bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics of adolescents referred for treatment of depressive disorders
Authors: Orchard Faith , Pass Laura , Marshall Tamsin , Reynolds Shirley
Published: July 2016

Background

Adolescence is a period of increased risk for the development of depression. Epidemiological and clinical studies suggest that the phenomenology of depression may differ during childhood and adolescence. However, participants in these studies may not reflect depressed young people referred to routine clinical services. The aim of this paper was to describe referrals for depression to aUKroutine public healthcare service for children and adolescents with mental health difficulties.

Method

This paper describes a consecutive series of adolescents (N = 100, aged 12–17 years), referred for depression to a routine public healthcare child and adolescent mental health service, in the south of England. Young people and their caregivers completed a structured diagnostic interview and self‐report measures of anxiety and depression.

Results

Fewer than half of young people referred for depression met diagnostic criteria for a depressive disorder. The key symptoms reported by those with depression were low mood or irritability, cognitive disturbances, sleep disturbances and negative self‐perceptions. Suicidal ideation was common and was considerably higher than reported in other studies. Caregiver and young person's accounts of adolescent symptoms of depression and anxiety were uncorrelated. Caregivers also reported fewer symptoms of depression in their child than adolescents themselves.

Conclusions

These data have direct relevance to the design and delivery of public mental health services for children and adolescents. However, we do not know how representative this sample is of other clinical populations in theUKor in other countries. There is a need to collect routine data from other services to assess the needs of this group of high‐risk adolescents.
Recent advances in congenital myasthenic syndromes
Authors: Ohno Kinji , Ohkawara Bisei , Ito Mikako
Published: July 2016

Congenital myasthenic syndromes (CMS) are heterogeneous disorders caused by germline mutations in genes expressed at the neuromuscular junction. Mutations have been identified in 24 genes encoding acetylcholine receptor subunits (CHRNA1, CHRNB1, CHRND, CHRNE and CHRNG), skeletal muscle sodium channel (SCN4A), signaling molecules driving acetylcholine receptor subunits clustering (AGRN, LRP4, MUSK and DOK7), synaptic structural proteins (COLQ, LAMB2 and COL13A1), postsynaptic structural proteins (RAPSN and PLEC), presynaptic molecules (CHAT, SYT2), glycosylation enzymes (GFPT1, DPAGT1, ALG2, ALG14 and GMPPB), and other less characterized molecules (PREPL and SCL25A1). CMS are recessive disorders, except for slow channel CMS and synaptotagmin 2 (SYT2)‐CMS. Onsets are largely less than 2 years, but adult‐onset is not rare, especially in slow‐channel CMS and limb‐girdle type CMS caused by glycosylation defects and by DOK7 mutations. Clinical features include fatigable muscle weakness, amyotrophy and minor facial anomalies. Eye, facial and bulbar muscles are frequently affected, but sparing of these muscles is observed, especially in limb‐girdle type CMS. Serum creatine kinase levels are frequently elevated in slow‐channel CMS, glutamine‐fructose‐6‐phosphate aminotransferase 1 (GFPT1)‐CMS, and guanosine diphosphate mannose pyrophosphorylase B (GMPPB)‐CMS. Electrophysiological findings supporting compromised neuromuscular signal transmission are a prerequisite for diagnosing CMS. Most CMS patients are likely to be underdiagnosed, and recognition of CMS in undiagnosed muscle weakness and/or amyotrophy is critical for diagnosing CMS.
Closed‐incision negative‐pressure therapy in high‐risk general surgery patients following laparotomy: a retrospective study
Authors: Zaidi A. , El‐Masry S.
Published: July 2016

Aim

Surgical site infection (SSI) and wound dehiscence are dreaded complications following laparotomy in general surgical patients, and can potentially occur more often in various comorbid states. Negative‐pressure wound therapy (NPWT) has a positive effect of on open and complicated wounds and so has been used for at‐risk surgical incisions with the aim of redistributing lateral tension and holding incision edges together. The aim of the present study was to compare the rate of wound complications following laparotomy in high‐risk general surgical patients with a clean incision treated with closed‐incision negative‐pressure therapy (ciNPT) with those receiving conventional care.

Method

A retrospective review was performed of the hospital medical records of patients who underwent laparotomy between 1 October 2010 and 31 March 2012. Records of 69 patients who received ciNPT and 112 who were managed by adherent gauze dressings were included in the final analysis.

Results

Two (2.9%) patients in the ciNPT group and 23 (20.5%) in the non‐NPWT group developed a wound complication following laparotomy (P < 0.0009). The relative risk (RR) was 0.14 (0.03–0.58), suggesting that infection is less likely to occur in ciNPT‐treated incisions, compared with gauze dressings.

Conclusion

ciNPT was associated with a positive clinical outcome and was a safe and effective method of postsurgical management in our general surgery patients considered to have risk of developing wound complications following laparotomy.
The Intersection of Citizenship Status, STEM Education, and Expected Labor Market Participation in Gulf Cooperation Council Countries
Authors: Wiseman Alexander W. , Abdelfattah Faisal A. , Almassaad Ahmad
Published: July 2016

Citizenship status influences the impact of science, technology, engineering, and mathematics (STEM) education on the youth labor market participation in the Arabian Gulf. This research examines the relationship between citizenship status, STEM education, and expected labor market participation in Gulf Cooperation Council (GCC) countries, and examines the intervening effects of information and communication technology (ICT) based instruction, specifically. The 2011 Trends in International Mathematics and Science Study (TIMSS) provides both labor market expectations and STEM education data from all participating GCC countries, including Saudi Arabia, Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates. Results suggest that ICT‐enhanced STEM education differently influences the human capital development of Gulf national and expatriate youth. For example, GCC nationals do not emphasize STEM education as an avenue for employment, while expatriate youth do. In particular, as Gulf national youths' parents' education level increases, students are less likely to think they need to do well in science to get the job they want. This is indicative of a broader trend in the Gulf nations to rely more on non‐education‐related factors such as family influence or connections for social, economic, and political mobility. In contrast, results also suggest that while STEM education contributes to potential private sector labor market participation among Gulf national youth, expatriate youth are more likely to expect to need or use STEM in the labor market.
Cooperative learning in ‘Special Needs in Dentistry’ for undergraduate students using the Jigsaw approach
Authors: Suárez‐Cunqueiro M. M. , Gándara‐Lorenzo D. , Mariño‐Pérez R. , Piñeiro‐Abalo S. , Pérez‐López D. , Tomás I.
Published: July 2016

Introduction

The goals of this study were to (i) describe the use of the Jigsaw approach for the resolution of clinical cases by undergraduate students in the subject ‘Special Needs in Dentistry’ and (ii) assess the impact of its implementation on academic performance and the students’ perception.

Materials and methods

The Jigsaw approach was applied to the fifth‐year in the subject ‘Special Needs in Dentistry’, as part of the Dentistry degree curriculum of the University of Santiago de Compostela, during the academic years 2012/2013 and 2013/2014. A total of 109 dental students were enrolled in the study, and the final marks of the Jigsaw (n = 55) and the non‐Jigsaw groups (n = 54) were compared. Students’ perceptions on the Jigsaw technique were assessed using a 13‐question questionnaire.

Results

Academic performance based on the final examination mark for the Jigsaw and non‐Jigsaw groups was 6.45 ± 1.49 and 6.13 ± 1.50, respectively. There were not students in the Jigsaw group who failed to attend the mandatory examination (0% vs. 12.96% in the non‐Jigsaw group, P = 0.006). The questionnaire's internal consistency was 0.90. The mean value for all the questionnaire items was 3.80, with the highest response score of 4.35 for the statement ‘I have seen the complexity that the resolution of a clinical case can involve’.

Conclusion

Based on the students’ perceptions, the Jigsaw approach could contribute to a better understanding of the complexity of solving clinical cases in the subject ‘Special Needs in Dentistry’. However, further investigations should be conducted to analyse the influence of this technique on students’ academic performance in the field of clinical dentistry.
Cultural competency and communication skills of dental students: clinical supervisors' perceptions
Authors: Mariño R. , Ghanim A. , Morgan M. , Barrow S.
Published: July 2016

Objectives

This study explored clinical supervisor's (CS) views and experiences of dental students' cultural competence (CC) at the Melbourne Dental School, The University of Melbourne, Australia. Additionally, this study explored CS insights into how CC could be taught.

Methods

Semi‐structured one‐to‐one interviews were organised with consenting CS. Interview topics included the following: the importance of CC, communication and rapport, the role of culture in oral health and the need for curriculum enhancement. Interviews were recorded, transcribed and thematically analysed to identify key areas using NVivo software.

Results

A total of 12 CS participated in this study. CS acknowledged the importance of CC and felt that it was important for good patient management. CS's definition of CC focused primarily on language and communication skills. CS felt that dental students were generally able to manage culturally diverse patients. However, CS indicated that additional training in this area would be beneficial. Concerns were raised about the students' ability to establish good rapport and communication, with CS highlighting areas such as misuse of interpreters and use of jargon. CS felt that clinical experience, confidence and a positive attitude are effective tools for overcoming cultural barriers. Furthermore, some CS also felt that cultural competency was a skill that is learnt through experience.

Conclusions

For most CS, cultural competence was an important part of the clinician–patient exchange which would benefit from enhanced curriculum. They also highlighted areas where transcultural education could be improved. The majority of CS believed dental students managed culturally diverse patients well.
Organic carbon characteristics in Swedish forest soil trace post‐depositional carbon dynamics
Authors: Routh J. , Bianchi T. S. , Hutchings J. A. , Kuhry P. , Ranjan R. K.
Published: July 2016

We investigated soil organic carbon (SOC) characteristics in three forests along a north–south transect in Sweden where these forest types cover about 69% of the landscape. There was variation in 14C ages, and the median ages ranged from about 25 to > 2500 cal BP in SOC. Although total SOC and nitrogen (N) contents decreased, stable carbon isotope and humification indices increased with depth. These progressive changes with depth and age were related to degradation. The δ13C values and specific biomarkers indicated that organic carbon was primarily from C3 plants. Biomarkers were effective in distinguishing OC input from specific sources (i.e. angiosperms, gymnosperms and grasses). A sharp decrease in biomarkers with depth indicated degradation of OC in the upper soil horizon, and limited contribution in the subsoil towards the stabilization of SOC. The sharp decrease in carbon stocks and 14C age in the soil OC pool with increasing soil depth, and quite large values for the percentage of modern carbon, suggested a decrease in SOC pools. Overall, these results showed that carbon sequestration in high latitude forests was small, and their role as potential carbon sinks needs to be reassessed.

Highlights

We studied soil organic carbon (SOC) characteristics in Swedish boreal and temperate forests.

The decline of SOC with depth contributes little to carbon sequestration in deeper soil horizons.

Soil degradation causes a decline in total carbon, nitrogen, alkanes and lignin with depth and age.

The role of these forests as carbon sinks needs to be reassessed because of degradation of SOC.
Long‐term management changes topsoil and subsoil organic carbon and nitrogen dynamics in a temperate agricultural system
Authors: Gregory A. S. , Dungait J. A. J. , Watts C. W. , Bol R. , Dixon E. R. , White R. P. , Whitmore A. P.
Published: July 2016

Soil organic carbon (SOC) and nitrogen (N) contents are controlled partly by plant inputs that can be manipulated in agricultural systems. Although SOC and N pools occur mainly in the topsoil (upper 0.30 m), there are often substantial pools in the subsoil that are commonly assumed to be stable. We tested the hypothesis that contrasting long‐term management systems change the dynamics of SOC and N in the topsoil and subsoil (to 0.75 m) under temperate conditions. We used an established field experiment in the UK where control grassland was changed to arable (59 years before) and bare fallow (49 years before) systems. Losses of SOC and N were 65 and 61% under arable and 78 and 74% under fallow, respectively, in the upper 0.15 m when compared with the grass land soil, whereas at 0.3–0.6‐m depth losses under arable and fallow were 41 and 22% and 52 and 35%, respectively. The stable isotopes 13C and 15N showed the effects of different treatments. Concentrations of long‐chain n‐alkanes C27, C29 and C31 were greater in soil under grass than under arable and fallow. The dynamics of SOC and N changed in both topsoil and subsoil on a decadal time‐scale because of changes in the balance between inputs and turnover in perennial and annual systems. Isotopic and geochemical analyses suggested that fresh inputs and decomposition processes occur in the subsoil. There is a need to monitor and predict long‐term changes in soil properties in the whole soil profile if soil is to be managed sustainably.

Highlights

Land‐use change affects soil organic carbon and nitrogen, but usually the topsoil only is considered.

Grassland cultivated to arable and fallow lost 13–78% SOC and N to 0.6 m depth within decades.

Isotopic and biomarker analyses suggested changes in delivery and turnover of plant‐derived inputs.

The full soil profile must be considered to assess soil quality and sustainability.
Prediction of soil organic and inorganic carbon at different moisture contents with dry ground VNIR: a comparative study of different approaches
Authors: Wijewardane N. K. , Ge Y. , Morgan C. L. S.
Published: July 2016

Visible and near infrared reflectance spectroscopy (VNIR) is a rapid and multi‐sensing technology that can provide spatially dense soil data for many disciplines. Soil moisture is the main barrier to the use of this technology in the field. The objective of this study was to compare the effectiveness of five approaches, external parameter orthogonalization (EPO), direct standardization (DS), global moisture modelling (GMM), slope bias correction (SB) and selective wavelength modelling (SWM), to enable models based on dry ground VNIR spectra of soil to be applied directly to moist spectra to predict organic carbon (OC) and inorganic carbon (IC). A total of 352 archived soil samples were selected and scanned, and of these 185 samples were used to develop dry ground models. The remaining 167 samples were rewetted to eight different moisture contents for the development (100) and validation (67) of the five moisture‐correction approaches. The results showed that EPO, DS and GMM account satisfactorily for the effect of moisture in soil spectra. They improved the prediction of OC substantially with an increase in R2 from almost zero for no correction to over 0.5, and an RPIQ (ratio of performance to interquartile range) from 0.38 to over 1.7. Improvement was also achieved with EPO, DS and GMM for IC; RPIQ increased from 0.53 to over 1.2. External parameter orthogonalization and DS showed that their effectiveness in moisture correction depended on the moisture content of the sample (larger moisture contents decrease the effectiveness), whereas this dependence was not observed for the moisture‐explicit DS and GMM methods. We concluded that EPO, DS and GMM are all viable approaches for moisture correction for VNIR‐based proximal soil sensors.

Highlights

Accounting for the effect of soil moisture on soil spectra is essential for in situ VNIR‐based soil sensors.

Five methods to remove the effect of moisture on VNIR modelling of soil OC and IC are investigated.

EPO, DS (with two implementations) and GMM showed promising results for moisture correction.

Correction done with moisture‐explicit DS and GMM showed little dependence with moisture content.
Systemic disease manifestations associated with epilepsy in tuberous sclerosis complex
Authors: Jeong Anna , Wong Michael
Published: July 2016

Objective

Epilepsy is one of the most disabling symptoms of tuberous sclerosis complex (TSC) and is a leading cause of morbidity and mortality in affected individuals. The relationship between systemic disease manifestations and the presence of epilepsy has not been thoroughly investigated. This study utilizes a multicenter TSC Natural History Database including 1,816 individuals to test the hypothesis that systemic disease manifestations of TSC are associated with epilepsy.

Methods

Univariate analysis was used to identify patient characteristics (e.g., age, gender, race, and TSC mutation status) associated with the presence of epilepsy. Individual logistic regression models were built to examine the association between epilepsy and each candidate systemic or neurologic disease variable, controlling for the patient characteristics found to be significant on univariate analysis. Finally, a multivariable logistic regression model was constructed, using the variables found to be significant on the individual analyses as well as the patient characteristics that were significant on univariate analysis.

Results

Nearly 88% of our cohort had a history of epilepsy. After adjusting for age, gender, and TSC mutation status, multiple systemic disease manifestations including cardiac rhabdomyomas (odds ratio [OR] 2.3, 95% confidence interval [CI] 1.3–3.9, p = 0.002), retinal hamartomas (OR 2.1, CI 1.0–4.3, p = 0.04), renal cysts (OR 2.1, CI 1.3–3.4, p = 0.002), renal angiomyolipomas (OR 3.0, CI 1.8–5.1, p < 0.001), shagreen patches (OR 1.7, CI 1.0–2.7, p = 0.04), and facial angiofibromas (OR 1.7, CI 1.1–2.9, p = 0.03) were associated with a higher likelihood of epilepsy. In the multivariable logistic regression model, cardiac rhabdomyomas (OR 1.9, CI 1.0–3.5, p = 0.04) remained significantly associated with the presence of epilepsy.

Significance

The identification of systemic disease manifestations such as cardiac rhabdomyomas that confer a higher risk of epilepsy development in TSC could contribute to disease prognostication and assist in the identification of individuals who may receive maximal benefit from potentially novel, targeted, preventative therapies.
Suspected new‐onset autoimmune temporal lobe epilepsy with amygdala enlargement
Authors: Malter Michael P. , Widman Guido , Galldiks Norbert , Stoecker Winfried , Helmstaedter Christoph , Elger Christian E. , Wagner Jan
Published: July 2016

Objective

Recent reports define temporal lobe epilepsy with amygdala enlargement (TLE‐AE) as a distinct electroclinical syndrome comparable to TLE with hippocampal sclerosis. In this retrospective observational study, we present the largest consecutive series of patients with new‐onset TLE‐AE to date and describe clinical characteristics and seizure outcome, and we aim to explore underlying autoimmune mechanisms within this syndrome.

Methods

We reviewed all consecutive patients between 2004 and 2014 at our tertiary epilepsy center at the University of Bonn, Germany, with new‐onset (<5 years) TLE‐AE, negative serum antibody (ab) test results, and with available follow‐up data for at least 12 months.

Results

We identified 40 patients (23 male) with TLE‐AE with a median age at epilepsy onset of 51 years (range 10–73) and a median disease duration of 11 months (range 0.5–55) at first presentation. At follow‐up, 50% of the entire cohort achieved seizure freedom. Of interest, patients with remittent features of AE at follow‐up (N = 24) had a superior outcome compared to those with stable magnetic resonance imaging (MRI) features of AE (N = 16): 17 (71%) of 24 were seizure‐free for at least 6 months compared to 3 (19%) of 16, respectively (p = 0.003). MRI volumetry confirmed significantly enlarged amygdalae in TLE‐AE in relation to healthy controls, and additionally showed significantly greater volume reductions in patients with remittent AE compared to those with stable AE.

Significance

TLE‐AE is a clinical syndrome beginning mostly in middle age, and in addition to its known association with ab‐positive limbic encephalitis, it occurs in an ab‐negative condition. Remission of AE in the course of the disease could be identified as a predictor for a favorable clinical outcome and is suspicious of an autoimmune etiology, although we could not confirm this hypothesis unequivocally with currently available noninvasive diagnostic tools.
The intriguing CP12‐like tail of adenylate kinase 3 from Chlamydomonas reinhardtii
Authors: Thieulin‐Pardo Gabriel , Schramm Antoine , Lignon Sabrina , Lebrun Régine , Kojadinovic Mila , Gontero Brigitte
Published: July 2016

Adenylate kinases (ADK) are key enzymes that maintain the energetic balance in cellular compartments by catalyzing the reaction: AMP + ATP↔2 ADP. Here, we analyzed the chloroplast ADK 3 from the green alga, Chlamydomonas reinhardtii for the first time. This enzyme bears a C‐terminal extension that is highly similar to the C‐terminal end of the intrinsically disordered protein CP12 that plays a major role in the redox regulation of key enzymes of the Calvin–Benson cycle like glyceraldehyde 3‐phosphate dehydrogenase (GAPDH) and phosphoribulokinase. The only other known example of a CP12‐like extension is found in the GapB isoform of GAPDH, where it is responsible for the autonomous redox regulation of the higher plant A2B2 GAPDH. In this study, we show that the CP12‐like tail is not involved in the redox regulation of ADK 3, but contributes greatly to its stability, and is essential for the post‐translational modification of the Cys221 residue by glutathione. This report highlights the fact that the C‐terminal part of the CP12 protein can act as a moonlighting, intrinsically disordered module conferring additional capabilities to the proteins to which it is added.

Enzymes

Adenylate kinase (ADK, EC 2.7.4.3) and glyceraldehyde 3‐phosphate dehydrogenase (GAPDH, EC 1.2.1.13)
A simplified extreme method for determining double‐K fracture parameters of concrete using experimental peak load
Authors: Qing L.B. , Nie Y.T. , Wang J , Hu Y
Published: July 2016

A simplified approach to obtain the double‐K fracture parameters of concrete for three‐point bending beams was proposed based on the extreme method. With the proposed method, the double‐K parameters can be easily obtained by the experimental peak load. This method requires fewer parameters or tests than the double‐K method and the peak load method. It also avoids complicated numerical integral compared with the traditional extreme method. The double‐K parameters obtained by the proposed method are slightly smaller than those by the double‐K method, and they do not seem to be influenced by the initial crack length to depth ratio.
Practical aspects of psychological support to the patient with haemophilia from diagnosis in infancy through childhood and adolescence
Authors: García‐Dasí M. , Torres‐Ortuño A. , Cid‐Sabatel R. , Barbero J.
Published: July 2016

Persons with haemophilia, living with their condition from infancy, require attention from a biopsychosocial approach, in which both the biological and the biographical dimension are addressed. These patients and their environment may benefit greatly from having professionals to help them manage, pre‐emptively if possible, to adapt to the disease, cope with the experience of suffering and overcome the difficulties caused by chronicity. The ultimate goal of the interventions was to achieve the best quality of life possible with tailored objectives throughout the patient's life, including disease control, addressing the particular difficulties, and achieving optimal empowerment. This article aims to describe the role of Health Psychology and its professionals in supporting the young patient with haemophilia and provide a brief guide that might be useful for health professionals involved in his care. From the psychological perspective, this paper focuses on communication of diagnosis, the role and support of the family, issues during infancy, childhood and adolescence and how the healthcare team can address them to provide successful support.
The reliability of histological grade in breast cancer core needle biopsies depends on biopsy size: a comparative study with subsequent surgical excisions
Authors: Focke Cornelia M , Decker Thomas , van Diest Paul J
Published: July 2016

Aims

In breast cancer patients undergoing neoadjuvant chemotherapy, histological grading needs to be performed on core needle biopsies (CNBs) that may not be representative of the whole tumour when they are small. Our aim was to study the influence of biopsy size on agreement rates for histological grade between CNBs and subsequent surgical excision biopsies (SEBs).

Methods and results

We calculated agreement and Cohen's κ between CNBs and SEBs of 300 early‐stage breast cancers. The number of cores, total core length, total tumour length and tumour/tissue ratio were assessed for each CNB set. Agreement rates for grade were calculated for different classes of core number and tumour/tissue ratio, and for total core lengths and tumour lengths per CNB set in 5–15‐mm intervals. Agreement on grade between CNBs and SEBs was 73% (κ = 0.59), with underestimation of grade in CNBs in 26% of cases and overestimation in 1% of cases. There was significantly higher concordance between CNBs and SEBs at a total core length of ≥50 mm than at a total core length of <50 mm (83% versus 68% agreement, P = 0.007), at a tumour length of ≥15 mm than at tumour length of <15 mm in CNBs (79% versus 67% agreement, P = 0.036), and at three or more cores than at fewer than three cores (75% versus 58% agreement, P = 0.048). The tumour/tissue ratio, pathological tumour size and radiological tumour size were not statistically different between concordant and discordant cases.

Conclusions

Agreement rates for histological grade in CNBs versus SEBs improve with increasing biopsy sample size.
Recent progress in the research about Propionibacterium acnes strain diversity and acne: pathogen or bystander?
Authors: Kwon Hyuck Hoon , Suh Dae Hun
Published: July 2016

Recent progress has steadily reported the existence of the diverse strains of Propionibacterium acnes, and these studies have contributed to the elucidation of their contradictory roles between normal commensals and pathogens. In this review, the authors aimed to provide an update on the recent understanding of research about P. acnes strain diversity and acne, analyzing the potential implications for clinical applications. Before the era of genomic research, P. acnes was known to be distinguished based on serological agglutination tests, cell wall sugar analysis, or fermentation traits. Since the complete genome sequence of P. acnes was first deciphered, genetic studies based on sequence data have expanded with the introduction of more refined and precise DNA‐based typing methods, including multilocus sequence typing and metagenomics. These sophisticated techniques have revealed that P. acnes consists of phylogenetically distinct cluster groups with various pathogenic traits, including elicitation of inflammation, protein secretome profile, and unique distribution patterns in various skin loci. In following large‐scale studies from patients’ acne samples have revealed that specific sequence types are included within the phylogenetic divisions and further suggested that particular P. acnes strains play an etiologic role in acne while others are associated with health, providing a firm platform for evidential‐based research into the exact role of this organism in acne. We strongly believe that future research would provide fruitful results in not only clarifying the apparent controversy with respect to roles of P. acnes but also developing therapeutic drugs by pinpointing specific targets of the pathogenic strain only.
Ongoing outbreak of cutaneous leishmaniasis in northwestern Yemen: clinicoepidemiologic, geographic, and taxonomic study
Authors: Khatri Mishri Lal , Di Muccio Trentina , Fiorentino Eleonora , Gramiccia Marina
Published: July 2016

Background

Cutaneous leishmaniasis (CL) is widespread in Yemen but has not been fully documented.

Objectives

This study aimed to investigate the clinicoepidemiologic and geographic aspects of CL in northwest Yemen and the taxonomic profile of the causative Leishmania species.

Methods

All CL cases diagnosed at the Dermatology Clinic of the Saudi Hospital at Hajjah during 1997–2012 were reviewed. Diagnoses were based on clinical, microscopic and, occasionally, histopathologic examinations. Leishmania species identification was carried out in 712 microscopically positive samples by multi‐locus enzyme electrophoresis and polymerase chain reaction–restriction fragment length polymorphism.

Results

During the surveillance period, 1343 cases of CL were diagnosed. Lesions per patient ranged from one to 71, but most patients had a single facial lesion, classified as representing the “dry type” in 1315 (97.9%) and “wet type” in 28 (2.1%) patients. Leishmania typing in 576 cases identified Leishmania tropica as the main species responsible (n = 529), followed by Leishmania infantum (n = 20), Leishmania donovani (n = 11), and members of the L. donovani complex (n = 8). Atypical molecular patterns were observed in eight CL cases diagnosed in areas in which the three Leishmania species were found sympatrically.

Conclusions

Cutaneous leishmaniasis appears to be endemic in northwest Yemen, where its incidence has recently increased abruptly. The disease presents clinically as the “dry type” and is caused mainly by L. tropica and occasionally by L. infantum, L. donovani, and L. donovani complex species. A sympatric diffusion of the three species is present in some governorates.
Evaluation of the correlation between serum levels of vitamin D and vitamin D receptor gene polymorphisms in an Egyptian population
Authors: Sobeih Shereen , Mashaly Heba M. , Gawdat Heba , Amr Khalda , Hamid Mahmoud Fawzy Abdel , Shaalan Eman
Published: July 2016

Background

Vitiligo is an autoimmune depigmentation disorder. Polymorphisms in the vitamin D receptor (VDR) have been found to be associated with vitiligo.

Objectives

To evaluate the potential association between VDR gene polymorphisms (ApaI, TaqI, and FokI) and vitiligo susceptibility, and to detect if there is correlation between serum 25‐hydroxyvitamin D [25(OH)D] levels and vitiligo and between VDR gene polymorphisms and 25(OH)D levels in vitiligo.

Materials and methods

Seventy‐five patients with vitiligo and 75 age and sex‐matched controls were subjected to detailed history taking and dermatological examination to determine the extent and clinical type of vitiligo. A blood sample (5 ml) was retrieved to investigate VDR gene polymorphisms and serum 25(OH)D level.

Results

Our results showed that the serum level of vitamin D is statistically significantly lower in patients than controls. The frequency of the ApaI variant a allele, the variant genotype (aa), and the variant genotype (tt) were significantly higher among the vitiligo cases than among controls. Our study also showed that the serum 25(OH)D levels were not significantly different among the different ApaI, TaqI, and FokI genotypes.

Conclusion

The present study showed that serum level of 25(OH)D is statistically significantly lower in patients than controls, so screening for vitamin D deficiency seems of value in patients with vitiligo for the possibility of vitamin D supplementation. We also report that VDR gene polymorphisms may be a risk for the development of vitiligo in an Egyptian population.
IgG4‐related skin disease may have distinct systemic manifestations: a systematic review
Authors: Bennett Adam E. , Fenske Neil A. , Rodriguez‐Waitkus Paul , Messina Jane L.
Published: July 2016

IgG4‐related disease (IgG4‐RD) is an increasingly prevalent protean multisystem disorder characterized by single or multi‐organ infiltration of IgG4‐bearing plasma cells. Skin involvement has been recognized and is relevant to proper diagnosis. A systematic literature review of 50 cases involving the skin reveals that patients with IgG4‐related skin disease show predominant involvement of the head and neck and have a distinct pattern of systemic involvement, also favoring the head and neck – lymphatics, orbit, salivary, and lacrimal glands – but generally lacking pancreaticobiliary involvement (16% of cases), which by contrast is a predominant manifestation in systemic IgG4‐RD (60% with pancreaticobiliary involvement). We summarize clinical and pathologic descriptive data from this systematic review. We review differential diagnosis and propose a diagnostic scheme for stratifying probability of disease based upon comprehensive integration of clinical, histopathologic, and laboratory data. Plasmacyte infiltration and storiform fibrosis are prominent in IgG4‐related skin disease, but obliterative venulitis is less common than in the prototypical IgG4‐related disease manifestation of autoimmune pancreatitis. IgG4 tissue and serum values, with a mean (±95% CI) in the reviewed cases of 132.8 ± 32.6 IgG4‐positive plasma cells per high‐power field and 580 ± 183.8 mg/dl, respectively, are incorporated into the suggested criteria. The distinct set of manifestations identified by this systematic review and the proposed diagnostic considerations, while requiring further validation in prospective studies, highlight the need to consider that IgG4‐related skin disease defines a unique systemic disease complex along the spectrum of IgG4‐RD.
Postoperative urinary incontinence exacerbates nocturia‐specific quality of life after robot‐assisted radical prostatectomy
Authors: Haga Nobuhiro , Aikawa Ken , Hoshi Seiji , Yabe Michihiro , Akaihata Hidenori , Hata Junya , Satoh Yuichi , Ogawa Soichiro , Ishibashi Kei , Kojima Yoshiyuki
Published: July 2016

Objectives

To elucidate the effect of postoperative urinary incontinence on nocturia‐related quality of life after robot‐assisted radical prostatectomy.

Methods

A total of 100 consecutive patients who underwent robot‐assisted radical prostatectomy completed a nocturia quality of life questionnaire score and a frequency‐volume chart before and after surgery. These patients were divided into two groups by continence status (continent and incontinent) according to the number of pad exchanges per day and the 1‐h pad test after surgery. Assessment was carried out before surgery, and then at 3 and 12 months after surgery.

Results

The Nocturia Quality of Life questionnaire total score and the Bother/Concern subscore were significantly lower in incontinent patients at 3 and 12 months after surgery (Nocturia Quality of Life questionnaire total score: Bother/Concern subscores P = 0.006: P = 0.04 at 3 months after surgery; and P = 0.04: P = 0.02 at 12 months). Both nocturnal maximum voided volume and nocturnal frequency were not significantly different between continent and incontinent patients. On multivariate analysis, nocturnal urinary frequency (P = 0.01) and urinary incontinence (P = 0.005) were significantly associated with nocturia‐specific quality of life.

Conclusions

Although the number of nocturia episodes was not significantly different between the continent and incontinent patients after surgery, the Nocturia Quality of Life questionnaire score was significantly worse in incontinent patients. In these patients, other than the number of nocturia episodes, psychological stress might worsen the Nocturia Quality of Life questionnaire score. Therefore, prevention of post‐prostatectomy incontinence might be important to avoid aggravating the Nocturia Quality of Life questionnaire score.
How does forest species specialization affect the application of the island biogeography theory in fragmented landscapes?
Authors: Dondina Olivia , Orioli Valerio , D'Occhio Pamela , Luppi Massimiliano , Bani Luciano
Published: July 2016

Aim

Overall species richness in habitat remnants is seldom explained by the island biogeography theory (IBT). In this study, we tested the effectiveness of theIBTin explaining species richness of forest birds with or without considering the effect of the different forest specialization of species (generalist,edgeandinterior; community analysis). We also identified single species and groups of species that could serve as indicators of different fragmentation degrees (indicator species analysis).

Location

Broadleaved forests in western Lombardy (northern Italy).

Methods

We evaluated bird species richness in 344 forest fragments. Fragment area (FA), distance from the nearest source area (> 1000 ha) (DSA) and number of neighbouring fragments (NF) were calculated for each fragment. Using Poisson generalized linear models, we compared a model that evaluated the relationships between fragment covariates and species richness to a model that also considered the effect of forest species specialization on each relationship. Moreover, we investigated the association between each species and particular fragmentation conditions by calculating the IndVal index.

Results

The application of theIBTto species richness performed significantly better if we took into account forest species specialization when evaluating the effect of fragment covariates. In particular, the positive effects ofFAandNFand the negative effect ofDSAwere significantly stronger oninteriorspecies rather than ongeneralistandedgespecies. Using the IndVal index we identified six species in three groups strongly associated with specific fragmentation degrees.

Main conclusions

The results showed the strong influence of the specialization of species on their distribution in fragmented landscapes.Interiorspecies were the best candidates as a proxy of fragmentation effects. However, the indicator species analyses revealed that not allinteriorspecies showed the same sensitivity to fragment covariates.
Hydrogen sulphide exacerbates acute pancreatitis by over‐activating autophagy viaAMPK/mTOR pathway
Authors: Ji Liang , Li Le , Qu Fengzhi , Zhang Guangquan , Wang Yongwei , Bai Xuewei , Pan Shangha , Xue Dongbo , Wang Gang , Sun Bei
Published: July 2016

Previously, we have shown that hydrogen sulphide (H2S) might be pro‐inflammatory during acute pancreatitis (AP) through inhibiting apoptosis and subsequently favouring a predominance of necrosis over apoptosis. In this study, we sought to investigate the detrimental effects of H2S during AP specifically with regard to its regulation on the impaired autophagy. The incubated levels of H2S were artificially intervened by an administration of sodium hydrosulphide (NaHS) or DL‐propargylglycine (PAG) after AP induction. Accumulation of autophagic vacuoles and pre‐mature activation of trypsinogen within acini, which indicate the impairment of autophagy during AP, were both exacerbated by treatment with NaHS but attenuated by treatment with PAG. The regulation that H2S exerted on the impaired autophagy during AP was further attributed to over‐activation of autophagy rather than hampered autophagosome–lysosome fusion. To elucidate the molecular mechanism that underlies H2S‐mediated over‐activation of autophagy during AP, we evaluated phosphorylations of AMP‐activated protein kinase (AMPK), AKT and mammalian target of rapamycin (mTOR). Furthermore, Compound C (CC) was introduced to determine the involvement of mTOR signalling by evaluating phosphorylations of downstream effecters including p70 S6 kinase (P70S6k) and UNC‐51‐Like kinase 1 (ULK1). Our findings suggested that H2S exacerbated taurocholate‐induced AP by over‐activating autophagy via activation of AMPK and subsequently, inhibition of mTOR. Thus, an active suppression of H2S to restore over‐activated autophagy might be a promising therapeutic approach against AP‐related injuries.
Deactivation in anterior cingulate cortex during facial processing in young individuals with high familial risk and early development of depression: fMRI findings from the Scottish Bipolar Family Study
Authors: Chan Stella W.Y. , Sussmann Jessika E. , Romaniuk Liana , Stewart Tiffany , Lawrie Stephen M. , Hall Jeremy , McIntosh Andrew M. , Whalley Heather C.
Published: July 2016

Background

Studies have identified perturbations in facial processing in bipolar disorder and major depressive disorder (MDD), but their relationship to genetic risk and early development of illness is unclear.

Methods

The Scottish Bipolar Family Study is a prospective longitudinal investigation examining young individuals (age 16–25) at familial risk of mood disorder. Participants underwent functional MRI using an implicit facial processing task employing angry and neutral faces. An explicit facial expression recognition task was completed outside the scanner. Clinical outcomes obtained 2 years after the scan were used to categorise participants into controls (n = 54), high‐risk individuals who had developed MDD (HR MDD; n = 30) and high‐risk individuals who remained well (HR Well, n = 43).

Results

All groups demonstrated activation patterns typically observed during facial processing, including activation of the amygdala, hippocampus, fusiform gyrus and middle frontal regions. Notably, the HR MDD group showed reduced activation of the anterior cingulate gyrus versus both the control and HR Well group for angry faces, and versus the HR Well group for neutral faces. Outside the scanner, the HR MDD group was less accurate in recognising fearful expressions than the HR Well group.

Conclusions

Here, we demonstrate functional abnormalities of the anterior cingulate cortex alongside facial emotional recognition deficits in high‐risk individuals in the early stages of depression compared with both controls and at‐risk individuals who remained well. These neural changes were associated with a current or future diagnosis of MDD and were not simply associated with increased familial risk.
Surveillance of patients with long‐segment Barrett's esophagus: A multicenter prospective cohort study in Japan
Authors: Matsuhashi Nobuyuki , Sakai Eiji , Ohata Ken , Ishimura Norihisa , Fujisaki Junko , Shimizu Tomoki , Iijima Katsunori , Koike Tomoyuki , Endo Takao , Kikuchi Takefumi , Inayoshi Tatsuya , Amano Yuji , Furuta Takahisa , Haruma Ken , Kinoshita Yoshikazu
Published: July 2016

Background and Aim

The incidence of esophageal adenocarcinoma (EAC) in cases with long‐segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long‐segment BE prospectively.

Methods

This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow‐up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed.

Results

Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow‐up esophagogastroduodenoscopy. In this follow‐up, three EACs developed in 251 observed patient‐years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow‐up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection.

Conclusions

The incidence rate of EAC in Japanese cases with long‐segment BE was calculated to be 1.2% in a year.
Plasma hypercoagulability in the presence of thrombomodulin but not of activated protein C in patients with cirrhosis
Authors: Lebreton Aurélien , Sinegre Thomas , Pereira Bruno , Lamblin Géraldine , Duron Cédric , Abergel Armand
Published: July 2016

Background and Aims

Cirrhosis significantly changes all hemostasis steps. Recent studies suggest that cirrhosis is associated with a coagulopathy leading to a hypercoagulable state. The underlying mechanisms are not fully understood, but protein C deficiency is probably a major determinant of this phenotype. The aim of this study was to compare the results of thrombin generation assays performed with addition of thrombomodulin or activated protein C to assess the effect of by‐passing the protein C activation step in cirrhotic patients and healthy controls.

Methods

Fifty‐eight patients with cirrhosis and 26 healthy controls were prospectively included in this study. Thrombin generation was determined in platelet‐poor plasma using 5 pM of tissue factor and 4 nM of phospholipids, without and with external addition of 1 nM thrombomodulin or 4 nM activated protein C. All results were normalized with the values of a pool of normal plasma samples to limit inter‐plate variability.

Results

When thrombin generation assays were performed in the presence of thrombomodulin, endogenous thrombin potential (ETP) and ETP with/ETP without TM ratio were significantly higher in cirrhotic patients than in healthy controls (P < 0.0001). Moreover, these values progressively increased with cirrhosis severity. When thrombin generation assays were performed with activated protein C, all thrombin generation parameters were comparable between healthy controls and cirrhotic patients, despite an acquired protein S deficiency.

Conclusion

In the presence of activated protein C, no hypercoagulability was observed, adding to the current evidence that acquired protein C deficiency plays a key role in the coagulation imbalance.
Pharmacokinetics of the MRI contrast agent gadobutrol in common marmoset monkeys (Callithrix jacchus)
Authors: Helms Gunther , Schlumbohm Christina , Garea‐Rodriguez Enrique , Dechent Peter , Fuchs Eberhard
Published: July 2016

Background

This study determined the pharmacokinetics of the contrast agent gadobutrol in marmosets by quantitative MRI to derive guidelines for neuroimaging protocols.

Methods

Local concentrations of gadobutrol were determined from consecutive gradient echo‐based mapping of the relaxation rate R1 on a clinical 3T MRI scanner. Half‐time of renal elimination was measured after injection of a triple dose of gadobutrol (0.3 mmol/kg) into the saphenous vein. A first‐order single‐compartment model was fitted to the measured R1 values and verified by blood analysis.

Results

Slow injection (1.5 minutes) resulted in an elimination half‐time of 26±4 minutes. After bolus injection (15 seconds), elimination was much slower (62±8 minutes) with 45% larger distribution volumes. Importantly, more gadobutrol entered the cerebrospinal fluid.

Conclusions

Slow injection and a latency of about 20 minutes are recommended to avoid extravasation. Application of a triple dose of gadobutrol compensates for the fast elimination in healthy marmosets.