bluuebunny/crossref_metadata_2025 huggingface dataset:
Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery versus laparoscopy as a day‐care procedure: a randomised controlled trial
Authors: Baekelandt JF , De Mulder PA , Le Roy I , Mathieu C , Laenen A , Enzlin P , Weyers S , Mol BWJ , Bosteels JJA
Published: October 2018

Objective

To compare hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) versus total laparoscopic hysterectomy (TLH) as a day‐care procedure.

Design

Parallel group, 1:1 randomised single‐centre single‐blinded trial, designed as a non‐inferiority study with a margin of 15%.

Setting

Belgian teaching hospital.

Population

Women aged 18–70 years scheduled to undergo hysterectomy for benign indications.

Methods

Randomisation to TLH (control group) or vNOTES (experimental group). Stratification according to uterine volume. Blinding of participants and outcome assessors.

Main outcome measures

The primary outcome was hysterectomy by the allocated technique. We measured the proportion of women leaving within 12 hours after hysterectomy and the length of hospital stay as secondary outcomes.

Results

We randomly assigned 70 women to vNOTES (n = 35) or TLH (n = 35). The primary endpoint was always reached in both groups: there were no conversions. We performed a sensitivity analysis for the primary outcome, assuming one conversion in the vNOTES group and no conversions in the TLH group: the one‐sided 95% upper limit for the differences in proportions of conversion was estimated as 7.5%, which is below the predefined non‐inferiority margin. More women left the hospital within 12 hours after surgery after vNOTES: 77 versus 43%, difference 34% (95% CI 13–56%), P = 0.007. The hospital stay was shorter after vNOTES: 0.8 versus 1.3 days, mean difference −0.5 days, (95% CI −0.98 to −0.02), P = 0.004.

Conclusions

vNOTES is non‐inferior to TLH for successfully performing hysterectomy without conversion. Compared with TLH, vNOTES may allow more women to be treated in a day‐care setting.

Tweetable abstract

RCT: vNOTES is just as good as laparoscopy for successful hysterectomy without conversion but allows more day‐care surgery.
Probiotic Properties of Lactobacillus Plantarum LRCC5193, a Plant‐Origin Lactic Acid Bacterium Isolated from Kimchi and Its Use in Chocolates
Authors: Lim Jung‐hoon , Yoon Seok‐min , Tan Pei‐Lei , Yang Siyoung , Kim Sae‐hun , Park Hyun‐jin
Published: October 2018

This study involves an investigation of the probiotic properties of lactic acid bacteria isolated from Kimchi, and their potential applications in chocolate. Lactobacillus plantarum—LRCC5193 (LP‐LRCC5193) demonstrated a significantly higher degree of heat, acid, and bile acid tolerance compared to other Kimchi isolates. The intestinal adhesion assay also revealed that 84.2 log percentage of LP‐LRCC5193 adhered to the Caco‐2 cells after 2 h of incubation. Furthermore, the lyophilized LP‐LRCC5193 maintained 92.9 log percentage and 97.2 log percentage survival rate within artificial stomach juice (pH 2.5, pepsin 0.04%) and artificial intestinal juice (oxgall 0.5%, trypsin 0.04%, and pancreatin 0.04%), respectively. Meanwhile, we also found that lyophilized LP‐LRCC5193 incorporated in chocolate exhibited significantly higher survivability than lyophilized LP‐LRCC5193 in both artificial gastric and intestinal juice under 1 to 3 hr incubation, where the survivability was within the range of 96.3 to 98.5 log percentage, and 98.8 to 98.9 log percentage, respectively. A 6‐month storage test further revealed that LP‐LRCC5193 demonstrated higher stability than the lyophilized LP‐LRCC5103 in 3 different temperature ranges, where the final survival rates were 97.2 log percentage (20 °C), 89.2 log percentage (33 °C), and 94.4 log percentage (15 to 30 °C/wk). Altogether, our data suggest that chocolate can be used as a tasty delivery vehicle for delivering putative probiotic strain, LP‐LRCC5193 to the gastrointestinal tract.

Practical Application

Lactobacillus plantarum LRCC5193 (LP‐LRCC5193) isolated from Kimchi demonstrated high stability under gastrointestinal environmental stresses and good adhesion to the intestinal epithelial cells in vitro. In addition, LP‐LRCC5193 containing chocolates remained highly stable after storage at room temperature for 6 months. Chocolate containing LP‐LRCC5193 can thus be considered a promising probiotic delivery system.
Body surface area as a novel risk factor for chylothorax complicating video‐assisted thoracoscopic surgery lobectomy for non‐small cell lung cancer
Authors: Li Shuangjiang , Wang Yan , Zhou Kun , Cheng Shan , Wu Yanming , Che Guowei
Published: October 2018

Background

The study was conducted to demonstrate the predictive value of body surface area (BSA) for chylothorax complicating video‐assisted thoracoscopic surgery (VATS) lobectomy for non‐small cell lung cancer (NSCLC).

Methods

Large‐scale retrospective analysis was conducted on the data of 1379 patients who underwent VATS lobectomy between January 2014 and October 2017 at our institution. Receiver operating characteristic analysis was conducted to determine a threshold BSA value for the prediction of chylothorax. This optimal BSA cutoff, other clinicopathological variables, and P < 0.15 were included into a multivariable logistic regression model to determine the risk factors for chylothorax.

Results

Twenty‐six patients (1.9%) developed postoperative chylothorax. The mean BSA in patients with chylothorax was significantly higher than in patients without (1.84 ± 0.14 vs. 1.73 ± 0.16 m2; P = 0.001). A BSA of 1.69 m2 was identified as the threshold value with maximum joint sensitivity (96.2%) and specificity (43.8%). Patients with BSA > 1.69 m2 had a significantly higher incidence of chylothorax (3.0% vs. 0.3%; P < 0.001) and a longer hospital stay (log rank P < 0.001) than patients with BSA ≤ 1.69 m2. Multivariable logistic regression analysis suggested that BSA > 1.69 m2 (odds ratio 7.35, 95% confidence interval 1.54–35.71; P = 0.013) was predictive of postoperative chylothorax.

Conclusions

BSA can serve as a novel categorical predictor for chylothorax complicating VATS lobectomy for NSCLC. It may be more helpful to incorporate a BSA cutoff into routine risk stratification tools for lung cancer surgery.
Discussions of Alcohol Use in an Online Social Network for Smoking Cessation: Analysis of Topics, Sentiment, and Social Network Centrality
Authors: Cohn Amy M. , Amato Michael S. , Zhao Kang , Wang Xi , Cha Sarah , Pearson Jennifer L. , Papandonatos George D. , Graham Amanda L.
Published: October 2018

Background

Few Internet smoking cessation programs specifically address the impact of alcohol use during a quit attempt, despite its common role in relapse. This study used topic modeling to describe the most prevalent topics about alcohol in an online smoking cessation community, the prevalence of negative sentiment expressed about alcohol use in the context of a quit attempt (i.e., alcohol should be limited or avoided during a quit attempt) within topics, and the degree to which topics differed by user social connectivity within the network.

Methods

Data were analyzed from posts from the online community of a larger Internet cessation program, spanning January 1, 2012 to May 31, 2015 and included records of 814,258 online posts. Posts containing alcohol‐related content (n = 7,199) were coded via supervised machine learning text classification to determine whether the post expressed negative sentiment about drinking in the context of a quit attempt. Correlated topic modeling (CTM) was used to identify a set of 10 topics of at least 1% prevalence based on the frequency of word occurrences among alcohol‐related posts; the distribution of negative sentiment and user social network connectivity was examined across the most salient topics.

Results

Three salient topics (with prevalence ≥10%) emerged from the CTM, with distinct themes of (i) cravings and temptations; (ii) parallel between nicotine addiction and alcoholism; and (iii) celebratory discussions of quit milestones including “virtual” alcohol use and toasts. Most topics skewed toward nonnegative sentiment about alcohol. The prevalence of each topic differed by users’ social connectivity in the network.

Conclusions

Future work should examine whether outcomes in Internet interventions are improved by tailoring social network content to match user characteristics, topics, and network behavior.
Paraskusella gen. nov., a new Afro‐Australian genus in the tribe Chironomini (Diptera: Chironomidae)
Authors: Cranston Peter S
Published: October 2018

One described species of Chironomidae, the African Paratendipes seydeli Freeman, 1957, and two newly described species from Australia are allocated to a new genus, Paraskusella gen. nov. Described from all life stages, Paraskusella donedwardi sp. nov. is restricted to south‐west Western Australia. Paraskusella bobhawkei sp. nov. is described from adult males and a female from northern Australia. Its possible immature stages are described as Paraskusella ‘K2’, a taxon with a wider northern to central and temperate distribution. The immature stages allow inference of proximity to the Afro‐Oriental‐Australian Skusella Freeman, 1961.
Predicting undetected glaucoma according to age and IOP: a prediction model developed from a primarily European‐derived population
Authors: Oskarsdottir Sigridur E. , Heijl Anders , Bengtsson Boel
Published: October 2018

Purpose

To model prediction of undetected glaucoma in a predominantly white population, based on intraocular pressure (IOP) and subject age.

Methods

In 1992–1997, a population screening for glaucoma was performed at Malmö University Hospital where individuals between 55–79 years of age (n = 46 614) living in Malmö, were invited to a free eye health examination. Recently examined patients were not invited (n = 4117). IOP and age were recorded for all screened subjects. Subjects who screened positive were further examined to establish or reject a glaucoma diagnosis. We performed multiple regression analysis of the combined effect of age and IOP on the likelihood of undetected glaucoma.

Results

In all, 32 918 subjects attended the screening (77.5% of invited), 22 218 women and 11 700 men, while 9579 refrained from participation. Glaucoma was diagnosed in 406 subjects. The proportion of subjects with glaucoma increased exponentially with increasing IOP and older age. Still, the majority of subjects with glaucoma (57%) had ≤IOP 21 mmHg. The predicted rate of undetected glaucoma was low, <5%, for subjects with IOP <25 mmHg, but rose rapidly with higher IOP, reaching 81% in the group with IOP >35 mmHg and age 75–79 years. The model fit well to the data (R2 = 0.97).

Conclusion

We created a model estimating the combined effect of IOP and age on the likelihood of undetected glaucoma. The model may facilitate case‐finding in European‐derived populations. Despite the important impact of IOP on the risk of glaucoma, a large proportion of subjects with undetected glaucoma had IOP ≤ 21 mmHg.
Cachexia does not induce loss of myonuclei or muscle fibres during xenografted prostate cancer in mice
Authors: Winje Ivan Myhre , Sheng Xia , Hansson Kenth‐Arne , Solbrå Andreas , Tennøe Simen , Saatcioglu Fahri , Bruusgaard Jo Christiansen , Gundersen Kristian
Published: October 2018

Aim

Cachexia is a severe wasting disorder involving loss of body‐ and muscle mass reducing survival and quality of life in cancer patients. We aim at determining if cachexia is a mere perturbation of the protein balance or if the condition also involves a degenerative loss of myonuclei within the fibre syncytia or loss of whole muscle fibres.

Methods

We induced cachexia by xenografting PC3 prostate cancer cells in nu/nu mice. Six weeks later, we counted myonuclei by in vivo microscopic imaging of single live fibres in the extensor digitorum longus muscle (EDL), and the EDL, soleus and tibialis anterior muscles were also harvested for ex vivo histology.

Results

The mice lost on average 15% of the whole‐body wt. The muscle wet weight of the glycolytic, fast EDL was reduced by 14%, the tibialis anterior by 17%, and the slow, oxidative soleus by 6%. The fibre cross‐sectional area in the EDL was reduced by 21% with no loss of myonuclei or any significant reduction in the number of muscle fibres. TUNEL‐positive nuclei or fibres with embryonic myosin were rare both in cachectic and control muscles, and haematoxylin‐eosin staining revealed no clear signs of muscle pathology.

Conclusion

The data suggest that the cachexia induced by xenografted prostate tumours induces a pronounced atrophy not accompanied by a loss of myonuclei or a loss of muscle fibres. Thus, stem cell related treatment might be redundant, and the quest for treatment options should rather focus on intervening with intracellular pathways regulating muscle fibre size.
Large Dams, Restructuring and Regional Integration in Southeast Asia
Authors: Hirsch Philip
Published: October 2018

Large dams are a dramatic intervention affecting ecosystems, livelihoods and resource use, notably in upland areas. Dams are significant, both in terms of their scale of impact and due to their role in appropriating part of the upland resource base for mainly lowland and urban beneficiaries. Whereas in the past the tensions associated with impact of dams in Southeast Asia have been played out within national borders, mainly in Thailand, the new impetus for dam construction reflects an internationalised agenda — namely integration of the mainland Southeast Asian regional resource economy. This paper examines the background to large dam construction in mainland Southeast Asia, current and projected developments, and their implications in a number of arenas. Case studies from Lao PDR, Thailand and Vietnam illustrate the main points. It is shown that political­economic restructuring associated with the changing geopolitics of the region is a major influence on the revived agenda for large dam construction, and that such restructuring modulates the direct and indirect impacts of dams at local, national and regional levels.
The Changing Organisation of Work in Malaysia’s Electronics Industry
Authors: Rasiah Rajah
Published: October 2018

The early growth phase of Malaysia’s electronics industry coincided in the 1970s with high unemployment and accelerated rural­urban migration and a willingness to make considerable concessions to foreign transnationals seeking suitable cheap and passive labour sites. The result was a very rigid exploitation of the labour force. Interviews with a variety of contemporary electronics firms show how this changed in the I 980s and I 990s. Demand for labour increased and unemployment declined, automation removed much of the labour intensity and raised the need for skill and cooperation and commitment of those hired to work in an increasingly sophisticated sector. Wages rose and management practices changed, together with the introduction of flexible production techniques, preventative maintenance and quality control, each of which required considerable employee participation. Despite these changes, both firms and government have resisted attempts nationwide unionisation of the industry.
Politics of Economic Adjustment: The Changing Nature of Women’s Work in Jharkand, India
Authors: Saihjee Aarti
Published: October 2018

This paper focuses on the ‘gendered’ politics of economic adjustment exemplified in India’s New Economic Policy (NEP) and interrogates NEP’s tacit appropriation of women’s labour (productive and reproductive) to maintain social reproduction during times of economic insecurity. Through a micro­study of an ‘Oraon’ village in the Jharkand region of Bihar, India, I explore the changing nature of women’s work and gender relations in response to the larger socio­economic transformation initiated by the NEP; and how in turn these changes are mediated through the interacting politics of the gendered ideology of the family and the household, class and ethnicity. Through the analysis of changing gender responsibilities within the household, I critique the ‘unitary model’ approach to household behaviour implicit in the NEP and argue for the need to move beyond it, to address the larger issues of gender equity and empowerment.
‘Changing My Thinking With a Western Woman’: Javanese Youths’ Constructions of Masculinity
Authors: Lette Helen
Published: October 2018

Yogyakarta’s ‘wild’ guides are young men who pursue fantasies of true love and easy wealth by striking up ‘love affairs’ with tourist women. A hegemonic masculinity emerges as male peergroup gossip evaluates dramatic incidents to pinpoint ideal male with­male image and behaviour. In romances with Western women, guides renegotiate the sexual aspect of their masculinity, as tourist women’s holiday­romance expectations of attentiveness and deference collide with this ideal masculine self­image. The tension between disgust and desire within guides’ lifestyle leads to fragmented performances of identity for their different audiences.
Interaction between warfarin and cannabis
Authors: Damkier Per , Lassen Dorte , Christensen Mette Marie Hougaard , Madsen Kenneth Grønkjær , Hellfritzsch Maja , Pottegård Anton
Published: October 2018

Delta‐9‐tetrahydrocannabinol (THC), the main psychoactive cannabinoid in cannabis, may inhibit the cytochrome P450 enzyme CYP2C9. Consequently, cannabis use might infer a risk of drug‐drug interaction with substrates for this enzyme, which includes drugs known to have a narrow therapeutic window. In this study, we describe a case report of a 27‐year‐old man treated with warfarin due to mechanical heart valve replacement who presented with elevated international normalized ratio (INR) value (INR = 4.6) following recreational cannabis use. We conducted a review of the available literature, using the PubMed and EMBASE databases while following PRISMA guidelines. Following screening of 85 articles, three eligible articles were identified, including one in vitro study and two case reports. The in vitro study indicated that THC inhibits the CYP2C9‐mediated metabolism of warfarin. One case study reported of a man who on two occasions of increased marijuana use experienced INR values above 10 as well as bleeding. The other case study reported of a patient who initiated treatment with a liquid formulation of cannabidiol for the management of epilepsy, ultimately necessitating a 30% reduction in warfarin dose to maintain therapeutic INR values. The available, although sparse, data suggest that use of cannabinoids increases INR values in patients receiving warfarin. Until further data are available, we suggest patients receiving warfarin be warned against cannabis use.
Evaluation of early wound healing scales/indexes in oral surgery: A literature review
Authors: Hamzani Yafit , Chaushu Gavriel
Published: October 2018

Background

The quality of the healing response after oral and maxillofacial surgery (OMS) is influenced by the nature of the tissue disruption and the circumstances surrounding wound closure. The use of wound healing scales may help the surgeon anticipate and, when possible, intervene so that wound repair can progress favorably.

Materials and Methods

Studies reported in the OMS literature of the last 20 years that applied scales/indexes to monitor the wound healing process were reviewed.

Results

We identified eight scales/indexes that were developed for use in OMS, including three that are modifications of a previously reported scale. Most were applied in split‐mouth trials of wound healing modifiers.

Conclusion

Wound healing scales are infrequently used in OMS. Those that are available do not allow for an association of the outcome parameters, modifiers used, or effectiveness of the modifiers with the different phases of the wound healing process (inflammatory, proliferative, and remodeling). Moreover, there is no consensus regarding the time frames that should be evaluated or the preferred scale. On the basis of these findings, we suggest a novel scale that distinguishes among the wound healing phases and yields three subscale scores and a total score.
Technetium‐99m‐anti‐tumour necrosis factor alpha scintigraphy as promising predictor of response to corticotherapy in chronic active Graves' ophthalmopathy
Authors: de Lacerda Adriano Machado , de Souza Sergio Augusto Lopes , Gutfilen Bianca , Barbosa da Fonseca Léa Mirian , Lobo Lopes Flávia Paiva Proença , Tonomura Elise , Vaisman Mário , Teixeira Patrícia de Fátima dos Santos
Published: October 2018

It has been suggested that technetium‐99m (99mTc)‐anti‐tumour necrosis factor alpha (TNF‐α) scintigraphy (SCI) may be a useful diagnostic tool in Graves' ophthalmopathy (GO). This study evaluated whether orbit total radioactivity uptake on SCI could be used to predict corticosteroid therapy (CorT) responses in active‐GO patients. A longitudinal study of patients with active GO defined by Clinical Active Score (CAS) >3/7 was done. Clinical, laboratory and SCI evaluations were performed at baseline and 3 months after concluding intravenous CorT. SCI (planar and tomographic) was assessed after intravenous injection of 10 mCi of 99mTc‐anti‐TNF‐α. Orbits and cerebral hemispheres were defined as regions of interest (ROIs) to enable orbit/hemisphere ROI‐ratios of total radioactive uptake. ROI‐ratios were considered positive at >2·5. Average total radiation uptake (TRU) was also determined for each orbit (AVGROI). Clinical, laboratory and SCI data were compared between responders (CAS became inactive) and non‐responders to CorT (18 patients). At baseline, AVGROI were higher in active OG orbits (67·3 cps) than in inactive ones (33·6 cps; P<0·05). AVGROI (absolute values) reduced (−29·9 cps) in CorT responders and tended (P = 0·067) to differ from variations occurred in non‐responders (+6·9 cps in patients with maintained CAS positivity post‐treatment). Higher baseline ROI‐ratios (4·9 versus 3·3; P = 0·056) and its pronounced reductions following CorT (−37% versus +56% in non‐responders; P = 0·036) tended to be associated with good CorT responses in the subgroup of GO history ≥1 year. SCI showed a good association with active eye disease and may be an additional tool to identify CorT responders.
Characteristics of the paralysed diaphragm studied by M‐mode ultrasonography
Authors: Boussuges Alain , Brégeon Fabienne , Blanc Philippe , Gil Jean‐Marie , Poirette Laurent
Published: October 2018

Background

M‐mode ultrasonography might be useful for detecting hemidiaphragm paralysis. The objective of the present study was to describe the motion recorded by M‐mode ultrasonography of both diaphragmatic leaves in patients with a pre‐established diagnosis of hemidiaphragm paralysis.

Methods

A study was conducted in 26 patients (18 men, 8 women) with unilateral diaphragmatic paralysis. They were referred to two different rehabilitation centres after thoracic surgery in 23 cases and cardiac interventional procedures in three cases. The pulmonary function tests and the study of the diaphragmatic motion using M‐mode ultrasonography were recorded.

Results

The pulmonary function tests showed a restrictive pattern. The M‐mode ultrasonography reported either the absence of motion or a weak paradoxical (cranial) displacement (less than 0·5 cm) of the paralysed hemidiaphragm during quiet breathing. A paradoxical motion was recorded in all patients during voluntary sniffing, reaching around −1 cm. During deep breathing, a paradoxical motion at the beginning of the inspiration was observed. Thereafter, a re‐establishment of the motion in the craniocaudal direction was recorded. The excursions measured on the healthy side, during quiet breathing and voluntary sniffing, were increased in patients suffering from contralateral hemidiaphragm paralysis, when compared with 170 healthy volunteers.

Conclusions

To detect diaphragmatic dysfunction in patients at risk, it would be useful to study diaphragmatic motion by M‐mode ultrasonography during quiet breathing, voluntary sniffing and deep breathing.
Diabetic nephropathy after kidney transplantation in patients with pretransplantation type II diabetes: A retrospective case series study from a high‐volume center in the United States
Authors: Cimeno Arielle , Munley Jennifer , Drachenberg Cinthia , Weir Matthew , Haririan Abdolreza , Bromberg Jonathan , Barth Rolf N. , Scalea Joseph R.
Published: October 2018

Background

Patients with type II diabetes mellitus (DM) undergoing renal transplantation are at risk of diabetic nephropathy (DN) in the transplanted kidney. The true risk of developing post‐transplantation DN is unknown, and post‐transplantation DN is poorly characterized in the literature.

Methods

The biopsy database at the University of Maryland Medical Center was queried for kidney transplant biopsies which demonstrated evidence of DN. The time from transplantation to biopsy‐proven DN (time to diagnosis, TTD) was calculated and analyzed in the context of demographics, serum creatinine, and onset of diabetes. By extrapolating the total number of patients who developed DN in the last 2 years, we estimated the recurrence rate of DN.

Results

Sixty patients whose renal biopsies met criteria were identified. The mean age was 56.6 (±1.58) years, and the mean creatinine level at time of biopsy was 1.65 (±0.12) mg/dL. Simultaneous pathological diagnoses were frequent on kidney biopsy; rejection was present at variable rates: classes I, IIA, IIB, and III were 5.0%, 66.7%, 18.4%, and 10%, respectively. The mean TTD was 1456 (±206) days. TTD was significantly shorter for patients receiving a cadaveric vs living donor renal transplant (1118 ± 184 vs 2470 ± 547 days, P = 0.004). Older patients (r = 0.378, P = 0.003) and patients with higher serum creatinine (r = 0.282, P = 0.029) had shorter TTDs. Extrapolations showed that 74.7% of patients would be free of DN 10 years after renal transplantation.

Conclusions

Diabetic nephropathy occurs after transplantation, and this appears to be due to both donor and recipient‐derived factors. Encouragingly, our estimates suggest that as many as 75% of patients may be free of DN at 10 years following kidney transplantation.
The importance of transplant program measures: Surveys of three national patient advocacy groups
Authors: Schaffhausen Cory R. , Bruin Marilyn J. , Chu Sauman , Wey Andrew , Snyder Jon J. , Kasiske Bertram L. , Israni Ajay K.
Published: October 2018

The Scientific Registry of Transplant Recipients (SRTR) provides federally mandated program‐specific transplant data to the public. Currently, there is little understanding of how different program measures are prioritized by patients in selecting a program for transplantation. This study recruited 479 transplant advocacy group members from mailing lists and social media of the National Kidney Foundation (NKF), transplant families (TF), and Transplant Recipient International Organization (TRIO). Survey participants identified how many different programs would be reasonable to consider and viewed four measures that have recently been displayed on SRTR public search result websites and six measures not recently displayed and indicated importance on a 5‐point scale. Four hundred two completed the survey (TF = 26; TRIO = 34; NKF = 342). Seventy‐eight percent indicated that considering more than one program would be reasonable. Linear mixed models adjusted for organization, education, and gender. Likert scores for pretransplant (transplant rate) and transplant volume measures were similar and were very or extremely important to over 80% of participants. Posttransplant (survival after transplant) was rated as 0.52 points higher, confidence interval (0.41, 0.64). Results indicate that many patient advocacy group members find a choice between two or more programs reasonable and value multiple measures when assessing programs where they may want to undergo transplantation.
“I Thought I Did Much Better”—Overconfidence in University Exams
Authors: Wüst Kirsten , Beck Hanno
Published: October 2018

Students tend to be overconfident about their future performance in university exams, which can lead to demotivation when faced with unexpectedly bad results. We hypothesized that overconfidence is partly a personality trait but also partly results from students’ insufficient knowledge of what is expected of them in university exams. It follows that this should decrease as the students learn what is really required. In a longitudinal study with 441 students from a southern German university, we asked students to solve intelligence test questions and to make estimates of their own performances. Additionally, students estimated their performance in a forthcoming maths and/or a descriptive statistics exam. Then shortly after the exam was taken they indicated their planned and effective hours of study. As expected, students did not, in the mean, overestimate their performance on intelligence test questions. Women were more likely than men to underestimate their performance. Over‐ or underestimation in intelligence test questions did, however, predict misestimation in the mathematics and the statistics exams. Also, further correlations of misestimation between the statistics and a financial mathematics exam could be found—as such misestimation can be interpreted to be a stable trait. Students with an "Abitur" qualification were more likely to underestimate their performance, while students with other preuniversity qualifications tended to overestimate their performance. No effect of personality factors was found. Against our expectations, students who had overestimated themselves later indicated a higher number of hours studied than other students. We suggest different strategies by which students and universities can actively counter overestimation.
Photodynamic therapy with a 5‐ALA patch does not increase the risk of conversion of actinic keratoses into squamous cell carcinoma
Authors: Reinhold Uwe , Petering Holger , Dirschka Thomas , Rozsondai András , Gille Jens , Kurzen Hjalmar , Ostendorf Rolf , Ebeling Andrea , Stocker Marcus , Radny Peter
Published: October 2018

Background

It is important to collect data about the risk of transformation of an actinic keratosis (AK) lesion into squamous cell carcinoma (SCC) after a single photodynamic therapy (PDT) with 5‐ALA patch for a longer follow‐up period under daily routine.

Questions addressed

The purpose of this non‐interventional study (NIS) was to collect data on the frequency of occurrence of SCCs in the treated area during an interval of 2 years after a single 5‐ALA patch‐PDT.

Experimental design

This prospective observational case‐only study included patients with mild AK lesions on the head and face treated with 5‐ALA patch‐PDT according to the Summary of Product Characteristics (SPC).

Results

In 370 patients, the risk of transformation of their treated AK lesion into SCC was 0.073% with its exact 95% confidence interval using the Poisson distribution of [0.009%, 0.262%]. The rate of complete clinical clearance on lesion basis after 3 months was 84.3%.

Conclusion

The efficacy and the safety results show no observation of an increased risk for conversion of an AK into a SCC 2 years after a single 5‐ALA patch‐PDT. Additionally, the high clinical complete remission rate under routine conditions is comparable to the rates observed in the approval trials.
Large‐scale environmental flow results in mixed outcomes with short‐term benefits for a semi‐arid floodplain plant community
Authors: Moxham Claire , Kenny Sally A. , Beesley Leah S. , Gwinn Daniel C.
Published: October 2018

Demonstrating and predicting the effectiveness of environmental watering to maintain ecosystem health is becoming increasingly important, notably in semi‐arid floodplain ecosystems. Modelling plant floodplain vegetation responses to inform environmental watering outcomes is also challenging.

We evaluated the effects of a large‐scale environmental flow event on a semi‐arid floodplain lakeside plant assemblage for meeting the management goal of increasing water‐dependant taxa and functional groups. We developed a multi‐taxon Bayesian hierarchical model to describe temporal and small‐scale spatial patterns in taxonomic occurrences. We then examined community summary metrics (proportion of native taxa, plant functional groups) to evaluate patterns for the entire floodplain lakes system, the scale most relevant to management.

Overall, in a system dominated by terrestrial dry plant taxa, 52.9% of terrestrial damp plant taxa showed a short‐term increase in occurrence in response to the environmental flow, which translated into similar responses in some functional groups. However, nearly half of the plant taxa that increased then demonstrated a decline by 18 months after the flow event. Our community summary metrics captured these general results; however, they were disproportionately influenced by a few abundant plant taxa.

These results highlight the advantages of multi‐taxon models for interpreting flow responses and developing effective environmental flow management strategies, because they can be used to summarise community responses, while preserving important taxon‐specific information.

In semi‐arid systems, where river regulation and climate change have reduced the frequency of flood events, the ability to deliver environmental flows during protracted periods of drought may be a policy option to restore or maintain the natural floodplain vegetation assemblage and prevents the transition to dryland taxa.
Ethnographic Reviews
Authors: deRoche Constance
Published: October 2018

Books reviewed in this issue.

They Leave Their Kidneys in the Fields: Illness, Injury, and Illegality among U.S. Farmworkers. Sarah Bronwen Horton.
Successful Helicobacter pylori eradication therapy improves symptoms of chronic constipation
Authors: Murata Masaki , Sugimoto Mitsushige , Otsuka Taketo , Nishida Atsushi , Inatomi Osamu , Bamba Shigeki , Andoh Akira
Published: October 2018

Backgrounds and Aims

Constipation is one of the most common gastrointestinal functional disorders. Recently, the gut microbiota has been implicated in the development of constipation. Helicobacter pylori infection is considered to be a possible factor influencing the gut microbiota profile. Here, we investigated the effect of H. pylori eradication therapy on symptoms of chronic constipation.

Methods

We recruited 166 H pylori‐positive patients who underwent eradication therapy after endoscopy. We evaluated the severity of symptoms of chronic constipation before eradication therapy and 2 months post‐therapy using two questionnaires, the Gastrointestinal Symptom Rating Scale (GSRS) and the Izumo scale. In addition, we evaluated association with constipation and H. pylori infection in patients with constipation‐related symptoms in not only all patients, but also patients with the constipation‐related symptoms in relation to eradication outcome, the severity of constipation‐related symptoms, and the severity of endoscopic gastric mucosal atrophy.

Results

Mean GSRS scores were 5.10 ± 2.67 in all patients and 6.15 ± 2.91 in constipation patients which were significantly lower than that before eradication (5.78 ± 3.27, P < 0.01 and 8.19 ± 3.09, P < 0.01, respectively). Constipation‐related scores of the GSRS questionnaire in the successful eradication group were significantly improved after eradication from 5.63 ± 3.06 in all patients and 8.00 ± 2.85 in constipation patients to 5.11 ± 2.71 (P = 0.02) and 6.16 ± 2.96 (P < 0.01), while scores in the failed eradication group before and after eradication were similar. Constipation‐related scores in patients with mild gastric atrophy (Kimura‐Takemoto classification, C‐I to O‐I) were significantly decreased after eradication, but were not decreased in patients with severe atrophy (O‐II and O‐III).

Conclusions

Successful eradication therapy for H. pylori infection may confer additional benefits in H. pylori‐positive patients with symptoms of chronic constipation, especially in patients with mild gastric atrophy.
Dynamics of antimicrobial resistance of Helicobacter pylori isolates in the Smolensk region of Russian Federation
Authors: Dekhnich Natalia , Ivanchik Natalie , Kozlov Roman , Alimov Alexander , Steshits Andrey , Kirsov Pavel , Pandav Krunal
Published: October 2018

Background

Efficacy of Helicobacter pylori eradication therapy depends on the chance of having a resistant H. pylori strain, which is ultimately related to the local antimicrobial resistance epidemiology.

Aim

To assess H. pylori resistance to clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline in adult patients in the Smolensk region of Russian Federation over a 9‐year period.

Materials and methods

Biopsy samples were taken from the gastric antrum and body of 573 and 210 patients with dyspepsia symptoms and positive rapid urease test during esophagogastroduodenoscopy in 2015‐2017 and 2009‐2010, respectively. Antimicrobial susceptibility testing was performed for clarithromycin, amoxicillin, metronidazole, levofloxacin, and tetracycline by the agar dilution method.

Results

A total of 143 strains of H. pylori isolated during 2015‐2017 and 133 strains isolated during 2009‐2010 were tested. Culture success rates were 30% vs 64% for the two periods. Over the 2015‐2017, the prevalence of resistance to clarithromycin was 6.3%, to amoxicillin 1.4%, to metronidazole 23.8%, to levofloxacin 24.5%, and to tetracycline 0.7%. Over the 2009‐2010, the corresponding resistance rates were 5.3%, 4.5%, 3.8%, 8.3%, and 0%, respectively. There were no significant increases in resistance to clarithromycin, amoxicillin, and tetracycline (P > 0.05) over the 9 years period. Significant increase in resistance to levofloxacin (8.3% in 2009‐2010% vs 24.5% in 2015‐2017, P < 0.01) and metronidazole (3.8% in 2009‐2010% vs 23.8% in 2015‐2017, P < 0.01) was observed.

Conclusions

H. pylori resistance to clarithromycin remained low in the Smolensk region of Russian Federation between 2009 and 2017. Resistance to levofloxacin and metronidazole increased between 2009 and 2017.
Nuclear β‐catenin and CDX2 expression in ovarian endometrioid carcinoma identify patients with favourable outcome
Authors: Wang Linyuan , Rambau Peter F , Kelemen Linda E , Anglesio Michael S , Leung Samuel , Talhouk Aline , Köbel Martin
Published: October 2018

Aims

Ovarian endometrioid carcinoma (EC) generally has a good prognosis. Adjuvant chemotherapy can be spared in low‐stage disease, but prognostic biomarkers are needed to refine the treatment threshold. Wnt/β‐catenin signalling is commonly altered in EC. We examined immunohistochemical expression of nuclear β‐catenin and CDX2 as prognostic biomarkers for EC; both are mediators of the Wnt pathway.

Methods and results

We evaluated two ovarian EC cohorts, discovery set (n = 183) and validation set (n = 174), with ovarian cancer‐specific survival (OCSS) as the primary end‐point. In univariable analysis, nuclear β‐catenin expression was significantly associated with longer OCSS in the discovery set [hazard ratio (HR) = 0.36, 95% confidence interval (CI) = 0.16–0.74, P = 0.004] and the validation set (HR = 0.35, 95% CI = 0.11–0.89, P = 0.006). Similar significant associations were observed with CDX2 expression in the discovery set (HR = 0.25, 95% CI = 0.11–0.50, P < 0.001) and validation set (HR = 0.27, 95% CI = 0.07–0.75, P = 0.020). In multivariable analysis, combined positivity of both markers was significantly associated with longer OCSS in the discovery set (HR = 0.20, 95% CI = 0.06–0.49, P < 0.001) and in the validation set (HR = 0.33 95% CI = 0.07–0.1.06, P = 0.047). In a stratified analysis for stage IC/II EC, combined positivity identified a subset of patients with a significantly longer OCSS in the discovery cohort but only a non‐significant trend in the validation cohort.

Conclusions

Nuclear β‐catenin and CDX2 expression individually or in combination are validated prognostic markers for ovarian EC. However, their full potential to stratify low risk patients at adjuvant threshold awaits further multimarker study.
Cellular profile of primary molars with pulp necrosis after treatment with antibiotic paste
Authors: Moura Lúcia de Fátima Almeida de Deus , Lima Marina de Deus Moura de , Lima Cacilda Castelo Branco , Bandeira Ana Victória Lopes , Moura Marcoeli Silva de , Conde Júnior Airton Mendes , Rizzo Márcia dos Santos
Published: October 2018

The interradicular region of primary molars is permeated by many foramina, channels and accessories that connect the pulp cavity with the periapical tissues anatomically. Thus, pulp decomposition products or drugs used in endodontic treatment can trigger inflammatory reactions. The aim of this study was to evaluate the blood cell profile of the alveolar region after extraction of primary molars treated with CTZ paste. Forty‐eight primary molars were selected with clinical and radiographic signs of extraction. The sample was divided into three groups with 16 teeth each: Group 1—healthy teeth; Group 2—untreated decayed teeth; and Group 3—teeth treated with CTZ paste. Immediately after the extraction, blood from the interface of the tooth socket was collected and smears were performed for further evaluation. The slides were stained by the Fast Panoptic® method and analysed by two previously trained examiners who counted the leucocytes in sets of 100 cells/slide, differentiating them into neutrophils, lymphocytes, monocytes, eosinophils and basophils. The data were analysed statistically by the MANOVA test. The blood samples from Group 2 differed significantly from Group 1 samples for all classes of leucocytes, except basophils, with higher average for lymphocytes (62.56), monocytes (7.81) and eosinophils (2.31). For Group 3, there was a relative difference (P < 0.05) to Group 2, of monocytes and eosinophils values. The blood cellularity interface in the tooth socket of primary teeth treated with CTZ paste is similar to those of healthy, exfoliated teeth and physiologically different from untreated decayed teeth.
From composites to factors: Bridging the gap between PLS and covariance‐based structural equation modelling
Authors: Kock Ned
Published: October 2018

Partial least squares (PLS) methods possess desirable characteristics that have led to their extensive use in the field of information systems, as well as many other fields, for path analyses with latent variables. Such variables are typically conceptualized as factors in structural equation modelling (SEM). In spite of their desirable characteristics, PLS methods suffer from a fundamental problem: Unlike covariance‐based SEM, they do not deal with factors, but with composites, and as such do not fully account for measurement error. This leads to biased parameters, even as sample sizes grow to infinity. Anchored on a new conceptual foundation, we discuss a method that builds on the consistent PLS technique and that estimates factors, fully accounting for measurement error. We provide evidence that this new method shares the property of statistical consistency with covariance‐based SEM but, like classic PLS methods, has greater statistical power. Moreover, our method provides correlation‐preserving estimates of the factors, which can be used in a variety of other tests. For readers interested in trying it, the new method is implemented in the software WarpPLS. Our detailed discussion should facilitate the implementation of the method in any numeric computing environment, including open source environments such as R and GNU Octave.
Coworker health awareness training: An evaluation
Authors: Oakie Taylor , Smith Nicholas A. , Dimoff Jennifer K. , Kelloway E. Kevin
Published: October 2018

Mental health issues are extremely common in the developed world, with as many as one in five people experiencing a mental illness every year. There are a host of negative outcomes for both organizations and individuals with mental health problems. One strategy that previous research has shown to be effective in reducing stigma around mental illness in organizations is mental health awareness training (MHAT) for leaders. The aim of the current study was to evaluate a complementary program to the MHAT, the Coworker Health Awareness Training Program (CHAT) for employees. The present study uses a wait‐list control design (N = 40) to test the effectiveness of the CHAT on various outcomes, such as knowledge, stigma, self‐efficacy in recognizing and addressing mental health problems, mental health promotion intentions, and willingness to use resources. Results showed that those employees who were trained with the CHAT displayed increases in knowledge, self‐efficacy, mental health promotion, and willingness to use resources. These results provide support for the effectiveness of the CHAT, and have practical and methodological implications.
Na2TiGeO5—A self‐light‐emitting phosphor with the stable structure and tunable emission resulted from Cr3+‐doped for FEDs
Authors: Wu Quansheng , Hu Zhibiao
Published: October 2018

For matching the high energy excitation by the low voltage electron beams, the phosphors with stable crystal structure and high energy level excitation band is necessary. In this work, it is interesting to find a suitable phosphor of Na2TiGeO5 with self‐light emitting property. The tight crystal structure of Na2TiGeO5 formed by edge‐shared NaO6 and TO5 polyhedrons corresponds to its good thermal stability and degradation resistance property. The results indicate that the PL and CL intensity can still remain beyond 80% and 90% at 150°C and after 1 hour electron beams bombardment, respectively. Under the 254 nm excitation, the bright blue light peaked at 460 nm can be detected and the light control has been realized with the Cr3+ doped, which changes blue light to cyan light. The high energy excitation is attributed to the charge transfer band (CTB) of Ti4+–O2−, which matches the electron beams. The bright CL emission light centered at 450 nm with good degradation resistance property has been detected. The results indicate its potential application in field emission display (FED)s.
Hepatocyte miR‐33a mediates mitochondrial dysfunction and hepatosteatosis by suppressing NDUFA5
Authors: Nie Hezhongrong , Yu Xiaohong , He Haihong , Zhou Lintao , Li Qing , Song Chunli , Wang Damin , Ren Tingyu , Chen Zeyan , Huang Hanlian , Dai Xiaoyan , Zhou Yiwen
Published: October 2018

Emerging evidence suggests that microRNAs (miRNAs) are essential for metabolic haemostasis of liver tissues. Among them, miR‐33a is supposed to modulate the cholesterol export and fatty acid oxidation, but whether miR‐33a involves in the process of fatty liver disease is unclear. To disclose the hypothesis, we utilized miR‐33a mimic and antisense to explore their effects in primary hepatocytes or high‐fat diet (HFD)‐fed mice. Treatment with palmitic acid (PA) or HFD significantly increased the expression of miR‐33a in hepatocytes or liver tissues. In primary hepatocytes, miR‐33a mimic decreased mitochondrial function, including reduction of ATP production and oxygen consumption, whereas miR‐33a inhibition protected PA‐induced mitochondrial dysfunction. Interestingly, miR‐33a selectively suppressed mitochondrial complex I activity and protein expression, but not other complexes. Through bioinformatics prediction, we found miR‐33a directly targeted on the 3′‐UTR of NDUFA5. Dual‐luciferase reporter analysis further confirmed the direct suppression of miR‐33a on NDUFA5 expression. More importantly, administration of miR‐33a antisense could effectively restore HFD‐induced mitochondrial dysfunction through up‐regulation of NDUFA5 levels. Mice treated with miR‐33a antisense also exhibited improved liver function and structural disorders under obese status. Taken together, miR‐33a was an important mediator of hepatocyte mitochondrial function, and the therapeutic benefits implied miR‐33a antisense had the potential clinical application in combating the fatty liver disease.