bluuebunny/crossref_metadata_2025 huggingface dataset:
Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis
Authors: Egner W. , Cook T. M. , Garcez T. , Marinho S. , Kemp H. , Lucas D. N. , Floss K. , Farooque S. , Torevell H. , Thomas M. , Ferguson K. , Nasser S. , Karanam S. , Kong K.‐L. , McGuire N. , Bellamy M. , Warner A. , Hitchman J. , Farmer L. , Harper N. J. N.
Published: May 2018

Background

The Royal College of Anaesthetists 6th National Audit Project examined Grade 3‐5 perioperative anaphylaxis for 1 year in the UK.

Objective

To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results.

Methods

We used a secure registry to gather details of Grade 3‐5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail. Panel consensus diagnosis, reaction grade, review of investigations and clinic assessment are reported and compared to the prior NAP6 baseline clinic survey.

Results

A total of 266 cases met inclusion criteria between November 2015 and 2016, detailing reactions and investigations. One hundred and ninety‐two of 266 (72%) had anaphylaxis with a trigger identified, of which 140/192 (75%) met NAP6 criteria for IgE‐mediated allergic anaphylaxis, 13% lacking evidence of positive IgE tests were labelled “non‐allergic anaphylaxis”. 3% were non‐IgE‐mediated anaphylaxis. Adherence to guidance was similar to the baseline survey for waiting time for clinic assessment. However, lack of testing for chlorhexidine and latex, non‐harmonized testing practices and poor coverage of all possible culprits was confirmed. Challenge testing may be underused and many have unacceptably delayed assessments, even in urgent cases. Communication or information provision for patients was insufficient, especially for avoidance advice and communication of test results. Insufficient detail regarding skin test methods was available to draw conclusions regarding techniques.

Conclusion and Clinical Relevance

Current clinical assessment in the UK is effective but harmonization of approach to testing, access to services and MHRA reporting is needed. Expert anaesthetist involvement should increase to optimize diagnostic yield and advice for future anaesthesia. Dynamic tryptase evaluation improves detection of tryptase release where peak tryptase is <14 μg/L and should be adopted. Standardized clinic reports containing appropriate details of tests, conclusions, avoidance, cross‐reactivity and suitable alternatives are required to ensure effective, safe future management options.
Laparoscopic technique of modified extraperitoneal (retrotransversalis) end colostomy for abdominoperineal excision
Authors: Tulina I. A. , Kitsenko Yu. E. , Ubushiev M. N. , Efetov S. K. , Wexner S. D. , Tsarkov P. V.
Published: May 2018

Aim

To describe the technique of a modified extraperitoneal retrotransversalis end colostomy as part of a laparoscopic abdominoperineal excision (APR).

Method

The colostomy site is preoperatively chosen and used intra‐operatively for a trocar. After the rectum has been mobilized the descending colon is freed. The peritoneal margin is gently grasped and the parietal peritoneum and extraperitoneal together with the transversalis fascia are separated from the transverse abdominal muscle fibres upwards for 3–4 cm aiming at the trocar site to form the extraperitoneal retrotransversalis canal. The stoma site trocar is partially withdrawn and its head is turned laterally until its tip is positioned in the layer between the abdominal wall muscles and underlying transversalis and extraperitoneal fascia together with the parietal peritoneum. The CO2 source can be attached so that the gas helps to separate the layers, after which the colostomy trephine is formed at the site of the trocar, the grasper is inserted to gently deliver the blunt end of the descending colon through the canal and the end colostomy is formed in a usual way.

Results

No procedure‐specific complications were noted in 39 patients who had laparoscopic APR with extraperitoneal retrotransversalis end colostomy from 2009 to 2016. In 23 patients who survived for 3.7 ± 1.7 years after surgery there were no clinical or CT signs of parastomal hernia or prolapse.

Conclusion

This single‐institution retrospective case series demonstrates that laparoscopic extraperitoneal retrotransversalis end colostomy is feasible, safe and effective in preventing parastomal hernias and stomal prolapse.
Nonsteroidal anti‐inflammatory drugs reduce the time to recovery of gut function after elective colorectal surgery: a systematic review and meta‐analysis
Authors: Milne T. G. E. , Jaung R. , O'Grady G. , Bissett I. P.
Published: May 2018

Aim

Postoperative ileus causes significant patient morbidity after abdominal surgery. Some evidence suggests nonsteroidal anti‐inflammatory drugs (NSAIDs) may reduce time to gut recovery, but there has not been a meta‐analysis to assess their efficacy. This systematic review and meta‐analysis aimed to determine the benefit of NSAIDs for recovery of postoperative gut function in patients undergoing elective colorectal surgery.

Method

MEDLINE, EMBASE, CENTRAL and reference lists were searched with no date or language restrictions. Randomized controlled trials comparing the use of NSAIDs with placebo in the perioperative or postoperative period were identified. Included studies reported outcomes relevant to gut function: time to pass flatus or stool and time to tolerate an oral diet. The mean difference in time from surgery until passage of flatus, stool and tolerance of diet were meta‐analysed using a random‐effects model in RevMan 5.3.

Results

This study identified 992 relevant articles. Five randomized controlled trials on patients undergoing elective colorectal surgery met our inclusion criteria and were meta‐analysed. Compared with placebo, NSAIDs significantly improved the time to pass flatus (mean difference −9.44 h, 95% CI: −17.22, −1.65, I2 = 70%, P = 0.02), time to pass stool (mean difference −12.09 h, 95% CI: −17.16, −7.02, I2 = 0%, P < 0.001) and time to tolerate a diet (mean difference −11.95 h, 95% CI: −18.66, −5.24, I2 = 0%, P < 0.001).

Conclusion

NSAIDs significantly improve time to gut recovery after elective colorectal surgery. Current evidence is not adequate to identify whether selective or nonselective drugs should be recommended. Further high‐power studies using selective drugs are required.
Compensating for an Inattentive Audience
Authors: Craycraft Nicole N. , Brown‐Schmidt Sarah
Published: May 2018

The common ground that conversational partners share is thought to form the basic context for language use. According to the classic view, inferences about common ground, or mutual knowledge, are guided by beliefs about the physical, cognitive, and attentional states of one's communicative partners. Here, we provide a first test of the attention assumption for common ground, the proposal that common ground for a co‐present entity—such as an object or an utterance—can only be formed if a person has evidence that his or her partner has also attended to it. In three experiments, a participant speaker and two partners learned names for novel monster pictures as a group. The speaker was then asked to describe the monsters to each partner separately in a referential communication task. The critical manipulation was the (in)attentiveness of one partner at different points in the study. Analysis of the speaker's referring expressions revealed that speakers assumed their partner shared common ground for the monster names only when that partner exhibited engaged attention as the names were learned. These findings provide key and novel support for the classic proposal that formation of common ground critically depends on assumptions about the attentional state of one's conversational partner.
Outcome following right‐extended split liver transplantation in the recent transplant era: Single‐center analysis of a German transplant center
Authors: Herden Uta , Fischer Lutz , Koch Martina , Li Jun , Achilles Eike‐Gert , Nashan Björn
Published: May 2018

Introduction

When a sufficiently high‐quality liver is available, classic liver graft splitting is performed. In such cases, a small child receives the left‐lateral split graft, with subsequent transplantation of the right‐extended graft in an adult.

Methods

We analyzed 64 patients who received right‐extended liver grafts from 2007 to 2015, and compared outcomes between cases of external vs in‐house graft splitting.

Results

We found excellent donor data and comparable recipient characteristics. Cold ischemic time was significantly longer for external (14 ± 2 hours; n = 38) vs internal (12 ± 2 hours; n = 26) liver graft splitting. Compared to the internal splitting group, the external liver graft splitting group showed significantly reduced 1‐ and 5‐year patient survival (100% vs 84%; P = .035) and higher rates of biliary (24% vs 12%) and vascular (8% vs 0%) complications.

Conclusions

The outcomes following right‐extended split LTX are disappointing given the excellent organ quality. External liver graft splitting was associated with worse outcome and surgical complication rates. This may be related to the prolonged cold ischemic time due to twofold transportation, as well as the ignorance of the splitting procedure details and related pitfalls.
Malignant melanoma with osteosarcomatous differentiation in a lymph node metastasis
Authors: Saleh Jasmine , Wang Michael L. , Harms Paul W. , Patel Rajiv M. , Fullen Douglas R.
Published: May 2018

Osteocartilaginous differentiation in malignant melanoma is rare and can pose a diagnostic challenge. In previously reported cases, melanomas were predominantly located on acral and mucosal sites, with osteocartilaginous differentiation present in either primary or recurrent lesions. We report a case of a 52‐year‐old female with malignant melanoma located on the right upper back exhibiting osteosarcomatous differentiation only in the axillary lymph node metastasis. This case serves to highlight that the divergent differentiation can occur in lymph node metastases while being absent in the primary lesion. The patient's medical history, careful histological examination, and immunohistochemistry may be necessary for establishing the correct diagnosis.
Nasojejunal‐stent technique: A new system to prevent fully covered metal stent migration in the treatment of benign esophageal diseases
Authors: Hernández Mondragón Oscar Víctor , Palos Cuellar Raquel , Murcio Pérez Enrique
Published: May 2018

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Cerebral vasculopathy in childhood neurofibromatosis type 2: cause for concern?
Authors: Lascelles Karine , Afridi Shazia , Siddiqui Ata , Hemingway Cheryl , Ferner Rosalie , Ganesan Vijeya
Published: May 2018

Unlike adult neurofibromatosis type 2 (NF2), which presents with symptoms related to bilateral vestibular schwannomas, children with NF2 most frequently present with ocular, dermatological, and neurological symptoms. Arteriopathy, a well‐established feature in neurofibromatosis type 1, is not a widely recognized feature of NF2. Here we report three children with NF2 with cerebral arteriopathy and/or arterial ischaemic stroke. Bevacizumab, a vascular endothethial growth factor inhibitor, is an established treatment for rapidly growing vestibular schwannomas; however, it carries a risk of both ischaemic and haemorrhagic stroke. Thus, the role of screening and risk to benefit ratio of bevacizumab in NF2 merit further consideration.

What this paper adds

Children with neurofibromatosis type 2 (NF2) may be at increased risk of cerebral vasculopathy and arterial ischaemic stroke.

Targeted magnetic resonance angiography should be performed in children with NF2 who are being considered for bevacizumab therapy.
Characteristics of high‐ and low‐risk individuals in the PRIORITY study: urinary proteomics and mineralocorticoid receptor antagonism for prevention of diabetic nephropathy in Type 2 diabetes
Authors: Tofte N. , Lindhardt M. , Adamova K. , Beige J. , Beulens J. W. J. , Birkenfeld A. L. , Currie G. , Delles C. , Dimos I. , Francová L. , Frimodt‐Møller M. , Girman P. , Göke R. , Havrdova T. , Kooy A. , Mischak H. , Navis G. , Nijpels G. , Noutsou M. , Ortiz A. , Parvanova A. , Persson F. , Ruggenenti P. L. , Rutters F. , Rychlík I. , Spasovski G. , Speeckaert M. , Trillini M. , von der Leyen H. , Rossing P.
Published: May 2018

Aim

To compare clinical baseline data in individuals with Type 2 diabetes and normoalbuminuria, who are at high or low risk of diabetic kidney disease based on the urinary proteomics classifier CKD273.

Methods

We conducted a prospective, randomized, double‐blind, placebo‐controlled international multicentre clinical trial and observational study in participants with Type 2 diabetes and normoalbuminuria, stratified into high‐ or low‐risk groups based on CKD273 score. Clinical baseline data for the whole cohort and stratified by risk groups are reported. The associations between CKD273 and traditional risk factors for diabetic kidney disease were evaluated using univariate and logistic regression analysis.

Results

A total of 1777 participants from 15 centres were included, with 12.3% of these having a high‐risk proteomic pattern. Participants in the high‐risk group (n=218), were more likely to be men, were older, had longer diabetes duration, a lower estimated GFR and a higher urinary albumin:creatinine ratio than those in the low‐risk group (n=1559, P<0.02). Numerical differences were small and univariate regression analyses showed weak associations (R2 < 0.04) of CKD273 with each baseline variable. In a logistic regression model including clinical variables known to be associated with diabetic kidney disease, estimated GFR, gender, log urinary albumin:creatinine ratio and use of renin‐angiotensin system‐blocking agents remained significant determinants of the CKD273 high‐risk group: area under the curve 0.72 (95% CI 0.68–0.75; P<0.01).

Conclusions

In this population of individuals with Type 2 diabetes and normoalbuminuria, traditional diabetic kidney disease risk factors differed slightly between participants at high risk and those at low risk of diabetic kidney disease, based on CKD273. These data suggest that CKD273 may provide additional prognostic information over and above the variables routinely available in the clinic. Testing the added value will be subject to our ongoing study. (European Union Clinical Trials Register: EudraCT 2012‐000452‐34 and Clinicaltrials.gov: NCT02040441).
Predicting obstructive coronary artery disease using carotid ultrasound parameters: A nomogram from a large real‐world clinical data
Authors: Wu Na , Chen Xinghua , Li Mingyang , Qu Xiaolong , Li Yueli , Xie Weijia , Wu Long , Xiang Ying , Li Yafei , Zhong Li
Published: May 2018

Background

Carotid ultrasound is a noninvasive tool for risk assessment of coronary artery disease (CAD). There is no consensus on which carotid ultrasound parameter constitutes the best measurement of atherosclerosis. We investigated which model of carotid ultrasound parameters and clinical risk factors (CRF) has the highest predictive value for CAD.

Materials and methods

We enrolled 2431 consecutive patients who have suspected CAD and underwent coronary angiography and carotid ultrasound with measurements of carotid intima‐media thickness (CIMT), total number of plaques and areas of different types of plaques classified by echogenicity.

Results

Total number of plaques demonstrated the highest incremental prediction ability to predict CAD over CRF (area under the curve [AUC] 0.752 vs 0.701, net reclassification index [NRI] = 0.514, P < .001), followed by area of maximum mixed and soft plaques. CIMT had no significant incremental value over CRF (AUC 0.704 vs 0.701, P = .241; NRI = 0.062, P = .168). The model comprising total number of plaques, areas of maximum soft, hard and mixed plaques plus CRF had the highest discriminatory (AUC = 0.757) and reclassification value (NRI = 0.567) for CAD. A nomogram based on this model was developed to predict CAD. For subjects at low and intermediate risk, the model comprising total number of plaques plus CRF was the best.

Conclusions

Total number of plaques, area of maximum soft, hard and mixed plaques showed significantly incremental prediction ability over CRF. A nomogram based on these factors provided an intuitive and practical method in detecting CAD.
Role of mu, but not delta or kappa, opioid receptors in context‐induced reinstatement of oxycodone seeking
Authors: Bossert Jennifer M. , Hoots Jennifer K. , Fredriksson Ida , Adhikary Sweta , Zhang Michelle , Venniro Marco , Shaham Yavin
Published: May 2018

Relapse to non‐medical use of prescription opioids often occurs after exposure to places previously associated with drug use. Here, we describe a rat model of context‐induced reinstatement of oxycodone seeking after repeated cycles of drug self‐administration and extinction‐induced abstinence. We also determined the role of mu, delta and kappa opioid receptors (MOR, DOR, KOR) in this reinstatement. We trained rats to self‐administer oxycodone for 6 h/day in context A; lever pressing was paired with a discrete cue. Next, we extinguished the lever pressing in the presence of the discrete cue in context B and then tested the rats for reinstatement of oxycodone seeking in both contexts. We retrained rats to self‐administer oxycodone in context A, re‐extinguished their lever pressing in context B and retested them for reinstatement in both contexts. Prior to testing, we injected the rats with vehicle or antagonists of MOR (naltrexone; 0.5 or 1.0 mg/kg), DOR (naltrindole; 7.5 or 15 mg/kg) or KOR (LY2456302; 5 or 10 mg/kg). We also tested the effect of naltrexone, naltrindole and LY2456302 on oxycodone self‐administration under fixed‐ratio‐1 (FR1) and progressive ratio (PR) reinforcement schedules. We observed context‐induced reinstatement of oxycodone seeking after repeated cycles of drug self‐administration and extinction. Naltrexone, but not naltrindole or LY2456302, injections decreased this reinstatement. Additionally, naltrexone increased oxycodone self‐administration under the FR1 schedule and decreased oxycodone self‐administration under the PR schedule; naltrindole and LY2456302 were ineffective. Results demonstrate a critical role of MOR, but not DOR or KOR, in context‐induced reinstatement of oxycodone seeking and oxycodone self‐administration.
α‐Synuclein activates innate immunity but suppresses interferon‐γ expression in murine astrocytes
Authors: Wang Jintang , Chen Zheng , Walston Jeremy D. , Gao Peisong , Gao Maolong , Leng Sean X.
Published: May 2018

Glial activation and neuroinflammation contribute to pathogenesis of neurodegenerative diseases, linked to neuron loss and dysfunction. α‐Synuclein (α‐syn), as a metabolite of neuron, can induce microglia activation to trigger innate immune response. However, whether α‐syn, as well as its mutants (A53T, A30P, and E46K), induces astrocyte activation and inflammatory response is not fully elucidated. In this study, we used A53T mutant and wild‐type α‐syns to stimulate primary astrocytes in dose‐ and time‐dependent manners (0.5, 2, 8, and 20 μg/ml for 24 hr or 3, 12, 24, and 48 hr at 2 μg/ml), and evaluated activation of several canonical inflammatory pathway components. The results showed that A53T mutant or wild‐type α‐syn significantly upregulated mRNA expression of toll‐like receptor (TLR)2, TLR3, nuclear factor‐κB and interleukin (IL)‐1β, displaying a pattern of positive dose–effect correlation or negative time–effect correlation. Such upregulation was confirmed at protein levels of TLR2 (at 20 μg/ml), TLR3 (at most doses), and IL‐1β (at 3 hr) by western blotting. Blockage of TLR2 other than TLR4 inhibited TLR3 and IL‐1β mRNA expressions. By contrast, interferon (IFN)‐γ was significantly downregulated at mRNA, protein, and protein release levels, especially at high concentrations of α‐syns or early time‐points. These findings indicate that α‐syn was a TLRs‐mediated immunogenic agent (A53T mutant stronger than wild‐type α‐syn). The stimulation patterns suggest that persistent release and accumulation of α‐syn is required for the maintenance of innate immunity activation, and IFN‐γ expression inhibition by α‐syn suggests a novel immune molecule interaction mechanism underlying pathogenesis of neurodegenerative diseases.
Gene editing vectors for studying nicotinic acetylcholine receptors in cholinergic transmission
Authors: Peng Can , Yan Yijin , Kim Veronica J. , Engle Staci E. , Berry Jennifer N. , McIntosh J. Michael , Neve Rachael L. , Drenan Ryan M.
Published: May 2018

Nicotinic acetylcholine receptors (nAChRs), prototype members of the cys‐loop ligand‐gated ion channel family, are key mediators of cholinergic transmission in the central nervous system. Despite their importance, technical gaps exist in our ability to dissect the function of individual subunits in the brain. To overcome these barriers, we designed CRISPR/Cas9 small guide RNA sequences (sgRNAs) for the production of loss‐of‐function alleles in mouse nAChR genes. These sgRNAs were validated in vitro via deep sequencing. We subsequently targeted candidate nAChR genes in vivo by creating herpes simplex virus (HSV) vectors delivering sgRNAs and Cas9 expression to mouse brain. The production of loss‐of‐function insertions or deletions (indels) by these ‘all‐in‐one’ HSV vectors was confirmed using brain slice patch clamp electrophysiology coupled with pharmacological analysis. Next, we developed a scheme for cell type‐specific gene editing in mouse brain. Knockin mice expressing Cas9 in a Cre‐dependent manner were validated using viral microinjections and genetic crosses to common Cre‐driver mouse lines. We subsequently confirmed functional Cas9 activity by targeting the ubiquitous neuronal protein, NeuN, using adeno‐associated virus (AAV) delivery of sgRNAs. Finally, the mouse β2 nAChR gene was successfully targeted in dopamine transporter (DAT)‐positive neurons via CRISPR/Cas9. The sgRNA sequences and viral vectors, including our scheme for Cre‐dependent gene editing, should be generally useful to the scientific research community. These tools could lead to new discoveries related to the function of nAChRs in neurotransmission and behavioral processes.
Reconciling multiple impacts of nitrogen enrichment on soil carbon: plant, microbial and geochemical controls
Authors: Ye Chenglong , Chen Dima , Hall Steven J. , Pan Shang , Yan Xuebin , Bai Tongshuo , Guo Hui , Zhang Yi , Bai Yongfei , Hu Shuijin
Published: May 2018

Impacts of reactive nitrogen (N) inputs on ecosystem carbon (C) dynamics are highly variable, and the underlying mechanisms remain unclear. Here, we proposed a new conceptual framework that integrates plant, microbial and geochemical mechanisms to reconcile diverse and contrasting impacts of N on soil C. This framework was tested using long‐term N enrichment and acid addition experiments in a Mongolian steppe grassland. Distinct mechanisms could explain effects of N on particulate and mineral‐associated soil C pools, potentially explaining discrepancies among previous N addition studies. While plant production predominated particulate C changes, N‐induced soil acidification strongly affected mineral‐associated C through decreased microbial growth and pH‐sensitive associations between iron and aluminium minerals and C. Our findings suggest that effects of N‐induced acidification on microbial respiration and geochemical properties should be included in Earth system models that predict ecosystem C budgets under future N deposition/input scenarios.
Multidomain intervention for the prevention of cognitive decline after stroke – a pooled patient‐level data analysis
Authors: Teuschl Y. , Ihle‐Hansen H. , Matz K. , Dachenhausen A. , Ratajczak P. , Tuomilehto J. , Ursin M. H. , Hagberg G. , Thommessen B. , Øksengård A. R. , Brainin M. ,   the ASPIS Study Group
Published: May 2018

Background and purpose

The aim of this pooled patient‐level data analysis was to test if multidomain interventions, addressing several modifiable vascular risk factors simultaneously, are more effective than usual post‐stroke care for the prevention of cognitive decline after stroke.

Methods

This pooled patient‐level data analysis included two randomized controlled trials using a multidomain approach to target vascular risk factors in stroke patients and cognition as primary outcome. Changes from baseline to 12 months in the trail making test (TMT)‐A, TMT‐B and 10‐words test were analysed using stepwise backward linear mixed models with study as random factor. Two analyses were based on the intention‐to‐treat (ITT) principle using different imputation approaches and one was based on complete cases.

Results

Data from 322 patients (157 assigned to multidomain intervention and 165 to standard care) were analysed. Differences between randomization groups for TMT‐A scores were found in one ITT model (P = 0.014) and approached significance in the second ITT model (P = 0.087) and for complete cases (P = 0.091). No significant intervention effects were found for any of the other cognitive variables.

Conclusion

We found indications that multidomain interventions compared with standard care can improve the scores in TMT‐A at 1 year after stroke but not those for TMT‐B or the 10‐words test. These results have to be interpreted with caution due to the small number of patients.
Skin sensitivity and skin microbiota: Is there a link?
Authors: Seite Sophie , Misery Laurent
Published: May 2018

Sensitive skin is defined by the occurrence of unpleasant sensations, accompanied or not by erythema, in response to stimuli which normally should not provoke such sensations and that cannot be linked to skin disease. Even if its pathophysiology is not completely known, hyper‐reactivity of the cutaneous nervous system associated with an abnormal skin barrier has been hypothesized as a primary culprit including more recently a role of the cutaneous microbiota. The objective of this short review is to discuss the relationship between the skin microbiota, skin sensitivity and the skin barrier function.
Altered expression of matrix remodelling associated 7 (MXRA7) in psoriatic epidermis: Evidence for a protective role in the psoriasis imiquimod mouse model
Authors: Ning Jinling , Shen Ying , Wang Ting , Wang Mengru , Liu Wei , Sun Yonghu , Zhang Furen , Chen Lingling , Wang Yiqiang
Published: May 2018

Preliminary data mining performed with Gene Expression Omnibus data sets implied that psoriasis may involve the matrix remodelling associated 7 (MXRA7), a gene with little function information yet. To test that hypothesis, studies were performed in human samples and murine models. Immunohistochemistry in normal human skin showed that MXRA7 proteins were present across the full epidermal layer, with highest expression level detected in the basal layer. In psoriatic samples, MXRA7 proteins were absent in the basal stem cells layer, while suprabasal keratinocytes were stained at a higher level than in normal tissues. In an imiquimod‐induced psoriasis‐like disease model in mice, diseased skins manifested similar MXRA7 expression pattern and change as in human samples, and MXRA7‐deficient mice developed severer psoriasis‐like diseases than wild‐type mice did. While levels of propsoriatic genes (eg IL17, IL22, IL23) in imiquimod‐stimulated MXRA7‐deficient mice were higher than in wild‐type mice, keratinocytes isolated from MXRA7‐deficient mice showed increased proliferation upon differentiation induction in culture. These data demonstrated that MXRA7 gene might function as a negative modulator in psoriasis development when propsoriatic factors attack, presumably via expression alteration or redistribution of MXRA7 proteins in keratinocytes.
Glass eel (Anguilla anguilla) recruitment to the river Lis: Ingress dynamics in relation to oceanographic processes in the western Iberian margin and shelf
Authors: Stratoudakis Yorgos , Oliveira Paulo B. , Teles‐Machado Ana , Oliveira José Manuel , Correia Maria João , Antunes Carlos
Published: May 2018

To provide new information on the ingress dynamics of glass eels at the Portuguese coast, the study analyzes catch per unit effort (CPUE) data from river Lis, biometric data from recruits in basins of western Portugal and meteo‐oceanographic data from the Iberian margin and shelf. Biometric data of glass eels in western Portugal are congruent with the latitudinal size gradient of leptocephali in oceanic surveys and show clear seasonality, with longest and heaviest individuals arriving from October to December. Generalized additive models fitted to CPUEs from two experimental fishing periods (1996–1997 and 2013–2014) show that availability of glass eels to the sampling gear was inversely related to lunar phase and sea wave height. CPUE was lowest from May to September, increased towards the end of the year and peaked in February–March, when recruits were almost 40% lighter than autumn arrivals. Commercial CPUE during the 1989–1990 fishing season was significantly higher than experimental fishing data in 1996–1997. Higher variance and smaller sample size in 2013–2014 prevent conclusive interdecadal comparisons. Finally, CPUE was significantly higher during the prevalence of northward current flow off western Portugal and during strong cross‐shelf westerly winds. Findings support the suggestion that eel recruitment in Portugal occurs mainly by leptocephali travelling along the Azores Current, deflected northwards through the Iberian Poleward Current, with river ingress, and possibly oceanic metamorphosis, modulated by seasonal dynamics in coastal hydrology and shelf/upper margin oceanography.
Importance of nutrients, organic matter and light availability on epilimnetic metabolic rates in a mesotrophic tropical lake
Authors: Brighenti Ludmila S. , Staehr Peter A. , M. Brandão Luciana P. , Barbosa Francisco A. R. , Bezerra‐Neto José Fernandes
Published: May 2018

Global changes, such as climate and land use alterations, are expected to affect freshwater ecosystems, modifying environmental conditions with ultimate effects on carbon and nutrient cycling. While effects of these changes have been the focus of several studies in temperate lakes, remarkably little effort has been dedicated to understanding the behaviour and responses of tropical lakes despite their importance in tropical environments.

In a factorial mesocosm study conducted in a tropical lake, we investigated how changes in environmental conditions, such as additions of inorganic nutrients and allochthonous organic matter, and shading, affect gross primary production (GPP), community respiration (R) and net community production (NCP) rates, and the occurrence of GPP light saturation and photoinhibition.

GPP rates in the mesocosms were enhanced by additions of inorganic nutrients (+NP) and organic matter (+C) and decreased with increasing mean light available (Ī). Apparent photoinhibition was pronounced in full light treatments (+L) without additions of nutrients (−NP) and organic matter (−C), occurring in 91% of the experimental days. This supports previous evidence of the importance of photoinhibition in the upper mixed layer of the lake, especially during nutrient depletion and high light availability in the warmer rainy season.

The main factor affecting metabolic rates was nutrients (NP), followed by organic matter (C). Effect of light (L) and the interaction between C and L were also significant for GPP and R rates.

Addition of allochthonous organic matter (+C) with a high content of coloured dissolved organic matter (CDOM) stimulated GPP rates and reduced the occurrence of apparent photoinhibition and light saturation. This also increased R rates in the mesocosms. However, R was strongly coupled to GPP, indicating that changes in respiration were more related to autotrophic activity than to a direct and independent stimulation of heterotrophic communities.

Our results strongly support recent evidence of the interactions between nutrients, organic matter and light conditions, which under a scenario of changes in the frequency and intensity of precipitation events and human‐mediated changes in land use, may affect the magnitude, variability and balance of metabolic processes in the productive upper mixed layers of tropical lakes.
Human impacts decouple a fundamental ecological relationship—The positive association between host diversity and parasite diversity
Authors: Wood Chelsea L. , Zgliczynski Brian J. , Haupt Alison J. , Guerra Ana Sofía , Micheli Fiorenza , Sandin Stuart A.
Published: May 2018

Human impacts on ecosystems can decouple the fundamental ecological relationships that create patterns of diversity in free‐living species. Despite the abundance, ubiquity, and ecological importance of parasites, it is unknown whether the same decoupling effects occur for parasitic species. We investigated the influence of fishing on the relationship between host diversity and parasite diversity for parasites of coral reef fishes on three fished and three unfished islands in the central equatorial Pacific. Fishing was associated with a shallowing of the positive host‐diversity–parasite‐diversity relationship. This occurred primarily through negative impacts of fishing on the presence of complex life‐cycle parasites, which created a biologically impoverished parasite fauna of directly transmitted parasites resilient to changes in host biodiversity. Parasite diversity appears to be decoupled from host diversity by fishing impacts in this coral reef ecosystem, which suggests that such decoupling might also occur for parasites in other ecosystems affected by environmental change.
Dependence on others for oral hygiene and its association with hand deformities and functional impairment in elders with a history of leprosy
Authors: Ferreira Raquel Conceição , Gonçalves Talita Xavier , Soares Anna Rachel dos Santos , Carvalho Luísa Rodrigues de Abreu , Campos Fernanda Lamounier , Ribeiro Marco Túlio de Freitas , Martins Andrea Maria Eleutério de Barros Lima , Ferreira Efigênia Ferreira e
Published: May 2018

Objective

To analyse the frequency of dependence on others for oral hygiene and its association with hand deformities, frailty and dependence on others for basic activities of daily living (BADL) among elders with a history of leprosy.

Background

Dependence on others for oral hygiene has not been considered in multifunctional geriatric assessments.

Material and methods

Edentulous elders with a history of leprosy who used complete dentures and resided in a former leprosy colony were classified as independent or partially/completely dependent on others for brushing their dentures or rinsing and for BADL, and as frail or robust. The presence of hand deformities was assessed by an occupational therapist.

Results

28.4% and 14.9% were completely/partially dependent on others for brushing and rinsing, respectively. The dependence for BADL was observed in 21.6% and hand deformities in 17.6%. A higher odds of dependence for brushing/rinsing was found among elders who were dependent on others for BADL. Brushing dependence (61.5%) was more frequent among participants with hand deformities than those without this condition (21.3%) (OR: 6.8; 95% IC: 1.2‐37.9;P = .028). There was no association between frailty and brushing (P = .068) or rinsing (P = .202) dependence.

Conclusion

Approximately one‐third of elders have a dependence on others for brushing; a smaller proportion is dependent on others for rinsing. Older people who are dependent on others for BADL and who present hand deformities are more likely to be dependent on others for denture brushing and rinsing. Elders may perform oral self‐care even when they present frailty.
Greater Occipital Nerve Injection versus Oral Steroids for Short Term Prophylaxis of Cluster Headache: A Retrospective Comparative Study
Authors: Wei Jerry , Robbins Matthew S.
Published: May 2018

Objective

To investigate our experience with oral steroid and greater occipital nerve (GON) injection with steroid as transitional treatments for cluster headache.

Background

Cluster headache is a primary headache disorder characterized by multiple episodes of intense unilateral pain with autonomic features. During cluster headache attacks, transitional therapies are useful while prophylactic dosages are initiated or increased. There are limited data comparing the efficacy of oral versus injected transitional treatments.

Methods

We retrospectively reviewed charts for patients evaluated with cluster headache at our center and captured episodes of transitional therapy utilized from 1995 to 2014. Treatment benefit was categorized into complete, partial, or no response.

Results

Forty‐three patients received transitional therapy over a total of 151 encounters, of which 140 were available for analysis. Encounters featured oral steroids (81, 57.9%) and GON injection (59, 42.1%). Of the 40 patients with treatment response data available, 24 patients received only one type of transitional therapy and 16 patients received both therapies. More encounters featuring oral steroids versus GON injections led to at least a partial response (82.7% vs 64.4%) and to a lesser extent a complete response (50.6% vs 35.6%). Among 16 patients treated with both therapies, 8 (50%) responded to both and 6 (37.5%) responded only to oral steroids.

Conclusions

Our single‐center, retrospective data suggest the majority of patients with cluster headache responded to both prednisone and GON injections for transitional treatment, with a higher response to oral steroids. Our results may inform study design for a randomized trial, which is warranted.
Transnational research training: Chinese visiting doctoral students overseas and their host supervisors
Authors: Shen Wenqin
Published: May 2018

International experience during doctoral training is critical in improving the quality of research training and establishing international networks. This study makes an original contribution to the understanding of the research partnership between visiting doctoral students and their supervisors. The current research draws upon empirical evidence from a survey, semi‐structured interviews and CV analysis of Chinese visiting doctoral students sponsored by the China Scholarship Council. Findings confirm the good quality of supervision and solid research mentorship for the recipient students, who are not officially enrolled in international host universities. This study also highlights research collaboration and networking, which have long‐term international research impact.
The role of transbronchial cryobiopsy in lung transplantation
Authors: Montero M Angeles , de Gracia Javier , Culebras Amigo Mario , Mugnier Jacqueline , Álvarez Antonio , Berastegui Cristina , Ortiz‐Villalón Cristian
Published: May 2018

Aims

Lung transplant monitoring is usually performed with forceps transbronchial biopsies. These types of biopsy show limited reliability and a high degree of variability, owing to insufficient material and compression artefact, which lead to misinterpretation and, eventually, inappropriate treatment of the transplanted patients. The following study was undertaken to assess the diagnostic yield, histological quality and safety of cryobiopsy (CB) in comparison with conventional forceps biopsy (FB) for sampling lung tissue in transplant recipients.

Methods and results

From January to December 2011, 81 consecutive transbronchial biopsies (41 FBs and 40 CBs) were indicated in single or bilateral lung transplantation recipients with clinical acute or chronic lung injury. Lung samples obtained by CB were larger (8.5 ± 6.5 mm in the FB group versus 22.1 ± 12.5 mm in the CB group; P < 0.0001) and had no crush artefacts (P = 0.002), allowing us to increase the diagnostic yield of acute (P = 0.0657) and chronic (P = 0.0053) cellular rejection.

Discussion

Transbronchial cryoprobe bronchoscopy allows the harvesting of larger and more expanded lung tissue samples, increasing the diagnostic yield in the monitoring of the lung allograft by means of a safe procedure.
An analysis of the timing and materials associated with pulp disease following restorative dental treatment
Authors: Yong J. B. , Sivarajan S. , Abbott P. V.
Published: May 2018

Aim

To assess whether the timing of pulp disease after tooth restoration was associated with type of restorative dental material used, extent of the restoration or tooth type.

Methodology

A comprehensive search and analysis of data using the Titanium Oral Health Management software program at The Oral Health Centre of Western Australia were performed to correlate procedural codes for teeth that had restorations placed and subsequently developed pulp disease requiring endodontic treatment or extraction from 1st January 2009 to 31st December 2013. Manual analysis of paper and/or electronic patient record cards was also performed. Data collected included restoration type, restored tooth surfaces, tooth type and the dates of restoration and subsequent endodontic intervention or extraction.

Results

Of 330 teeth that met the inclusion criteria, 84 (26%) had composite resin restorations, 80 (24%) had amalgams, 119 (36%) had glass–ionomer cement (GICs), and 47 (14%) had crowns. The average time between restoration and further intervention was 330 days with a range from 3 to 1775 days (approximately 5 years). Teeth restored with crowns or five‐surface restorations were significantly more likely to require earlier intervention than other restorations. Premolar and anterior teeth were also more likely to require earlier intervention.

Conclusions

Teeth that developed pulp disease requiring further intervention that were restored with crowns and five‐surface GIC developed the disease sooner than teeth that were restored with amalgam or composite. In teeth with five‐surface restorations that developed pulp disease requiring further intervention, premolar and anterior teeth developed the pulp disease sooner than molars.
Helper T‐cell responses and pulmonary fungal infections
Authors: McDermott Andrew J. , Klein Bruce S.
Published: May 2018

The mucosal surface of the respiratory tract encounters microbes, such as fungal particles, with every inhaled breath. When pathogenic fungi breach the physical barrier and innate immune system within the lung to establish an infection, adaptive immunity is engaged, often in the form of helper CD4 T‐cell responses. Type 1 responses, characterized by interferon‐γ production from CD4 cells, promote clearance of Histoplasma capsulatum and Cryptococcus neoformans infection. Likewise, interleukin‐17A (IL‐17A) production from Th17 cells promotes immunity to Blastomyces dermatitidis and Coccidioides species infection by recruiting neutrophils. In contrast the development of T helper type 2 responses, characterized by IL‐5 production from T cells and eosinophil influx into the lungs, drives allergic bronchopulmonary aspergillosis and poor outcomes during C. neoformans infection. Experimental vaccines against several endemic mycoses, including Histoplasma capsulatum, Coccidioides, Cryptococcus and Blastomyces dermatitidis, induce protective T‐cell responses and foreshadow the development of vaccines against pulmonary fungal infections for use in humans. Additionally, recent work using antifungal T cells as immunotherapy to protect immune‐compromised patients from opportunist fungal infections also shows great promise. This review covers the role of T‐cell responses in driving protection and pathology in response to pulmonary fungal infections, and highlights promising therapeutic applications of antifungal T cells.
Chemomechanical analysis for interfacial reactions between γ‐TiAl alloy and glass‐ceramic coating in micro/nano scale
Authors: Liu Wenyuan , Yu Wenshan , Shen Shengping
Published: May 2018

To simulate interfacial reactions process and deformation in γ‐TiAl and glass‐ceramic coating system at high temperature, we developed a coupled chemomechanical model with chemical reactions, diffusion, and mechanical deformation incorporated. Tensile radial and circumferential stresses develop in interfacial zone and coatings as the interfacial reactions occur. Tensile radial stress could tear coatings off alloys while the tensile circumferential stress could result in crack initiation and propagation, even spalling of coatings. The bulk radial stress can be markedly reduced by taking the surface effect into account. Consequently, tensile radial stress vanishes in alloy‐coating system on nano scale.
(Hf0.2Zr0.2Ta0.2Nb0.2Ti0.2)C high‐entropy ceramics with low thermal conductivity
Authors: Yan Xueliang , Constantin Loic , Lu Yongfeng , Silvain Jean‐François , Nastasi Michael , Cui Bai
Published: May 2018

A novel high‐entropy carbide ceramic, (Hf0.2Zr0.2Ta0.2Nb0.2Ti0.2)C, with a single‐phase rock salt structure, was synthesized by spark plasma sintering. X‐ray diffraction confirmed the formation of a single‐phase rock salt structure at 26‐1140°C in Argon atmosphere, in which the 5 metal elements may share a cation position while the C element occupies the anion position. (Hf0.2Zr0.2Ta0.2Nb0.2Ti0.2)C exhibits a much lower thermal diffusivity and conductivity than the binary carbides HfC, ZrC, TaC, and TiC, which may result from the significant phonon scattering at its distorted anion sublattice. (Hf0.2Zr0.2Ta0.2Nb0.2Ti0.2)C inherits the high elastic modulus and hardness of the binary carbide ceramics.
Effects of Porphyromonas gingivalis LPS and LR12 peptide on TREM‐1 expression by monocytes
Authors: Dubar Marie , Carrasco Kevin , Gibot Sebastien , Bisson Catherine
Published: May 2018

Periodontal disease involves the activation of host immune response, acting not only as defender of periodontal tissues against bacterial aggression but also as mediator of tissue destruction. Triggering receptor expressed on myeloid cells 1 (TREM‐1) is an immune receptor that synergizes with Toll‐like receptors in amplifying the inflammatory response mediated by microbial molecules.

Aim

To investigate the role of P. gingivalis lipopolysaccharide (LPS) and the effect of LR12, a TREM‐1 inhibitory peptide, on the expression of membrane‐bound and soluble form of TREM‐1 on human primary monocytes, as well as the production of proinflammatory cytokines.

Material and Methods

Cells were stimulated with 1 μg/ml of LPS with or without LR12. PCR, flow cytometry and ELISA were used to determine TREM‐1 expressions and cytokines release by monocytes.

Results

P. gingivalis LPS can induce a significant increase in TREM‐1 expression (mRNA, membrane‐bound and soluble form, p < 0.001) as well as cytokines (IL‐1β, TNFα) and chemokines (IL‐8) production by monocytes. This monocytes’ activation was partly prevented by LR12.

Conclusions

TREM‐1 inhibitors such as LR12 could be interesting for the modulation of the excessive inflammatory response that occurs during periodontal disease.