bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of dupilumab on hand eczema in patients with atopic dermatitis: An observational study
Authors: Oosterhaven Jart A.F. , Voorberg Angelique N. , Romeijn Geertruida L.E. , de Bruin‐Weller Marjolein S. , Schuttelaar Marie L.A.
Published: June 2019

Systemic treatment options for chronic hand eczema are limited. Dupilumab is used in atopic dermatitis (AD) but is not licensed for (isolated) hand eczema. In this observational prospective study we aimed to determine the response of hand eczema to dupilumab in patients with AD. Adult patients with hand eczema and AD received dupilumab s.c. at a 600 mg loading dose, followed by 300 mg every 2 weeks. Primary outcome was a minimum improvement of 75% on the Hand Eczema Severity Index after 16 weeks (HECSI‐75). Secondary outcomes were severity, measured using the Photographic guide; quality of life improvement as patient‐reported outcome, measured using the Dermatology Life Quality Index (DLQI); and AD severity, measured using the Eczema Area and Severity Index (EASI). Forty‐seven patients were included (32 males; mean age, 45 years). HECSI‐75 was achieved by 28 (60%). Mean HECSI score reduction was 49.2 points (range, 0–164; 95% within‐subject confidence interval, 46.4–52.0), which was already significantly decreased after 4 weeks (P < 0.001). DLQI score mean improvement was 8.8 points (standard deviation [SD], 6.0) or 70.0% decrease (SD, 26.4) (P < 0.001). Eighteen patients (38%) were classified as responders on the Photographic guide. There was no difference in response between chronic fissured and recurrent vesicular clinical subtypes. Similar percentages of patients achieving EASI‐75 and HECSI‐75 were seen after 16 weeks. In conclusion, this study shows a favorable response of hand eczema to dupilumab in patients with AD. This raises the question whether a response will also be seen in isolated hand eczema.
Time evolution of methotrexate‐induced kidney injury: A comparative study between different biomarkers of renal damage in rats
Authors: Severin María Julia , Campagno Romina Valeria , Brandoni Anabel , Torres Adriana Mónica
Published: June 2019

Methotrexate (MTX) is commonly used in the treatment of malignant diseases and autoimmune and chronic inflammatory disorders. Along with its effective therapeutic power, MTX has adverse effects on the kidneys. Discovery of new biomarkers is required to improve the early detection of renal damage and optimize the effectiveness of treatments. The aim of this study was to evaluate the time course of MTX‐induced nephrotoxicity and to compare the urinary excretion of the organic anion transporter 5 (uOat5) with alterations in other markers of renal function, and to elucidate the possible molecular mechanisms involved in uOat5. Animals were exposed to a unique dose of MTX (80 mg/kg body weight, intraperitoneal). Experiments were carried out at days 2, 4, 8 or 14 after MTX administration. Markers of renal damage, such as creatinine and urea plasma levels, urinary activity of alkaline phosphatase, microalbuminuria, urinary excretion of neutrophil gelatinase‐associated lipocalin (uNGAL) and histopathology, were evaluated. Renal organic anion transporter 5 (Oat5) expression and its presence in different urine fraction were assessed by western blotting. uOat5 was significantly increased 2 days after MTX treatment, before than any alteration in other parameters of kidney injury or renal morphology occurred. uNGAL showed an inverted pattern of urinary excretion compared to uOat5. Exosomal pathway is involved in the urinary excretion of Oat5 and depends on the degree of damage induced by MTX. These experimental data allow proposing uOat5 as a potential non‐invasive biomarker for early detection of MTX‐induced nephrotoxicity.
Maternal and infant pregnancy outcomes in women with psoriatic arthritis: a Swedish nationwide cohort study
Authors: Remaeus K , Stephansson O , Johansson K , Granath F , Hellgren K
Published: June 2019

Objective

Studies on pregnancy outcomes in psoriatic arthritis (PsA) are scarce and typically of small size. Available studies have reported conflicting results. The aim of this study was to describe maternal and infant pregnancy outcomes among women with PsA compared with women without PsA.

Design

Nationwide cohort study.

Setting

Nationwide Swedish registers.

Population

A total of 41 485 singleton pregnancies in 1997–2014, of which 541 pregnancies were identified with PsA exposure and 40 944 pregnancies were unexposed.

Methods

By linkage of national health and population register data, we obtained information on individual pregnancies and compared outcomes among pregnancies with PsA and non‐PsA pregnancies. Relative risks were estimated by odds ratios (ORs) with 95% CIs using a generalised linear regression model with generalised estimating equations. Adjustments were made for maternal factors and calendar year of birth.

Main outcome measures

Maternal and infant pregnancy outcomes.

Results

Pregnancies to women with PsA had increased risks of preterm birth (adjusted OR 1.63; 95% CI 1.17–2.28), elective and emergency caesarean deliveries (adjusted OR 1.47; 95% CI 1.10–1.97 and adjusted OR 1.43; 95% CI 1.08–1.88, respectively) compared with non‐PsA pregnancies. No increased risks were observed for pre‐eclampsia, stillbirth or other infant outcomes apart from preterm birth.

Conclusion

The majority of women with PsA have uneventful pregnancies with respect to adverse outcomes. In the present study, we found increased risks of preterm birth and caesarean delivery compared with non‐PsA pregnancies.

Tweetable abstract

Women with psoriatic arthritis have uneventful pregnancies but are at increased risk of preterm birth and caesarean delivery.
Eliminated patient fee and changes in dispensing patterns of asthma medication in children—An interrupted time series analysis
Authors: Dahlén Elin , Komen Joris , Jonsson Eva W. , Almqvist Catarina , Kull Inger , Wettermark Björn
Published: June 2019

In 2016, all prescription drugs included in the reimbursement system in Sweden were made available for children (age 0‐17 years) without any patient fees. Our aim was to estimate the association between this intervention and the dispensing patterns of asthma medications among children. Dispensing data on asthma medications for all children living in Stockholm County during 2014‐2017 were selected to include two years before (January 2014‐December 2015) and after (January 2016‐December 2017) the intervention. In an uncontrolled before and after study, the measures of utilization were as follows: the proportion of children with at least one dispensed asthma medication (prevalence); the number of children initiated on treatment after an 18‐month drug‐free period (incidence); the number of defined daily doses (DDDs) dispensed per child; and the number of children with at least two prescriptions with controller medication (inhaled corticosteroid or leukotriene receptor antagonist) dispensed during 18 months (persistence). In an interrupted time series (ITS) analysis, all measures were included except for persistence. Socio‐economic status was defined using Mosaic data. The prevalence increased after the intervention (from 11.9% to 13.0%). However, the ITS analysis showed a positive trend already before the intervention, and consequently, the increase was not attributable to the intervention. For incidence, similar patterns were observed. There was an increase in dispensed volumes related to the intervention, 46.3 DDDs/child/month before and 51.1 after the intervention (P‐value 0.01). The proportion of children with persistent asthma medication increased from 46.0% to 51.9% in children with low socio‐economic status. In conclusion, the intervention was only modestly associated with changes in the dispensing patterns of asthma medication, with the volume dispensed per child increasing slightly, particularly in children with low socio‐economic status.
Government and civil society organizations: Close but comfortable? Lessons from creating the Dutch “Strategic Partnerships for Lobby and Advocacy”
Authors: Van Wessel Margit , Hilhorst Dorothea , Schulpen Lau , Biekart Kees
Published: June 2019

Motivation

Governments commonly support the advocacy role of civil society organizations (CSOs) in development, but studies argue that close linkages between government and CSOs are problematic. The Netherlands’ Dialogue and Dissent policy programme brings together the Netherlands Ministry of Foreign Affairs (NMFA) and 25 (alliances of) CSOs as advocacy partners. The programme is set up from an awareness of the challenging nature of such collaboration.

Purpose

We contribute to understanding the ways in which issues with donor–CSO collaboration can be engaged in donor policies.

This article addresses two questions: To what extent and how does this programme confront and overcome the challenges of close collaboration between government and CSOs? What practical lessons can be learned?

Approach

We conducted 33 (group) interviews with CSOs and policy officers involved with the Dialogue and Dissent programme, exploring their understandings, expectations and strategies as partners in the programme. We also analysed CSO programmes, policy documents and publicly available information.

Findings

In Dialogue and Dissent, space for dissent, flexibility and relative equality between government and CSOs positively address mutuality and institutional pressures. Challenges remain as estimated strategic significance, diverging capacities and risks to autonomy work against mutuality. Certain challenges are engaged with, but we identified no strategies countering pressures that stem from managerialism within the NMFA, external political pressures and conflicting government objectives. While the programme counters tendencies towards institutionalization of CSOs as insiders, some important challenges to public engagement identified in the literature remain insufficiently addressed.

Conclusions

Conditions built into policy can address challenges identified in the literature. However, challenges remain that are rooted in wider organizational and political realities. Lessons for practice are: (1) the advocacy role of CSOs can be advanced by building in certain formal conditions and advancing these informally; (2) flexibility allows for collaboration to develop as government and CSOs negotiate their roles, cognizant of pressures that get in the way; (3) challenges rooted beyond the support policy and government agency involved in the collaboration will constrict the power of policy design; (4) public engagement as a foundation for CSOs’ advocacy roles deserves much more attention.
Enhancing Microbial Sulfate Reduction of Hydrocarbons in Groundwater Using Permeable Filled Borings
Authors: Buscheck Timothy , Mackay Douglas , Paradis Charles , Schmidt Radomir , de Sieyes Nicholas
Published: June 2019

At a service station closed in 1993, groundwater contained benzene that persisted above the cleanup goal of 1 mg/L in zones depleted of background sulfate. The benzene and other petroleum hydrocarbons (PHCs) were present as much as 36 feet (11 m) below the water table and therefore remediation of a thick saturated zone interval was required. Microcosms using site sediments demonstrated that anaerobic benzene biodegradation occurred only if sulfate was added, suggesting sulfate addition as a remediation approach. Twenty‐four boreholes (9.1″ diameter and 56′ deep) were drilled around four monitoring wells, in which benzene concentrations exceeded 1 mg/L. The boreholes were backfilled with a mixture of gravel and 15,000 pounds of gypsum (which releases sulfate as it dissolves) to create “Permeable Filled Borings” (PFBs). Concurrently, nine high pressure injections (HPIs) of gypsum slurry were conducted in other site locations (312 pounds of gypsum total). PFBs were expected to release sulfate for up to 20 years, whereas HPIs were expected to produce a short‐lived plume of sulfate. Concentrations of benzene and sulfate in groundwater were monitored over a 3‐year period in six monitoring wells. In two wells near PFBs, benzene concentrations dropped below the cleanup goal by two to three orders of magnitude; in one well, sulfate concentrations exceeded 500 mg/L for the most recent 18 months. Benzene concentrations in two other PFB monitoring wells declined by a factor of 2 to 4, but remained above 1 mg/L, presumably due to high‐dissolved PHC concentrations and possibly greater residual PHC mass in adjacent sediments, and therefore greater sulfate demand. However, hydrogen and sulfur isotopic enrichment in benzene and sulfate, respectively, confirmed biodegradation of benzene and stimulation of sulfate‐reducing conditions. Thus, it is hypothesized that the PHC mass in adjacent sediments will decline over time, as will dissolved PHC concentrations, and eventually benzene concentrations will decrease below the cleanup goal. Benzene in two HPI monitoring wells was below the cleanup goal for all but one sampling event before HPIs were conducted and remained below the cleanup goal after HPIs; there was no stimulation of sulfate‐reducing conditions. It is concluded that sulfate released from PFBs contributed to declining benzene concentrations.
Clinical and epidemiologic features of melasma: a multicentric cross‐sectional study from India
Authors: Sarkar Rashmi , Jagadeesan Soumya , Basavapura Madegowda Shasikumar , Verma Sonali , Hassan Iffat , Bhat Yasmeen , Minni Khushboo , Jha Abhijeet , Das Anupam , Jain Geraldine , Arya Latika , Mandlewala Zubin , Bagadia Jimish , Garg Vijay
Published: June 2019

Background

Though melasma is a common skin condition in India, epidemiological studies are few and geographically confined. The present study was designed to gain insights into factors involved in causation and aggravation of melasma, demographic distribution, clinical presentations, and treatment patterns.

Methods

A cross‐sectional multicentric study was conducted in 10 centers distributed across the four regions of India. Data including demographics, personal and family medical history, triggering and aggravating factors, clinical patterns, and details of past treatment regimens were recorded, and severity was estimated using the modified Melasma Area and Severity Index (MASI) score. Data collected by site dermatologists were collated and analyzed.

Results

The study evaluated 1,001 patients with melasma from 10 centers. Mean age was 38.02 years. Females dominated (85%). Proportion of males was highest in the east (22.2%) and lowest in the south (10.8%). Majority of patients belonged to intermediate skin phototypes. There was a significant difference (P = 0.000) between duration of sun exposure and duration of cooking fire/occupational heat exposure across the four regions. There was a significant association (P = 0.003, Mann‐Whitney U test) and a positive correlation between duration of cooking heat/occupational heat exposure and severity of melasma. Sunscreens were used by only one‐fifth of the study population (19.6%) whereas use of steroids and triple combinations was more common (28%).

Conclusion

One of the largest studies on melasma from the subcontinent, this study describes the epidemiological determinants of melasma. Data suggests that the duration of cooking fire/occupational heat exposure may be linked to severity of melasma. Sunscreen use seems inadequate in Indian patients; use of steroid‐containing medications is more common.
Health and economic burden of influenza‐associated illness in South Africa, 2013‐2015
Authors: Tempia Stefano , Moyes Jocelyn , Cohen Adam L. , Walaza Sibongile , Edoka Ijeoma , McMorrow Meredith L. , Treurnicht Florette K. , Hellferscee Orienka , Wolter Nicole , von Gottberg Anne , Nguweneza Athermon , McAnerney Johanna M. , Dawood Halima , Variava Ebrahim , Cohen Cheryl
Published: June 2019

Background

Economic burden estimates are essential to guide policy‐making for influenza vaccination, especially in resource‐limited settings.

Methods

We estimated the cost, absenteeism, and years of life lost (YLL) of medically and non‐medically attended influenza‐associated mild and severe respiratory, circulatory and non‐respiratory/non‐circulatory illness in South Africa during 2013‐2015 using a modified version of the World Health Organization (WHO) worksheet based tool for estimating the economic burden of seasonal influenza. Additionally, we restricted the analysis to influenza‐associated severe acute respiratory illness (SARI) and influenza‐like illness (ILI; subsets of all‐respiratory illnesses) as suggested in the WHO manual.

Results

The estimated mean annual cost of influenza‐associated illness was $270.5 million, of which $111.3 million (41%) were government‐incurred costs, 40.7 million (15%) were out‐of‐pocket expenses, and $118.4 million (44%) were indirect costs. The cost of influenza‐associated medically attended mild illness ($107.9 million) was 2.3 times higher than that of severe illness ($47.1 million). Influenza‐associated respiratory illness costs ($251.4 million) accounted for 93% of the total cost. Estimated absenteeism and YLL were 13.2 million days and 304 867 years, respectively. Among patients with influenza‐associated WHO‐defined ILI or SARI, the costs ($95.3 million), absenteeism (4.5 million days), and YLL (65 697) were 35%, 34%, and 21% of the total economic and health burden of influenza.

Conclusion

The economic burden of influenza‐associated illness was substantial from both a government and a societal perspective. Models that limit estimates to those obtained from patients with WHO‐defined ILI or SARI substantially underestimated the total economic and health burden of influenza‐associated illness.
Should fast pathway ablation be reconsidered in typical atrioventricular nodal re‐entrant tachycardia?
Authors: Tuohy Stephen , Trulock Kevin M. , Wiggins Newton B. , Bassiouny Mohammed , Ono Maki , Kiehl Eric L. , Cantillon Daniel , Tarakji Khaldoun , Tanaka Christine , Dresing Thomas , Saliba Walid , Varma Niraj , Tchou Patrick
Published: June 2019

Introduction

Atrioventricular nodal re‐entry tachycardia (AVNRT) is the most common, regular narrow‐complex tachycardia. The established treatment is catheter ablation of the AV nodal slow pathway (SP). However, in a select group of patients with long PR intervals in sinus rhythm, SP ablation can lead to AV block due to the absence of robust anterograde conduction through the fast pathway (FP). This report aims to demonstrate that AV nodal FP ablation is a reasonable approach in patients with AVNRT and poor or absent anterograde FP conduction.

Methods and Results

Standard electrophysiology study techniques were used in the electrophysiology laboratory. Catheter ablations were performed using radiofrequency energy. Mapping of intracardiac activation was performed with electroanatomical mapping systems. Outcomes were assessed acutely during the procedure and during routine clinical follow‐up. Six patients with first‐degree AV block and recurrent AVNRT who underwent ablation of their tachycardia at our institution are presented. One patient underwent ablation of AV nodal SP resulting in high‐degree AV block necessitating pacemaker implantation. The remaining five patients underwent ablation of the AV nodal FP guided by electroanatomical mapping of the earliest atrial activation in tachycardia. These five had successful treatment of the tachycardia with preservation of anterograde AV nodal conduction. Mapping and ablation approach to eliminate retrograde FP conduction are described.

Conclusion

In select patients with AVNRT and poor anterograde FP conduction, retrograde FP ablation is reasonable and is less likely to result in AV block and pacemaker dependency.
Usefulness of ICD electrograms analysis to distinguish endocardial vs epicardial ventricular tachycardia in arrhythmogenic right ventricular cardiomyopathy
Authors: Kodali Santhisri , Shirai Yasuhiro , Callans David J. , Zado Erica S. , Marchlinski Francis E. , Santangeli Pasquale
Published: June 2019

Introduction

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by an epicardial (EPI) to endocardial (ENDO) fibrofatty infiltration of the RV predisposing to both EPI and ENDO ventricular tachycardia (VT). The relative timing between the VT QRS onset on the far‐field ventricular electrogram (VEGM) to the local activation time recorded at the RV apex on the near‐field VEGM from stored implantable cardioverter‐defibrillator (ICD) events of VT can be helpful to discriminate ENDO from EPI VT in ARVC.

Methods and results

We analyzed consecutive ARVC patients undergoing catheter ablation between 2006 and 2018. Only patients with retrievable ICD VEGMs of clinical VTs which could be matched with VTs induced at the time of ablation were included. A total of 26 VT events (16 ENDO, 10 EPI) from 19 ARVC patients were examined, yielding a mean far‐field to near‐field interval of 33 ± 15 ms for ENDO VTs and 52 ± 20 ms for EPI VTs (P = .020). At receiver‐operating characteristic analysis, a far‐field to a near‐field interval of 60 ms or more ruled out ENDO VTs in 16 (100%) cases and identified EPI VTs with a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 73%. An interval of less than or equal to 30 ms ruled out EPI VTs in eight (80%) cases and diagnosed ENDO VTs with a PPV of 80% and an NPV of 50%.

Conclusion

Far‐field to near‐field ICD VEGM timing may be used to predict ENDO vs EPI VT in ARVC before ablation, indicating an ENDO origin if the timing is less than or equal to 30 ms and an EPI origin if greater than or equal to 60 ms.
Endodontically treated posterior teeth restored with or without crown restorations: A 5‐year retrospective study of survival rates from fracture
Authors: Jirathanyanatt Titalee , Suksaphar Warattama , Banomyong Danuchit , Ngoenwiwatkul Yaowaluk
Published: June 2019

Aim

The aim of the present study was to investigate survival rates from fracture of endodontically treated posterior teeth (ETT) restored with or without crowns with recall periods of up to 5 years.

Methods

ETT with single‐unit crown or resin composite restorations were studied based on the inclusion criteria. Restoration, tooth structure loss, adjacent teeth, fracture, and restorability were recorded. Survival rates from fracture were calculated, and risk factors were identified.

Results

Overall, survival rate of ETT with crowns (92.2%) was significantly higher than resin composites (77.4%) (P < 0.05). ETT with one or two surface loss/es and two adjacent teeth had a high survival rate of 86.9%, which was not significantly different to ETT with crowns (P ≥ 0.05). Restoration and adjacent teeth were identified as significant factors. The majority of fractured ETT with resin composites were restorable, whereas those with crowns were unrestorable. Survival rates from unrestorable fracture were not significantly different between the crown (93.1%) and resin composite (96%) (P ≥ 0.05).

Conclusions

The survival rate from the fracture of ETT restored with crowns was significantly higher than ETT restored with resin composites, but was not significantly different to ETT with one or two ETT with one or two surface loss/es and two adjacent teeth. ETT restored with resin composites had mostly restorable fracture, whereas ETT with unrestorable fracture were similar between the two restorations.
Radial shockwave therapy for male erectile rejuvenation in a dermatology and/or medical aesthetic practice
Authors: Goldberg David , Andriessen Anneke , Gold Michael
Published: June 2019

Introduction

Erectile dysfunction is defined as the inability to achieve and maintain an erection to satisfactorily complete intercourse. Treatment depends on the cause and includes phosphodiesterase 5 inhibitor medications, penile pumps, implants, and surgery. Low‐intensity shockwave therapy has been shown to be effective and safe for the treatment of erectile dysfunction.

Objective

We explored the role of low‐intensity radial shockwave therapy for erectile dysfunction treatment in a dermatology and/or medical aesthetic practice setting.

Materials and Methods

A literature review was conducted on radial low‐intensity shockwave technology in use for erectile rejuvenation to explore its positioning, safety, efficacy, tolerability, subject satisfaction, and usability in a dermatology and/or medical aesthetic setting.

Results

Low‐intensity shockwave therapy was shown to be effective in subjects with organic erectile dysfunction, and the treatment effect was maintained for up to 2 years post‐treatment. The treatment is reported to be safe and well‐tolerated and have little downtime. Many dermatologists use low‐intensity shockwave therapy for the treatment of cellulite and other conditions. This type of treatment is now available for erectile dysfunction and seems an attractive and safe option for subjects with organic vascular erectile dysfunction.

Conclusions

Studies and clinical experience suggest that male erectile rejuvenation using low‐intensity radial shockwave therapy seems an attractive option. The treatment can be safely, and effectively, delivered by trained staff as part of the total package that is available to men in a dermatology and/or medical aesthetic practice.
Childbearing Worldviews and Contraceptive Behavior Among Young Women
Authors: Shepherd Hana , Marshall Emily A.
Published: June 2019

Objective

The objective of this study was to classify young women into groups based on their childbearing worldviews—patterns of attitudes about domains related to childbearing—and to test whether these groups predict contraceptive behavior.

Background

Contraceptive behavior—defined here as contraceptive use or abstinence—among young women in the United States illustrates the often puzzling relationship between attitudes and behavior. This study argues that considering sets of attitudes relevant to childbearing in relation to each other can explain apparent contradictions between attitudes and contraceptive behavior.

Method

Using data from the Relationship Dynamics and Social Life study of young women (N = 832), this study analyzes the relationships among attitudes about childbearing by using latent class analysis to partition survey respondents into meaningful groups, and then multinomial logistic regression analysis to examine the relationship between group membership and contraceptive behavior. Latent class analysis identifies classes that share similar relationships between responses across a series of variables to measure childbearing worldviews.

Results

Latent class analysis identifies six classes of young women that share childbearing worldviews, four of which were predicted by the existing literature. Membership in those classes is then shown to predict contraceptive behavior, an important behavioral outcome.

Conclusion

The concept of worldviews and the method for identifying them will allow family researchers to identify meaningful groups in a population as well as to generate theories about childbearing and contraceptive behavior.
Missed opportunities for oral cancer screening in Australia
Authors: Webster John D. , Batstone Martin , Farah Camile S.
Published: June 2019

Objectives

Most patients with oral cancer lack early symptoms, therefore most present with advanced stage of disease. Early detection of oral cancer and oral potentially malignant disorders (OPMDs) in the asymptomatic phase via an opportunistic oral cancer screening examination is important as survival rates are significantly improved if the disease is treated at an earlier stage. The objective is to identify opportunities to achieve early stage diagnosis of oral cancer in Australian patients.

Materials and Methods

A cohort of 103 patients newly diagnosed with oral cancer were surveyed at a tertiary hospital Head and Neck Clinic. Patient awareness, knowledge, risk factors and diagnostic delay in oral cancer diagnosis were investigated. The asymptomatic period before diagnosis was studied to identify opportunities for improving opportunistic screening rates in Australia.

Results

Australian patients have poor awareness of oral cancer with 46% having never heard of oral cancer, and poor knowledge of risk factors for oral cancer. Only 7% were diagnosed in the asymptomatic phase and all by dental practitioners. Once symptomatic, median diagnostic delay was 9 weeks. In the asymptomatic phase before diagnosis, patients attended general medical practitioners far more often than general dental practitioners. Both groups rarely discussed risk factors for oral cancer (<10%) or performed opportunistic oral cancer screening examinations (<10%) with their patients.

Conclusion

Asymptomatic diagnosis of oral cancer at an earlier stage of disease is possible in the primary medical setting but increased awareness and knowledge are required in both patients and health practitioners.
Size‐dependent investment in tusk length, testis size and sperm length in a biparental geotrupid beetle
Authors: Rosa M. E. , Kiss J. , Barta Z. , Kosztolányi A.
Published: June 2019

Males of extreme small or large sizes often experience different levels of pre‐ and postcopulatory sexual selection that result in alternative ways to gain fertilization success. Here, we investigated such alternative mating tactics in Lethrus apterus, a biparental geotrupid beetle species with noticeable intermale size variation by comparing tusk (mandibular process) length, testis size and sperm length between large and small males. Firstly, we demonstrated evidence for male polymorphism as extremely large males had longer tusks relative to their body size than extremely small individuals. Secondly, large males had bigger testes than small males throughout the breeding season, however, a significant decrease was observed over time in large but not in small individuals. Thirdly, sperm length did not differ between the two size categories. Although these results do not explain how the observed large body size variation can be maintained in L. apterus, the non allometric relationship found between tusk length and body size and the lower decrease in testis size over the breeding season in case of small individuals might refer to the presence of alternative mating tactics in this species.
How Have Chronic Pain Management Programs Progressed? A Mapping Review
Authors: Lewis Gwyn N. , Bean Debbie , Mowat Rebecca
Published: June 2019

Objectives

Multidisciplinary pain management programs (PMPs) were established in the 1970s and are widely regarded as the gold standard management for people with chronic, noncancer pain. However, the recommended content of PMPs is not well described. The aim of the study was to determine the most common content and structure of inpatient PMPs, and describe how these have changed over time.

Methods

A mapping review was performed of studies incorporating an inpatient PMP. Information on the content, format, structure, clinicians involved, and outcome measures was extracted. Publications were analyzed across 5 decades from the 1970s to the 2010s.

Results

One hundred and four studies were included. All programs included physical therapy and psychology components, and most included education. While the physical therapy component did not change substantially, there was a shift from operant conditioning approaches to more cognitive behavioral methods over time, along with a reduction in active medication withdrawal and family involvement. Involvement of physical therapists, physicians, and psychologists remained high in the programs, but the inclusion of nurses and occupational therapists declined from the 2000s. The outcome measures revealed a shift to assessment of quality of life and general health.

Discussion

Some of the content and format of PMPs has evolved over time, largely with developments in psychological approaches, and there is now more of a holistic approach to assessment.
A Randomized Controlled Trial to Evaluate the Effect of Pulsed Radiofrequency as a Treatment for Anterior Cutaneous Nerve Entrapment Syndrome in Comparison to Anterior Neurectomy
Authors: Maatman Robbert C. , van Kuijk Sander M.J. , Steegers Monique A.H. , Boelens Oliver B.A. , Lim Toine C. , Scheltinga Marc R.M. , Roumen Rudi M.H.
Published: June 2019

Background

Chronic abdominal pain can be due to entrapped intercostal nerves (anterior cutaneous nerve entrapment syndrome [ACNES]). If abdominal wall infiltration using an anesthetic agent is unsuccessful, a neurectomy may be considered. Pulsed radiofrequency (PRF) applies an electric field around the tip of the cannula near the affected nerve to induce pain relief. Only limited retrospective evidence suggests that PRF is effective in ACNES.

Methods

A multicenter, randomized, nonblinded, controlled proof‐of‐concept trial was performed in 66 patients. All patients were scheduled for a neurectomy procedure. Thirty‐three patients were randomized to first receive a 6‐minute cycle of PRF treatment, while the other 33 were allocated to an immediate neurectomy procedure. Pain was recorded using a numeric rating scale (NRS, 0 [no pain] to 10 [worst pain possible]). Successful treatment was defined as >50% pain reduction. Patients in the PRF group were allowed to cross over to a neurectomy after 8 weeks.

Results

The neurectomy group showed greater pain reduction at 8‐week follow‐up (mean change from baseline −2.8 (95% confidence interval [CI] −3.9 to −1.7) vs. −1.5 (95% CI −2.3 to −0.6); P = 0.045) than the PRF group. Treatment success was reached in 12 of 32 (38%, 95% CI 23 to 55) of the PRF group and 17 of 28 (61%, 95% CI 42 to 72) of the neurectomy group (P = 0.073). Thirteen patients were withdrawn from their scheduled surgery. Adverse events were comparable between treatments.

Conclusions

PRF appears to be an effective and minimally invasive treatment option and may therefore be considered in patients who failed conservative treatment options before proceeding to a neurectomy procedure. Anterior neurectomy may possibly lead to a greater pain relief compared with PRF in patients with ACNES, but potential complications associated with surgery should be discussed.
Vertical Deployment of Multilayered Metallic Microstructures With High Area-to-Mass Ratios by Thermal Actuation
Authors: Ren Zhongjing , Yuan Jianping , Su Xiaoyu , Sun Hao , Galos Richard , Shi Yong , Mangla Sundeep , Lu Ming , Camino Fernando
Published: June 2019

Lightweight microstructures with high area-to-mass ratios, or low surface densities, show great potential applications in microrobots, soft electronics, medical devices, and solar sailing. However, the bending stiffness of such microstructures is usually too low to work effectively. In order to obtain active microstructures with enhanced bending stiffness, a new design for thermally actuated multilayered metallic microstructures with high area-to-mass ratios is presented in this article. The microstructures made of aluminum and NiTi alloy are fabricated to demonstrate the feasibility of vertical deployment of such microstructures under thermal actuation. The concept design and working principle of designed multilayered metallic microstructures are based on symmetrical deposition of metals Al\NiTi\NiTi\Al, followed by practical microfabrication processes, such as photolithography, physical vapor deposition (PVD), and dry etch. The area-to-mass ratios of such microstructures could be up to 400 m2/kg. Then, experiments for electrical characterization are set up for thermal actuation or Joule heating. Besides that, the equivalent resistances of such microstructures with regard to temperatures are calibrated, allowing for the determination of in situ temperatures of deformed microstructures when being heated in the vacuum chamber of scanning electron microscope (SEM). Finally, vertical deployment of such thin microstructures is detected and measured, which validates the feasibility of stiffness enhancement through the symmetrical design and thermal actuation.
A Foam-Core Meniscus Coating Process for Retrofit Anti-Reflective Coatings
Authors: Saranam Venkata Rajesh , Chang Chih-Hung , Paul Brian K.
Published: June 2019

Foam-core meniscus coating is being used to retrofit 100 nm-scale sol–gel anti-reflective coatings (ARCs) onto in-field solar panels through the deposition, evaporation, and curing of wet films. Advantages of this technique include the means to control fluid flow relative to substrate motion and the ability to conform to large, warped substrates. While simple in practice, no models exist for predicting critical outcomes such as film thickness. In this paper, preliminary experiments are used to identify important process parameters, and an analytical model is developed and validated for predicting the thickness of silica sol–gel films deposited on solar glass.
Homogeneous–Heterogeneous Reactions in Boundary-Layer Flow of a Maxwell Nanofluid Over a Stretching Surface
Authors: Xu Nai-Li , Xu Hang
Published: June 2019

Based on Buongiorno's theory and Cauchy equations of motion, a model is developed to examine homogeneous–heterogeneous reactions in boundary layer flow of a nanofluid over a stretching sheet in which a uniform magnetic field is added perpendicular to the flow direction. We apply the shooting method and the fourth-order Runge–Kutta integration to obtain multiple solutions of nonlinear ordinary differential equations with various physical parameters. Results show that nanofluids play significant roles in the procedures of homogeneous and heterogeneous reactions, which may help maintain the stability of chemical reactions. In addition, the terms related to Maxwell fluid either have effect on stability of the system; furthermore, the increasing elastic and magnetic parameters delay the appearance of bifurcation points.
Measurements of nonlinearity parameter B/A of water-saturated glass beads under uniaxial compressive loading
Authors: Lee Hunki , Noh Eunghwy , Ohm Won-Suk , Kwon Oh-Cho
Published: June 2019

This Letter reports measurements of nonlinearity parameter B/A of water-saturated glass beads under uniaxial compression representative of the gravitational loading in seabed. The finite-amplitude method in conjunction with the multi-Gaussian beam model is used to determine B/A, in which the use of an accurate source function is found to be important in achieving the overall measurement accuracy. The estimated B/A is on the order of a hundred and decreases with increasing uniaxial compression up to 50 kPa, so that B/A could change as much as 20% over a depth of 5 m for a typical coarse sandy sediment.
Evidence of a Ceiling Effect for Training Volume in Muscle Hypertrophy and Strength in Trained Men—Less is More?
Authors: Barbalho Matheus , Coswig Victor S. , Steele James , Fisher James P. , Giessing Jurgen , Gentil Paulo
Published: June 2019

This article has been retracted at the request of the authors on April 16, 2020. They performed an a posteriori analysis of the data and identified inconsistencies that changed their evaluation of the results. The authors apologize for the inconvenience.
Similar Cardioventilatory but Greater Neuromuscular Stimuli With Interval Drop Jump Than With Interval Running
Authors: Ducrocq Guillaume P. , Hureau Thomas J. , Meste Olivier , Blain Grégory M.
Published: June 2019

Context: Drop jumps and high-intensity interval running are relevant training methods to improve explosiveness and endurance performance, respectively. Combined training effects might, however, be achieved by performing interval drop jumping. Purpose: To determine the acute effects of interval drop jumping on oxygen uptake ()—index of cardioventilatory/oxidative stimulation level and peripheral fatigue—a limiting factor of explosiveness. Methods: Thirteen participants performed three 11-minute interval training sessions during which they ran 15 seconds at 120% of the velocity that elicited maximal () (ITrun), or drop jumped at 7 (ITDJ7) or 9 (ITDJ9) jumps per 15 seconds, interspersed with 15 seconds of passive recovery. and the time spent above 90% of () were collected. Peripheral fatigue was quantified via preexercise to postexercise changes in evoked potentiated quadriceps twitch (ΔQT). Power output was estimated during ITDJs using optical sensors. Results: All participants reached 90% of or higher during ITrun and ITDJ9, but only 11 did during ITDJ7. was not different between ITrun and ITDJ9 (145 [76] vs 141 [151] s; P = .92) but was reduced during ITDJ7 (28 [26] s; P = .002). Mean ΔQT in ITDJ9 and ITDJ7 was not different (−17% [9%] vs −14% [8%]; P = .73) and greater than in ITrun (−8% [7%]; P = .001). No alteration in power output was found during ITDJs (37 [10] W·kg−1). Conclusion: Interval drop jumping at a high work rate stimulated the cardioventilatory and oxidative systems to the same extent as interval running, while the exercise-induced increase in fatigue did not compromise drop jump performance. Interval drop jumping might be a relevant strategy to get concomitant improvements in endurance and explosive performance.
Beating Yourself: How Do Runners Improve Their Own Records?
Authors: Foster Carl , de Koning Jos J. , Thiel Christian , Versteeg Bram , Boullosa Daniel A. , Bok Daniel , Porcari John P.
Published: June 2019

Background: Pacing studies suggest the distribution of effort for optimizing performance. Cross-sectional studies of 1-mile world records (WRs) suggest that WR progression includes a smaller coefficient of variation of velocity. Purpose: This study evaluates whether intraindividual pacing used by elite runners to break their own WR (1 mile, 5 km, and 10 km) is related to the evolution of pacing strategy. We provide supportive data from analysis in subelite runners. Methods: Men’s WR performances (with 400-m or 1-km splits) in 1 mile, 5 km, and 10 km were retrieved from the IAAF database (from 1924 to present). Data were analyzed relative to pacing pattern when a runner improved their own WR. Similar analyses are presented for 10-km performance in subelite runners before and after intensified training. Results: WR performance was improved in 1 mile (mean [SD]: 3:59.4 [11.2] to 3:57.2 [8.6]), 5 km (13:27 [0:33] to 13:21 [0:33]), and 10 km (28:35 [1:27] to 28:21 [1:21]). The average coefficient of variation did not change in the 1 mile (3.4% [1.8%] to 3.6% [1.6%]), 5 km (2.4% [0.9%] to 2.2% [0.8%]), or 10 km (1.4% [0.1%] to 1.5% [0.6%]) with improved WR. When velocity was normalized to the percentage mean velocity for each race, the pacing pattern was almost identical. Very similar patterns were observed in subelite runners in the 10 km. When time improved from 49:20 (5:30) to 45:56 (4:58), normalized velocity was similar, terminal RPE increased (8.4 [1.6] to 9.1 [0.8]), coefficient of variation was unchanged (4.4% [1.1%] to 4.8% [2.1%]), and VO2max increased (49.8 [7.4] to 55.3 [8.8] mL·min−1·kg−1). Conclusion: The results suggest that when runners break their own best performances, they employ the same pacing pattern, which is different from when WRs are improved in cross-sectional data.
Ischemic Preconditioning: Improved Cycling Performance Despite Nocebo Expectation
Authors: Cheung Christian P. , Slysz Joshua T. , Burr Jamie F.
Published: June 2019

Purpose: Ischemic preconditioning (IPC) through purposeful circulatory occlusion may enhance exercise performance. The value of IPC for improving performance is controversial owing to challenges with employing effective placebo controls. This study examines the efficacy of IPC versus a deceptive sham protocol for improving performance to determine whether benefits of IPC are attributable to true physiological effects. It was hypothesized that IPC would favorably alter performance more than a sham treatment and that physiological responses to exercise would be affected only after IPC treatment. Methods: In a randomized order, 16 participants performed incremental exercise to exhaustion on a cycle ergometer in control conditions and after sham and IPC treatments. Participants rated their belief as to the efficacy of each treatment compared with control. Results: Time to exhaustion was greatest after IPC (control = 1331 [270] s, IPC = 1429 [300] s, sham = 1343 [255] s, P = .02), despite negative performance expectations after IPC and positive expectation after sham. Maximal aerobic power remained unchanged after both SHAM and IPC (control = 42.0 [5.2], IPC = 41.7 [5.5], sham = 41.6 [5.5] mL·kg−1·min−1, P = .7), as did submaximal lactate concentration (control = 8.9 [2.6], sham = 8.0 [1.9], IPC = 7.7 [2.1] mmol, P = .1) and oxygen uptake (control = 37.8 [4.8], sham = 37.5 [5.3], IPC = 37.5 [5.5] mL·kg−1·min−1, P = .6). Conclusions: IPC before cycling exercise provides an ergogenic benefit that is not attributable to a placebo effect from positive expectation and that was not explained by traditionally suggested mechanisms.
Effects of Weighted Vest Loading During Daily Living Activities on Countermovement Jump and Sprint Performance
Authors: Simpson Jeffrey D. , Cosio-Lima Ludmila , Scudamore Eric M. , O’Neal Eric K. , Stewart Ethan M. , Miller Brandon L. , Chander Harish , Knight Adam C.
Published: June 2019

Purpose: Wearing a weighted vest (WV) during daily living and training can enhance jump and sprint performance; however, studies examining the efficacy of this method in female populations is limited. This study examined the effect of wearing a WV during daily living and training on countermovement jump (CMJ), change-of-direction, and sprint performance. Methods: Trained females were separated into intervention (n = 9) and control (n = 10) groups. The intervention group wore WVs of ∼8% body mass 4 days per week for 8 hours per day (32 h/wk total), and 3 training sessions per week for the first 3 weeks. Subsequently, 3 weeks of regular training without WV stimulus was completed. The control group received no intervention and continued normal training for 6 weeks. Average and best performance was assessed on the single CMJ, four continuous CMJ, t-test change-of-direction drill, and a 25-m sprint at baseline, week 3, and week 6. Results: No significant interactions or group effects were found. However, significant time main effects revealed increases in average rate of force development during the CMJ from baseline to week 3 (P = .048) and week 6 (P = .013), whereas peak vertical ground reaction force increased during the four continuous CMJ from baseline to week 3 (P = .048) and week 6 (P = .025) for both groups. Conclusions: The lower relative WV load used in this study failed to elicit significant improvements in jump and sprint performance in comparison with routine training, or that which have been found in past investigations with elite male athletes completing high-intensity performance tasks with greater WV loads.
The Effects of Virtual Kayak Paddling Exercise on Postural Balance, Muscle Performance, and Cognitive Function in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial
Authors: Choi Wonjae , Lee Seungwon
Published: June 2019

Deterioration of physical and psychological health is an important issue in older adults aged 65 years or more. This study aimed to determine whether a virtual kayak paddling (VKP) exercise could improve postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment. Sixty participants were randomly assigned to the VKP (n = 30) or control group (n = 30). Participants in the VKP group performed the paddling exercise in a virtual environment for 60 min twice a week for 6 weeks, whereas those in the control group performed home exercises. Postural balance (p < .05), muscle performance (p < .05), and cognitive function (p < .05) were significantly improved in the VKP group and were superior to those in the control group (p < .05). Thus, the findings indicate that VKP exercise improves postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment.
Targeting thrombogenicity and inflammation in chronic HIV infection
Authors: O’Brien Meagan P. , Zafar M. Urooj , Rodriguez Jose C. , Okoroafor Ibeawuchi , Heyison Alex , Cavanagh Karen , Rodriguez-Caprio Gabriela , Weinberg Alan , Escolar Gines , Aberg Judith A. , Badimon Juan J.
Published: June 2019

Patients with HIV have higher thrombogenicity that correlates with markers of inflammation; both respond to clopidogrel treatment.