bluuebunny/crossref_metadata_2025 huggingface dataset:
Secukinumab effects on disease burden, patient needs and benefits, and treatment satisfaction in patients with plaque psoriasis across European regions: patient perspective data from the PROSE study
Authors: da Silva N. , Sommer R. , Ortmann C.‐E. , Jagiello P. , Bachhuber T. , Augustin M.
Published: July 2021

Background

Cross‐cultural differences in healthcare policies and patient–physician communication may influence the quality of care and patients' perceived benefits and satisfaction with psoriasis treatment.

Objectives

To compare the disease burden and patient needs at baseline, and patient benefits and satisfaction with secukinumab treatment across Europe.

Methods

PROSE was an open‐label, prospective, non‐randomized, stratified multicentre study of 52 weeks of secukinumab treatment, in 16 European countries. Secondary analysis of the PROSE study data by European regions was performed to identify cross‐cultural differences in disease burden and patient needs at baseline, and in clinical improvement, patient‐reported treatment benefits and satisfaction at 52 weeks post‐treatment.

Results

At baseline, Dermatology Life Quality Index impairment was reported to be greater in patients from Eastern Europe (EE: 15.4 ± 7.1) vs. Northern Europe (NE: 13.3 ± 6.7) and Western Europe (WE: 13.6 ± 6.9), but while differences were statistically significant (F‐test = 5.5,P < 0.001), their clinical significance is uncertain. There were no significant differences between regions in Psoriasis Area and Severity Index at baseline (F‐test = 1.6). There were considerable differences in patients' needs (Patient Need Questionnaire) between geographical regions, with WE focused more on reducing physical impairment [vs. Southern Europe (SE)/EE], EE on reducing social impairment (vs. NE/WE) and SE on reducing impairment due to therapy (vs. NE/WE). At Week 52, patients from EE reported more benefits (Patient Benefit Index) with secukinumab treatment (vs. WE/SE), while patients from NE reported higher global treatment satisfaction (vs. SE).

Conclusions

Differences in patients' needs and treatment satisfaction across Europe are likely a result of diverse medical systems, socio‐economic status and infrastructural access. A patient‐centred approach to treating psoriasis may fulfil patient needs and maximize treatment satisfaction. (NCT02752776).
Characteristics of children and adolescents with atopic dermatitis who attended therapeutic patient education
Authors: Barbarot S. , Boralevi F. , Shourick J. , Sampogna F. , Mahé E. , Merhand S. , Bursztejn A.‐C. , Mallet S. , Ezzedine K. , Abasq C. , Taïeb C. , Lasek A. , Bodemer C.
Published: July 2021

Background

Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease. Therapeutic patient education (TPE) has been demonstrated to be effective in AD in reducing disease severity and improving coping and quality of life.

Objectives

To describe the sociodemographic and clinical characteristics of children and adolescents with AD who had attended TPE sessions, as well as the characteristics of their parents, and compare them with those who did not attend TPE.

Methods

Parents of children with AD aged 6–17 years old were recruited from a representative sample of the French population contacted by e‐mail. Sociodemographic data and clinical information were collected in patients and parents. Clinical severity was assessed by parents using a proxy version of the Patient‐Oriented Eczema Measure (POEM). Attendance to TPE sessions was assessed by the following question ‘did your child or one or both parents attended TPE for AD?’. Also, the number of sessions was recorded. Determinants of TPE attendance were evaluated by univariable and multivariable analyses.

Results

Data were collected on 1063 parents and children with AD. A total of 131 (12.3%) children and/or parents attended TPE sessions. Most of them attended 2–5 TPE sessions. In that group, there were 85 boys (64.9%), and severity evaluated by POEM was mild in 29.8%, moderate in 52.7% and severe in 17.6% of patients. In the multivariable model, attending TPE sessions was significantly associated with sex of the child (boy vs. girl), consultation with a dermatologist or a paediatrician, high clinical severity and presence of AD in parents.

Conclusions

Despite recommendations, the use of TPE in children with AD is still low in France. There is a need for implementing such programmes in the management of the disease, in particular when the disease is severe.
Photosystem I P700 chlorophyll a apoprotein A1 as PCR marker to identify diatoms and their associated lineage
Authors: Vinayak Vandana , Khan Mohd Jahir , Jha Anupam Nath , Harish
Published: July 2021

The morphological characteristics of diatoms are useful for studying their taxonomy. However, the distinction between closely related diatom taxa can be very difficult, especially when the morphological characters are modified by environmental constraints. In the present study, 13 fresh water diatoms were identified morphologically and cultured under axenic conditions. To check this, PCR primers specific for multilocus genes were designed to amplify and screen 13 fresh water diatom monocultures. Multilocus PCR primers (DRR3, scfcpA,Lhcf11,SIT1,SIT3,SIT4,LOC101218388,COI‐5P,rbcL,rbcL‐3P,LSU D2/D3,UPA,psaA, and18S rRNA) were tested. It was found thatpsaAgene, a plant pigment chlorophyll‐based PCR marker, amplified in all the diatoms. Out of 13 diatom amplicons, only two fresh water diatoms DNA were sequenced. This includedCyclotella meneghinianaandSellaphora pupula. The Sanger sequencing results thus established that morphologically identified diatom,Sellaphora pupula, exhibited close phylogeny toSellaphorawhereas fresh waterCyclotella meneghinianahas close lineage to marine diatomThallosiosira.
Insulin‐like growth factor binding protein 1 ameliorates lipid accumulation and inflammation in nonalcoholic fatty liver disease
Authors: Pan Jiaqi , Cen Li , Zhou Tianyu , Yu Mengli , Chen Xueyang , Jiang Wenxi , Li Youming , Yu Chaohui , Shen Zhe
Published: July 2021

Background and Aims

Insulin‐like growth factor binding protein 1 (IGFBP1) is recently proved to be associated with glucose regulation and insulin resistance. However, little is known about its direct impact on nonalcoholic fatty liver disease (NAFLD). This study aims to investigate the effect and potential mechanism of IGFBP1 in NAFLD.

Methods

We first measured the expression level of IGFBP1 in NAFLD patients, mice, and cells. Then in in vivo study, C57BL/6 mice were fed with a methionine/choline‐deficient (MCD) diet for 4 weeks to establish the model of NAFLD. And for the last 2 weeks, the mice were injected intraperitoneally with vehicle or recombinant mouse IGFBP1 0.015 mg/kg/d. The L02 cells were treated with free fatty acids (FFA) or palmitate acids (PA) and recombinant IGFBP1 for 48 h. Integrin‐linked kinase (ILK) inhibitor and small interfering RNA were used to explore the potential interactions between IGFBP1 and integrin β1 (ITGB1).

Results

The expression of IGFBP1 was increased in NAFLD patients, mice, and cells. IGFBP1 treatment significantly ameliorated lipid accumulation and hepatic injury in MCD‐fed mice. IGFBP1 downregulated hepatic lipogenesis and upregulated lipid β‐oxidation. In addition, IGFBP1 attenuated the nuclear factor‐kappa B (NF‐κB) and extracellular regulated protein kinases (ERK) signaling pathways. In vitro, we proved that IGFBP1 relieved FFA‐induced lipid accumulation via interacting with ITGB1 and alleviated inflammation by inhibiting NF‐κB and ERK signaling pathways.

Conclusions

IGFBP1 treatment significantly ameliorated hepatic steatosis by interacting with ITGB1 and suppressed inflammation by inhibiting NF‐κB and ERK signaling pathways. Therefore, IGFBP1 might be a potential therapeutic target for NAFLD.
Enantiomers of 4‐aminopentanoic acid act as false GABAergic neurotransmitters and impact mouse behavior
Authors: Wawro Adam M. , Gajera Chandresh R. , Baker Steven A. , Leśniak Robert K. , Montine Kathleen S. , Fischer Curt R. , Saw Nay L. , Shamloo Mehrdad , Montine Thomas J.
Published: July 2021

Imbalance in the metabolic pathway linking excitatory and inhibitory neurotransmission has been implicated in multiple psychiatric and neurologic disorders. Recently, we described enantiomer‐specific effects of 2‐methylglutamate, which is not decarboxylated to the corresponding methyl analogue of gamma‐aminobutyric acid (GABA): 4‐aminopentanoic acid (4APA). Here, we tested the hypothesis that 4APA also has enantiomer‐specific actions in brain. Mouse cerebral synaptosome uptake (nmol/mg protein over 30 min) of (R)‐4APA or (S)‐4APA was time and temperature dependent; however, the R enantiomer had greater uptake, reduction of endogenous GABA concentration, and release following membrane depolarization than did the S enantiomer. (S)‐4APA exhibited some weak agonist (GABAA α4β3δ, GABAA α5β2γ2, and GABAB B1/B2) and antagonist (GABAA α6β2γ2) activity while (R)‐4APA showed weak agonist activity only with GABAA α5β2γ2. Both 4APA enantiomers (100 mg/kg IP) were detected in mouse brain 10 min after injection, and by 1 hr had reached concentrations that were stable over 6 hr; both enantiomers were cleared rapidly from mouse serum over 6 hr. Two‐month‐old mice had no mortality following 100–900 mg/kg IP of each 4APA enantiomer but did have similar dose‐dependent reduction in distance moved in a novel cage. Neither enantiomer at 30 or 100 mg/kg impacted outcomes in 23 measures of well‐being, activity chamber, or withdrawal from hot plate. Our results suggest that enantiomers of 4APA are active in mouse brain, and that (R)‐4APA may act as a novel false neurotransmitter of GABA. Future work will focus on disease models and on possible applications as neuroimaging agents.

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Reimagining the Global South: Consumer welfare and public policy insights from the United States' Gulf Coast
Authors: Dadzie Charlene A.
Published: July 2021

Pockets of vulnerable communities located in the US Gulf Coast live out a curious existence, experiencing diseases, environmental disruptions, healthcare access challenges, and quality of life characteristic of the Global South. The persistent lack of access to goods and services available in other parts of the US hinders these individuals' consumption adequacy. Thus, policymakers have an opportunity to develop impactful solutions informed by a nuanced understanding of the challenges to these consumers' welfare.
Effects of Covid‐19 lockdown on parental functioning in vulnerable families
Authors: Helland Maren Sand , Lyngstad Torkild Hovde , Holt Tonje , Larsen Linda , Røysamb Espen
Published: July 2021

Objective

The aim of this study was to increase the knowledge about how the initial Covid‐19 lockdown influenced parental functioning in vulnerable families.

Background

The Covid‐19 pandemic has caused major changes to family life. Using a natural experiment design can potentially adjudicate on former inconclusive findings about the effects of lockdown on parental functioning in vulnerable families.

Method

Responses from parents in a sample of potentially vulnerable families in Norway were divided into a lockdown group if participating at baseline and during the initial Covid‐19 lockdown (n = 820 responses) or into a control group if participating at baseline and before lockdown (n = 1368 responses). Mixed model regression analyses were used to mimic a wait‐list design investigating direct lockdown effects on mental health, parenting stress, and three aspects of interparental conflicts, as well as moderation effects.

Results

The lockdown group showed significantly higher levels of parenting stress compared with the control group, but no aversive lockdown effect on mental health or destructive conflicts were found. In fact, decreased levels of verbal aggression and child involvement in conflict were found during lockdown among parents living apart. Pre‐existing financial problems and conflict levels, age of youngest child, and parent gender did not moderate the lockdown effects.

Conclusion

The initial lockdown did not seem to adversely affect parental functioning, beyond increased parenting stress. Caution should be taken when generalizing the findings as child effects and long‐term lockdown effects were not investigated.
Comparison of outcomes with the single‐puncture and double‐puncture techniques of arthrocentesis of the temporomandibular joint: An updated systematic review and meta‐analysis
Authors: Nagori Shakil Ahmed , Bansal Adity , Jose Anson , Roychoudhury Ajoy
Published: July 2021

Objective

To compare intra‐operative and postoperative outcomes between the single‐puncture and the standard double‐puncture techniques of arthrocentesis.

Methods

PubMed, Embase, ScienceDirect and CENTRAL databases were searched from inception up to 31st August 2020. Randomised controlled trials (RCTs), prospective and retrospective studies conducted on patients with temporomandibular joint disorders comparing any type of single‐puncture arthrocentesis with standard double‐puncture arthrocentesis and reporting intra‐operative/postoperative outcomes were included. Assessment of the risk of bias was done with the Cochrane Collaboration risk assessment tool.

Results

Thirteen studies were included (12 were RCTs). Analysis of a limited number of studies indicated no difference in pain or maximal mouth opening (MMO) between the single‐puncture type‐1 or type‐2 and the double‐puncture technique at various follow‐up intervals. Pooled analysis (four studies) demonstrated that the single‐puncture type‐2 technique requires significantly less operating time as compared to the double‐puncture method. No such difference was noted between single‐puncture type‐1 and double‐puncture techniques. Analysis of two studies indicated significantly reduced intra‐operative needle relocations with the single‐puncture techniques. Studies were not of high quality with concerns of bias in randomisation, allocation concealment and blinding.

Conclusions

Limited data indicate no difference in pain or MMO with single‐ or double‐puncture techniques of arthrocentesis. Amongst the three techniques, the single‐puncture type‐2 technique has the advantages of significantly lower operating time and reduced intra‐operative needle relocations and it may be the preferred method of TMJ arthrocentesis in clinical practice.
In‐person vs home schooling during the COVID‐19 pandemic: Differences in sleep, circadian timing, and mood in early adolescence
Authors: Stone Julia E. , Phillips Andrew J. K. , Chachos Evangelos , Hand Anthony J. , Lu Sinh , Carskadon Mary A. , Klerman Elizabeth B. , Lockley Steven W. , Wiley Joshua F. , Bei Bei , Rajaratnam Shantha M. W. ,   for the CLASS Study Team
Published: July 2021

During the COVID‐19 pandemic, schools around the world rapidly transitioned from in‐person to remote learning, providing an opportunity to examine the impact of in‐person vs remote learning on sleep, circadian timing, and mood. We assessed sleep‐wake timing using wrist actigraphy and sleep diaries over 1‐2 weeks during in‐person learning (n = 28) and remote learning (n = 58, where n = 27 were repeat assessments) in adolescents (age M ± SD = 12.79 ± 0.42 years). Circadian timing was measured under a single condition in each individual using salivary melatonin (Dim Light Melatonin Onset; DLMO). Online surveys assessed mood (PROMIS Pediatric Anxiety and Depressive Symptoms) and sleepiness (Epworth Sleepiness Scale – Child and Adolescent) in each condition. During remote (vs in‐person) learning: (i) on school days, students went to sleep 26 minutes later and woke 49 minutes later, resulting in 22 minutes longer sleep duration (all P < .0001); (ii) DLMO time did not differ significantly between conditions, although participants woke at a later circadian phase (43 minutes, P = .03) during remote learning; and (iii) participants reported significantly lower sleepiness (P = .048) and lower anxiety symptoms (P = .006). Depressive symptoms did not differ between conditions. Changes in mood symptoms were not mediated by sleep. Although remote learning continued to have fixed school start times, removing morning commutes likely enabled adolescents to sleep longer, wake later, and to wake at a later circadian phase. These results indicate that remote learning, or later school start times, may extend sleep and improve some subjective symptoms in adolescents.
Association between periodontal inflammation and serum lipid profile in a healthy population: A cross‐sectional study
Authors: Mikami Risako , Mizutani Koji , Matsuyama Yusuke , Matsuura Takanori , Kido Daisuke , Takeda Kohei , Takemura Shu , Nakagawa Keita , Mukaiyama Yuto , Suda Tomonari , Yasuda Takako , Ohta Syujiro , Takaya Norihide , Fujiwara Takeo , Izumi Yuichi , Iwata Takanori
Published: July 2021

Aims

The impact of periodontal inflammation on lipid metabolism is controversial. This study aimed to investigate the association between full‐mouth periodontal inflammation and serum lipid levels.

Materials and Methods

In this cross‐sectional study, we performed periodontal and bacteriological examinations during medical checkup on 131 subjects. The association between the periodontal inflamed surface area (PISA) and the lipid markers was analyzed by multiple linear regression, adjusting for age, sex, smoking, and body mass index.

Results

Overall, 118 medically healthy participants were analyzed. The proportions of none, mild, moderate, and severe periodontitis were 37.3%, 32.2%, 25.4%, and 5.1%, respectively. Multivariate analysis showed that high‐density lipoprotein cholesterol was significantly higher in participants with the lowest tertile of PISA values (PISA low, coefficient: 7.94; 95% confidence interval [CI]: 1.63, 14.26, p = .01) compared to those in other tertiles (PISA high). Low‐density/high‐density lipoprotein cholesterol and total/high‐density lipoprotein cholesterol ratios were significantly lower in the PISA‐low group than the PISA‐high group (coefficient: −0.26 and −0.30; 95% CI: −0.50, −0.02, and −0.59, −0.0002; p = .04 and .0498). Serum high‐sensitivity C‐reactive protein level, but not serum Porphyromonas gingivalis antibody titer, partly explained the association between PISA and high‐density lipoprotein cholesterol. A significant interaction between female sex and PISA values toward high‐density lipoprotein cholesterol level was detected.

Conclusion

Periodontal inflammation was inversely associated with higher high‐density lipoprotein cholesterol, especially in females. Elevated serum C‐reactive protein partly explained this association.
Mending fences in a buyer–supplier relationship: The role of justice in relationship restoration
Authors: Mir Saif , Blessley Misty , Zacharia Zach , Aloysius John
Published: July 2021

While the extant literature has examined causes for buyer–supplier relationship dissolution, the restoration of severed buyer–supplier relationships has been overlooked. Drawing on organizational justice theory, our research develops and tests a model of relationship restoration. We examine how the supplier's restoration tactics—acknowledgment, compensation, and operational transparency, influence the interactional, distributive, and procedural fairness perception, respectively, of the buyer, resulting in relationship restoration. The results are based on a 2 (Acknowledgment – Yes/No) × 2 (Compensation – Yes/No) × 2 (Operational Transparency – Yes/No) vignette‐based study with 390 experienced practitioners. The analysis shows that compensating the buyer and providing transparent procedures for dealing with similar situations in the future, lead to higher distributive fairness and procedural fairness, respectively, resulting in restored relationships. Compensation makes up for past supplier malperformance, whereas operational transparency mitigates future concerns. We also find that restoration tactics based on interactional justice are less effective than those based on procedural and distributive justice. There is only marginal support for the indirect positive effect of acknowledgment on restoration intentions (p < 0.10). These results point to the importance of knowing how to approach a buyer to initiate relationship restoration. Managers must understand and evaluate the specific needs of each buyer when proposing a compensatory design that appeals to the buyer. Additionally, establishing procedures that are appealing to all buyers can be a challenge for a supplier, due to the differing benefits to the supplier provided by each buyer.
Mindful larks and lonely owls: The relationship between chronotype, mental health, sleep quality, and social support in young adults
Authors: Walsh Nyissa A. , Repa Lily M. , Garland Sheila N.
Published: July 2021

Chronotype is related to mental health, with evening chronotypes being more susceptible to psychological disorders than intermediate and morning types. The present study investigated the relationship between chronotype, mental health, sleep quality, and social support in Canadian young adults. We surveyed 3160 university students aged 18–35 years. Participants completed the Morningness–Eveningness Questionnaire, the Hospital Anxiety and Depression Scale, the Mindful Attention Awareness Scale, the Pittsburgh Sleep Quality Index, and the Medical Outcomes Study – Social Support Survey. We conducted Bonferroni‐corrected one‐way analyses of covariance with post hoc paired comparisons to determine the relationship between the aforementioned variables, with age and sex as covariates. We further looked at the moderation of social support on the relationship between chronotype and sleep quality. Overall, 55%, 36% and 9% of participants were classified as intermediate, evening and morning types, respectively. There was a significant difference between chronotype on levels of depression, anxiety, and sleep quality, with evening types reporting more severe symptomology than morning‐types and intermediate types. Morning types reported greater levels of overall social support and mindfulness. Evening types reported the lowest levels of all types of social support. Social support did not moderate the relationship between chronotype and sleep quality. This study further demonstrates the association between worse psychological well‐being and eveningness and between more social support, and mindfulness in morning chronotype young adults. Education and intervention are warranted to help evening chronotypes manage the potential negative features of their circadian rhythm, as well as to cultivate a greater sense of social support and mindfulness.
Multiple soil factors explain eutrophication signals in the understorey vegetation of temperate forests
Authors: Roth Marina , Michiels Hans‐Gerhard , Puhlmann Heike , Sucker Carina , Hauck Markus
Published: July 2021

Questions

Vegetation in forest understories is determined by a complex interplay of many different environmental factors, including light, water and nutrient availability. Changes in these conditions, especially changes in nitrogen (N) availability, have been widely discussed to cause shifts in species composition and loss of oligotrophic species. We examined whether nitrogen is the most important factor for the decline of nitrogen‐sensitive species in understorey communities, as measured by average Ellenberg N values and the share and number of nitrogen‐sensitive character species.

Location

Nine different oligo–mesotrophic types of temperate forest in southwest Germany.

Methods

We combined understorey vegetation and soil data from 135 forest stands. To study the importance of variables in explaining the vegetation gradients, we used random forest analyses and non‐metric multidimensional scaling (NMDS) ordinations combined with fitting of environmental vectors.

Results

We detected strong differences between three examined forest type groups: eutrophication in the understorey vegetation of broad‐leaved forests on carbonate soils was strongly related to high canopy closure and low soil carbon/phosphorus (C/P) ratio. In broad‐leaved forests on acidic soil, base saturation played a major role, but the vegetation was also influenced by the C/N and C/P ratios. In coniferous forests on acidic soil, soil pH and organic layer depth were important, as were the C/N, C/P and N/P ratios.

Conclusion

Our results show that eutrophication in understorey forest vegetation is not monocausal. Rather, oligotrophic species of forest communities are reduced at sites with higher N or P availability and/or higher base saturation and soil pH. These conditions favor fast‐growing ubiquitous species in the competition for light and other limiting factors. Since these factors were of varying importance between the forest types examined, differences shaping the forest communities need to be regarded when evaluating the impact of environmental changes, for example through atmospheric nitrogen deposition.
Male meiotic recombination rate varies with seasonal temperature fluctuations in wild populations of autotetraploid Arabidopsis arenosa
Authors: Weitz Andrew P. , Dukic Marinela , Zeitler Leo , Bomblies Kirsten
Published: July 2021

Meiosis, the cell division by which eukaryotes produce haploid gametes, is essential for fertility in sexually reproducing species. This process is sensitive to temperature, and can fail outright at temperature extremes. At less extreme values, temperature affects the genome‐wide rate of homologous recombination, which has important implications for evolution and population genetics. Numerous studies in laboratory conditions have shown that recombination rate plasticity is common, perhaps nearly universal, among eukaryotes. These studies have also shown that variation in the length or timing of stresses can strongly affect results, raising the important question whether these findings translate to more variable field conditions. Moreover, lower or higher recombination rate could cause certain kinds of meiotic aberrations, especially in polyploid species—raising the additional question whether temperature fluctuations in field conditions cause problems. Here, we tested whether (1) recombination rate varies across a season in the wild in two natural populations of autotetraploid Arabidopsis arenosa, (2) whether recombination rate correlates with temperature fluctuations in nature, and (3) whether natural temperature fluctuations might cause meiotic aberrations. We found that plants in two genetically distinct populations showed a similar plastic response with recombination rate increases correlated with both high and low temperatures. In addition, increased recombination rate correlated with increased multivalent formation, especially at lower temperature, hinting that polyploids in particular may suffer meiotic problems in conditions they encounter in nature. Our results show that studies of recombination rate plasticity done in laboratory settings inform our understanding of what happens in nature.
Potential determinants of the E/e′ ratio in non‐dialysis compared with dialysis patients
Authors: Hsu Hon‐Chun , Norton Gavin R. , Robinson Chanel , Woodiwiss Angela J. , Dessein Patrick H.
Published: July 2021

Aim

We hypothesized that arterial function and N‐terminal natriuretic peptide (NT‐proBNP) levels as a marker of volume overload, relate differently to E/e′ as an index of diastolic function in dialysis compared with non‐dialysis patients with chronic kidney disease. We further examined whether cardiovascular risk factors attenuated these relationships.

Methods

We assessed cardiovascular risk factors and determined arterial function indices by applanation tonometry using SphygmoCor software and E/e′ by echocardiography in 103 (62 non‐dialysis and 41 dialysis) patients.

Results

In established confounder adjusted analysis, dialysis status impacted the pulse wave velocity‐E/e′ relationship (interaction p = .01) but not the NT‐proBNP level‐E/e′ association (interaction p = .1). Upon entering arterial function measures and NT‐proBNP levels simultaneously in regression models, arterial function measures were associated with E/e′ (p = .008 to .04) in non‐dialysis patients whereas NT‐proBNP levels were related to E/e′ in dialysis patients (p = .009 to .04). Bivariate associations were found between diabetes (p < .0001) and E/e′ in non‐dialysis patients, and haemoglobin concentrations and E/e′ (p = .02) in those on dialysis. Upon adjustment for diabetes in non‐dialysis patients, only central pulse pressure remained associated with E/e′ (p = .02); when haemoglobin concentrations were adjusted for in dialysis patients, NT‐proBNP levels were no longer associated with E/e′ (p = .2). In separate models, haemoglobin levels were associated with E/e′ independent of left ventricular mass index and preload and afterload measures (p = .02 to .03).

Conclusion

The main determinants of E/e′ may differ in non‐dialysis compared with dialysis patients. These include arterial function and diabetes in non‐dialysis patients, and volume overload and anaemia in dialysis patients.
Effect of mesenchymal stem cells with platelet‐rich plasma carriers on bone formation after rapid maxillary expansion: An Animal Study
Authors: Ebadifar Asghar , Eslamian Ladan , Motamedian Saeed Reza , Badiee Mohammad Reza , Mohaghegh Sadra , Farahani Mohammadhossein , Mohebbi Rad Masoud , Mohammad‐Rahimi Hossein , Khojasteh Arash
Published: July 2021

Objective

To evaluate the effect of bone mesenchymal stem cells (BMSCs) with or without platelet‐rich plasma (PRP) carriers on sutural new bone formation after rapid palatal expansion (RPE).

Settings and sample population

Sixty male Wistar rats were used in this study.

Material and Methods

All samples were subjected to 50cN of palatal expansion force for 7 days followed by 3 weeks of the retention period. The experimental groups received a single‐dose injection of the specified solution at the time of retainer placement (BMSCs, PRP, BMSCs+PRP, normal saline). BMSCs used in this study were marked with the green fluorescent protein (GFP). New bone formation (NBF) in the sutural area was evaluated by µCT and occlusal radiography. In addition, semi‐quantitative analyses were performed on histology images to analyse the quality of sutural bone, connective tissue and vascularization. Immunohistochemistry analyses were conducted for osteocalcin and collagen type I proteins.

Results

After the 21‐day retention period, limited GFP marked cells were detected around the sutural area. Samples treated with BMSCs + PRP had the highest NBF and showed higher expression of collagen type I and osteocalcin.

Conclusion

Injecting BMSCs + PRP may increase sutural bone density significantly. However, injecting BMSCs or PRP carriers alone did not affect sutural bone density.
The effectiveness of topical forms of dexamethasone in the treatment of oral lichen planus— A systematic review
Authors: Łukaszewska‐Kuska Magdalena , Ślebioda Zuzanna , Dorocka‐Bobkowska Barbara
Published: July 2021

The goal of this systematic review was to assess the efficacy of dexamethasone compared to other treatments in oral lichen planus (OLP). The literature search used the following inclusion criteria: randomized controlled trials (RCT) comparing dexamethasone and other treatment strategies in patients with OLP. The outcome measures included relief of symptoms, decrement of erosive area size, and changes in quality of life. A computer and manual search was performed in Pubmed, Web of Science, and Cochrane Library up to January 31, 2021. The risk of bias was measured with the Revised Cochrane risk‐of‐bias tool for randomized trials. Eight trials with 131 study participants and 132 controls were identified. The following interventions were compared dexamethasone mouthwash, and 5% methylene blue‐mediated photodynamic therapy, low‐level laser therapy, amlexanox, clobetasol mouthwash, ketoconazole with amitriptyline, and thalidomide 1% paste. The therapeutic outcomes were more advantageous for dexamethasone in comparison with photodynamic therapy (PDT) (2 RCT) and low‐level laser therapy (LLLT). Comparable effects were observed for dexamethasone, amlexanox, thalidomide, and PDT (1 RCT). Clobetasol showed more effective action than dexamethasone. Given the small sample sizes, heterogeneity and the few studies included, there is limited evidence to support the selection of treatment for OLP.
Bacterial spectrum analysis and antimicrobial susceptibility study of osteoradionecrosis of the jaw in Southern China
Authors: Zhu Yue , Liang Jianfeng , Wang Fang , Li Jiaxin , Wang Cheng , Hou Jinsong
Published: July 2021

Objective

Osteoradionecrosis of the jaw (ORNJ) is one of the most common and serious complications after radiotherapy of head and neck malignancies due to the high incidence of nasopharyngeal cancer in Southern China. Clinicians lack understanding and consensus on anti‐infective treatment in ORNJ lesions. This research aims to provide evidence for rational use of antibiotics by reviewing the bacterial spectrums and antimicrobial susceptibility test of ORNJ patients.

Methods

We collected patient who was diagnosed with ORNJ from November 2012 to June 2019 in our hospital. Exudate or bone unexposed wound surface sampling, agar plates culturing, and susceptibility testing were analyzed. Descriptive statistics were used for data presentation.

Results

A total of 219 samples were collected in our retrospective study. The most common cultured bacteria were Klebsiella pneumoniae (15.10%), Pseudomonas aeruginosa (13.54%), and Staphylococcus aureus (10.94%). Methicillin‐resistant Staphylococcus aureus (MRSA) accounted for 5.21% in the whole positive samples. Ticarcillin, Ofloxacin, Vancomycin, Tigecycline, and Meropenem were more susceptible than other antibiotics to treat uncontrollable infection.

Conclusions

Our research provided objective evidence for understanding the types of local bacterial flora and drug susceptibility in ORNJ lesions and gave a guiding reference for empirical antibiotics medication.
Identification of melanoma‐specific exosomal miRNAs as the potential biomarker for canine oral melanoma
Authors: Husna Al Asmaul , Rahman Md Mahfuzur , Lai Yu‐Chang , Chen Hui‐Wen , Hasan Md Nazmul , Nakagawa Takayuki , Miura Naoki
Published: July 2021

Considering the importance of the canine cancer model of human disease, as well as the need for strategies for canine cancer management, the properties of exosomes are an emerging topic in canine oncology. In our study, exosomal RNA was isolated and investigated by next‐generation sequencing. We identified several differentially expressed microRNAs (miRNAs/miRs) in the exosomes of two melanoma cell lines compared with non‐tumor reference exosomes. We explored these potential melanoma‐specific exosomal miRNAs further and found that miR‐143 and let‐7b increased in primary, whereas miR‐210, 708, 221, and 222 increased in metastatic site originated melanoma cells. Further analysis showed miR‐143 and 221 significantly increased in plasma exosomes of metastatic melanoma patients. Moreover, the sensitivity and specificity are >85% for differentiating the non‐metastatic and metastatic patients. Therefore, these miRNAs can be an incredible biomarker candidate to identify metastatic melanoma and facilitate a better prognosis.
Influence of gender and sexual identity on adolescent skin health
Authors: Covelli Isabela , Ahrens Kym , Onchiri Frankline M. , Inwards‐Breland David , Boos Markus D.
Published: July 2021

Background/Objective

Studies have identified dermatologic conditions and relevant skin‐related behaviors that distinctly or disproportionately impact sexual and gender minority (SGM) adults compared with their cisgender/heterosexual counterparts, but whether these observations apply to SGM adolescents remains unknown. We aimed to describe the nature and frequency of skin conditions in SGM youth relative to their cisgender/heterosexual peers and explore adolescents’ attitudes toward their skin health and accessing dermatologic care.

Methods

SGM and cisgender/heterosexual youth aged 13‐21 years seen at Seattle Children's Hospital Adolescent Medicine and Gender clinics from June to December 2019 were invited to participate in this cross‐sectional survey study, with subsequent statistical analysis.

Results

One‐hundred and eighteen subjects were included in the study. Sexual orientation did not affect how participants personally felt about and cared for their skin, though gender identity did influence this relationship. (P = .012) Both sexual and gender minority youth demonstrated a preference for a dermatologist who identified as SGM and would be more likely to actively seek care from these providers. (P < .001) There was no difference in the reported prevalence of most dermatologic conditions among groups based on sexual orientation or gender identity.

Conclusion

Dermatologists should inquire with adolescent and young adult patients how their sexual orientation and gender identities influence how they view their skin, in an effort to guide counseling and demonstrate holistic support for adolescents. Therapeutic alliances with SGM youth may be strengthened by providers who openly identify as SGM.
Facial hypopigmentation in skin of color: An atypical presentation of lichen nitidus
Authors: Polcari Ingrid C. , Mancini Anthony J. , Stein Sarah L.
Published: July 2021

Lichen nitidus is a benign skin condition of unknown etiology that is classically described on the trunk, extremities, and genitalia as pinpoint flat‐topped papules. In dark‐skinned persons, the lesions may appear shiny or even hypopigmented. Lichen nitidus is less often described on the face. We describe a series of pediatric patients with skin of color who presented with the chief complaint of facial skin lightening and had associated clinical findings consistent with lichen nitidus.
Superimposed linear atopic dermatitis treated with dupilumab
Authors: Leszczynska Maria A. , Trainor Megan A. , Henkel Emily , Keeling Brett H. , Diaz Lucia Z.
Published: July 2021

Common polygenic skin disorders, such as atopic dermatitis, may rarely present in a segmental or linear distribution due to cutaneous mosaicism. Only seven cases of superimposed linear atopic dermatitis have been reported to date. Here, we present a child with severe superimposed linear atopic dermatitis and highlight the first successful use of dupilumab in its treatment.
Commentary: Language barriers in medicine and the role of the pediatric dermatologist
Authors: Maly Nancy Cheng
Published: July 2021

Languages other than English represent an ever‐growing component of the tapestry of the United States. Studies have shown that language barriers can impact access to care and quality of care, particularly in specialty clinics. Given the additional challenges faced by language interpretation in pediatric settings, the field of pediatric dermatology is uniquely positioned to contribute meaningfully to improving care for families with limited English proficiency.
Henoch‐Schönlein purpura: Another COVID‐19 complication
Authors: El Hasbani Georges , Taher Ali T. , Jawad Ali S. M. , Uthman Imad
Published: July 2021

Whether affecting children or adults, SARS‐CoV‐2 infection (COVID‐19) can have multi‐organ involvement mediated by an inflammatory cascade. Immunoglobulin A (IgA) is one of the key components of the inflammatory cascade that can lead to endothelial injury and inflammation. IgA vasculitis or Henoch‐Schönlein purpura (HSP) has been rarely reported in the context of COVID‐19. In this report, we highlight a case of HSP occurring 2 days after diagnosis of COVID‐19 in a 16‐year‐old boy, who presented with palpable purpura of the lower extremities and buttocks, diffuse abdominal pain, hemoptysis, and hematochezia. He was treated with oral prednisolone with rapid clinical improvement.
Generalized eczematous dermatitis and pruritus responsive to dupilumab in a patient with immune dysregulation, polyendocrinopathy, enteropathy, X‐linked (IPEX) syndrome
Authors: Maher Maeve C. , Hall Erin M. , Horii Kimberly A.
Published: July 2021

This case describes a patient with immune dysregulation, polyendocrinopathy, enteropathy, X‐linked (IPEX) syndrome with diffuse eczematous dermatitis and severe, intractable pruritus. Despite a bone marrow transplant and immunosuppressive therapy, his skin findings and pruritus persisted. Off‐label dupilumab provided significant improvement and almost complete clearance of the dermatitis and pruritus. This is the first known report of dupilumab being used in a patient with IPEX syndrome.
Metabolomic characteristics of hand‐foot‐mouth disease facilitate discovery and diagnosis of pathogeny
Authors: Zhu Hongwei , Xu Rui , Zang Huanhuan , Feng Jianghua , Shen Guiping , Liu Pei
Published: July 2021

Background

Hand‐foot‐mouth disease (HFMD) is a significant public health concern, especially in Asia‐Pacific countries. Its diagnosis mainly depends on clinical symptoms. It is easy to miss the source of infection and best treatment period. This research aims to provide a tool for its early clinical diagnosis and for predicting the possibility of complications.

Methods

The serum samples of 39 HFMD children and 36 healthy children were collected for clinical testing and 1H‐NMR spectroscopy. Metabolomic analyses were performed to obtain the metabolic differences between the HFMD and healthy children and to speculate on the pathogenesis of HFMD.

Results

Thirty‐nine children were divided into severe cases and mild cases. Severe cases demonstrated more obvious inflammatory responses, but no metabolic difference was observed between the severe and mild cases. The metabolic differences between HFMD and healthy children were noticeable. Ten differential metabolites were screened out as the potential biomarkers for HFMD, and seven disturbed metabolic pathways responsible for HFMD were affected by inflammation, impaired intestinal absorptive function, and immune response.

Conclusions

Our results will provide a complementary tool for the early diagnosis of HFMD and potential ideas for later treatment.
A clinical study of carbon dioxide lattice laser–assisted or microneedle‐assisted 5‐aminolevulinic acid–based photodynamic therapy for the treatment of hypertrophic acne scars
Authors: Yan Dongmei , Zhao Hongyi , Li Chenxi , Xia Aiting , Zhang Jiaojiao , Zhang Si , Yun Qing , Li Xiaoxin , Huang Feng , Tian Yan
Published: July 2021

Objective

To study the clinical efficacy, recurrence rate and safety of 5‐aminolevulinic acid–based photodynamic therapy (ALA‐PDT) combined with microneedle or CO2 lattice laser (CO2FL), in comparison with intrascar betamethasone injection in the treatment of hypertrophic acne scar.

Methods

Fifty‐two patients with hypertrophic acne scars at the mandibular angle were enrolled and assigned to different therapy groups. Sixteen patients were treated with microneedle‐assisted incorporation of ALA. Twenty‐eight patients underwent CO2FL‐assisted incorporation of ALA. Eight patients received standard therapy with intrascar injection of glucocorticoid. Two dermatologists, blinded to the therapy groups, independently evaluated the scars in all patients using the average value of the Vancouver Scar Scale score, which was treated as an integer variable.

Results

After three rounds of treatment, there was no significant difference in therapeutic effective rate among the microneedle, laser and topical glucocorticoid groups (93.75% vs 100% vs 100%, P = .855). One out of 16 patients (6.25%) in the microneedle group, no patient (0%) in the laser group and two out of eight patients (25%) in the topical glucocorticoid group had recurrence. The laser group showed a higher rate of adverse effects, which were usually mild and reversible, except for pigmentation. Adverse reactions could be completely subsided within 3 weeks.

Conclusions

Either CO2FL or microneedle combined ALA‐PDT for hypertrophic scar, as to topical glucocorticoid therapy, showed equivalent clinical effects but lower recurrence rate within 6 months of follow‐up period.
Chronic Disease Progression Prediction: Leveraging Case‐Based Reasoning and Big Data Analytics
Authors: Nenova Zlatana , Shang Jennifer
Published: July 2021

Physicians caring for chronically ill individuals need to predict patients' disease progression, as accurate disease projections can facilitate better treatment decisions. The power of prediction is prevention, as it is easier to prevent than to reverse. In this research, we propose a data‐driven model for accurate and fast disease trajectory prediction, using electronic health records (EHRs) from Veterans Affairs Hospitals. EHRs contain tremendous amount of frequently updated, highly dimensional and not equally spaced data in diverse formats (e.g., numeric, textual, images, and videos). We propose an intelligent case‐based reasoning (iCBR) approach to better predict kidney disease progression, which can help prevent patients' health deterioration and prolong lives. Our iCBR contributes to the literature by enhancing the automation and personalization capabilities of the conventional case‐based reasoning (CBR). Through the iCBR, we advance the utilization of patient's laboratory data, vital sign, clinic visit, and comorbidity information. We examine (1) if the number of cases chosen for predicting the new patient's disease progression should be tailored, and (2) what the best number of prediction cases should be if customization is warranted. We link the number of cases selected for disease prediction with patient's disease characteristics. By comparing the results of the iCBR and popular machine learning and statistics models adapted to our problem, we find that the iCBR outperforms other methods. While the proposed model is applied to patients with chronic kidney disease, it can be readily applied to other chronic diseases such as diabetes, due to its similar data structure.
Mitigating Product Quality Risk under External Financial Pressure: Inspection, Insurance, and Cash/Collateralized Loan
Authors: Chen Jing , Wei Hang , Xie Lei
Published: July 2021

We consider a single‐period manufacturing problem wherein a risk‐neutral manufacturer procures product components from an upstream supplier. Component quality is uncertain. Dysfunctional components result in defective products associated with an external failure cost. There is external financing pressure related to financial stress. The manufacturer can use the internal cash‐flow and a collateralized loan to manage product quality risk through incoming inspection, business insurance, and cash hoard. We find that there is no cash hoard if a collateralized loan is used, and the cash hoard's value increases as external financing pressure decreases. Interestingly, more initial internal cash‐flow does not always lead to more investments in inspection and insurance. We also find that business insurance may improve a manufacturer's inspection effort. Finally, we reveal that, as the initial internal cash‐flow increases, inspection and insurance first substitute and then complement each other.
Risk Transmission Across Supply Chains
Authors: Titman Sheridan
Published: July 2021

Firms along a supply chain are exposed to risks that emanate from shocks that affect the supply of the commodity at the beginning of the chain, as well as shocks to the demand for the products and services that are produced at the end of the supply chain. These risk exposures tend to depend on production technologies as well as supply and demand elasticities. A key takeaway is that firms that use commodity inputs cannot in general rely on either the historical covariance between input prices and profits or industry practice to determine their strategies for hedging commodity price exposures.
Canine‐specific tail‐in, head‐out sperm agglutination
Authors: Brown G.J. , Nöthling J.O. , De Cramer K.G.M.
Published: July 2021

An interesting pattern of tail‐in, head‐out sperm agglutination was identified in a Brucella canis seronegative subfertile dog. Centrifuged seminal plasma from this dog could induce a similar pattern of agglutination in six other dogs, but not in ejaculates from a single stallion and two rams. The agglutination pattern was short‐lived and appeared to depend on motility of spermatozoa, although intensity of agglutination may have been affected by concentration of agglutinating factor.