ronza Alberto di , Sharma Jaiprakash , Sardiello Marco
Published: August 2018

This review focuses on the pathways that regulate lysosome biogenesis and that are implicated in numerous degenerative storage diseases, including lysosomal storage disorders and late‐onset neurodegenerative diseases. Lysosomal proteins are synthesized in the endoplasmic reticulum and trafficked to the endolysosomal system through the secretory route. Several receptors have been characterized that execute post‐Golgi trafficking of lysosomal proteins. Some of them recognize their cargo proteins based on specific amino acid signatures, others based on a particular glycan modification that is exclusively found on lysosomal proteins. Nearly all receptors serving lysosome biogenesis are under the transcriptional control of transcription factor EB (TFEB), a master regulator of the lysosomal system. TFEB coordinates the expression of lysosomal hydrolases, lysosomal membrane proteins, and autophagy proteins in response to pathways sensing lysosomal stress and the nutritional conditions of the cell among other stimuli. TFEB is primed for activation in lysosomal storage disorders but surprisingly its function is impaired in some late‐onset neurodegenerative storage diseases like Alzheimer's and Parkinson's, because of specific detrimental interactions that limit TFEB expression or activation. Thus, disrupted TFEB function presumably plays a role in the pathogenesis of these diseases. Multiple studies in animal models of degenerative storage diseases have shown that exogenous expression of TFEB and pharmacological activation of endogenous TFEB attenuate disease phenotypes. These results highlight TFEB‐mediated enhancement of lysosomal biogenesis and function as a candidate strategy to counteract the progression of these diseases.

image

This article is part of the Special Issue “Lysosomal Storage Disorders”.
The layered anatomy of the jawline
Authors: Suwanchinda Atchima , Rudolph Christina , Hladik Casey , Webb Katherine L. , Custozzo Amanda , Muste Justin , Schalet Grant , Hamade Hassan , Frank Konstantin , Patel Ashit , Cotofana Sebastian
Published: August 2018

Background

To investigate the layered anatomy of the jawline and to provide anatomic background for the formation of the labiomandibular sulcus, the jowl deformity, and the “double‐chin” for safe and effective minimally invasive procedures.

Materials and Methods

Seventy‐two fresh‐frozen human cephalic cadavers (32 males, 40 females; mean age 75.2 ± 10.9 years, BMI 24.2 ± 6.6 kg/m2, 99% Caucasian ethnicity) were investigated by layer‐by‐layer anatomical dissection. Magnet resonance and computed tomographic imaging was additionally carried out to support the anatomical findings.

Results

No major neuro‐vascular structures were found to run in the subdermal plane or in the subcutaneous fat. The jowl deformity was identified to be caused by the loose adherence of the platysma to the mandible, which occurs posterior (but not anterior) to the mandibular ligament. The formation of the submental sulcus was identified to be caused by the submental septum, an osteo‐cutaneous adhesion spanning all facial layers in the submental area. The formation of the labiomandibular sulcus was caused by the change in the subcutaneous fibro‐connective arrangement rather than by an underlying adhesion or ligament.

Conclusion

The layered arrangement of the jawline predisposes this region for subdermal and subcutaneous treatment options located superficial to the platysma. Subdermal subcision procedures might have a beneficial effect on the labiomandibular sulcus as the boundary between the different types of subcutaneous arrangement, which form the sulcus, is being smoothened.
Measurements of tension on wound edges after strip harvest surgery
Authors: Ahmad Muhammad
Published: August 2018

Objective

To measure the wound closure tension after strip surgery.

Materials and Methods

The study was conducted in a private setup on patients undergoing first hair restoration surgery. The donor strip was marked with the patient in sitting position after checking the vertical scalp mobility. Six stitches of nonabsorbable suture were passed through the intact skin with a loop of 3‐4 cm; two stitches were passed in the midline and two on either side. The end of the digital scale was passed through the loop. The scales were then pulled in the opposite direction to measure the tension. The tension was measured at all three points, that is, A, B, & C. The data were collected and reviewed statistically.

Results

A total of 20 patients were included in the study. The mean age of the patients was 33.05 years. The mean wound closure tension in the midline (point A & A′) was 2.3115 lb‐f (range 0.30‐3.69), whereas the tension at point B & B′ was 2.562 lb‐f (range 0.36‐4.03) and 2.6345 lb‐f (range 0.51‐4.71) at C & C′, respectively. The average tension after removal of 10‐mm strip was 0.90 lb‐f. The removal of 11‐mm‐wide strip resulted in 2.693 lb‐f, 12 mm removal had 2.445 lb‐f, 13 mm removal had 2.545 lb‐f, 14 mm removal had 2.701 lb‐f, and 15 mm removal had 3.063 lb‐f average.

Conclusion

Measurement of wound closure tension is important to be kept minimal in order to obtain a good scar.