bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of combination behavioral activation for smoking cessation and varenicline for treating tobacco dependence among individuals with current or past major depressive disorder: A 2 × 2 factorial, randomized, placebo‐controlled trial
Authors: Hitsman Brian , Papandonatos George D. , Gollan Jacqueline K. , Huffman Mark D. , Niaura Raymond , Mohr David C. , Veluz‐Wilkins Anna K. , Lubitz Su Fen , Hole Anita , Leone Frank T. , Khan Sadiya S. , Fox Erica N. , Bauer Anna‐Marika , Wileyto E. Paul , Bastian Joseph , Schnoll Robert A.
Published: April 2023

Background and Aims

Treatment of depression‐related psychological factors related to smoking behavior may improve rates of cessation among adults with major depressive disorder (MDD). This study measured the efficacy and safety of 12 weeks of behavioral activation for smoking cessation (BASC), varenicline and their combination.

Design, Setting, Participants

This study used a randomized, placebo‐controlled, 2 × 2 factorial design comparing BASC versus standard behavioral treatment (ST) and varenicline versus placebo, taking place in research clinics at two urban universities in the United States. Participants comprised 300 hundred adult smokers with current or past MDD.

Interventions

BASC integrated behavioral activation therapy and ST to increase engagement in rewarding activities by reducing avoidance, withdrawal and inactivity associated with depression. ST was based on the 2008 PHS Clinical Practice Guideline. Both treatments consisted of eight 45‐min sessions delivered between weeks 1 and 12. Varenicline and placebo were administered for 12 weeks between weeks 2 and 14.

Measurements

Primary outcomes were bioverified intent‐to‐treat (ITT) 7‐day point‐prevalence abstinence at 27 weeks and adverse events (AEs).

Findings

No significant interaction was detected between behavioral treatment and pharmacotherapy at 27 weeks (χ2(1) = 0.19,P = 0.67). BASC and ST did not differ (χ2(1) = 0.43,P = 0.51). Significant differences in ITT abstinence rates (χ2(1) = 4.84,P = 0.03) emerged among pharmacotherapy arms (16.2% for varenicline, 7.5% for placebo), with results favoring varenicline over placebo (rate ratio = 2.16, 95% confidence interval = 1.08, 4.30). All significant differences in AE rates after start of medication were higher for placebo than varenicline.

Conclusion

A randomized trial in smokers with major depressive disorder found that varenicline improved smoking abstinence versus placebo at 27 weeks without elevating rates of adverse events. Behavioral activation for smoking cessation did not outperform standard behavioral treatment, with or without adjunctive varenicline therapy.
Does polygenic risk for substance‐related traits predict ages of onset and progression of symptoms?
Authors: Kranzler Henry R. , Feinn Richard , Xu Heng , Ho Brendan L. , Saini Divya , Nicastro Olivia R. , Jacoby Anya , Toikumo Sylvanus , Gelernter Joel , Hartwell Emily E. , Kember Rachel L.
Published: April 2023

Background and Aims

Genetic risk can influence disease progression. We measured the impact of genetic risk for substance use disorders (SUDs) on substance use onset and progression of symptoms.

Design, Setting, Participants

Using findings from genome‐wide association studies (GWASs) of alcohol use disorder (AUD), opioid use disorder (OUD) and smoking trajectory (SMK) as discovery samples, we calculated polygenic risk scores (PRSs) in a deeply phenotyped independent target sample. Participants in the target sample were recruited from 2000 to 2020 from US inpatient or outpatient settings or through advertisements and comprised 5692 European‐ancestry individuals (EUR) (56.2% male) and 4918 African‐ancestry individuals (AFR) (54.9% male).

Measurements

This study measured age of first substance use, regular use, reported problems and dependence diagnosis and progression from regular use to onset of problems and dependence for alcohol, opioids and smoking. We examined the contribution of PRS to each milestone and progression measure.

Findings

EUR and males reported an earlier onset and shorter progression times than AFR and females, respectively. Among EUR, higher AUD PRS predicted earlier onset and more rapid progression to alcohol‐related milestones (P < 0.001). Although the AUD PRS was a stronger moderator of problem onset among females (P = 0.017), it was more predictive of the progression to problems among males (P = 0.005). OUD and SMK PRS in EUR also predicted earlier onset of the respective milestones (P < 0.001). Among AFR, where power is lower due to the smaller discovery sample, AUD PRS predicted age of regular alcohol use (P = 0.039) and dependence (P = 0.001) and progression from regular use to diagnosis (P = 0.045), while SMK PRS predicted earlier age of initiation (P = 0.036).

Conclusions

Genetic risk for SUDs appears to predict substance use milestones and symptom progression among European‐ancestry individuals and, to a lesser extent, African‐ancestry individuals.
Gaming disorder and stigma‐related judgements of gaming individuals: An online randomized controlled trial
Authors: Galanis Christina R. , Weber Nathan , Delfabbro Paul H. , Billieux Joel , King Daniel L.
Published: April 2023

Background and aims

The inclusion of gaming disorder (GD) in the International Classification of Diseases 11th Revision (ICD‐11) has generated scholarly debate, including claims about its potential stigmatizing effects on the wider gaming population. The present study aimed to estimate the effect of addiction‐based and non‐addiction–based conceptualizations of problem gaming on stigma of gamers.

Design

This preregistered experiment involved a 2 (health information: addiction‐related or non‐addiction‐related) × 3 (vignette: problem, regular or casual gamer) randomized, between‐subjects design.

Setting

An international sample of participants was recruited via Prolific in June and July 2021.

Participants

Participants were eligible (n = 1228) if they were aged 35 to 50 years, played video games for no more than 6 hours per week and did not endorse DSM‐5 or ICD‐11 criteria for GD.

Intervention and comparator

Participants were provided with an explanation of problem gaming as related to either an addictive disorder (i.e. ‘addiction’ explanation) or personal choice and lifestyle factors (i.e. ‘non‐addiction’ explanation).

Measurements

The Attribution Questionnaire (AQ) and Universal Stigma Scale (USS) assessed stigma toward each gamer vignette. Vignettes described a problem gamer (with features of GD); a regular gamer (frequent gaming; some life interference); and a casual gamer (infrequent gaming; no life interference).

Findings

Problem gamer vignettes (mean [M] = 113.3; 95% CI = 111.5–115.4) received higher AQ stigma ratings than regular (M = 94.0; 95% CI = 91.9–95.9) and casual gamers (M = 80.1; 95% CI = 78.2–82.1). Although significant, the effect of health information type on AQ stigma ratings was negligible (addiction group [M = 97.6; 95% CI = 95.9–99.1], non‐addiction group [M = 94.1; 95% CI = 92.6–95.8]). However, the addiction information group scored lower on USS blame and responsibility than the non‐addiction information group with at least a small effect (99.1% confidence).

Conclusions

Framing of problem gaming as an addictive disorder or non‐addictive activity appears to have a negligible effect on stigma of different gamers among middle‐age adults with minimal gaming experience. The concept of ‘gaming addiction’ seems unlikely to be an important influence on public stigma of gaming.
Unequal but not separate: Emergence of rich–poor cooperation in resource exchange
Authors: Chen Jiayu , Igarashi Tasuku
Published: April 2023

Addressing inequality is a critical challenge for society as a whole and requires sustained efforts to promote fairness and opportunity for all. Filling in the resource gap across social classes is essential in reducing inequality. Previous studies have revealed that ingroup favouritism hinders the rich from cooperating with the poor and expands the wealth gap. Nevertheless, how to find ways of narrowing the gap between the rich and the poor remains an open question. Inducing rich–poor cooperation could be effective in eliciting resource flow across classes. In this study, two experiments using a modified Prisoner's Dilemma game were conducted in Japan (N = 213) and China (N = 150) to examine whether highlighting partners' cooperativeness under permeable group boundaries induces rich–poor cooperation. All participants were allocated to the rich group and participated in the game with programmed rich‐ or poor‐group partner bots, whose cooperation rates were manipulated. Despite the initial resource disparities between participants and the partner bots, participants were more likely to select and cooperate with cooperative poor‐group partners than with non‐cooperative rich‐group partners. Generalized trust played an important role in the enhancement of rich–poor cooperation. The findings shed light on the possibility of reducing inequality and promoting social mobility in society.
Whole‐bowel irrigation should not be used routinely in poisoned patients
Authors: Sandilands Euan A.
Published: April 2023

Whole‐bowel irrigation is a method of gastric decontamination in the poisoned patient involving administration of large volumes of osmotically balanced polyethylene glycol‐electrolyte solution to empty the gastrointestinal tract of ingested toxins before absorption, limiting systemic toxicity. While this approach may seem intuitive, and observational studies confirm it can lead to expulsion of tablets or packets in the rectal effluent, there is a lack of evidence correlating this with improved patient outcomes. Administration of whole‐bowel irrigation is also challenging to the inexperienced physician and associated with adverse effects, which may be serious. Recommendations for whole‐bowel irrigation are therefore limited to patients who have ingested modified‐release preparations, those who have ingested pharmaceuticals not adsorbed by activated charcoal and for the removal of packages in “body packers”. Until more robust evidence is available from high‐quality prospective studies demonstrating efficacy, the use of whole‐bowel irrigation should not be used routinely in poisoned patients.
Associations between sleep variables and ostensibly paranormal experiences and paranormal beliefs: A scoping review
Authors: Rauf Betul , Perach Rotem , Madrid‐Valero Juan J. , Denis Dan , Sharpless Brian A. , Farron Hope , French Christopher C. , Gregory Alice M.
Published: April 2023

Night‐time is a period of great significance for many people who report paranormal experiences. However, there is limited understanding of the associations between sleep variables and seemingly paranormal experiences and/or beliefs. The aim of this review is to improve our understanding of these associations while unifying a currently fragmented literature‐base into a structured, practical review. In this pre‐registered scoping review, we searched for relevant studies in MEDLINE (PubMed), PsycINFO (EBSCO), Web of Science and EMBASE using terms related to sleep and ostensibly paranormal experiences and beliefs. Forty‐four studies met all inclusion criteria. All were cross‐sectional and most investigated sleep paralysis and/or lucid dreaming in relation to ostensibly paranormal experiences and paranormal beliefs. Overall, there were positive associations between many sleep variables (including sleep paralysis, lucid dreams, nightmares, and hypnagogic hallucinations) and ostensibly paranormal experiences and paranormal beliefs (including those of ghosts, spirits, and near‐death experiences). The findings of this review have potential clinical implications such as reducing misdiagnosis and treatment development and provide foundations for further research. Our findings also highlight the importance of understanding why so many people report ‘things that go bump in the night’.
Premature conclusions about the signal‐to‐noise ratio in structural equation modeling research: A commentary on Yuan and Fang (2023)
Authors: Schuberth Florian , Schamberger Tamara , Rönkkö Mikko , Liu Yide , Henseler Jörg
Published: April 2023

In a recent article published in this journal, Yuan and Fang (British Journal of Mathematical and Statistical Psychology, 2023) suggest comparing structural equation modeling (SEM), also known as covariance‐based SEM (CB‐SEM), estimated by normal‐distribution‐based maximum likelihood (NML), to regression analysis with (weighted) composites estimated by least squares (LS) in terms of their signal‐to‐noise ratio (SNR). They summarize their findings in the statement that “[c]ontrary to the common belief that CB‐SEM is the preferred method for the analysis of observational data, this article shows that regression analysis via weighted composites yields parameter estimates with much smaller standard errors, and thus corresponds to greater values of the [SNR].” In our commentary, we show that Yuan and Fang have made several incorrect assumptions and claims. Consequently, we recommend that empirical researchers not base their methodological choice regarding CB‐SEM and regression analysis with composites on the findings of Yuan and Fang as these findings are premature and require further research.
MEMCONS: How Contemporaneous Note‐Taking Shapes Memory for Conversation
Authors: Brown‐Schmidt Sarah , Jaeger Christopher B. , Evans Melissa J. , Benjamin Aaron S.
Published: April 2023

Written memoranda of conversations, or memcons, provide a near‐contemporaneous record of what was said in conversation, and offer important insights into the activities of high‐profile individuals. We assess the impact of writing a memcon on memory for conversation. Pairs of participants engaged in conversation and were asked to recall the contents of that conversation 1 week later. One participant in each pair memorialized the content of the interaction in a memcon shortly after the conversation. Participants who generated memcons recalled more details of the conversations than participants who did not, but the content of recall was equally and largely accurate for both participants. Remarkably, only 4.7% of the details of the conversation were recalled by both of the partners after a week delay. Contemporaneous note‐taking appears to enhance memory for conversation by increasing the amount of information remembered but not the accuracy of that information. These findings have implications for evaluating the testimony of participants on conversations with major political or legal ramifications.
The İmportance of tumor markers in patients undergoing resection for lung metastasis of colorectal carcinoma
Authors: Ozgur Gizem Kececi , Tekneci Ahmet Kayahan , Bakali Edward Hassan , Akcam Tevfik Ilker , Ergonul Ayse Gul , Ozdil Ali , Turhan Kutsal , Cakan Alpaslan , Cagırıcı Ufuk
Published: April 2023

Objectives

In patients with suitable conditions, complete resection is a potential curative treatment for lung metastases of colorectal cancers (CRC). Various prognostic factors affecting survival have been reported in these patients. In our study, the prognostic significance of CEA and CA19‐9 tumor markers in patients who underwent lung resection for CRC metastasis was researched.

Methods

Fifty‐three patients who underwent lung resection for CRC metastasis between January 2015 and July 2021 were included in the study. The relationship between preoperative and postoperative CEA and CA19‐9 values, survival times, tumor size, and preoperative CEA and CA19‐9 levels were investigated.

Results

Patients with high preoperative and postoperative CEA had shorter survival (OS) compared with patients with lower values (p ≤ 0.001 and p = 0.009, respectively). Disease‐free survival (DFS) was also shorter in patients with higher preoperative CEA values (p = 0.008). For patients with higher preoperative and postoperative CA 19–9 values, OS and DFS were shorter (p = 0.013 and p ≤ 0.001) and (p = 0.042 and p ≤ 0.001), respectively. There was a weak positive correlation between preoperative CEA value and tumor size (p = 0.008, Pearson correlation coefficient = 0.360). However, a strong positive correlation between preoperative CA19‐9 value and tumor size was discovered (p ≤ 0.001, Pearson correlation coefficient = 0.603).

Conclusion

In our study, it was shown that preoperative‐postoperative CEA and CA19‐9 levels in patients with metastatic colon carcinoma are associated with overall survival.
Histiocytoid melanoma: Diagnostic pitfall and mimicker of non‐Langerhans cell histiocytoses including reticulohistiocytoma
Authors: Grand David G. , Barton Dorothea T. , Yan Shaofeng , Sriharan Aravindhan , Momtahen Shabnam , Cloutier Jeffrey M. , LeBlanc Robert E.
Published: April 2023

Melanoma and benign histiocytic proliferations can sometimes show considerable clinical and histopathologic overlap. Recently, cases of melanomas resembling xanthogranuloma and Rosai–Dorfman disease have been reported, and herein we report a case of melanoma closely mimicking reticulohistiocytoma. An 84‐year‐old man presented with a 1 cm purple‐red nodule on his arm concerning for squamous cell carcinoma. While the biopsy findings resembled reticulohistiocytoma, the clinical context and regression changes at the lesion perimeter raised stronger concern for melanoma, which was confirmed with immunohistochemistry. We review prior rare reports of melanomas resembling non‐Langerhans cell histiocytic proliferations and summarize helpful clinical and histopathologic clues to avoid a diagnostic pitfall when confronted with this unusual quandary.
Trends in alcohol expenditure in Australia from 1984 to 2015–2016: An exploratory study
Authors: Smit Koen , Dowling Rowan , Livingston Michael , Room Robin , Laslett Anne‐Marie , Ferrier Adamm , Livingstone Charles , Borland Ron , Jiang Heng
Published: April 2023

Introduction

Excessive alcohol use is associated with non‐communicable diseases and social problems, such as work absence, financial problems and family violence. Expenditure and expenditure shares on alcohol are valuable measures to monitor financial activities on this risk behaviour. The aim of this paper is to report trends in alcohol expenditure in Australia over the last two decades.

Methods

Data are from six waves of Australian Household Expenditure Surveys from 1984 to 2015–2016. We explored trends of alcohol expenditure among Australians and in different socio‐demographic groups in the last 30 years. We further examined changes of expenditure on different on‐ and off‐premises beverages over time.

Results

Absolute alcohol expenditure has remained the same between the 1980s and 2016, after accounting for inflation. However, a declining trend in relative alcohol expenditure as a proportion of total household expenditure was found across nearly all demographic groups (e.g., sex, age, employment, household income), except for women aged 45–54, who showed an increasing trend of alcohol expenditure after 1998–1999.

Discussion and Conclusions

The current study shows declines in relative alcohol expenditure, which may reflect declines in alcohol's relative importance within the elements of the person's lifestyle they need to pay for and/or increased awareness of alcohol's health and social harms. Further longitudinal analysis should explore additional predictors of household expenditure on alcohol. Results suggest that current bi‐annual indexation increases in alcohol tax should account for increases in income to ensure the effectiveness of pricing. Moreover, attention is needed to address drinking among middle‐aged females.
How should nicotine vaping be regulated in Australia?
Authors: Mendelsohn Colin , Wodak Alex , Hall Wayne
Published: April 2023

In Australia, nicotine vaping products are regulated as prescription‐only medicines which can only be sold from a pharmacy, with the aim of preventing youth access and allowing use by adult smokers with a doctor's support. The Therapeutic Goods Administration has acknowledged that this policy has not achieved its goals. Instead, a thriving black market has developed which sells unregulated vape products to children and adults. Very few adult vapers use the legal prescription pathway. Regulation should find the optimal balance between facilitating legal access for adult smokers while restricting access by youth. The preferred approach is a tightly regulated consumer model with nicotine vaping products sold by licenced retail outlets with strict age‐of‐sale verification. Regulations should be proportionate to risk and reflect the lower harms of vaping relative to smoking. A consumer model would bring Australia into line with other Western countries and improve population health.
Status quo und Zukunftsperspektiven der molekularen Diagnostik in der Dermatologie
Authors: Gebhardt Christoffer , Eyerich Kilian , Garzorz‐Stark Natalie
Published: April 2023

Die Molekulardiagnostik (MDx) ist zu einer unentbehrlichen Säule der Diagnostik in der Dermatologie geworden. Moderne Sequenzierungstechnologien ermöglichen die Identifizierung seltener Genodermatosen, die Analyse somatischer Mutationen beim Melanom ist Voraussetzung für zielgerichtete Therapien und infektiöse Erreger der Haut lassen sich durch PCR und andere Amplifikationsverfahren schnell nachweisen. Um allerdings Innovation in der Molekulardiagnostik voranzutreiben und bislang ungedeckte klinische Bedarfe zu decken, müssen die Forschungsaktivitäten gebündelt und die Pipeline von der Idee bis zum MDx‐Produkt klar strukturiert werden. Nur so können die Anforderungen an die technische Validität und den klinischen Nutzen neuartiger Biomarker erfüllt werden und die lang gehegte Vision von personalisierter Medizin verwirklicht werden.
Neue Entwicklungen in der Behandlung des Basalzellkarzinoms
Authors: Kunstfeld Rainer , Nguyen Van Anh
Published: April 2023

Im Jahr 2013 hat die systemische Therapie Einzug in die Behandlung des lokal fortgeschrittenen (locally advanced, laBCC) und metastasierten Basalzellkarzinoms (mBCC) gefunden. Mittlerweile ist auch die Immuntherapie in dieser Indikation zugelassen. Weitere Immuntherapeutika und andere Substanzklassen – darunter auch Kombinationsstrategien – befinden sich gegenwärtig in klinischer Entwicklung beziehungsweise werden in klinischen Studien untersucht. Diese könnten zukünftig die Therapiemöglichkeiten bei laBCC und mBCC bedeutend erweitern.
Developments and perspectives in allergology
Authors: Treudler Regina , Simon Jan‐Christoph
Published: April 2023

Allergology is a key part of dermatological care. This paper reviews current pathophysiological, diagnostic and therapeutic developments in immediate‐type allergies.

Type‐2 inflammation is involved in several allergological diseases such as allergic rhinitis and asthma. Allergen immunotherapy as an important therapeutic procedure is regulated in Germany by an official legal directive (Therapieallergene‐Verordnung). Therapeutically, several biologics are already available that target interleukin (IL)‐4, ‐5, ‐13, ‐33, or TSLP (thymic stromal lymphopoietin). Collateral efficacy may result in simultaneous treatment of allergological comorbidities.

In mast cell mediated diseases (urticaria, anaphylaxis), there is increasing understanding of mast cell activation pathways. Several mast cell receptors such as MRGPRX2 (mas‐related G protein coupled receptor X2) and Siglec‐8 (sialinic acid binding Ig like lectin‐8) as well as intracellular signaling pathways have recently been identified. Clinical trials are underway with drugs acting on mast cell receptors and intracellular signaling, i.e., Bruton's tyrosine kinase inhibitors.

Further perspectives on biomarkers, novel therapeutics and unmet needs for future research activities are presented.
Bullöse Autoimmundermatosen
Authors: Holtsche Maike M. , Boch Katharina , Schmidt Enno
Published: April 2023

Bullöse Autoimmundermatosen (BAID) sind eine heterogene Gruppe von etwa einem Dutzend Erkrankungen, die klinisch durch Erosionen und Blasen und immunpathologisch durch Autoantikörper gegen Strukturproteine der Haut oder Transglutaminase 2/3 charakterisiert sind. Die Diagnostik der BAID hat in der letzten Dekade enorme Fortschritte gemacht durch die Verfügbarkeit standardisierter serologischer Nachweismethoden, welche in Kenntnis des klinischen Bildes die Diagnose bei der überwiegenden Mehrheit der Patienten erlaubt. Durch die Entwicklung verschiedener In‐vitro‐ und In‐vivo‐Modelle zu den häufigsten BAID, zum Beispiel bullöses Pemphigoid, Pemphigus vulgaris, Schleimhautpemphigoid sowie der seltenen Epidermolysis bullosa acquisita, ist es möglich, Schlüsselmoleküle und Entzündungswege zu identifizieren und die Wirkung neuer antientzündlicher Therapien präklinisch zu evaluieren. Die Zulassung von Rituximab für den moderaten und schweren Pemphigus vulgaris und die Entwicklung nationaler und internationaler Leitlinien für die häufigsten BAID stellt einen beträchtlichen Fortschritt in der Versorgung dieser Patienten dar. Trotzdem ist das limitierte therapeutische Armamentarium die größte Herausforderung für das Management der BAID. Mehrere randomisierte kontrollierte klinische Studien der Phasen II und III geben jedoch Anlass zur Hoffnung, dass in den nächsten Jahren neue wirksame und sichere Therapieoptionen zur Verfügung stehen werden. Die vorliegende Übersichtsarbeit fasst Epidemiologie, Klinik, Diagnostik, Pathophysiologie und Therapie der BAID zusammen und gibt einen Ausblick auf den aktuellen diagnostischen und therapeutischen Bedarf sowie zukünftige Entwicklungen.
Dermatopathologie – aktueller Stand und Entwicklung in der deutschsprachigen Dermatologie
Authors: Mitteldorf Christina , Tronnier Michael
Published: April 2023

Die Dermatopathologie ist seit mehr als 100 Jahren integraler Bestandteil der Dermatologie und unverzichtbar für eine hochwertige Patientenversorgung. Im deutschsprachigen Raum können Dermatologen eine Zusatzqualifikation für Dermatopathologie nach entsprechender Weiterbildung erlangen. Seit vielen Jahren geht die dermatopathologische Diagnostik über die Morphologie weit hinaus. Heute sind Immunhistochemie und Molekularpathologie ein fester Bestandteil und Voraussetzungen für den Erhalt unseres Faches. Durch die zunehmende Implementierung der Digitalisierung und „künstlicher Intelligenz“ ist das Fach zukunftsorientiert und bietet jungen Kollegen ein attraktives Arbeitsumfeld. Auch für die Forschung ist die Dermatopathologie unverzichtbar, dem sollte in Zukunft auch durch Schaffung akademischer Positionen und Professuren Rechnung getragen werden.
Dermatochirurgie – von der operativen Alternative zum integralen Bestandteil der dermatologischen Therapie
Authors: Hafner Jürg , Löser Christoph R. , Roka Florian
Published: April 2023

Lange Zeit wurde die Dermatochirurgie auch innerhalb der Dermatologie als isoliertes, nicht immer bedeutendes Teilgebiet betrachtet. Als therapeutische Option galt sie entweder als Goldstandard der Erstlinientherapie, beispielsweise bei der Operation des Basalzellkarzinoms und der Behandlung von Melanomen in frühen Stadien, oder als letzte Option, zum Beispiel bei der Behandlung von Warzen. Dass hier ein tiefgreifender Wandel stattgefunden hat und die Dermatochirurgie heute ein integraler, gleichberechtigter, manchmal führender, aber immer wichtiger Bestandteil der Dermatologie ist, zeigt diese Übersicht an drei Beispielen aus der geriatrischen Dermatologie, der Behandlung der Hidradenitis suppurativa (Acne inversa) und der Melanomtherapie. Ergänzt wird die Arbeit durch einen Abschnitt zur wichtigsten Therapieform innerhalb der Dermatochirurgie, der mikroskopisch (mikrographisch) kontrollierten Chirurgie.
Atopische Dermatitis – Perspektiven und unerfüllte medizinische Bedarfe
Authors: Buhl Timo , Werfel Thomas
Published: April 2023

Die atopische Dermatitis (AD) ist eine chronisch‐entzündliche Hauterkrankung, zu der in den vergangenen Jahren viele neue Erkenntnisse durch ein besseres Verständnis vor allem von Pathophysiologie, Begleiterkrankungen und Therapeutika gewonnen wurden. In dieser Übersichtsarbeit werden hierzu neue und praxisrelevante Ergebnisse aus der aktuellen Forschung vorgestellt. In der Diagnostik der AD und zu verschiedenen Subtypen wurden viele Studien durchgeführt, dennoch hat sich hier bislang kein diagnostischer Biomarker oder klinischer Prädiktor für ein Therapieansprechen in der klinischen Routine etabliert. Für die topische Behandlung sind einige Wirkstoffe wie Januskinase (JAK)‐Inhibitoren in fortgeschrittenen Stadien der klinischen Prüfung oder bereits in anderen Ländern zugelassen, die wahrscheinlich auch bei uns bald zur Behandlung von bestimmten Ekzem‐Unterformen zur Verfügung stehen werden. Die aktuellen Systemtherapeutika umfassen zwei Antikörper zur Inhibition der Interleukin (IL)‐4/13‐Signalkaskaden sowie drei JAK‐Inhibitoren mit etwas unterschiedlichen Effektivitäts‐ und Sicherheitsprofilen. Unter den in der Entwicklung fortgeschrittenen Antikörpertherapien zur AD finden sich als vielversprechende neue Ziele die Blockade der IL‐31‐Wirkung, des Neurokinin‐1‐Rezeptors auf sensorischen Neuronen sowie die Inhibition der OX40/OX40L‐Achse zur Interaktion von kutanen dendritischen Zellen und T‐Lymphozyten. Primäre Prävention und Modulation des sequenziellen Krankheitsgeschehens sowie Effekte auf Begleiterkrankungen durch frühzeitige therapeutische Intervention werden wichtige Fragen in der zukünftigen Forschung zur AD sein.
Mycosis fungoides und Sézary‐Syndrom – Überblick und Ausblick
Authors: Latzka Johanna , Trautinger Franz
Published: April 2023

Mycosis fungoides und Sézary‐Syndrom sind die wichtigsten Vertreter aus der heterogenen Gruppe der kutanen T‐Zell‐Lymphome. Die Erkrankungen sind selten und die Diagnose, die immer eine klinisch‐pathologische Korrelation erfordert, wird vor allem bei Frühformen der Mycosis fungoides, oft verzögert gestellt. Die Prognose der Mycosis fungoides ist stadienabhängig und in Frühstadien meist günstig. Klinisch relevante prognostische Parameter fehlen und ihre Entwicklung ist Gegenstand aktueller klinischer Forschung. Sézary‐Syndrom, charakterisiert durch initiale Erythrodermie und leukämische Ausschwemmung, ist eine Erkrankung mit hoher Sterblichkeit, bei der mit neuen Therapieoptionen in vielen Fällen gutes Ansprechen erreicht werden kann. Die zellbiologische Pathogenese und Immunologie der Erkrankungen ist heterogen, wobei rezente Ergebnisse vor allem auf Veränderungen in spezifischen Signaltransduktionswegen hindeuten, die zukünftige Behandlungsziele darstellen können. Die aktuelle Therapie von Mycosis fungoides und Sézary‐Syndrom ist in erster Linie palliativ, topische und systemische Optionen können allein oder in Kombination verwendet werden. Nur bei ausgewählten Patienten können durch allogene Stammzelltransplantation dauerhafte Remissionen erzielt werden. Ähnlich wie in anderen Bereichen der Onkologie vollzieht sich auch bei der Entwicklung neuer Therapien für kutane Lymphome ein Wandel von relativ ungezielter Empirie hin zu einer krankheitsspezifischen zielgerichteten Pharmakotherapie auf Basis experimentell gewonnener Erkenntnisse.
Social and gender norms informing, voicing, and reporting against sexual harassment among domestic workers in Kampala's informal economy
Authors: Namuggala Victoria Flavia , Oosterom Marjoke
Published: April 2023

Motivation

Urbanization and the increasing number of double‐income households has led to a rise in demand for domestic workers in many African countries. With a population of over 75% people below 30 years of age, young people's unemployment is a major challenge for Uganda. Approximately 90% of young people work in the informal economy. Domestic workers' informal employment is unregulated and precarious.

Purpose

The article examines the role of social and gender norms in voicing and formal reporting of sexual harassment. It demonstrates the intersecting risk factors that create exposure to sexual harassment, challenges relating to voicing, as well as how restrictive norms are reproduced by other actors.

Methods and approach

The study adopted a qualitative research approach; desk review, qualitative, and visual methods. Primary data collection included safety audits and body mappings with groups of live‐in domestic workers and firm workers, and in‐depth individual interviews with domestic workers. Safety audits discussed forms of harassment and response mechanisms while the body mappings focused on language.

Findings

Isolated working conditions increase the risk of experiencing sexual harassment and limit avenues for reporting. Social and gender norms undermine domestic workers' ability to report it formally. The culture of silence and notions of victim blaming, stigmatization, and lack of a language that raises matters of sexual harassment all hinder women's voice towards self‐care and justice. Social and gender norms contribute to the persistence of sexual harassment through its normalization.

Policy implications

Domestic work should legally be recognized as work and labour laws need to extend to domestic workers. Workplace sexual harassment policy needs to extend to all workspaces, regardless of the number of employees. Domestic workers need better access to information, co‐workers, and associations, for instance through information technology. Advocacy for the rights of domestic workers and network building are recommended.
Use of self‐inflating tissue expanders in equine surgery: A prospective study of 20 cases
Authors: Cullen Matthew , Mair Tim , Brennan Moses , Hennessy Simon , Tessier Caroline , Crawford Andrew , Swan Marc C. , Archer Debra
Published: April 2023

Background

Tissue expansion is a well‐established technique in reconstructive surgery. Self‐inflating tissue expanders (STE) have not been widely adopted by veterinary surgeons, and clinical descriptions of their use in horses are lacking.

Objective

To describe the indications, clinical experiences and outcomes of a series of equine cases that used a hydrogel‐based STE to assist soft tissue reconstruction.

Study design

Prospective clinical study.

Methods

Case details, surgical techniques and outcomes were recorded for horses requiring use of an STE, using a predesigned data collection sheet completed by the treating surgeon. All horses underwent two surgical procedures as part of their treatment: one to place the STE(s) and a second to remove the device(s) and perform reconstructive surgery using the expanded tissue.

Results

Twenty horses had STEs implanted at seven clinics and had sufficient follow‐up for inclusion in the study. Indications for using the expanders included the following: expansion of skin prior to excision of a neoplastic lesion (n = 13), repair of a sinocutaneous fistula (n = 2), repair of chronic scarring or a nonhealing wound (n = 2), repair of a full‐thickness ear pinna defect (n = 1) and repair of a rectovestibular injury (n = 2). The degree of tissue expansion was graded as good in 19/20 cases (95%) and provided sufficient tissue to cover the entire defect in 11/20 cases (55%). STE‐associated complications occurred in 9/20 horses (45%), but none of these complications were serious. The final clinical outcome was graded by the treating surgeon as good or excellent in 15/20 horses (75%).

Main limitations

Only one type of STE device is described, and its use was not compared with other treatments. Information regarding use of the STE at locations other than the head (n = 3) is limited.

Conclusions

Use of a STE device in horses resulted in no serious complications and provided a good outcome in a variety of equine clinical cases.
Ocular findings in a population of geriatric equids in the United Kingdom
Authors: Chalder Ria , Housby‐Skeggs Nicola , Clark Claire , Pollard Danica , Hartley Claudia , Blacklock Benjamin
Published: April 2023

Background

There are a growing number of horses, ponies, and donkeys aged 15 years or older in the United Kingdom, yet there have been no studies utilising a complete ophthalmic examination to investigate the prevalence of ophthalmic pathology within this population.

Objectives

To investigate the prevalence of ophthalmic pathology and associations with signalment, in a convenience sample of geriatric equids in the United Kingdom.

Study design

Cross sectional.

Methods

Horses, ponies, and donkeys aged 15 years or older based at The Horse Trust charity underwent a full ophthalmic examination including slit lamp biomicroscopy and indirect ophthalmoscopy. Relationships between signalment and pathology were assessed using Fisher's exact and Mann–Witney U tests.

Results

Fifty animals were examined ranging from 15 to 33 years (median 24, interquartile range [IQR] 21, 27). The prevalence of ocular pathology was 84.0% (95% confidence interval [CI] 73.8, 94.2%; n = 42). Four animals (8.0%) had adnexal pathology, while 37 (74.0%) and 22 (44.0%) had at least one form of anterior or posterior segment pathology, respectively. Of those with anterior segment pathology, 26 animals (52.0%) had cataract in at least one eye, with the most common location being anterior cortical (65.0% of those animals with cataract). Animals with posterior segment pathology included 21 animals (42.0%) with fundic pathology, with senile retinopathy being the most common (42.9% of all animals with fundic pathology). Despite the high prevalence of ocular pathology, all eyes examined remained visual. The most common breeds were Irish Draught (24.0%, n = 12), Shetland (18.0%, n = 9) and Thoroughbred (10%, n = 5); the majority were geldings (74.0%, n = 37). There was a statistically significant relationship between the presence of anterior segment pathology and breed (p = 0.006), with all Cobs and Shetlands examined having anterior segment pathology. The presence of posterior segment pathology and senile retinopathy were associated with older median age (posterior segment pathology: 26.0 years [interquartile range {IQR} 24.0, 30.0 years] vs. 23.5 years [IRQ 19.5, 26.5 years], p = 0.03; senile retinopathy: 27.0 years [IQR 26.0, 30 years] vs. 24.0 years [IQR 20.0, 27.0], p = 0.04). None of the pathologies investigated were more prone to affect one versus both eyes (p > 0.05; 71.4% of ocular pathologies were bilateral while 28.6% were unilateral).

Main limitations

Data were obtained from a relatively small sample size of a single cohort of animals that lacked a control group.

Conclusions

There was a high prevalence and wide range of ocular lesions in this subset of geriatric equids.
A mini‐review on anticancer‐related properties of azithromycin and its potential activities in overcoming the challenges of glioblastoma
Authors: Hassan Siti Nazihahasma , Mohamed Yusoff Abdul Aziz , Idris Zamzuri , Mohd Redzwan Norhanani , Ahmad Farizan
Published: April 2023

The resistance, plasticity and heterogeneity of cancer cells, including glioblastoma (GB) cells, have prompted the investigation of various agents for possible adjuncts and alternatives to existing therapies. This includes a macrolide antibiotic, azithromycin (AZI). It possesses intriguing anticancer properties in a range of cancer models in vitro, such as antiproliferative, pro‐apoptotic, anti‐autophagy and anti‐angiogenic effects. In fact, AZI is renowned for its ability to eradicate cancer stem cells by inhibiting mitochondrial biogenesis and respiration. AZI‐containing regimens in cancer patients for different purposes have shown favourable (i.e., attributed to its antibacterial activity) and unfavourable outcomes. Whilst its direct anticancer effects have yet to be clinically proven. To that end, this review provides a summary of AZI anticancer studies and delineates its potential activities in overcoming the challenges of GB.
Mean stress adjustment models for stress‐life fatigue of notched components
Authors: Orloske Kevin Michael , Collins Ryan Michael
Published: April 2023

Tensile mean stress effects in notched metallic components are studied. Steel and aluminum stress‐life fatigue data are analyzed using the generalized linear and Walker constant‐life models with two classical approaches to mean stress adjustment, namely, the nominal mean stress method and the residual stress method. Particular attention is given to the number of free parameters when evaluating model performance. A generalization of the residual stress method is proposed both with one and zero additional free parameters. Analysis of the test data indicates that the Walker equation provides a better correlation for notched components than the generalized linear constant life relation and that the classical approaches to mean stress adjustment are overly optimistic (i.e., unsafe). The optimal degree of mean stress adjustment is shown to be sensitive to the relative stress gradient. The proposed zero parameter mean stress adjustment model improves model correlation performance in nearly all cases studied.
A multi‐satellite framework to rapidly evaluate extreme biosphere cascades: The Western US 2021 drought and heatwave
Authors: Feldman Andrew F. , Zhang Zhen , Yoshida Yasuko , Gentine Pierre , Chatterjee Abhishek , Entekhabi Dara , Joiner Joanna , Poulter Benjamin
Published: April 2023

The increasing frequency and intensity of climate extremes and complex ecosystem responses motivate the need for integrated observational studies at low latency to determine biosphere responses and carbon‐climate feedbacks. Here, we develop a satellite‐based rapid attribution workflow and demonstrate its use at a 1–2‐month latency to attribute drivers of the carbon cycle feedbacks during the 2020–2021 Western US drought and heatwave. In the first half of 2021, concurrent negative photosynthesis anomalies and large positive column CO2 anomalies were detected with satellites. Using a simple atmospheric mass balance approach, we estimate a surface carbon efflux anomaly of 132 TgC in June 2021, a magnitude corroborated independently with a dynamic global vegetation model. Integrated satellite observations of hydrologic processes, representing the soil–plant–atmosphere continuum (SPAC), show that these surface carbon flux anomalies are largely due to substantial reductions in photosynthesis because of a spatially widespread moisture‐deficit propagation through the SPAC between 2020 and 2021. A causal model indicates deep soil moisture stores partially drove photosynthesis, maintaining its values in 2020 and driving its declines throughout 2021. The causal model also suggests legacy effects may have amplified photosynthesis deficits in 2021 beyond the direct effects of environmental forcing. The integrated, observation framework presented here provides a valuable first assessment of a biosphere extreme response and an independent testbed for improving drought propagation and mechanisms in models. The rapid identification of extreme carbon anomalies and hotspots can also aid mitigation and adaptation decisions.
Bureaucratic bias in integrated administrative systems: A large‐scale study of government officials
Authors: Trondal Jarle , Haslerud Gjermund
Published: April 2023

The study examines bureaucrats facing administrative architectures that are multiple, overlapping, ambiguous and sometimes incompatible. It makes two main contributions. Firstly, by an organizational approach it derives fine‐grained predictions on how bureaucrats maneuver when taking part in integrated multilevel administrative orders. Secondly, benefitting from a large‐N data‐set (N = 4285) from 16 ministries and 47 government agencies in Norway, the study demonstrates how organizational factors systematically ‘moderate’ and bias behavioral perceptions among government officials. Moreover, to probe the robustness of explanatory models, the study specifies patterns of moderation by outlining multiple interaction models as well as illustrating how interaction effects unfold. The study finds that few moderators make dramatic effects by profoundly weakening relationships. Moderating variables either strengthen or attenuate already apparent effects, thus probing the empirical robustness of the models.
The mental health of staff working in UK prisons during the Covid‐19 pandemic
Authors: Memon Amina , Hunt Ashley , Thelwall Ellamay , Hardwick Nick , Johnson Sverre Urnes
Published: April 2023

This article presents the results of an opportunistic, cross‐sectional, self‐report survey of the well‐being of staff working in prisons throughout the UK. The survey was completed by 594 participants in the early part of 2021 at the height of the Covid‐19 pandemic. Self‐report measures indicated concerning levels of burnout and 43.4% of participants were above the established cut‐offs on the Generalised Anxiety Disorder (GAD‐7) scale. Eighty‐one per cent reported that their mental and physical health had deteriorated and many said emotional support was lacking. Further research is required to establish how typical and persistent these concerns are.
Overexpression of MicroRNA‐155 aggravates pulpitis by targeting kinesin superfamily Proteins‐5C based on illumina high‐throughput sequencing
Authors: Jiang Ye , He Ying , Chen Yue , Zeng Jun , Huang Wenmian , Huang Lishan , Luo Jiaxin , Ma Yukun , Wu Lihong , Yang Xuechao
Published: April 2023

Aim

To investigate the regulatory role of miR‐155 and Kinesin Superfamily Proteins‐5C (KIF‐5C) in the progression of pulpitis based on bioinformatic analysis.

Methodology

Normal pulp tissues and pulpitis pulp tissues were collected and subjected to high‐throughput sequencing and the differentially expressed miRNAs were determined. An in vitro and in vivo pulpitis model was established. HE, IHC staining and histological evaluation were used to verify the inflammatory state of human and mouse pulp tissues. The mRNA expression of IL‐1β and TGF‐β1 were determined by RT‐qPCR and protein expression of IL‐1α, IL‐4, IL‐8, IL‐13, IFN‐γ, IL‐6, IL‐10 and MCP‐1 were determined by protein chip. The target genes of miR‐155 were predicted by miRanda database and verified by Dual‐luciferase reporter assay, RT‐qPCR and western blotting. MiR‐155 lentivirus were used to upregulate or downregulate miR‐155 and the siRNA of KIF‐5C was used to downregulate KIF‐5C. The expression of miR‐155 or KIF‐5C was determined by RT‐qPCR. All statistics were analysed using GraphPad prism 8.2.

Results

The high‐throughput sequencing results showed that 6 miRNAs (miR‐155, miR‐21, miR‐142, miR‐223, miR‐486, miR‐675) were significantly upregulated in diseased human pulp tissues, and miR‐155 was significantly elevated among the six miRNAs. RT‐qPCR results demonstrated that miR‐155 expression was upregulated in human pulpitic tissue, mice pulpitic tissue and LPS‐HDPCs. IL‐1β was increased while TGF‐β1 was decreased in lenti‐miR‐155 transfected LPS‐HDPCs. Analysis of protein chip results indicated that lenti‐miR‐155 transfected LPS‐HDPCs produced higher levels of IL‐8, IL‐6, MCP‐1. The opposite results were obtained when miR‐155 was inhibited. Through miRanda database screen and Dual‐luciferase reporter assay, the target gene (KIF‐5C) of miR‐155 was identified. In lenti‐miR‐155 transfected LPS‐HDPCs, the expression of KIF‐5C was downregulated. However, when shRNA‐miR‐155 was transfected to LPS‐HDPCs, the opposite result was obtained. Silent RNA was used to knock down KIF‐5C, the results showed that when both KIF‐5C and miR‐155 were knocked down simultaneously, the downregulated expression of inflammatory factors observed in LPS‐HDPCs following miR‐155 knockdown was rescued.

Conclusion

MiR‐155 plays an important role in promoting pulpitis through targeting KIF‐5C and may serve as a potential therapeutic target.