bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a Screening Tool for Child Sex Trafficking Among Patients With High‐Risk Chief Complaints in a Pediatric Emergency Department
Authors: Kaltiso Sheri‐Ann O. , Greenbaum V. Jordan , Agarwal Maneesha , McCracken Courtney , Zmitrovich April , Harper Elizabeth , Simon Harold K.
Published: November 2018

Objectives

The objective was to apply and evaluate a screening tool to identify victims of child sex trafficking (CST) in a pediatric emergency department (PED) population.

Methods

This prospective, observational study was conducted from July 2017 to November 2017 at the PED of a free‐standing, inner‐city children's hospital. Patients 10 to 18 years of age presenting with chief complaints related to high‐risk social or sexual behaviors were recruited in a representative convenience sampling. A previously developed six‐item screening tool was administered verbally to participants. A positive screen was defined as two positive answers from the six items. A patient was considered a “true” CST victim if any information obtained during the visit indicated that their circumstances fulfilled the federal definition of CST. Descriptive statistics were calculated for all variables of interest. CST screening tool analysis included sensitivity, specificity, and positive and negative predictive values (PPV, NPV). Those patients identified as positive for CST were referred to social services and received the current standard of care.

Results

A total of 254 patients met chief complaint screening criteria and eligibility; 215 were approached to participate and 203 agreed to participate. Of the 203 participants, 100 screened positive with the tool (49%). The total number of CST victims identified was 11 (5.4%), 10 of whom screened positive. With a cutoff score of two positive answers the tool demonstrated a 90.9% (95% confidence interval [CI] = 58.7%–99.8%) sensitivity, 53.1% (95% CI = 45.6%–60.4%) specificity, 10.0% (95% CI = 5.0%–17.6%) PPV, and 99.0% (95% CI = 94.7%–99.9%) NPV.

Conclusions

Applied to an inner‐city PED population of 203 participants with high‐risk chief complaints, the screening tool has high sensitivity and high NPV. This makes it appropriate for an initial screening to rule out CST in this high‐risk population. Applicability for broader use and additional practice settings are warranted given the significant positivity rate among those presenting with high‐risk concerns.
Does meeting the Milan criteria at the time of recurrence of hepatocellular carcinoma after curative resection have an impact on prognosis?
Authors: Kim Hyo‐Sin , Yi Nam‐Joon , Kim Jong Man , Hong Suk Kyun , Kwon Choon Hyuck David , Joh Jae‐Won , Lee Kwang‐Woong , Suh Kyung‐Suk
Published: November 2018

Background

The survival outcomes of recurrent hepatocellular carcinoma (HCC) after curative resection remain unclear due to lack of clear basis for the selection of treatment option. We investigated overall survival (OS) after intrahepatic recurrence and re‐recurrence free survival (rRFS) of the patients with recurrent HCC, and whether Milan criteria (MC) status at resection and recurrence impacts on OS and rRFS.

Method

We enrolled 959 patients who experienced recurrence after primary hepatic resection for HCC. We divided the cohort into four groups according to MC at two periods: IN‐rIN MC (HCC within MC at the time of resection‐recurrence within MC), IN‐rOUT MC (HCC within MC at the time of resection‐recurrence outside MC), OUT‐rIN MC (HCC outside MC at the time of resection‐recurrence within MC), and OUT‐rOUT MC (HCC outside MC at the time of resection‐recurrence outside MC).

Results

In the entire cohort, 1‐, 3‐, and 5‐year OS after recurrence was 81.0%, 55.7%, and 45.8%, respectively, while rRFS was 63.7%, 46.1%, and 42.0%, respectively. The IN‐rIN MC group had the best outcomes (5‐year OS and rRFS, 54.5% and 45.7%, respectively). The IN‐rOUT and OUT‐rIN MC groups had better 5‐year OS outcomes than the OUT‐rOUT MC group (46.5%, 38.6%, and 24.8%, respectively; P < 0.05). However, 5‐year rRFS did not differ among the three groups (37.5%, 36.6%, and 31.9%, respectively; P > 0.05).

Conclusion

Survival after first recurrence following curative primary resection for HCC was affected by MC at both time of resection and recurrence. Both the IN‐rOUT and OUT‐rIN MC groups with similar survival outcomes can be saved via curative treatment.
Key considerations prior to nasal high flow deployment in a Peruvian PICU from providers’ perspectives
Authors: Ellington Laura E. , Jacob‐Files Elizabeth , Becerra Rosario , Mallma Gabriela , Tantalean da Fieno José , Nielsen Katie R.
Published: November 2018

Aim

Implementation of healthcare interventions in resource‐limited settings remains challenging. This exploratory qualitative study describes social and institutional factors to consider prior to nasal high flow deployment in a middle‐income country.

Methods

Researchers conducted eight nursing focus groups and four semi‐structured physician interviews at Instituto Nacional de Salud del Niño in Lima, Peru. Participants were identified via purposive sampling. Data were transcribed, translated and coded using a rigorous and iterative process. Pertinent themes were identified using thematic analysis with Dedoose software.

Results

Thirty‐nine nurses and four physicians participated in focus groups and interviews, respectively. Participants identified five major factors: (i) Adequate training, (ii) Clinician buy‐in, (iii) Resource‐limited setting, (iv) Local social context and (v) Organizational change management. To create buy‐in, physicians and nurses emphasised the need to recognise benefit of the intervention and agree with clinical practice standardization. Physicians and nurses described barriers specific to resource‐limited settings, including unreliable supply chain, whereas nurses shared concerns about increasing workload and physician–nurse social hierarchy. Participants recognised the importance of team commitment and ongoing interdisciplinary communication for sustainability.

Conclusion

While some factors to consider prior to deployment of healthcare technology are universal, resource‐limited settings have unique implementation barriers.
Patterns of changes in bipolar depressive symptoms revealed by trajectory analysis among 482 patients with bipolar disorder
Authors: Behrendt‐Møller Ida , Madsen Trine , Sørensen Holger Jelling , Sylvia Louisa , Friedman Edward S , Shelton Richard C , Bowden Charles L , Calabrese Joseph R , McElroy Susan L , Ketter Terence A , Reilly‐Harrington Noreen A , Gao Keming , Thase Michael , V Bobo William , Tohen Mauricio , McInnis Melvin , Kamali Masoud , Kocsis James H , Deckersbach Thilo , Köhler‐Forsberg Ole , Nierenberg Andrew A
Published: November 2018

Introduction

Depressive episodes are often prevalent among patients with bipolar disorder, but little is known regarding the differential patterns of development over time. We aimed to determine and characterize trajectories of depressive symptoms among adults with bipolar disorder during 6 months of systematic treatment.

Methods

The pragmatic clinical trial, Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (CHOICE), randomized 482 outpatients with bipolar disorder to lithium or quetiapine. Depressive symptoms were rated at up to 9 visits using the Montgomery‐Asberg Depression Rating Scale (MADRS). Growth mixture modeling was utilized to identify trajectories and multinomial regression analysis estimated associations with potential predictors.

Results

Four distinct trajectories of depressive symptoms were identified. The responding class (60.3%) with a rapid reduction and subsequent low level; the partial‐responding class (18.4%) with an initial reduction followed by an increase during the remaining weeks; the fluctuating class (11.6%) with a fluctuation in depressive symptoms; and the non‐responding class (9.7%) with sustained moderate‐severe depressive symptoms. Bipolar type I predicted membership of the non‐responding class and randomization to quetiapine predicted membership of either the responding or the non‐responding class.

Conclusion

Approximately 30% experienced a partial or fluctuating course, and almost 10% had a chronic course with moderate‐severe depression during 6 months. Patients diagnosed with bipolar type 1 had higher risk of being categorized into a class with a worse outcome. While no differences in average overall outcomes occurred between the lithium and quetiapine groups, trajectory analysis revealed that the lithium group had more variable courses.
The timing of salt structure growth in the Southern Permian Basin (Central Europe) and implications for basin dynamics
Authors: Warsitzka Michael , Jähne‐Klingberg Fabian , Kley Jonas , Kukowski Nina
Published: November 2018

In this paper, a literature‐based compilation of the timing and history of salt tectonics in the Southern Permian Basin (Central Europe) is presented. The tectono‐stratigraphic evolution of the Southern Permian Basin is influenced by salt movement and the structural development of various types of salt structures. The compilation presented here was used to characterize the following syndepositional growth stages of the salt structures: (a) “phase of initiation”; (b) phase of fastest growth (“main activity”); and (c) phase of burial’. We have also mapped the spatial pattern of potential mechanisms that triggered the initiation of salt structures over the area studied and summarized them for distinct regions (sub‐basins, platforms, etc.). The data base compiled and the set of maps produced from it provide a detailed overview of the spatial and temporal distribution of salt tectonic activity enabling the correlation of tectonic phases between specific regions of the entire Southern Permian Basin. Accordingly, salt movements were initiated in deeply subsided graben structures and fault zones during the Early and Middle Triassic. In these areas, salt structures reached their phase of main activity already during the Late Triassic or the Jurassic and were mostly buried during the Early Cretaceous. Salt structures in less subsided sub‐basins and platform regions of the Southern Permian Basin mostly started to grow during the Late Triassic. The subsequent phase of main activity of these salt structures took place from the Late Cretaceous to the Cenozoic. The analysis of the trigger mechanisms revealed that most salt structures were initiated by large‐offset normal faults in the sub‐salt basement in the large graben structures and minor normal faulting associated with thin‐skinned extension in the less subsided basin parts.
Thermal and exhumation histories of the northern subalpine chains (Bauges and Bornes—France): Evidence from forward thermal modeling coupling clay mineral diagenesis, organic maturity and carbonate clumped isotope (Δ47) data
Authors: Mangenot Xavier , Deçoninck Jean‐Francois , Bonifacie Magali , Rouchon Virgile , Collin Pierre‐Yves , Quesne Didier , Gasparrini Marta , Sizun Jean‐Pierre
Published: November 2018

Assessing the thermal evolution of sedimentary basins over time is a major aspect of modern integrated basin analysis. While the behavior of clay minerals and organic matter with increasing burial is well documented in different geological and thermal settings, these methods are often limited by the temperature ranges over which they can be precisely applied and by the available material. Here, we explore the emergent Δ47 clumped isotope geospeedometry (based on the diffusional redistribution of carbon and oxygen isotopes in the carbonate lattice at elevated temperatures) to refine time‐temperature paths of carbonate rocks during their burial evolution. This study provides a reconstruction of the thermal and exhumation history of the Upper Cretaceous thrust belt series in the western subalpine massifs (Bauges and Bornes, French Alps) by a new approach combining for the first time available data from three independent geothermometers. The investigated area presents two zones affected by contrasting thermal histories. The most external zone has undergone a relatively mild thermal history (T < 70°C) and does not record any significant clay mineral diagenetic transformation. By contrast, the internal zone has experienced tectonic burial (prealpine nappes) in response to thrusting, resulting in overheating (T > 160–180°C) that induced widespread clay mineral diagenetic transformations (progressive illitization from R0 to R1 and R3 illite‐smectite mixed‐layers), organic matter maturation (oil window) and Δ47 thermal resetting with apparent equilibrium temperatures above 160°C. The three employed geothermal indicators conjointly reveal that the investigated Upper Cretaceous rocks have suffered a wide range of burial temperatures since their deposition, with a thermal maximum locally up to 160–180°C. High temperatures are associated with the tectonic emplacement of up to 4 km of prealpine nappes in the northern part of the studied area. Finally, a forward thermal modeling using Δ47, vitrinite reflectance and clay mineral data, is attempted to precisely refine the burial and exhumation histories of this area.
Donor liver apoptosis is associated with early allograft dysfunction and decreased short‐term graft survival after liver transplantation
Authors: Zhu Zebin , Tang Yunhua , Huang Shanzhou , Zhao Qiang , Schroder Paul M. , Zhang Zhiheng , Zhang Yixi , Sun Chengjun , Wang Linhe , Ju Weiqiang , Wang Dongping , Guo Zhiyong , He Xiaoshun
Published: November 2018

Background

The clinical significance of apoptosis in assessing the quality of donor liver grafts remains unknown.

Aims

This study aimed to determine whether apoptosis in a donor liver is predictive of early allograft dysfunction (EAD) and graft survival after liver transplantation (LT).

Methods

Donor liver specimens were analyzed for apoptosis using TUNEL assays. The prognostic factors for EAD were identified through logistic regression analyses, and a nomogram was developed.

Results

The apoptosis index of donor livers in EAD patients was significantly higher than that of donors livers in non‐EAD patients (median 5.3; interquartile range [IQR] 3.4 vs 3.5; 3.6, P < 0.001). Multivariate analyses identified the apoptosis index of the donor liver (HR = 6.927, P < 0.001) and five other characteristics as independent predictors of EAD. A nomogram built on these predictive variables showed good calibration and discriminatory abilities, with a c‐index value of 0.847. The 30‐day graft survival rates in the high apoptosis index (apoptosis index >4.4%) group were significantly lower than those in the low apoptosis index (apoptosis index ≤4.4%) group (84.4% vs 97.6%, P = 0.004).

Conclusions

Donor liver apoptosis plays a significant role in predicting EAD after LT. Furthermore, a high apoptosis index in the donor liver was associated with inferior graft survival in the short‐term.
FracKfinder: A MATLAB Toolbox for Computing Three‐Dimensional Hydraulic Conductivity Tensors for Fractured Porous Media
Authors: Young Nathan L. , Reber Jacqueline E. , Simpkins William W.
Published: November 2018

Fractures in porous media have been documented extensively. However, they are often omitted from groundwater flow and mass transport models due to a lack of data on fracture hydraulic properties and the computational burden of simulating fractures explicitly in large model domains. We present a MATLAB toolbox, FracKfinder, that automates HydroGeoSphere (HGS), a variably saturated, control volume finite‐element model, to simulate an ensemble of discrete fracture network (DFN) flow experiments on a single cubic model mesh containing a stochastically generated fracture network. Because DFN simulations in HGS can simulate flow in both a porous media and a fracture domain, this toolbox computes tensors for both the matrix and fractures of a porous medium. Each model in the ensemble represents a different orientation of the hydraulic gradient, thus minimizing the likelihood that a single hydraulic gradient orientation will dominate the tensor computation. Linear regression on matrices containing the computed three‐dimensional hydraulic conductivity (K) values from each rotation of the hydraulic gradient is used to compute the K tensors. This approach shows that the hydraulic behavior of fracture networks can be simulated where fracture hydraulic data are limited. Simulation of a bromide tracer experiment using K tensors computed with FracKfinder in HGS demonstrates good agreement with a previous large‐column, laboratory study. The toolbox provides a potential pathway to upscale groundwater flow and mass transport processes in fractured media to larger scales.
A Critical Analysis of Transverse Dispersivity Field Data
Authors: Zech Alraune , Attinger Sabine , Bellin Alberto , Cvetkovic Vladimir , Dietrich Peter , Fiori Aldo , Teutsch Georg , Dagan Gedeon
Published: November 2018

Transverse dispersion, or tracer spreading orthogonal to the mean flow direction, which is relevant e.g, for quantifying bio‐degradation of contaminant plumes or mixing of reactive solutes, has been studied in the literature less than the longitudinal one. Inferring transverse dispersion coefficients from field experiments is a difficult and error‐prone task, requiring a spatial resolution of solute plumes which is not easily achievable in applications. In absence of field data, it is a questionable common practice to set transverse dispersivities as a fraction of the longitudinal one, with the ratio 1/10 being the most prevalent. We collected estimates of field‐scale transverse dispersivities from existing publications and explored possible scale relationships as guidance criteria for applications. Our investigation showed that a large number of estimates available in the literature are of low reliability and should be discarded from further analysis. The remaining reliable estimates are formation‐specific, span three orders of magnitude and do not show any clear scale‐dependence on the plume traveled distance. The ratios with the longitudinal dispersivity are also site specific and vary widely. The reliability of transverse dispersivities depends significantly on the type of field experiment and method of data analysis. In applications where transverse dispersion plays a significant role, inference of transverse dispersivities should be part of site characterization with the transverse dispersivity estimated as an independent parameter rather than related heuristically to longitudinal dispersivity.
Successful use of arterio‐venous graft for hemodialysis in patient with hemophilia
Authors: Amberker Deepa , Li Ting Ting , Rampure Ritesh
Published: November 2018

Hemodialysis (HD) is not the preferred approach for dialysis in patients with hemophilia. HD in such patients can possess a high risk of bleeding from arterio‐venous cannulation and hence peritoneal dialysis is the first choice in patients with hemophilia. The bleeding risk can be overcome by the prophylactic administration of factor VIII, which is a very costly solution. Here, we present a case of hemophilia with successful HD using an arterio‐venous graft averting the need for factor VIII. We review the literature on epidemiology and risk factors for chronic kidney disease in patients with hemophilia. We also discuss the dialysis and arterio‐venous graft options. In patients with hemophilia who are not candidates for peritoneal dialysis, tri‐layered arterio‐venous grafts offer distinct advantages.
Flexible nest‐site selection under anthropogenic habitat change in an Afrotropical understorey insectivore
Authors: Van De Loock Dries , Strubbe Diederik , Thijs Koen W. , Van De Peer Thomas , De Neve Liesbeth , Githiru Mwangi , Matthysen Erik , Lens Luc
Published: November 2018

Human activities impact upon natural habitats used by birds for breeding and foraging, and lead to changes in the composition and spatial distribution of predator communities, mainly through loss, fragmentation and disturbance of formerly pristine habitat. Yet possible fitness consequences of such changes through impacts on bird nest‐site selection remain poorly known. Here we study nest‐site selection and reproductive success of Placid Greenbuls Phyllastrephus placidus in the Taita Hills, southeast Kenya. We show that habitat features associated with nest‐site selection by this insectivorous, open‐cup‐nesting bird species vary among forest fragments that are exposed to different levels of habitat disturbance. Such differences in sites selected for breeding result from a plastic response to fragment‐specific conditions or may be driven by fragment‐specific variation in the distribution and availability of certain habitat features. Given the overall high nest predation rates in our study area, we expected variation in nest‐site selection to correlate with reproductive success and nestling condition, but detected no such relationship. Because predator density and nest predation rates may vary strongly in space and time, a better understanding of spatio‐temporal variation in predator communities is needed to assess the possible adaptive value of nest‐site selection strategies for reducing the high predation rates that are typical for this and many other open‐cup‐nesting tropical passerines.
Assessment of postoperative renal function after adrenalectomy in patients with primary aldosteronism
Authors: Onohara Tadashi , Takagi Toshio , Yoshida Kazuhiko , Iizuka Junpei , Okumi Masayoshi , Kondo Tsunenori , Ishida Hideki , Tanabe Kazunari
Published: November 2018

Objective

To investigate kidney function change during adrenalectomy in patients with primary aldosteronism and assess predictors of kidney function decline.

Methods

The present study included 90 patients who underwent adrenalectomy for primary aldosteronism between 2004 and 2017. Kidney function was evaluated 1 month after surgery. Predictors associated with a ≥10% decline in the estimated glomerular filtration rate were investigated. Kidney parenchymal volume was compared before and after surgery in 10 patients using volumetric studies.

Results

The mean estimated glomerular filtration rate decline in the total cohort at 1 month after surgery was 13.3% (before: 72.9 mL/min/1.73 m2, after: 64.9 mL/min/1.73 m2, P < 0.0001). The mean serum plasma aldosterone concentration (before: 373 pg/mL vs after: 78 pg/mL, P < 0.0001) and potassium level (before: 3.7 mEq/L vs after: 3.9 mEq/L, P = 0.0001) were also significantly different after surgery. Age (odds ratio 6.37, P = 0.0006), preoperative plasma aldosterone concentration (odds ratio 3.12, P = 0.0209) and preoperative serum potassium level (odds ratio 2.87, P = 0.0010) were independent predictors of a ≥10% decline in estimated glomerular filtration rate. Volumetric studies in 10 patients showed that mean postoperative parenchymal volume was significantly decreased compared with the preoperative volume (263 cc vs 312 cc, P = 0.0003), with decreases in estimated glomerular filtration rate from 63 to 56 mL/min/1.73 m2 (P = 0.0146).

Conclusions

Kidney function deterioration after adrenalectomy can be detected in patients with primary aldosteronism. Age, preoperative plasma aldosterone concentration and preoperative potassium level are significant predictors of a decrease in the estimated glomerular filtration rate. Normal parenchymal volume decreases in line with renal functional deterioration.
Exploring the association between parental psychiatric disease and childhood atopic dermatitis: a matched case–control study
Authors: Hamann C.R. , Egeberg A. , Silverberg J.I. , Gislason G. , Skov L. , Thyssen J.P.
Published: November 2018

Background

Maternal prenatal psychiatric disease has been identified as a possible risk factor for atopic dermatitis development in her children. We quantified the associations between maternal and paternal psychiatric disease and the development of atopic dermatitis in their offspring using nationwide registries.

Methods

All children in Denmark born between 1 January 1996 and 31 December 2011 who developed atopic dermatitis prior to their fifth birthday were identified and individually matched 1:10 with controls from the general population and with children receiving care in a similar ambulatory/hospital setting. Conditional logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals.

Results

A total of 8602 children with atopic dermatitis were matched with controls. Rates of parental psychiatric care were similar in the atopic dermatitis and control groups. When compared to the general population, weak associations were found between childhood atopic dermatitis and maternal history of depression [OR 1.18 (95% confidence interval: 1.12–1.26)], alcohol abuse [OR 1.37 (1.17–1.60)] and illicit drug use [OR 1.34 (1.14–1.60)]. However, associations became insignificant when the paediatric ambulatory/hospital control group was used [OR 1.05 (0.99–1.13)], [OR 1.14 (0.98–1.34)] and [OR 1.03 (0.88–1.22)], respectively. No paternal psychiatric disease or prenatal maternal psychiatric disease associated with the AD development in the offspring.

Conclusions

While we found no consistent associations between maternal or paternal psychiatric disease and the subsequent development of atopic dermatitis in their offspring, children of parents with substance abuse issues may be more likely to receive an atopic dermatitis diagnosis.
Integrated cultural practices for whitefly management in organic tomato
Authors: Togni Pedro Henrique Brum , Marouelli Waldir Aparecido , Inoue‐Nagata Alice Kazuko , Pires Carmen Silvia Soares , Sujii Edison Ryoiti
Published: November 2018

The whitefly Bemisia tabaci (Hemiptera: Aleyrodidae) is a serious pest among the diverse insect fauna of the tomato crop, especially when cultivated in organic systems. The feeding behaviour of B. tabaci is responsible for direct damage to tomato plants and for the transmission of several viruses, such as begomoviruses. The objective of this study was to evaluate the effect of integrating the cultural practices of intercropping and irrigation systems on B. tabaci abundance and the incidence of begomovirus in organic tomato systems. Field experiments were performed in the dry season for 2 years when B. tabaci abundance and begomovirus incidence were compared in tomato crops planted either in monoculture or intercropped with coriander and irrigated by overhead sprinklers or by a drip irrigation system. Tomato plants intercropped with coriander and irrigated by overhead sprinklers showed the lowest levels of B. tabaci colonization by adult and nymph densities. Most likely, the coriander plants produced visual and olfactory barriers for insect host plant selection, and the overhead sprinkler irrigation physically interfered with the movement and establishment of the insects. The combined effect of intercropping and sprinkler irrigation made tomato plants less suitable for B. tabaci establishment. Moreover, tomatoes intercropped with coriander and irrigated by sprinkler irrigation also reduced the incidence of begomovirus‐infected plants. In summary, integrating tomato–coriander intercropping and sprinkler irrigation can help manage B. tabaci and associated viruses in organic tomato crops.
Diagnostic accuracy of intraoral photographic orthodontic records
Authors: Jackson Tate H. , Kirk Christopher J. , Phillips Ceib , Koroluk Lorne D.
Published: November 2018

Objective

The aims of this study were (1) to investigate how relevant intraoral photographs are to contemporary orthodontic diagnosis and (2) to assess orthodontists' ability to accurately diagnose angle classification and dental midlines using standardized intraoral photographs.

Methods

Study participants were orthodontists who completed a survey regarding photography protocols and their use of intraoral photographs for diagnosis. Each participant was randomized to complete 1 visual diagnostic task regarding either angle classification or midlines. Accuracy was compared across groups and camera angulations.

Results

In all, 80% of 192 respondents reported using photographs and clinic notes to plan orthodontic treatment; 50% also included dental casts. For the angle task, accuracy judging molar and canine classification was 79.9% and 51.3%, respectively with ideal standardized photographs. As camera angulation deviated, accuracy decreased significantly (P < 0.0001). For the midline task, accuracy judging the direction of deviation decreased with a small camera angulation change yet increased with a large change (P < 0.001).

Conclusions

When using ideal intraoral photographs alone to diagnose angle classification and midline relationships, accuracy is not likely to be greater than 80%. As camera angulation becomes less ideal, by 15 degrees when judging angle classification or 4 degrees when judging midlines, accuracy is likely to significantly decrease.

Clinical significance

For the clinician who wants to have the most accurate and complete records, our results suggest that intra‐oral photos alone may not be adequate when it comes to judging occlusal relationships such as angle classification and esthetic parameters like midlines. When using ideal intraoral photographs to diagnose angle classification and midline relationships, accuracy is not likely to be greater than 80%. As camera angulation becomes less ideal, by as little as 15 degrees when judging angle classification or 4 degrees when judging midlines, accuracy is likely to decrease significantly. Understanding these limitations will allow clinicians to improve both their clinical photography technique and their diagnostic skills.
The increase of interfollicular epidermal stem cells and regulation of aryl hydrocarbon receptor and its repressors in the skin through hydroporation with anti‐aging cocktail
Authors: Shin Jung‐Won , Choi Hye‐Ryung , Yang Seung‐Hye , Choi Ji‐Young , Na Jung‐Im , Huh Chang‐Hun , Park Kyoung‐Chan
Published: November 2018

Backgrounds

Hydroporation is a procedure that involves a subsonic flow of air and microdroplets into the skin. We previously reported that hydroporation treatment with a cocktail solution containing copper‐glycyl‐L‐histidyl‐L‐lysyl, oligo hyaluronic acid, rhodiola extract, tranexamic acid, and β‐glucan yielded positive effects on skin aging.

Objectives

The aim of this study was to evaluate the effects of hydroporation with anti‐aging cocktail on interfollicular epidermal stem cells (IFESCs) and expression of aryl hydrocarbon receptor (AhR)/AhR repressor (AhRR) in the skin.

Methods

Skin samples from six volunteers who were treated with hydroporation were analyzed via confocal microscopic examination.

Results

Markers for dermal matrix (procollagen type I and fibrillin‐1) and basement membrane (type IV collagen and integrin α6) were increased after treatment. Moreover, there was a significant increase in the expression level of histone deacetylase 1‐positive/p63‐negative basal cells, which we previously reported as interfollicular epidermal stem cells. The expression level of AhR was significantly decreased, whereas that of AhRR was increased. This indicates an alteration in the interaction between the skin and environment posttreatment.

Conclusion

Anti‐aging hydroporation treatment recovered the stem cell potential of basal cells. Moreover, this treatment decreased AhR and increased AhRR in the skin, which may protect the skin from the harmful environment.
Appearance of aging signs in differently pigmented facial skin by a novel imaging system
Authors: Campiche Remo , Trevisan Solène , Séroul Pierre , Rawlings Anthony V. , Adnet Cyprien , Imfeld Dominik , Voegeli Rainer
Published: November 2018

Background

Facial wrinkles, pores, and uneven skin tone are major beauty concerns. There is differential manifestation of aging signs in different ethnic groups. In this regard, studies on Black Africans from the African continent are scarce.

Objective

To investigate facial wrinkles, pores, and skin tone in Black African women from Mauritius Island and elucidate the differences to Caucasian women from France.

Methods

Facial images were taken using the imaging system ColorFace®. Wrinkles and pores were measured by their length, depth, surface, volume, and number; for skin tone, we measured L*a*b* and calculated ITA, IWANewtone, and color homogeneity.

Results

We found good correlations of wrinkle and pore scores with expert ranking done on ColorFace® images for Caucasians (Spearman's rho = 0.78 and 0.72) and Black Africans (Spearman's rho = 0.86 and 0.65). Caucasians showed more advanced facial signs of aging than Black Africans. Exceptions were vertical lines on upper lip and the depth of pores which were greatest for the Black African subjects. Black Africans had higher heterogeneity scores indicative for uneven skin tone. Luminance (L*) was significantly higher in Caucasians but a* and b* values were significantly higher in the Black African subjects. ITA and IWANewtone were significantly higher for Caucasians.

Conclusions

The high correlation between expert ranking and wrinkle and pore measurements prove ColorFace® a valid imaging system to study skin aging. Our results show that Africans from the African continent show delayed signs of aging compared to Caucasians. Some exceptions suggest that ethnic differences in facial aging are a complex phenomenon.
CT features of extrahepatic arterioportal fistula in two cats
Authors: Choi M. , Kim H. , Yoon J. , Choi M.
Published: November 2018

Two cats presented with large volume ascites and the cause was suspected to be portal hypertension. On contrast CT they both showed enhancement of the main portal vein during the arterial phase and an anomalous connection between the celiac artery and extrahepatic portal vasculature, prompting a diagnosis of extrahepatic arterioportal fistula. An extrahepatic arterioportal fistula is a connection between any artery and the portal vein outside the liver and, to our knowledge, this is the first report in cats.
Characterization of changes in intrahepatic immune cell populations during HCV treatment with sofosbuvir and ribavirin
Authors: Orr Cody , Aartun Johannes , Masur Henry , Kottilil Shyam , Meissner Eric G.
Published: November 2018

Treatment of chronic hepatitis C virus (HCV) infection with direct‐acting antivirals (DAAs) results in a sustained virologic response (SVR) in most patients. While highly efficacious, ~3%‐5% of patients do not achieve SVR despite having virus that appears susceptible. It is unclear whether host factors contribute to treatment failures, although innate and adaptive immunity may play a role. Previous studies showed that after DAA treatment, the composition of intrahepatic immune cells does not normalize relative to healthy volunteers, even in cases where SVR is achieved. We used paired pre‐ and post‐treatment liver biopsies from 13 patients treated with sofosbuvir and ribavirin, 4 of whom relapsed, to analyse intracellular immune changes during DAA treatment and explore correlations with inflammation and treatment outcome. We performed single marker immunohistochemistry followed by electronic image capture, manual annotation of parenchymal and non‐parenchymal regions, and quantitative image analysis. The predominant cellular change during treatment was a decrease in CD8+ cellular density in both parenchymal and non‐parenchymal regions. CD68+ Kupffer cell density correlated with hepatic inflammation (AST, ALT) pre‐treatment, but did not change during treatment. CD4+ cellular density decreased in non‐parenchymal regions and, intriguingly, was lower pre‐treatment in subjects who eventually relapsed. Other cellular markers (CD56, CD20), as well as markers of apoptosis (TIA‐1) and activated stellate cells, did not change significantly during treatment or differ by treatment outcome. The predominant intrahepatic cellular change during DAA treatment of chronic HCV infection is a reduction in CD8+ cellular density, but this did not correlate with treatment outcome.
Identification and removal of contaminating microbial DNA from PCR reagents: impact on low-biomass microbiome analyses
Authors: Stinson L.F. , Keelan J.A. , Payne M.S.
Published: November 2018

Reagent-derived contamination can compromise the integrity of microbiome data, particularly in low microbial biomass samples. This contamination has recently been attributed to the ‘kitome’ (contamination introduced by the DNA extraction kit), prior to which attention was mostly paid to potential contamination introduced by PCR reagents. In this study, we assessed the proportion to which our DNA extraction kit and PCR master mix introduce contaminating microbial DNA to bacterial microbial profiles generated by 16S rRNA gene sequencing. Utilizing a commercial dsDNase treatment protocol to decontaminate the PCR master mix, we demonstrated that the vast majority of contaminating DNA was derived from the PCR master mix. Importantly, this contamination was almost completely eliminated using the simple dsDNase treatment, resulting in a 99% reduction in contaminating bacterial reads. We suggest that dsDNase treatment of PCR reagents should be explored as a simple and effective way of reducing contamination in low-biomass microbiome studies and producing more robust and reliable data.

Significance and Impact of the Study

Reagent contamination with microbial DNA is a major problem in microbiome studies of low microbial biomass samples. Levels of such contaminating DNA often outweigh what is present in the sample and heavily confound subsequent data analysis. Previous studies have suggested this contamination is primarily derived from DNA extraction kits. Here, we identified the PCR master mix as the primary source of contamination, and showed that enzymatic removal of the contamination drastically reduced the blank signal and improved precision. Decontamination of PCR master mixes may have the potential to improve the sensitivity and accuracy of low-biomass microbiome studies.
A thylakoid‐located carbonic anhydrase regulates CO2 uptake in the cyanobacterium Synechocystis sp. PCC 6803
Authors: Sun Nan , Han Xunling , Xu Min , Kaplan Aaron , Espie George S. , Mi Hualing
Published: November 2018

Carbonic anhydrases (CAs) are involved in CO2 uptake and conversion, a fundamental process in photosynthetic organisms. Nevertheless, the mechanism underlying the regulation of CO2 uptake and intracellular conversion in cyanobacteria is largely unknown.

We report the characterization of a previously unrecognized thylakoid‐located CA Slr0051 (EcaB) from the cyanobacterium Synechocystis sp. PCC 6803, which possesses CA activity to regulate CO2 uptake.

Inactivation of ecaB stimulated CO2 hydration in the thylakoids, suppressed by the classical CA inhibitor acetazolamide. Absence of ecaB increased the reduced state of the photosynthetic electron transport system, lowered the rate of photosynthetic O2 evolution at high light (HL) and pH, and decreased the cellular affinity for extracellular inorganic carbon. Furthermore, EcaB was upregulated in cells grown at limiting CO2 concentration or HL in tandem with CupA. EcaB is mainly located in the thylakoid membranes where it interacts with CupA and CupB involved in CO2 uptake by converting it to bicarbonate.

We propose that modulation of the EcaB level and activity in response to CO2 changes, illumination or pH reversibly regulates its conversion to HCO3 by the two CO2‐uptake systems (CupA, CupB), dissipating the excess HCO3− and alleviating photoinhibition, and thereby optimizes photosynthesis, especially under HL and alkaline conditions.
Oral ulceration with bone sequestration: Retrospective study of eight cases and literature review
Authors: Thermos Grigorios , Kalogirou Eleni‐Marina , Tosios Konstantinos I. , Sklavounou Alexandra
Published: November 2018

Objective

Oral ulceration with bone sequestration (OUBS) describes a site‐specific intraoral ulcer that covers exposed, non‐vital bone in patients lacking any etiological factor known to induce osteonecrosis. We aimed to conduct a retrospective study of eight new cases of OUBS and review the literature.

Subjects and Methods

This is a retrospective study of OUBS cases, diagnosed and managed during 2007–2017. Inclusion criteria were the presence of oral ulcer with exposed non‐vital bone at sites of bone prominence and the absence of any factor known to cause osteonecrosis. The English literature was reviewed on original OUBS cases.

Results

Eight patients (5 males and 3 females, aged 27–75 years) were diagnosed with OUBS during years 2007–2017. Four cases involved the mandibular mylohyoid ridge, one a mandibular anterior exostosis and three the maxillary buccal/palatal exostoses. Exposed bone was removed under local anesthesia, resulting in complete healing in all cases. The literature review yielded 32 OUBS cases in the mandible.

Conclusion

Oral ulceration with bone sequestration is a distinct, probably under‐reported rather than rare clinical entity that should be regarded the provisional diagnosis in case of an oral ulcer covering exposed, non‐vital bone at sites of bone prominence in patients lacking any etiological factor known to induce osteonecrosis.
Patient knowledge of FDA‐mandated sunscreen labeling terminology: A cross‐sectional survey
Authors: Prado Giselle , Svoboda Ryan M. , Teplitz Rebeca W. , Farberg Aaron S. , Rigel Darrell S.
Published: November 2018

Background

Insufficient understanding of sunscreen labeling terminology is a barrier to effective use. The Food and Drug Administration (FDA) issued the “final rule” on sunscreen labeling in 2011, in an effort to promote effective usage. However, relatively little is known about patient knowledge of sunscreen labeling terminology. This study assesses the sunscreen labeling knowledge of dermatology patients, with an emphasis on understanding of the FDA‐mandated wording.

Methods

A validated survey was administered to consecutive dermatology office patients. Respondents answered questions about sunscreen use practices, sunscreen knowledge, and demographics. To assess their sunscreen knowledge, they responded to questions on the concepts of sun protection factor, broad‐spectrum, and waterproof.

Results

A total of 334 patients completed surveys. Only 8.7% of patients correctly answered all three questions related to sunscreen labeling terminology. Patients with a personal history of skin cancer were more likely to answer more than half of the questions correctly (P = 0.004). Older persons and those with darker skin types were most likely to answer all questions incorrectly.

Conclusion

General understanding of sunscreen labeling was poor, and a minority of consumers comprehended the key features of sunscreen labeling. This knowledge gap appeared to be slightly smaller in the subpopulation of patients with a personal history of skin cancer.
Protecting direct seeded grasses from herbicide application: can new extruded pellet formulations be used in restoring natural plant communities?
Authors: Brown Vanessa S. , Ritchie Alison L. , Stevens Jason C. , Harris Richard J. , Madsen Matthew D. , Erickson Todd E.
Published: November 2018

Restoration of native plant communities through direct seeding often experience low seedling establishment success rates, partly due to competition with invasive weed species. To improve seeding success, herbicides can be applied to control weed competition, however, this can have negative impacts on the seeded species. Activated carbon (AC) can be incorporated into newly developed seed enhancement technologies to adsorb herbicides and increase seedling tolerance. This study expands upon research completed to date, by developing new formulations of extruded pellets containing AC, aiming to provide increased protection to seeded species and increase herbicide selectivity. We tested six extruded pellet formulations, which included two pellet formula variations, and three quantities of AC, to examine the impact on emergence (without herbicide) and mortality (with herbicide) of Lolium rigidum Gaudin (annual ryegrass). Extruded pellet formulations containing a superabsorbent polymer (3%) and AC (10%) did not impede emergence (79%), in the absence of herbicide, similar to the non‐pelleted seeds (81%). This extruded pellet formulation increased seedling tolerance to Simazine (a pre‐emergent, soil applied herbicide) application, with mortality reduced from 96% in non‐pelleted seeds, and 77% in pellets containing no AC, to 22% in pellets containing AC. The results from this study demonstrate that AC extruded pelleting can be used as a restoration seeding technology by protecting seeds from the negative effects of pre‐emergent herbicide applications. Field evaluations with native seeds will mark an important step forward to ensure seed enhancement technology options, such as AC extruded pelleting, are available for restoring natural plant communities in restoration programs.
Physical activity associates with disease characteristics of severe asthma, bronchiectasis and COPD
Authors: Cordova‐Rivera Laura , Gibson Peter G. , Gardiner Paul A. , McDonald Vanessa M.
Published: November 2018

Background and objective

Physical activity (PA) in obstructive airway diseases (OAD) is likely to be impaired but this has not been extensively studied outside of chronic obstructive pulmonary disease (COPD). We describe PA levels in severe asthma and bronchiectasis compared to moderate–severe COPD and to controls, and tested the cross‐sectional associations of PA (steps/day) with shared disease characteristics in the OAD group.

Methods

Adults with OAD (severe asthma = 62, COPD = 67, bronchiectasis = 60) and controls (n = 63) underwent a multidimensional assessment, including device‐measured PA levels.

Results

The OAD group included 189 participants (58.7% females), with median (interquartile range) age of 67 (58–72) years and mean forced expiratory volume in the first second (FEV1) % predicted of 69.4%. Demographic characteristics differed between groups. Compared to controls (52.4% females, aged 55 (34–64) years, median 7640 steps/day), those with severe asthma, bronchiectasis and COPD accumulated less steps/day: median difference of −2255, −2289, and −4782, respectively (P ≤ 0.001). Compared to COPD, severe asthma and bronchiectasis participants accumulated more steps/day: median difference of 2375 and 2341, respectively (P ≤ 0.001). No significant differences were found between the severe asthma and bronchiectasis group. Exercise capacity, FEV1% predicted, dyspnoea and systemic inflammation differed between groups, but were each significantly associated with steps/day in OAD. In the multivariable model adjusted for all disease characteristics, exercise capacity and FEV1% predicted remained significantly associated.

Conclusion

PA impairment is common in OAD. The activity level was associated with shared characteristics of these diseases. Interventions to improve PA should be multifactorial and consider the level of impairment and the associated characteristics.