bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic review of Latin American national oral health surveys in adults
Authors: Duran Doris , Monsalves Maria Jose , Aubert Josefina , Zarate Victor , Espinoza Iris
Published: April 2018

Background

Oral diseases represent a main public health problem worldwide. There is scarce information about oral health indicators in adults in middle‐income countries in Latin America and Africa.

Objectives

To identify and describe national health surveys with national representative samples that included oral health assessment for adults in Latin America.

Methods

A systematic review was conducted in scientific and regional bibliographic databases (PubMed, SciELO, Wos and Embase); this was complemented with searchings in grey literature (Google Scholar, Open Grey and government health organization websites), from August 2016 to May 2017 (from 2000 to date). Studies conducted, supervised or funded by Ministries of Health or National Health Institutes were included. Data extracted included country, year, methods, interview and dental examination. Two researchers independently performed search and data extraction. Results were discussed as a group.

Results

Only 5 countries in Latin America have developed national health surveys evaluating the dental status in adults, with overall national representative samples during 2000‐2015: Brazil, Colombia, Panama, Chile and Uruguay. Main differences were observed in the type of dental indicators selected, measure of dental services access and the professional who performed the dental examination. While some dental surveys were specifically designed as oral health surveys (Brazil, Colombia, Panama and Uruguay) and the examination was performed by dentists, other surveys represent a module within a general health survey (Chile) and the examination was performed by nurses.

Conclusions

There are a small number of Latin American countries that report research about dental status with national representation samples. Most of these studies have been conducted as national oral health surveys, and fieldwork was carried out by dentists. The development of oral health research in this part of the world should be promoted as these surveys provide relevant information to monitor oral health and evaluate the effectiveness of health programmes.
Tree nut allergies: Allergen homology, cross‐reactivity, and implications for therapy
Authors: Smeekens J. M. , Bagley K. , Kulis M.
Published: April 2018

Tree nut allergy is a potentially life‐threatening disease that is increasing in prevalence, now affecting 1% of the general population in the United States. While other food allergies often resolve spontaneously, tree nut allergies are outgrown in less than 10% of cases. Due to the likelihood of cross‐sensitization to multiple tree nut allergens, the current treatment guideline is strict avoidance of all nuts once one tree nut allergy has been diagnosed. For example, walnut and pecan are highly cross‐reactive, along with cashew and pistachio, but the extent of clinical, IgE‐mediated cross‐reactivity among other tree nuts remains unclear, therefore making avoidance of all tree nuts a safe approach. There have been recent advances in immunotherapy for food allergies. For instance, there are investigational immunotherapies for milk, egg and peanut allergies, specifically oral immunotherapy, sublingual immunotherapy and epicutaneous immunotherapy. However, there are no large randomized controlled clinical trials for tree nut allergies. Even though there has been less research into tree nut allergy immunotherapies, the evidence of T‐cell cross‐reactivity among tree nuts exists in animal models and in T cells from allergic patients indicates that immunotherapeutic interventions may be possible. Here, we review the literature regarding epidemiology, allergen homology and cross‐reactivity among tree nuts, and explore how current findings can be employed for effective therapy.
Sensitization to various minor house dust mite allergens is greater in patients with atopic dermatitis than in those with respiratory allergic disease
Authors: Park K. H. , Lee J. , Lee J.‐Y. , Lee S. C. , Sim D. W. , Shin J. U. , Park C. O. , Lee J.‐H. , Lee K. H. , Jeong K. Y. , Park J.‐W.
Published: April 2018

Background

Various allergenic proteins are produced by house dust mites (HDM). However, the allergenicity and clinical implications of these allergens are unknown.

Objective

The purpose of this study was to identify allergens in Dermatophagoides farinae and elucidate the sensitization profiles to these in Korean patients suffering from respiratory (allergic rhinitis and/or asthma) and atopic dermatitis symptoms.

Methods

IgE reactivities in sera from 160 HDM allergy patients were analysed by one‐ and two‐dimensional gel electrophoresis and immunoblotting. IgE‐reactive components were identified by liquid chromatography‐coupled electrospray ionization‐tandem mass spectrometry. Nine recombinant mite allergens (Der f 1, Der f 2, Der f 10, Der f 11, Der f 13, Der f 14, Der f 30, Der f 32 and Der f Alt a 10) were produced, and the IgE reactivity in sera to each was determined by ELISAs.

Results

Der f 1 and Der f 2 were recognized by IgE in serum samples from 88.1% and 78.1% of all patients, respectively. Patients with respiratory allergies were mainly sensitized to these major allergens, whereas patients with atopic dermatitis symptoms showed polysensitization to major and minor allergen components (including Der f 11, Der f 13, Der f 14, Der f 32 and Der f Alt a 10).

Conclusions

Patients with respiratory allergic disease sensitize to major allergen components of HDM. Those with atopic dermatitis were sensitized to a broader range of minor allergen components of HDM (Der f 11, Der f 13, Der f 14, Der f 32 and Der f Alt a 10).
Effect of a punctal plug on ocular surface disease in patients using topical prostaglandin analogues: a randomized controlled trial
Authors: Sherwin Justin C , Ratnarajan Gokulan , Elahi Babar , Bilkiewicz‐Pawelec Anna , Salmon John F
Published: April 2018

Importance

Ocular surface disease (OSD) is common and can reduce treatment compliance and quality of life.

Background

To determine whether a punctal plug improves OSD and reduces intraocular pressure (IOP) in patients using prostaglandin analogue monotherapy.

Design

Randomized controlled trial.

Participants

Sixty eligible subjects aged >18 years with symptomatic OSD from glaucoma clinics were invited to participate. Lacrimal or glaucoma surgery, lid malposition and contact lens wear were exclusion criteria.

Methods

One eye received an inferior punctal plug, leaving the fellow eye as a control.

Main Outcome Measures

Ocular surface disease index (OSDI), tear film breakup time (TF‐BUT), Oxford cornea score, tear osmolarity and IOP were compared at baseline and 6 weeks by masked investigators.

Results

From 60 eligible, 48 (80.0%) participated (mean age 69.6 years; 60.0% female). OSDI reduced following plug insertion (mean difference [MD] 14.5, 95% confidence interval [CI] 5.06–23.94, P < 0.001). Compared to control eyes, in eyes receiving plugs the TF‐BUT increased (MD 2.3 s, 95% CI 1.4–3.2, P < 0.001), the Oxford cornea score decreased (MD 0.5, 95% CI 0.3–0.7, P < 0.001), and tear osmolarity decreased (MD 10 mOsm/L, 95% CI 3.5–16.5, P = 0.003). Punctal plugs resulted in a significantly lowered IOP (MD 1.5 mmHg, 95% CI 0.1–2.9, P = 0.032). Sub‐group analyses showed similar efficacy regardless of prostaglandin preservative status or lubricant drop use. Plugs were well tolerated but extrusion occurred in 8.5%, and epiphora increased in 6.5% eyes.

Conclusions and Relevance

Punctal plug insertion improves subjective and objective measures of OSD and results in a reduced IOP in patients with symptomatic ocular surface disease using prostaglandin analogue monotherapy.
Clinical, molecular genetics and therapeutic aspects of syndromic obesity
Authors: Geets E. , Meuwissen M.E.C. , Van Hul W.
Published: April 2018

Obesity has become a major health problem worldwide. To date, more than 25 different syndromic forms of obesity are known in which one (monogenic) or multiple (polygenic) genes are involved. This review gives an overview of these forms and focuses more in detail on 6 syndromes: Prader Willi Syndrome and Prader Willi like phenotype, Bardet Biedl Syndrome, Alström Syndrome, Wilms tumor, Aniridia, Genitourinary malformations and mental Retardation syndrome and 16p11.2 (micro)deletions. Years of research provided plenty of information on the molecular genetics of these disorders and the obesity phenotype leading to a more individualized treatment of the symptoms, however, many questions still remain unanswered. As these obesity syndromes have different signs and symptoms in common, it makes it difficult to accurately diagnose patients which may result in inappropriate treatment of the disease. Therefore, the big challenge for clinicians and scientists is to more clearly differentiate all syndromic forms of obesity to provide conclusive genetic explanations and eventually deliver accurate genetic counseling and treatment. In addition, further delineation of the (functions of the) underlying genes with the use of array‐ or next‐generation sequencing‐based technology will be helpful to unravel the mechanisms of energy metabolism in the general population.
Refining the phenotype associated with biallelic DNAJC21 mutations
Authors: D'Amours G. , Lopes F. , Gauthier J. , Saillour V. , Nassif C. , Wynn R. , Alos N. , Leblanc T. , Capri Y. , Nizard S. , Lemyre E. , Michaud J.L. , Pelletier V.‐A. , Pastore Y.D. , Soucy J.‐F.
Published: April 2018

Inherited bone marrow failure syndromes (IBMFS) are caused by mutations in genes involved in genomic stability. Although they may be recognized by the association of typical clinical features, variable penetrance and expressivity are common, and clinical diagnosis is often challenging. DNAJC21, which is involved in ribosome biogenesis, was recently linked to bone marrow failure. However, the specific phenotype and natural history remain to be defined. We correlate molecular data, phenotype, and clinical history of 5 unreported affected children and all individuals reported in the literature. All patients present features consistent with IBMFS: bone marrow failure, growth retardation, failure to thrive, developmental delay, recurrent infections, and skin, teeth or hair abnormalities. Additional features present in some individuals include retinal abnormalities, pancreatic insufficiency, liver cirrhosis, skeletal abnormalities, congenital hip dysplasia, joint hypermobility, and cryptorchidism. We suggest that DNAJC21‐related diseases constitute a distinct IBMFS, with features overlapping Shwachman‐Diamond syndrome and Dyskeratosis congenita, and additional characteristics that are specific to DNAJC21 mutations. The full phenotypic spectrum, natural history, and optimal management will require more reports. Considering the aplastic anemia, the possible increased risk for leukemia, and the multisystemic features, we provide a checklist for clinical evaluation at diagnosis and regular follow‐up.
Longitudinal left ventricular function is globally depressed within a week of STEMI
Authors: Pahlm Ulrika , Seemann Felicia , Engblom Henrik , Gyllenhammar Tom , Halvorsen Sigrun , Hansen Henrik Steen , Erlinge David , Atar Dan , Heiberg Einar , Arheden Håkan , Carlsson Marcus
Published: April 2018

Sixty percent of stroke volume (SV) is generated by atrioventricular plane displacement (AVPD) in a healthy left ventricle (LV). The aims were to determine the effect of ST‐elevation myocardial infarction (STEMI) on AVPD and contribution of AVPD to SV and to study the relationship between AVPD and infarct size (IS) and location. Patients from CHILL‐MI and MITOCARE studies with cardiovascular magnetic resonance within a week of STEMI (n = 177, 59 ± 11 years) and healthy controls (n = 20, 62 ± 11 years) were included. Left ventricular volumes were quantified in short‐axis images. AVPD was measured in six locations in long‐axis images. Longitudinal contribution to SV was calculated as AVPD multiplied by the short‐axis epicardial area. Patients (IS 17 ± 10% of LV) had decreased ejection fraction (48 ± 8%) compared to controls (60 ± 5%, P<0·001). Global AVPD was decreased in patients (11 ± 2 mm versus 15 ± 2 mm in controls, P<0·001) and this held true for both infarcted and remote segments. AVPD contribution to SV was lower in patients (58 ± 9%) than in controls (64 ± 8%) (P<0·001). There was a weak negative correlation between IS and AVPD (r2=0·06) but no differences in global AVPD linked to infarct location. Decrease in global and regional AVPD occur even in remote myocardium within 1 week of STEMI. Global AVPD decrease is independent of MI location, and MI size has only minor effect. Longitudinal pumping is slightly lower compared to controls but remains to be the main component to SV even after STEMI. These results highlight the difficulty in determining infarct location and size from longitudinal measures of LV function.
Interglacial refugia on tropical mountains: Novel insights from the summit rat (Rattus baluensis), a Borneo mountain endemic
Authors: Camacho‐Sanchez Miguel , Quintanilla Irene , Hawkins Melissa T. R. , Tuh Fred Y. Y. , Wells Konstans , Maldonado Jesus E. , Leonard Jennifer A.
Published: April 2018

Aim

The genetics of organisms currently isolated in refugia has received little attention compared to post‐glacial expansions. We study the population history and connectivity of a rat endemic to montane habitat in Borneo to better understand the history and potential of populations in interglacial mountain refugia.

Location

Sabah, Borneo, Malaysia.

Methods

We performed a field survey of the summit rat (Rattus baluensis) on two mountains, Mt. Kinabalu and Mt. Tambuyukon, its entire known distribution. We sequenced mitogenomes and 27 introns (19 of which were polymorphic) in 49 individuals from both populations. We analysed their current genetic structure and diversity, and inferred their demographic history with approximate Bayesian computation.

Results

Summit rats were tightly associated with mountain mossy forest and scrubland above 2,000 m, facilitating the prediction of their past and future distributions. The genetic analysis supports a Holocene fragmentation of a larger population into smaller ones that are now isolated in interglacial refugia on mountaintops. These findings are consistent with climatic reconstructions and the retreat of upland forest to higher elevations after the Last Glacial Maximum (LGM), ~21 kya.

Main conclusions

The two isolated populations of summit rats formed through the upland shift of their habitat after the LGM. The current trend of global warming will likely lead to diminishing suitable upland habitat and result in the extinction of the population on Mt. Tambuyukon. The population on Mt. Kinabalu, the higher peak, could persist at higher elevations, highlighting the singular value of high tropical mountains as reservoirs of biodiversity during past and ongoing climate change.
Operations in Space: Exploring a New Industry
Authors: Wooten Joel O. , Tang Christopher S.
Published: April 2018

This article sets the stage for examining operations management research opportunities in the emerging industry that involves operations in outer space. Currently, space exploration is moving in new and exciting directions, thanks to private investment and a more collaborative, commercial industry structure. While we do not yet know if space will be the next big industry, we make the case that the potential is certainly there. In this article, we outline the challenges presented within the “space industry” and highlight opportunities for operations management researchers in three categories—manufacturing operations, supply chain management, and sustainable operations. We also outline important questions related to stakeholder decisions and needs.
Roles of Xenopus chemokine ligand CXCLh (XCXCLh) in early embryogenesis
Authors: Goto Toshiyasu , Ito Yuzuru , Michiue Tatsuo
Published: April 2018

Several chemokine molecules control cell movements during early morphogenesis. However, it is unclear whether chemokine molecules affect cell fate. Here, we identified and characterized the CXC‐type chemokine ligand in Xenopus laevis, Xenopus CXCLh (XCXCLh), during early embryogenesis. XCXCLh is expressed in the dorsal vegetal region at the gastrula stage. Both overexpression and knockdown of XCXCLh in the dorsal region inhibited gastrulation. XCXCLh contributed to the attraction of mesendodermal cells and accelerated the reassembly of scratched culture cells. Also, XCXCLh contributed to early endodermal induction. Overexpression of VegTmRNA or high concentrations of calcium ions induced XCXCLh expression. XCXCLh may play roles in both cell movements and differentiation during early Xenopus embryogenesis.
Kinematic motion abnormalities and bimanual performance in children with unilateral cerebral palsy
Authors: Gaillard Florence , Cretual Armel , Cordillet Sebastien , Le Cornec Caroline , Gonthier Corentin , Bouvier Brice , Heyman Rachel , Marleix Sylvette , Bonan Isabelle , Rauscent Hélène
Published: April 2018

Aim

To evaluate the relationship between the movement abnormalities of the impaired upper limb in children with unilateral cerebral palsy (CP) and bimanual performance.

Method

Twenty‐three children with unilateral CP (mean age 11y 10mo [SD 2y 8mo]) underwent evaluation of bimanual performance (Assisting Hand Assessment [AHA]) and a three‐dimensional movement analysis to measure deviations in the movement of their affected upper limb, and compared with 23 typically developing children (TDC) (mean age 11y 11mo [SD 2y 5mo]). Kinematic indices, such as the Global Arm Profile Score (APS), which summarizes the global movement deviation of the upper limb from the norm, and the Global Arm Variable Score (AVS), which represent movement deviations for a given joint, were calculated and correlated to AHA.

Results

Values of kinematic indices were significantly higher in children with unilateral CP than in TDC. A strong correlation between Global‐APS and AHA score (r=−0.75) was found. Other significant correlations were found with Global‐AVS, especially in distal joints.

Interpretation

Children with unilateral CP had more movement deviations than TDC. The global movement deviation of the impaired upper limb was strongly correlated with bimanual performance. The influence of distal abnormalities confirms the importance of considering these limitations in therapeutics.

What this paper adds

Children with unilateral cerebral palsy had more movement deviations than typically developing children in unimanual tasks.

A strong relationship was found between movement deviations of the impaired upper limb and bimanual performance.
Medicine based evidence and personalized care of patients
Authors: Horwitz Ralph I. , Charlson Mary E. , Singer Burton H.
Published: April 2018

Background

For the past 70‐ years patient care has been dominated by Evidence Based Medicine (EBM) with its emphasis on Randomized Controlled Trials (RCTs) and clinical guidelines to standardize medical decision‐making.

Methods

Critical assessment of the literature and analyses of the arguments that favor patient care based primarily on individual variability in disease risk or treatment response versus emphasis on group standardization.

Results

Medicine Based Evidence (MBE) is used to guide decision making for an individual patient at hand by profiling the clinical features (biology) and life experience (biography) of the patient and then finding approximate matches to the patient in a clinical library of patients assembled from diverse sources (RCTs, cohorts, registries, electronic health records and more).

Conclusion

Medicine is transitioning from population based model of clinical care that relies on average results from RCTs to an individual‐based model of “personalized” medicine. For individualized care of the patient at hand, MBE is the preferred scientific strategy to generate evidence for patient care.
Development of 3D imaging technique of reconstructed human epidermis with immortalized human epidermal cell line
Authors: Inoue Yu , Hasegawa Seiji , Miyachi Katsuma , Yamada Takaaki , Nakata Satoru , Ipponjima Sari , Hibi Terumasa , Nemoto Tomomi , Tanaka Masahiko , Suzuki Ryo , Hirashima Naohide
Published: April 2018

The epidermis, the outermost layer of the skin, retains moisture and functions as a physical barrier against the external environment. Epidermal cells are continuously replaced by turnover, and thus to understand in detail the dynamic cellular events in the epidermis, techniques to observe live tissues in 3D are required. Here, we established a live 3D imaging technique for epidermis models. We first obtained immortalized human epidermal cell lines which have a normal differentiation capacity and fluorescence‐labelled cytoplasm or nuclei. The reconstituted 3D epidermis was prepared with these lines. Using this culture system, we were able to observe the structure of the reconstituted epidermis live in 3D, which was similar to an in vivo epidermis, and evaluate the effect of a skin irritant. This technique may be useful for dermatological science and drug development.
Urbanization drives contemporary evolution in stream fish
Authors: Kern Elizabeth M. A. , Langerhans R. Brian
Published: April 2018

Human activities reduce biodiversity but may also drive diversification by modifying selection. Urbanization alters stream hydrology by increasing peak water velocities, which should in turn alter selection on the body morphology of aquatic species. Here, we show how urbanization can generate evolutionary divergence in the body morphology of two species of stream fish, western blacknose dace (Rhinichthys obtusus) and creek chub (Semotilus atromaculatus). We predicted that fish should evolve more streamlined body shapes within urbanized streams. We found that in urban streams, dace consistently exhibited more streamlined bodies while chub consistently showed deeper bodies. Comparing modern creek chub populations with historical museum collections spanning 50 years, we found that creek chub (1) rapidly became deeper bodied in streams that experienced increasing urbanization over time, (2) had already achieved deepened bodies 50 years ago in streams that were then already urban (and showed no additional deepening over time), and (3) remained relatively shallow bodied in streams that stayed rural over time. By raising creek chub from five populations under common conditions in the laboratory, we found that morphological differences largely reflected genetically based differences, not velocity–induced phenotypic plasticity. We suggest that urbanization can drive rapid, adaptive evolutionary responses to disturbance, and that these responses may vary unpredictably in different species.
Pentameric last‐digit preference and stage border avoidance in pathology measurement
Authors: den Bakker Michael A , Damhuis Ronald A M
Published: April 2018

Aims

Cancer treatment relies on accurate staging, an essential aspect of which is determination of the size of a tumour. Measuring the size of a tumour in daily practice often proves problematic and results in rounding of values to approximate values. It has been shown that size values are most frequently reported with end digits of 0 or 5.

Methods and results

We sought to determine whether this observation holds true in our national cancer registry of breast and lung tumours. Data from patients with breast and lung cancer were retrieved from the Netherlands National Cancer Registry and analysed for tumour size. Whereas a preference for terminal digits of 0 or 5 (pentameric preference) was clearly present for lung cancer, critical pentameric values at stage boundaries were avoided in breast cancer.

Conclusions

In conclusion, pathologists adopt a practical approach to tumour size measurement by rounding values and avoiding stage border boundary values, thus circumventing potential difficulties in treatment decisions.
‘We Don't do Measure and Quotes’: How Agency Responses Criminalise and Endanger the Safety of Children Missing in Care in New South Wales, Australia
Authors: COLVIN EMMA , McFARLANE KATH , GERARD ALISON , McGRATH ANDREW
Published: April 2018

This article presents qualitative data from interviews with 46 welfare and justice professionals to examine the criminalisation of children who go missing within the Out‐Of‐Home‐Care (OOHC) residential environment. Participants had specific experience with children living in residential facilities, either through the direct provision of care services, the development of OOHC policy initiatives or through their role as law enforcement, legal or justice personnel. The research found that agency practices, which were designed to protect children, actually serve to conflate going missing with criminality, accelerating children's involvement in the justice system and ultimately endangering children's safety.
Onychoscopic evaluation of onychomycosis in a tertiary care teaching hospital: a cross‐sectional study from South India
Authors: Chetana Kayathi , Menon Roshni , David Brinda G.
Published: April 2018

Background

Onychoscopy is the dermoscopic evaluation of nail and associated structures. It is useful in identifying the various onychoscopic patterns which act as a link between naked eye examination and nail histopathology and may help in avoiding nail biopsy in unnecessary cases.

Objectives

To evaluate the onychoscopic patterns in confirmed cases of onychomycosis.

Methods

An observational, prospective, cross‐sectional study was performed in 500 patients with symptoms related to the nails and nail folds. Onychomycosis was confirmed in 234 patients by KOH mount/fungal culture/biopsy. These patients underwent dermoscopy with a handheld 20× polarized contact dermoscope (Heine's delta 20 T). The dermoscopic patterns were identified, and their correlation with the clinical subtype of onychomycosis was analyzed.

Results

The study included 234 confirmed cases of onychomycosis. The common dermoscopic patterns observed were spikes (43.16%), jagged (29.9%), longitudinal striae (49.1%), linear edge (3.4%), and distal irregular termination (34.6%). The statistically significant findings of distal and lateral subungual onychomycosis (DLSO) were longitudinal striae, spikes, and jagged patterns. The new patterns observed in our study are bluish streaks and globules (8.9%) and bluish gray globules (7.6%) in cases of DLSO which were not statistically significant.

Conclusion

Onychoscopy, being handy, inexpensive, and noninvasive, has the potential to reduce the invasive procedures. Statistically significant patterns in DLSO and total dystrophic onychomycosis (TDO) are described in our study. Few new patterns have been described whose significance has to be tested by conducting larger sample size studies.
Clinical and dermoscopic spectrum of discoid lupus erythematosus: novel observations from lips and oral mucosa
Authors: Salah Eman
Published: April 2018

Background

Under dermoscopy, discoid lupus erythematosus (DLE) exhibits specific findings. Commonly DLE lesions affect sun‐exposed sites, especially the face. However, most of the dermoscopic reports come from scalp DLE. To our knowledge, the dermoscopic pattern for mucosal and labial DLE has not been previously reported.

Methods

This study included 20 patients with histopathologically confirmed DLE lesions. Full history taking was obtained with photo documentation of lesions including the sites involved, the number of lesions per site, and the total number of lesions affecting every patient. Finally, a dermoscopic examination was performed.

Results

Almost 85% of patients had only cutaneous DLE lesions, while 15% showed both cutaneous and mucosal lesions. Follicular keratotic plugging (56.1%) and scales (52.6%) were the most frequently detected dermoscopic criteria. A significant correlation was found between lesion's age and the following dermoscopic criteria: (early lesions: follicular keratotic plugs and perifollicular white halos; while late lesions: telangiectasia and white structureless areas). Furthermore, telangiectasia, white structureless areas, and ulceration were found in dermoscopy of mucosal DLE. Also, telangiectasia, brown pigment spots, scales, white structureless areas, bleeding spots, and erosions were detected in dermoscopy of labial DLE. Moreover, labial storiform telangiectasia was seen under dermoscopy in patients with associated SLE.

Conclusions

Dermoscopy is a valuable tool for diagnosing DLE at different sites and in differentiating between the early and end‐stage lesions. Herein, we reported the first dermoscopic view for DLE affecting the lips and oral mucosa. Labial storiform telangiectasia could be a dermoscopic sign of coexisting SLE.
Understanding the structural characteristics, pasting and rheological behaviours of pregelatinised cassava starch
Authors: Wang Xintian , Wang Hongwei , Song Jianing , Zhang Yangyang , Zhang Hua
Published: April 2018

The structural characteristics, pasting and rheological behaviours of cassava starch before and after pregelatinisation were determined by various modern analysis techniques. Pregelatinisation, especially in an ultrasonic environment, can disrupt the granule structure, crystalline structure and short‐range ordered molecular structure of cassava starch. Compared with native starch, pregelatinisation had significantly decreased viscosities and weakened gel structures of starch pastes. Not only did native and pregelatinised starch pastes exhibit shear‐thinning behaviours but also the pregelatinised treatment resulted in the formation of weak gel structures. This study enabled us to acquire the desired pasting and rheological properties of pregelatinised starch by modulating its hierarchical structural changes.
The importance of pulse pressure on cardiovascular risk and total mortality in the general population: Is sex relevant?
Authors: Tadic Marijana , Quarti‐Trevano Fosca , Bombelli Michele , Facchetti Rita , Cuspidi Cesare , Mancia Giuseppe , Grassi Guido
Published: April 2018

The aim of the present study is to investigate the predictive value of pulse pressure (PP) on cardiovascular events in the general population and in both sexes, separately. The study involved 2045 participants from the PAMELA study who underwent 24‐hour ambulatory blood pressure (BP) monitoring. The participants were followed from the initial medical visit for a time interval of 137 ± 23 months. It was found that office, home, and 24‐hour blood pressures were significantly higher in the individuals who experienced cardiovascular (CV) events. Office, 24‐hour, and daytime PP were independent predictors of CV events after adjustment for main demographic and clinical parameters in the whole study population. Nighttime PP was an additional independent predictor in men. In conclusion, PP represents an important predictor of cardiovascular events in the general population, particularly among men. Daytime and 24‐hour PP have greater predictive importance than nighttime PP in the general population.
Does perinatal exposure to exogenous oxytocin influence child behavioural problems and autistic‐like behaviours to 20 years of age?
Authors: Guastella Adam J. , Cooper Matt N. , White Christopher R.H. , White Melanie K. , Pennell Craig E. , Whitehouse Andrew J.O.
Published: April 2018

Background

The neuropeptide and hormone oxytocin is known to have a significant impact on social cognition and behaviour in humans. There is growing concern regarding the influence of exogenous oxytocin (OT) administration in early life on later social and emotional development, including autism spectrum disorder (ASD). No study has examined offspring development in relation to the dose of exogenous oxytocin administered during labour.

Methods

Between 1989 and 1992, 2,900 mothers were recruited prior to the 18th week of pregnancy, delivering 2,868 live offspring. The Child Behaviour Checklist was used to measure offspring behavioural difficulties at ages 5, 8, 10, 14 and 17 years. Autism spectrum disorder was formally diagnosed by consensus of a team of specialists. At 20 years, offspring completed a measure of autistic‐like traits, the Autism Spectrum Quotient (AQ). Oxytocin exposure prior to birth was analysed using categorical and continuous approaches (maternal oxytocin dose) with univariate and multivariate statistical techniques.

Results

Categorical analyses of oxytocin exposure prior to birth demonstrated no group differences in any measures of child behaviour. A small in magnitude dose–response association was observed for clinically significant total behaviour symptoms (adjusted odds ratio 1.03; 95% CI: 1.01–1.06, p < .01). Exogenous oxytocin administration prior to birth was not associated with ASD (OR: 0.64; 95% CI: 0.15–2.12, p = .46) or high levels of autistic‐like traits (p = .93), as assessed by the AQ.

Conclusions

This study is the first to investigate longitudinal mental health outcomes associated with the use of oxytocin‐based medications during labour. The results do not provide evidence to support the theory that exogenous OT has a clinically significant negative impact on the long‐term mental health of children.
An empirical test for a zone of canalization in thermal reaction norms
Authors: Fossen Erlend I. F. , Pélabon Christophe , Einum Sigurd
Published: April 2018

Theoretical models on the evolution of phenotypic plasticity predict a zone of canalization where reaction norms cross, and genetic variation is minimized in the environment a population most frequently encounter. Empirical tests of this prediction are largely missing, in particular for life‐history traits. We addressed this prediction by quantifying thermal reaction norms of three life‐history traits (somatic growth rate, age and size at maturation) of a Norwegian population of Daphnia magna and testing for the occurrence of an intermediate temperature (Tm) at which genetic variance in the traits is minimized. Size at maturation changed relatively little with temperature compared to the other traits, and there was no genetic variance in the shape of the reaction norm. Consequently, age at maturation and somatic growth rate were strongly negatively correlated. Both traits showed a strong genotype–environment interaction, and the estimated Tm was 14 °C for both age at maturation and growth rate. This value of Tm corresponds well with mean summer temperatures experienced by the population and suggests that the population has evolved under stabilizing selection in temperatures that fluctuate around this mean temperature. These results suggest local adaptation to temperature in the studied population and allow predicting evolutionary trajectories of thermal reaction norms under changing thermal regimes.
Collagen IV and laminin‐1 expression in embryonic mouse lens using principal components analysis technique
Authors: SIJILMASSI O. , LÓPEZ ALONSO J.M. , BARRIO ASENSIO M.C. , DEL RÍO SEVILLA A.
Published: April 2018

Immunohistochemistry section staining is not always easy to interpret. Manual quantification of immunohistochemical staining is limited by the observer visual ability to detect changes in level staining. Hence, the quantification of immunostaining by means of digital image analysis allows us to measure accurately protein expression percentages in immunobiological stained tissues and ensures to overcome the visual limitations. We perform an experimental study to analyse the impact of folic acid (FA) deficiency into collagen IV and laminin‐1 expression in the embryonic mouse lens. The study starts with microscope images of embryos mouse lens whose mothers fed a diet deficient in FA during 2 and 8 weeks. A principal component analysis (PCA) image processing is used to analyse these images coming from control and FA deficit groups. The method permits to define an index of over‐ or infraexpression of collagen IV and laminin‐1 associated to different spatial organisation structures (PC processes). Additionally, it permits to determine in precise percentage the exact quantity of the overexpression or infraexpression and finally to comprehend molecular regionalisation and expression in both control and deficient groups. The results suggest that even with 2 weeks of deficit of FA the expression and distribution of both molecules is affected.
Characteristics and service needs of women and babies admitted to residential parenting units in New South Wales: A mixed‐methods study
Authors: Priddis Holly , Thornton Charlene , Fowler Cathrine , Schmied Virginia , Tooher Jane , Dickinson Marie , Dahlen Hannah G
Published: April 2018

Aims and objectives

To examine the characteristics and service needs of women and babies admitted to residential parenting services (RPS) in the first year following birth in New South Wales, Australia.

Background

In Australia, there is a tiered system to support maternal, child and family health, which includes RPS.

Design

Sequential explanatory mixed‐methods design.

Methods

Individual patient data were obtained from a random review of 10% of all medical records (n = 300 of 3,011 admissions) of women with an infant of <12 months of age who were admitted to RPS in 2013. Following review of the medical records, qualitative data were collected via interviews with eight women who accessed RPS. Chi‐square analysis and Student's t test were used to analyse quantitative data. Qualitative data were analysed using a descriptive interpretive approach. An integrative approach was taken in reporting the findings.

Results

Women admitted to the RPS were on average 32 years of age, were Australian born (72%) and had a university qualification (40%), and most were employed. The majority of women were primiparous (60%) and had a vaginal birth (61%). Women with male infants were much more likely to be admitted to the RPS (58%) compared to the NSW male‐to‐female ratio (51.3% vs. 48.7%). Over 50% of women reported mental health issues with 27% having an Edinburgh Postnatal Depression Scale score ≥13 on admission. The primary reason women sought parenting support was for sleep and settling (83%). During their stay, services used by women included social workers (44%), psychologists (52%) and psychiatrists (4.5%).

Conclusion

Women who access RPS report psychosocial and mental health issues. Services provided by RPS support women during this challenging early parenting period by providing multidisciplinary, holistic and peer support.

Relevance to clinical practice

A high prevalence of mental health issues identified in this study indicated a need for ongoing training and support for RPS staff. Ensuring clinicians have the appropriate skill sets to best support their clientele will maximise the outcomes for women and families who access RPS during the early parenting period.
Children's and young people's experiences of a parent's critical illness and admission to the intensive care unit: A qualitative meta‐synthesis
Authors: MacEachnie Lise H , Larsen Hanne B , Egerod Ingrid
Published: April 2018

Background

Little is known about how children and young people experience and manage the critical illness of a parent and a parent's admission to the intensive care unit (ICU).

Objective

The aim of this study was to search and interpret the existing literature describing children's and young people's experiences of a parent's illness trajectory in the ICU.

Method

A qualitative meta‐synthesis was conducted based on a systematic literature search of online databases.

Findings

Four main themes were identified and synthesised to describe the integrated experiences of children and young people: (a) the parent–child bond, (b) the unfamiliar environment, (c) the impact of the illness and (d) the experience of being overseen as close family members.

Conclusion

Experiencing a parent's critical illness and admittance to the ICU is overwhelming. The bond between the parent and child is exposed by the separation from the ill parent. To comprehend and manage the experience, children and young people seek information depending on their individual capacities. They express a need to be close to their ill parent and to be seen and approached as close members of the family. However, children experience being overseen in their needs for support during their parent's ICU illness with the risk of being left in loneliness, sadness and lack of understanding of the parent's illness.

Relevance for clinical practice

Children and young people as relatives need to be acknowledged as close members of the family, when facing the illness trajectory of a parent, who is admitted to the ICU. They need to be seen as close family members and to be approached in their needs for support in order to promote their well‐being during a family illness crisis. Early supportive interventions tailored to include children of the intensive care patient are recommended.
Family functioning in the context of an adult family member with illness: A concept analysis
Authors: Zhang Yingzi
Published: April 2018

Aim

To describe and explain how the concept of family functioning has been used in the targeted sample of health literature on adult family members with illness.

Background

Understanding the influence of illness on family functioning is central to the provision of patient‐ and family‐centred care. There is lack of consistency in utilising family functioning which creates confusion about the concept and can interfere with theory development in nursing science. A clear conceptual definition of attributes of family functioning based on concept analysis could act as a guide in the development of instruments to assess family functioning, the design of family‐based interventions and their application in clinical practice.

Design

Concept analysis.

Data sources

Academic Search Premier, ProQuest Research Library, Family & Society Studies Worldwide, PsycINFO, SocINDEX, PubMed and CINAHL databases were searched within the last 20 years (1997–Dec. 2016) using the terms “family function*” and “patient.” Studies of paediatric patients and non‐English articles were excluded.

Method

Rodgers’ evolutionary perspective.

Results

The findings suggest that family functioning in the context of illness is defined as family members' ability to maintain cohesive relationships with one another, fulfil family roles, cope with family problems, adjust to new family routines and procedures and effectively communicate with each other.

Conclusion

Further research is needed to inform nurses’ practice when assessing families or providing patient‐ and family‐centred interventions to support family functioning across different sociocultural and political contexts, and further identification and evaluation of antecedents and consequences regarding family functioning from a nursing perspective.

Relevance to clinical practice

Having a comprehensive understanding of the attributes, antecedents and consequences of ineffective family functioning can facilitate healthcare providers’ ability to identify strengths and potential targets to improve family functioning among their clients.
Correlation between the median particle size of chewed frankfurter sausage and almonds during masticatory performance test
Authors: Sumonsiri P. , Thongudomporn U. , Paphangkorakit J.
Published: April 2018

The correlation between chewing and gastric function is best reflected when the same food type is used during both tests. We proposed frankfurter sausage as test food for masticatory performance as it can also be used in gastric emptying test. The suitability of frankfurter sausage to determine masticatory performance, however, has never been examined. To examine the correlations between the median particle size of frankfurter sausage and almonds (as standard test food) after different numbers of chewing cycles. Twenty‐seven subjects performed masticatory performance tests by chewing 2 types of test foods, that is, a piece of almond or 5‐g frankfurter sausage cubes placed in a sealed latex bag, for 5 and 15 chewing cycles. For each individual, right and left sides were tested separately. Chewed samples obtained from both sides were pooled. Median particle sizes were determined using a multiple sieving method. Spearman’s rank correlation was used to examine any correlation between median particle sizes of the 2 test foods after 5 and 15 cycles. Median particle sizes after 5 and 15 cycles were 2.04 ± 0.87 and 0.95 ± 0.58 mm for almonds and 4.16 ± 0.19 and 3.73 ± 0.25 mm for frankfurter sausage, respectively. Significant correlations were observed between the median particle size of chewed frankfurter sausage after 15 cycles and that of chewed almonds after 5 and 15 cycles (r = .76, P < .01 and r = .52, P = .01, respectively). Frankfurter sausage chewed for 15 cycles may be suitable for the determination of masticatory performance in conjunction with gastric emptying test.
New perspectives on the complexity of genetic predisposition to autoimmune liver disease in indigenous Canadians
Authors: Mason Andrew L. , Siminovitch Katherine A.
Published: April 2018

See Article on Page 940
“Accept and Utilize”: Alternative Medicine, Minimality, and Ethics in an Indonesian Healing Collective
Authors: Long Nicholas J.
Published: April 2018

Cosmopolitan forms of alternative medicine have become very popular in contemporary Indonesia. Many healers have trained in an eclectic range of techniques, predicated on ontological claims so diverse that they call each other's legitimacy into question. This article explores how a collective of alternative healers in central Java navigated the quandaries presented by such therapeutic eclecticism over a six‐year period. Healers’ engagement with, or indifference toward, the principles underpinning therapeutic efficacy fluctuated in ways that allowed them to surmount the dilemmas of Islamization, the changing demographic of their collective's membership, and the threat of commercialization, thereby maintaining a medical landscape in which alternative healing was widely available and accessible. Transformations in their understanding, experience, and practice of healing should thus be understood in terms of how enduring ethical commitments are refracted through ongoing engagements with a changing social world.
Incongruence in molecular species delimitation schemes: What to do when adding more data is difficult
Authors: Jacobs Sarah J. , Kristofferson Casey , Uribe‐Convers Simon , Latvis Maribeth , Tank David C.
Published: April 2018

Using multiple, independent approaches to molecular species delimitation is advocated to accommodate limitations and assumptions of a single approach. Incongruence in delimitation schemes is a potential by‐product of employing multiple methods on the same data, and little attention has been paid to its reconciliation. Instead, a particular scheme is prioritized, and/or molecular delimitations are coupled with additional, independent lines of evidence that mitigate incongruence. We advocate that incongruence within a line of evidence should be accounted for before comparing across lines of evidence that can themselves be incongruent. Additionally, it is not uncommon for empiricists working in nonmodel systems to be data‐limited, generating some concern for the adequacy of available data to address the question of interest. With conservation and management decisions often hinging on the status of species, it seems prudent to understand the capabilities of approaches we use given the data we have. Here, we apply two molecular species delimitation approaches, spedeSTEM and BPP, to the Castilleja ambigua (Orobanchaceae) species complex, a relatively young plant lineage in western North America. Upon finding incongruence in our delimitation, we employed a post hoc simulation study to examine the power of these approaches to delimit species. Given the data we collected, we find that spedeSTEM lacks the power to delimit while BPP is capable, thus allowing us to address incongruence before proceeding in delimitation. We suggest post hoc simulation studies like this compliment empirical delimitation and serve as a means of exploring conflict within a line of evidence and dealing with it appropriately.