bluuebunny/crossref_metadata_2025 huggingface dataset:
Women desiring less care than recommended during childbirth: Three years of dedicated clinic
Authors: van der Garde Matthijs , Hollander Martine , Olthuis Gert , Vandenbussche Frank , van Dillen Jeroen
Published: February 2019

Background

Some women decline recommended care during pregnancy and birth. This can cause friction between client and provider.

Methods

A designated outpatient clinic was started for women who decline recommended care in pregnancy. All women who attended were analyzed retrospectively. The clinic used a systematic multidisciplinary approach. During the first visit, women told their stories and explained the reasoning behind their birth plan. The second visit was used to present the evidence underpinning recommendations and attempt to reach a compromise if care within recommendations was still not acceptable to the woman. During the third visit, a final birth plan was decided on.

Results

From January 1, 2015, until December 31, 2017, 55 women were seen in the clinic, 29 of whom declined items of recommended care during birth and were included in the study. After discussions had been completed, 38% of birth plans were within recommendations, 38% were a compromise, in which both the woman and the care provider had made certain concessions, and 24% did not reach an agreement and delivered with another provider either at home or elsewhere. All maternal and perinatal outcomes were good.

Conclusions

Using a respectful and systematic multidisciplinary approach, in which women feel heard and are invited to explain their motivations for their birth plans, we are able to arrive at a plan either compatible with or much closer to recommendations than the woman’s initial intentions in most cases, thereby preventing negative choices.
GSK2646264, a spleen tyrosine kinase inhibitor, attenuates the release of histamine in ex vivo human skin
Authors: Ramirez Molina Cesar , Falkencrone Sidsel , Skov Per S. , Hooper‐Greenhill Edward , Barker Mike , Dickson Marion C.
Published: February 2019

Background and Purpose

Chronic spontaneous urticaria presents as a heterogeneous syndrome characterised by wheals, angioedema, or both for greater than 6 weeks. Spleen tyrosine kinase mediates allergen‐induced mast cell degranulation via the IgE signalling pathway, a central component of wheal formation and inflammation. In this study, we investigated the effects of perfused or topically administered GSK2646264 on IgE‐mediated histamine release from mast cells in an ex vivo human skin model.

Experimental Approach

Using a novel SkiP device, ex vivo human skin from mastectomy surgeries was challenged with anti‐IgE, complement 5a (C5a), and buffer to induce histamine release from skin mast cells. Histamine was collected via microdialysis fibres and measured fluorometrically. GSK2646264 was delivered via perfusion either using microdialysis fibres or topically in a cream. Drug concentrations in the skin were measured by LC–MS, and a pharmacokinetic/ pharmacodynamic (PK/PD) relationship developed.

Key Results

Perfused GSK2646264 significantly inhibited anti‐IgE (but not C5a)‐induced histamine release in a concentration‐dependent manner. The 0.5, 1, and 3% cream delivered GSK2646264 to the dermis above the IC90 and dose‐dependently attenuated anti‐IgE‐induced histamine release.

Conclusions and Implications

GSK2646264 administered topically or direct to the dermis blocked histamine release from in situ skin mast cells. A PK/PD relationship curve suggests that dermal concentrations above 6.8 μM should lead to approximately 90% inhibition of histamine release from skin mast cells following activation of the Fc fragment of IgE receptor 1a, implicating a potential use for the compound in skin mast cell diseases such as urticaria.
Semaphorin‐3E attenuates intestinal inflammation through the regulation of the communication between splenic CD11C+ and CD4+CD25− T‐cells
Authors: Kermarrec Laëtitia , Eissa Nour , Wang Hongxing , Kapoor Kunal , Diarra Abdoulaye , Gounni Abdelilah S. , Bernstein Charles N. , Ghia Jean‐Eric
Published: February 2019

Background and Purpose

An alteration in the communication between the innate and adaptive immune cells is a hallmark of ulcerative colitis (UC). Semaphorin‐3E (SEMA3E), a secreted guidance protein, regulates various immune responses.

Experimental Approach

We investigated the expression of SEMA3E in colonic biopsies of active UC patients and its mechanisms in Sema3e−/− mice using an experimental model of UC.

Key Results

SEMA3E level was decreased in active UC patients and negatively correlated with pro‐inflammatory mediators. Colonic expression of SEMA3E was reduced in colitic Sema3e+/+ mice, and recombinant (rec‐) Plexin‐D1 treatment exacerbated disease severity. In vivo rec‐SEMA3E treatment restored SEMA3E level in colitic Sema3e+/+ mice. In Sema3e−/− mice, disease severity was increased, and rec‐SEMA3E ameliorated these effects. Lack of Sema3e increased the expression of CD11c and CD86 markers. Colitic Sema3e−/− splenocytes and splenic CD11c+ cells produced more IL‐12/23 and IFN‐γ compared to Sema3e+/+, and rec‐SEMA3E reduced their release as much as NF‐κB inhibitors, whereas an NF‐κB activator increased their production and attenuated the effect of rec‐SEMA3E. Colitic Sema3e−/− splenic CD11c+/CD4+CD25− T‐cell co‐cultures produced higher concentrations of IFN‐γ and IL‐17 when compared to colitic Sema3e+/+ splenic cell co‐cultures, and rec‐SEMA3E decreased these effects. In vitro, anti‐IL‐12p19 and ‐12p35 antibodies and rec‐IL‐12 and ‐23 treatment confirmed the crosstalk between CD11c+ and CD4+CD25− T‐cells.

Conclusion and Implications

SEMA3E is reduced in colitis and modulates colonic inflammation by regulating the interaction between CD11c+ and CD4+CD25− T‐cells via an NF‐κB‐dependent mechanism. Thus, SEMA3E could be a potential therapeutic target for UC patients.
Low‐level laser and adipose‐derived stem cells altered remodelling genes expression and improved collagen reorganization during tendon repair
Authors: Lucke Letícia D. , Bortolazzo Fernanda O. , Theodoro Viviane , Fujii Lucas , Bombeiro André L. , Felonato Maíra , Dalia Rodrigo A. , Carneiro Giane D. , Cartarozzi Luciana P. , Vicente Cristina Pontes , Oliveira Alexandre L. R. , Mendonça Fernanda A. S. , Esquisatto Marcelo A. M. , Pimentel Edson R. , de Aro Andrea A.
Published: February 2019

Objectives

The cellular therapy using adipose‐derived mesenchymal stem cells (ASCs) aims to improve tendon healing, considering that repaired tendons often result in a less resistant tissue. Our objective was to evaluate the effects of the ASCs combination with a low‐level laser (LLL), an effective photobiostimulation for the healing processes.

Materials and methods

Rats calcaneal tendons were divided into five groups: normal (NT), transected (T), transected and ASCs (SC) or LLL (L), or with ASCs and LLL (SCL).

Results

All treated groups presented higher expression of Dcn and greater organization of collagen fibres. In comparison with T, LLL also up‐regulated Gdf5 gene expression, ASCs up‐regulated the expression of Tnmd, and the association of LLL and ASCs down‐regulated the expression of Scx. No differences were observed for the expression of Il1b, Timp2, Tgfb1, Lox, Mmp2, Mmp8 and Mmp9, neither in the quantification of hydroxyproline, TNF‐α, PCNA and in the protein level of Tnmd. A higher amount of IL‐10 was detected in SC, L and SCL compared to T, and higher amount of collagen I and III was observed in SC compared to SCL.

Conclusions

Transplanted ASCs migrated to the transected region, and all treatments altered the remodelling genes expression. The LLL was the most effective in the collagen reorganization, followed by its combination with ASCs. Further investigations are needed to elucidate the molecular mechanisms involved in the LLL and ASCs combination during initial phases of tendon repair.
Performance of new spirometry reference values in preoperative assessment of lung function
Authors: Vogt Barbara , Hennig Victoria , Deuß Kathinka , Balke Lorenz , Weiler Norbert , Frerichs Inéz
Published: February 2019

Background

Pulmonary function is not routinely assessed in patients without respiratory disease and symptoms before surgery, even if they are smokers. We aimed to check whether the new spirometric reference values of the worldwide Global Lung Initiative (GLI) affected the preoperative assessment of lung function in allegedly lung‐healthy patients compared with the still commonly used old predicted values.

Methods

Two hundred nineteen allegedly lung‐healthy non‐smokers, past and current smokers were examined by spirometry before elective surgery. The obtained values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1/FVC were transformed into z‐scores according to the GLI guidelines. A comparison between the new and old reference values was performed. FEV1 was used for the grading of airway obstruction.

Results

One hundred eighty‐three subjects performed the ventilation manoeuvre according to the GLI recommendations and were analysed. Most non‐smokers and past smokers met the new references ranges for spirometric values. Only z‐scores of FEV1/FVC distinguished among all three patient groups, FEV1 between smokers and the other two groups and FVC did not discriminate the groups, irrespective of the reference values used. Airway obstruction was identified in 24% of asymptomatic smokers by z‐scores of FEV1/FVC but in only 14% by the old predicted values. In elderly smokers (>60 years), the corresponding values rose to 50% and 30%. Old predicted values of FEV1 underestimated the degree of airway obstruction mainly in middle‐aged smokers.

Conclusion

Allegedly lung‐healthy current smokers showed a higher proportion of preoperatively reduced lung function when z‐scores were used, especially in elderly subjects.
Sweet syndrome with pseudocarcinomatous hyperplasia: A case report and review of the literature
Authors: Wipf Angela , Wipf Heidi , Miller Daniel
Published: February 2019

Pseudocarcinomatous (pseudoepitheliomatous) hyperplasia represents reactive epidermal change mimicking squamous cell carcinoma (SCC), owing to a variety of inflammatory and neoplastic phenomena, including deep fungal infections, CD30‐positive lymphomas, and others. We report a case of Sweet syndrome (SS) arising in a patient with acute myelogenous leukemia, with persistent orolabial involvement which mimicked SCC both clinically and microscopically, but resolved entirely with adequate corticosteroid treatment. Clinicians should be aware that neutrophilic dermatoses such as SS and pyoderma gangrenosum may rarely exhibit pseudocarcinomatous epidermal changes similar to those seen in soft tissue infections and other inflammatory dermatoses.
Association between allopurinol and cardiovascular outcomes and all‐cause mortality in diabetes: A retrospective, population‐based cohort study
Authors: Weisman Alanna , Tomlinson George A. , Lipscombe Lorraine L. , Perkins Bruce A. , Hawker Gillian A.
Published: February 2019

Aim

To assess the association between allopurinol and mortality and cardiovascular outcomes in an allopurinol‐treated diabetes cohort.

Materials and Methods

We conducted a population‐based retrospective cohort study in Ontario, Canada. Eligible subjects were ≥ 66 years old with diabetes and a first prescription for allopurinol between 1 April, 2002 and 31 March, 2012 and were followed until 31 March, 2016. The primary outcome was a composite: all‐cause mortality, non‐fatal cardiovascular event (myocardial infarction, revascularization procedure, or stroke) or congestive heart failure (CHF). Secondary outcomes were components of the primary outcome and pneumonia as a negative tracer. Allopurinol was modelled as time‐varying exposed versus unexposed, daily dose category and cumulative dose using sex‐specific multivariable Cox proportional hazards models.

Results

Over a median follow‐up of 4.65 years (interquartile range 1.79–7.81), 16 266/23 103 males and 10 571/15 313 females experienced the primary outcome. Allopurinol was associated with a reduction in the primary outcome [adjusted hazard ratios (aHR) 0.77 (95% confidence interval 0.75–0.80) and 0.81 (0.78–0.84) for males and females, respectively], driven by marked reductions in all‐cause mortality and modest reductions in cardiovascular events/CHF. There was no effect of cumulative allopurinol dose on any outcome, and allopurinol was also associated with reduced risk of pneumonia in males [aHR 0.88 (0.83, 0.93)].

Conclusions

Allopurinol was associated with reduced mortality and cardiovascular outcomes. However, lack of cumulative dose effect and a positive tracer outcome in males suggests residual bias. Future research assessing whether allopurinol prevents vascular complications in diabetes requires a clinical trial.
Maize root‐derived C in soil and the role of physical protection on its relative stability over shoot‐derived C
Authors: Xu Hui , Vandecasteele Bart , Zavattaro Laura , Sacco Dario , Wendland Matthias , Boeckx Pascal , Haesaert Geert , Sleutel Steven
Published: February 2019

Evidence is accumulating that belowground crop residues contribute more efficiently to the build‐up and maintenance of native soil organic carbon (SOC) than aboveground plant parts. We corroborated previous testing of the hypothesis that root‐C would preferentially accumulate in soil microaggregates, where it is physically protected against microbially mediated decomposition. In three European field trials with C3 to C4 crop transitions, we compared the content of maize‐C (Zea mays L.) in soil from rotations with grain maize (MG) or silage maize (MS) (i.e. with incorporation of roots and shoots or roots only). After decades of maize cultivation, SOC content did not differ within three out of four MG–MS pairs, although obviously larger amounts of shoot biomass were added to soil in the case of MG. We found that relative contribution of roots was on average 3.5 times more than shoots to the build‐up of SOC per equivalent mass of residue C added to soils. Preferential occlusion of root‐C as silt‐sized intra‐microaggregate particulate organic matter (iPOM) was not observed. There were much larger effects from shoot incorporation on maize‐C in the >53‐μm fraction and free silt and clay. Storage of root‐C as sand‐sized iPOM was not quantified here, but first estimates suggested that physical entrapment at this level could only partly explain the longevity of root‐C in soil. We reconfirm the relative stability of root‐C in soil, but do not conclude that this stems from preferential physical entrapment over shoot‐C. Future work should investigate the cause of preferential root‐C association with the clay‐sized fraction and if this occurs before or after microbial processing.

Highlights

The hypothesized preferential physical stabilization of root‐C was assessed.

Aboveground biomass had a minor effect on SOC storage in European long‐term trials.

Contribution of maize root‐C to maintenance of SOC was three‐fold that of shoot‐C inputs.

There was no preferential occlusion of root‐C in silt‐sized microaggregates.
On the importance of habitat continuity for delimiting biogeographic regions and shaping richness gradients
Authors: Fenberg Phillip B. , Rivadeneira Marcelo M.
Published: February 2019

The formation and maintenance of biogeographic regions and the latitudinal gradient of species richness are thought to be influenced, in part, by the spatial distribution of physical habitat (habitat continuity). But the importance of habitat continuity in relation to other variables for shaping richness gradients and delimiting biogeographic regions has not been well established. Here, we show that habitat continuity is a top predictor of biogeographic structure and the richness gradient of eastern Pacific rocky shore gastropods (spanning c. 23 000 km, from 43°S to 48°N). Rocky shore habitat continuity is generally low within tropical/subtropical regions (compared to extratropical regions), but particularly at biogeographic boundaries where steep richness gradients occur. Regions of high rocky shore habitat continuity are located towards the centres of biogeographic regions where species turnover tends to be relatively low. Our study highlights the importance of habitat continuity to help explain patterns and processes shaping the biogeographic organisation of species.
Effects of exercise training on multiple sclerosis biomarkers of central nervous system and disease status: a systematic review of intervention studies
Authors: Negaresh R. , Motl R. W. , Zimmer P. , Mokhtarzade M. , Baker J. S.
Published: February 2019

Background and purpose

Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system (CNS) that can be tracked through biomarkers of disease status. We investigated the effects of exercise on MS biomarkers associated with CNS status including imaging, blood–brain barrier (BBB) function and neurotrophic factors.

Methods

We conducted open‐dated searches of Scopus, Medline, EMBASE and the Cochrane Library. We included studies written in English describing interventions of exercise that measured one or more of the biomarkers associated with MS published up to October 2018.

Results

We located a total of 3012 citations through searches in electronic databases. Of these, 16 studies were eligible for review; six studies focused on magnetic resonance imaging (MRI) markers, nine studies focused on neurotrophic factors and three studies focused on BBB function markers. It is of note that two studies included both neurotrophic factor and BBB function markers and are therefore included across categories of biomarkers in this review. The existing evidence from MRI studies confirmed that exercise training can improve CNS integrity and function. There is evidence of a positive effect of exercise training on modulation of BBB permeability markers and brain‐derived neurotrophic factor.

Conclusions

Exercise successfully improves MRI outcomes and peripheral biomarkers (i.e. brain‐derived neurotrophic factor) in people with MS. This suggests that exercise can be recommended as an adjuvant therapy for MS treatment. This conclusion is tempered by some methodological limitations including small sample sizes and high drop‐out rates in the reviewed studies.
Comparative regenerative biology of spiny (Acomys cahirinus) and laboratory (Mus musculus) mouse skin
Authors: Jiang Ting‐Xin , Harn Hans I‐Chen , Ou Kuang‐Ling , Lei Mingxing , Chuong Cheng‐Ming
Published: February 2019

Wound‐induced hair follicle neogenesis (WIHN) has been demonstrated in laboratory mice (Mus musculus) after large (>1.5 × 1.5 cm2) full‐thickness wounds. WIHN occurs more robustly in African spiny mice (Acomys cahirinus), which undergo autotomy to escape predation. Yet, the non‐WIHN regenerative ability of the spiny mouse skin has not been explored. To understand the regenerative ability of the spiny mouse, we characterized skin features such as hair types, hair cycling, and the response to small and large wounds. We found that spiny mouse skin contains a large portion of adipose tissue. The spiny mouse hair bulge is larger and shows high expression of stem cell markers, K15 and CD34. All hair types cycle synchronously. To our surprise, the hair cycle is longer and less frequent than in laboratory mice. Newborn hair follicles in anagen are more mature than C57Bl/6 and demonstrate molecular features similar to C57Bl/6 adult hairs. The second hair cycling wave begins at week 4 and lasts for 5 weeks, then telogen lasts for 30 weeks. The third wave has a 6‐week anagen, and even longer telogen. After plucking, spiny mouse hairs regenerate in about 5 days, similar to that of C57Bl/6. After large full‐thickness excisional wounding, there is more de novo hair formation than C57Bl/6. Also, all hair types are present and pigmented, in contrast to the unpigmented zigzag hairs in C57Bl/6 WIHN. These findings shed new light on the regenerative biology of WIHN and may help us understand the control of skin repair vs regeneration.
A geographic information system‐based model for economical and eco‐friendly high‐speed railway route determination using analytic hierarchy process and least‐cost‐path analysis
Authors: Yildirim Volkan , Bediroglu Sevket
Published: February 2019

In this study, geographic information system (GIS)‐based network analysis and analytic hierarchy process (AHP) methods were applied to the Erzincan–Trabzon segment of the Turkish high‐speed railway (HSR) project. A new hybrid route, which considers both economic and environmental criteria, was created and compared with three different routes from various preconstruction studies. The route‐generating analysis included the eight parameters (criteria) of slope, geology, soil quality, rivers, protected areas, roads, land cover, and lakes. The optimum route for connecting the port of Trabzon to Turkey's interior via HSR was generated. The weights for determining the route were tested for sensitivity. The study demonstrated the efficiency of GIS and AHP integration in generating optimum routes for HSR projects according to given databases. All these GIS and AHP analyses were applied automatically with our novel GIS extension for determining optimum HSR routes. The final route has preserved cultural and historical structures, environmental integrity. The new hybrid route also decreased construction costs by approximately 12%, and the least‐cost‐path analysis confirmed the environmental efficiency of the route.
Recovery of fatigue life using laser peening on 2024‐T351 aluminium sheet containing scratch damage: The role of residual stress
Authors: Smyth Niall A. , Toparli M. Burak , Fitzpatrick Michael E. , Irving Phil E.
Published: February 2019

The aim of the current work was to study the effect of laser shock peening (LSP) when applied to 2‐mm thick 2024‐T351 aluminium samples containing scratch‐like defects in the form of V‐shaped scribes 50 to 150 μm deep. The scribes decreased fatigue life to 5% of that of the pristine material. The effect of laser peening on fatigue life was dependent on the specifics of the peen treatment, ranging from further reductions in life to restoration of the fatigue life to 61% of pristine material. Fatigue life was markedly sensitive to near‐surface tensile residual stress, even if a compressive residual stress field was present at greater depth. Fatigue life after peening was also dependent on sample distortion generated during the peening process. Sample distortion modified local stresses generated by externally applied loads, producing additional life changes. Models based on residual stress intensity and crack closure concepts were successfully applied to predict fatigue life recovery.
Tumour parcellation and quantification (TuPaQ): a tool for refining biomarker analysis through rapid and automated segmentation of tumour epithelium
Authors: Abdelsamea Mohammed M , Grineviciute Ruta B , Besusparis Justinas , Cham Sulayman , Pitiot Alain , Laurinavicius Arvydas , Ilyas Mohammad
Published: February 2019

Background and aims

Immunohistochemistry (IHC) is an essential component of biomarker research in cancer. Automated biomarker quantification is hampered by the failure of computational algorithms to discriminate ‘negative’ tumour cells from ‘negative’ stromal cells. We sought to develop an algorithm for segmentation of tumour epithelium in colorectal cancer (CRC), irrespective of the biomarker expression in the cells.

Methods and results

We developed tumour parcellation and quantification (TuPaQ) to segment tumour epithelium and parcellate sections into ‘epithelium’ and ‘non‐epithelium’. TuPaQ comprises image pre‐processing, extraction of regions of interest (ROIs) and quantification of tumour epithelium (total area occupied by epithelium and number of nuclei in the occupied area). A total of 286 TMA cores from CRC were manually annotated and analysed using the commercial halo software to provide ground truth. The performance of TuPaQ was evaluated against the ground truth using a variety of metrics. The image size of each core was 7000 × 7000 pixels and each core was analysed in a matter of seconds. Pixel × pixel analysis showed a sensitivity of 84% and specificity of 95% in detecting epithelium. The mean tumour area obtained by TuPaQ was very close to the area quantified after manual annotation (r = 0.956, P < 0.001). Moreover, quantification of tumour nuclei by TuPaQ correlated very strongly with that of halo (r = 0.891, P < 0.001).

Conclusion

TuPaQ is a very rapid and accurate method of separating the epithelial and stromal compartments of colorectal tumours. This will allow more accurate and objective analysis of immunohistochemistry.
ET SI C'ÉTAIT PAR LA FIN QUE TOUT COMMENÇAIT? PEN BEFORE PLOT, OR TRESCH ON POE'S REVERSALS
Authors: HELBIG DANIELA K.
Published: February 2019

This brief comment offers some reflections on John Tresch's “Compositor's Reversal.” Contrasting his approach with Gaston Bachelard's, I situate Tresch in the tradition of reading Edgar A. Poe's Narrative of Arthur Gordon Pym as a riddle to be decoded. I suggest that Tresch's analytical emphasis on material composition practices rather than Pym's content opens up insightful ways of reading both Pym itself in terms of its composition, style, and narrative voice, and also Poe's well‐known programmatic Philosophy of Composition. The key achievement of Tresch's article beyond its engagement with Poe scholarship is its contribution to the study of writing practices and media studies more broadly. By demonstrating the tight connection Poe forged between natural theology and the material practice of typography, Tresch inserts the typesetting process as an important step in the historiographical trajectory between pen and typewriter. He shows that the mid‐nineteenth‐century context of natural theology marks a decisive difference in connotation between Poe's compositional play with questions of authorship and plausibility, of truth and appearance both described in and performed by his narrative, and later concerns with the apparatus and its potential for the production of an écriture automatique.
HIDE AND SEEK
Authors: NAPPI CARLA
Published: February 2019

This response takes up the final question offered by David Lurie's essay: “In the end, is it ever possible to write a fully nonallegorical history of writing's origins?” by considering the nature of allegory, its relationship to hiding and invisibility, and the material quality of its character when invoked to describe an origin.
Establishing a hepatitis C continuum of care among HIV/hepatitis C virus‐coinfected individuals in EuroSIDA
Authors: Amele S , Peters L , Sluzhynska M , Yakovlev A , Scherrer A , Domingo P , Gerstoft J , Viard JP , Gisinger M , Flisiak R , Bhaghani S , Ristola M , Leen C , Jablonowska E , Wandeler G , Stellbrink H , Falconer K , D'Arminio Monforte A , Horban A , Rockstroh JK , Lundgren JD , Mocroft A ,   the EuroSIDA study group
Published: February 2019

Objectives

The aim of the study was to establish a methodology for evaluating the hepatitis C continuum of care in HIV/hepatitis C virus (HCV)‐coinfected individuals and to characterize the continuum in Europe on 1 January 2015, prior to widespread access to direct‐acting antiviral (DAA) therapy.

Methods

Stages included in the continuum were as follows: anti‐HCV antibody positive, HCV RNA tested, currently HCV RNA positive, ever HCV RNA positive, ever received HCV treatment, completed HCV treatment, follow‐up HCV RNA test, and cure. Sustained virological response (SVR) could only be assessed for those with a follow‐up HCV RNA test and was defined as a negative HCV RNA result measured > 12 or 24 weeks after stopping treatment.

Results

Numbers and percentages for the stages of the HCV continuum of care were as follows: anti‐HCV positive (n = 5173), HCV RNA tested (4207 of 5173; 81.3%), currently HCV RNA positive (3179 of 5173; 61.5%), ever HCV RNA positive (n = 3876), initiated HCV treatment (1693 of 3876; 43.7%), completed HCV treatment (1598 of 3876; 41.2%), follow‐up HCV RNA test to allow SVR assessment (1195 of 3876; 30.8%), and cure (629 of 3876; 16.2%). The proportion that achieved SVR was 52.6% (629 of 1195). There were significant differences between regions at each stage of the continuum (P < 0.0001).

Conclusions

In the proposed HCV continuum of care for HIV/HCV‐coinfected individuals, we found major gaps at all stages, with almost 20% of anti‐HCV‐positive individuals having no documented HCV RNA test and a low proportion achieving SVR, in the pre‐DAA era.
Micro‐CT analysis of chronic apical periodontitis induced by several specific pathogens
Authors: Chen S. , Lei H. , Luo Y. , Jiang S. , Zhang M. , Lv H. , Cai Z. , Huang X.
Published: February 2019

Aim

To conduct three‐dimensional micro‐CT analysis of bone destruction, periapical sclerotic changes and inflammatory root resorption (IRR) to compare the differences between Enterococcus faecalis (Ef)‐ and Porphyromonas gingivalis (Pg)‐induced chronic apical periodontitis (CAP).

Methodology

Mono‐species bacteria‐induced CAP was established in the first and second molars of the right maxilla and mandible of male Sprague–Dawley rats. Fifteen animals were divided into three groups with five rats in each group: control group, Ef‐CAP group and Pg‐CAP group. The maxilla and mandible were harvested and then scanned by micro‐CT. Alveolar bone destruction was evaluated by measuring the volume of alveolar bone resorption, bone volume fraction (BV/TV), trabecular thickness (Tb. Th), trabecular number (Tb. N) and trabecular spacing (Tb. Sp). The results were analysed using one‐way analysis of variance and Fisher's least significant difference methods (LSD). The sclerotic changes in the periapical bone were graded and the IRR indexes were scored. The data were analysed using the chi‐square test.

Results

The alveolar bone resorption volume of the Pg‐CAP group was significantly larger than that of the Ef‐CAP group (P < 0.01). In the maxilla, both Pg‐CAP and Ef‐CAP groups had a significant decrease in BV/TV and increase in Tb. Sp (P < 0.01) with the more significant changes of trabecular bone in the Pg‐CAP group. A significant reduction of Tb. N was only found in the Pg‐CAP group (P < 0.05). There was no significant change in Tb. Th in either group (P > 0.05). In the mandible, except for an increase in Tb. Sp in the Pg‐CAP group (P < 0.05), there was no significant change in BV/TV, Tb. Th or Tb. N (P > 0.05). No obvious sclerotic change was observed. IRR was detected in significantly more root surfaces in the Pg‐CAP group (240 surfaces, 60%) than those in the Ef‐CAP group (178 surfaces, 44.5%) (P < 0.001). The IRR extension was also significantly more advanced in the Pg‐CAP group (P < 0.05).

Conclusions

Pg‐CAP caused more substantial alveolar bone destruction and IRR than Ef‐CAP. The maxilla was more susceptible to CAP in terms of microstructural changes of trabecular bone than the mandible. Tb. Sp was the most sensitive index for evaluating the residual alveolar bone of CAP.
Saccharomyces cerevisiae biosorbed with grape pomace flavonoids: adsorption studies and in vitro simulated gastrointestinal digestion
Authors: de Oliveira Anna Lou Mucharski Strafit , Maciel Giselle Maria , Rossetto Raquel , de Liz Marcus Vinicius , Rampazzo Ribeiro Valéria , Haminiuk Charles Windson Isidoro
Published: February 2019

The residual Saccharomyces cerevisiae from brewing was used as a biosorbent of flavonoids of hydro alcoholic extract from samples of grape pomace (Merlot and Tannat). Biosorption assays verified that the pseudo‐second order kinetic model and the Dubinin‐Raduschkevich isotherm model presented the best fit, with free energy of adsorption (E) of 7.1 and 6.5 kJ for the Merlot and Tannat varieties, respectively, indicating that the yeast has many binding sites and adsorption was a physical process. The analysis of microscopy and spectroscopy showed differences in structure and composition of the yeast after biosorption, demonstrating that the application was effective, which was confirmed by the chromatographic analysis, where a reduction in 17% and 50% in the catechin peak was observed in the Merlot and Tannat samples, respectively. Finally, there was an increase in the in vitro bioaccessibility of flavonoids in 68% for the Merlot sample and 88% for Tannat, reaching the main objective of this application.
Quantitative analysis of desmopressin (DDAVP) response in adult patients with type 1 von Willebrand disease
Authors: Guddati Achuta K. , Rosovsky Rachel P. , Van Cott Elizabeth M. , Kuter David J.
Published: February 2019

Introduction

Patients with Type 1 von Willebrand disease (VWD) have reduced amounts of von Willebrand factor (VWF) in their blood. Desmopressin (DDAVP) has been used to raise the blood levels of VWF in these patients. However, not all patients with Type 1 VWD are known to respond to DDAVP therapy. We sought to compare the levels of Factor VIII, VWF antigen (VWF:Ag), VWF ristocetin cofactor (VWF:RCo), and fibrinogen at different time points after administration of DDAVP.

Methods

A retrospective analysis was conducted at a single institution on 89 patients with Type 1 VWD who received a single intravenous dose of 0.3 μg/kg DDAVP. Levels of Factor VIII, VWF:Ag, VWF:RCo, and fibrinogen were measured before and then 30, 60, 90, and 120 minutes after completion of DDAVP administration.

Results

Median levels of Factor VIII, VWF:Ag, and VWF:RCo were significantly elevated (P < 0.001) at 30 (175 IU/dL, 111 IU/dL, 127 IU/dL), 60 (218 IU/dL, 138 IU/dL, 139 IU/dL), and 90 (212 IU/dL, 134 IU/dL, 130 IU/dL) minutes time points when compared to their respective baseline values (71 IU/dL, 54 IU/dL, 54 IU/dL). At 60 minutes, 96% of subjects were responders, but three subjects failed to respond at any time point.

Conclusion

Measurement of levels of Factor VIII, VWF:Ag, and VWF:RCo, optimally at 60 minutes after the DDAVP infusion, is sufficient to confirm a patient as a responder in a DDAVP challenge test. Curtailing the number of time points of measurement will result in significant savings in cost and time to patients and their providers.
Association of breastfeeding and gestational diabetes mellitus with the prevalence of prediabetes and the metabolic syndrome in offspring of Hispanic mothers
Authors: Vandyousefi Sarvenaz , Goran Michael I. , Gunderson Erica P. , Khazaee Erfan , Landry Matthew J. , Ghaddar Reem , Asigbee Fiona M. , Davis Jaimie N.
Published: February 2019

Background

The effects of breastfeeding (BF) on metabolic syndrome (MetS) and diabetes mellitus in children exposed to gestational diabetes mellitus (GDM) in utero have rarely been evaluated.

Objective

This study assessed BF and GDM in relation to the prevalence of prediabetes and MetS in Hispanic children and adolescents (8‐19 y).

Methods

This is a longitudinal study with 229 Hispanic children (8‐13 y) with overweight/obesity, family history of diabetes, and an average of four annual visits (AV). Participants were categorized as follows: never (negative for prediabetes/MetS at all AVs), ever (positive for prediabetes/MetS at any visit), intermittent (positive for prediabetes/MetS at 1‐2 AVs), and persistent (positive for prediabetes/MetS at greater than or equal to 3 AVs).

Results

Compared with GDM offspring who were not BF (referent), GDM offspring who were BF had lower odds of persistent prediabetes (OR = 0.18; 95% CI, 0.04‐0.82; P = 0.02) and MetS (OR = 0.10; 95% CI, 0.02‐0.55; P = 0.008). Compared with referent group, non‐GDM offspring who were BF, and non‐GDM offspring not BF had lower odds of persistent prediabetes (OR = 0.10; 95% CI, 0.03‐0.39; P = 0.001; OR = 0.05; 95% CI, 0.01‐0.11; P < 0.001) and MetS (OR = 0.14; 95% CI, 0.04‐0.59; P = 0.01 and OR = 0.04; 95% CI, 0.01‐0.11; P < 0.001).

Conclusions

These results show BF is protective against prediabetes and MetS in offspring regardless of GDM status.
Nurses’ disaster preparedness and core competencies in Turkey: a descriptive correlational design
Authors: Taskiran G. , Baykal U.
Published: February 2019

Aim

This descriptive correlational study aimed to identify nurses’ perceptions of their own disaster preparedness and core competencies.

Background

As disasters have increased in number and severity in recent years, it is crucial that nurses should be appropriately prepared. There is still limited research on this issue in Turkey.

Introduction

With changes in disaster policies in the last decade, the need to improve the disaster core competencies of nurses has also increased.

Methods

A sample of 406 nurses selected with convenience sampling and working in an 1816‐bed capacity university hospital was included in this descriptive correlational study. A single‐item visual scale and the 45‐item Nurses Perceptions of Disaster Core Competencies Scale were used.

Results

‘Technical Skills’ scored highest across the subscales of the scale, and ‘Critical Thinking Skills’ scored lowest. When the total and subscale scores were compared by age group, professional experience, working position and prior disaster experience, there were statistically significant differences.

Conclusions

The Turkish nurses had different levels of disaster core competencies and considered themselves more competent in some areas of disaster preparedness than in others. There are clearly gaps to be filled in disaster preparedness and core competencies in Turkish nurses.

Implications for nursing and policy

Nurse managers should advocate for increasing disaster preparedness for all nurses. This could be accomplished by offering formal training in disaster preparedness and/or by scheduling regular disaster drills, perhaps using a mix of tabletop exercises with occasional hospital‐wide disaster scenarios. In addition, managers should regularly evaluate nurses’ disaster core competencies to achieve effective preparation plans and training.
The impact of a prospective 4‐year longitudinal school intervention for improving oral health and oral health inequalities in primary schoolchildren in Flanders‐Belgium
Authors: Lambert Martijn Jacky , De Visschere Luc M. J. , Martens Luc C. , Deschepper Ellen , Vanobbergen Jacques
Published: February 2019

Background

Oral diseases and socio‐economic inequalities in children are a persisting problem.

Aim

To investigate the 4‐year longitudinal impact of an oral health promotion programme on oral health, knowledge, and socio‐economic inequalities in primary schoolchildren.

Design

The intervention was carried out between 2010 and 2014 within a random sample of Flemish primary schoolchildren (born in 2002). It consisted of an annual oral health education session. ICDAS/DMFT, care level, knowledge scores, and plaque index were used as outcome variables. Being entitled to a corrective policy measure was used as social indicator. Mixed model analyses were conducted to evaluate changes over time between intervention and control group and between higher and lower social subgroups.

Results

A total of 1058 participants (23.8%) attended all four sessions. The intervention had a stabilizing effect on the number of decayed teeth and increased knowledge scores. No statistically different effect on the two social groups could be demonstrated. Socio‐economic inequalities were present both at T0 and T4.

Conclusion

The oral health promotion programme had a positive impact on oral health knowledge and stabilized the number of decayed teeth. No impact on inequalities could be demonstrated, although a higher dropout rate in children with a lower social status was seen.
An exact algorithm for the maximum quasi‐clique problem
Authors: Ribeiro Celso C. , Riveaux José A.
Published: February 2019

Given a graph and a threshold , the maximum quasi‐clique problem amounts to finding a maximum cardinality subset of the vertices in V such that the edge density of the graph induced in G by is greater than or equal to the threshold. This problem is NP‐hard and has a number of applications in data mining, for example, in social networks or phone call graphs. In this work, we present an exact algorithm to solve this problem, based on a quasi‐hereditary property. We also propose a new upper bound that is used for pruning the search tree. Numerical results show that the new approach is competitive and outperforms the best integer programming approaches in the literature. The new upper bound is consistently tighter than previously existing bounds.
Effect of Panax ginseng extract on the activity of diabetic fibroblasts in vitro
Authors: Namgoong Sik , Lee Hyunsu , Han Seung‐Kyu , Lee Hyup‐Woo , Jeong Seong‐Ho , Dhong Eun‐Sang
Published: February 2019

Numerous studies have demonstrated the various medicinal properties of Panax ginseng, including angiogenic, immuno‐stimulating, antimicrobial, and anti‐inflammatory activities, which can be helpful in chronic wound healing. However, a direct role for P. ginseng in chronic wound healing has not been demonstrated. The present study was designed to evaluate the effects of P. ginseng extract on diabetic fibroblasts in vitro. Human diabetic fibroblasts were cultured in the presence of Ginsenoside Rb1 (G‐Rb1), the active component in P. ginseng (10 ng/mL), and untreated diabetic fibroblasts were used as controls. Cell proliferation, collagen synthesis, the production of various growth factors (basic fibroblast growth factor [bFGF]; vascular endothelial growth factor [VEGF]; and transforming growth factor‐β1 [TGF‐β1]), and the synthesis of matrix metalloproteinase 1 (MMP‐1) and tissue inhibitor of metalloproteinases 1 (TIMP‐1) were compared using enzyme‐linked immunosorbent assay and immunofluorescence staining. Compared with the control group, G‐Rb1‐treated fibroblasts showed significantly (P < 0.05) higher levels of cell proliferation, collagen synthesis, VEGF, TGF‐β1, and TIMP‐1. However, no significant differences in bFGF and MMP‐1 levels were observed between the two groups. These results suggest that P. ginseng treatment may stimulate the wound‐healing activity of diabetic fibroblasts in vitro.
Diversity in daytime and night‐time transpiration dynamics in barley indicates adaptation to drought regimes across the Middle‐East
Authors: Sadok Walid , Tamang Bishal G.
Published: February 2019

A challenge to breeding drought‐tolerant barley in the Middle‐East is that precipitation and evaporative demand patterns dictate opposite water use strategies (conservative vs. risk‐taking). To characterize these strategies, we examined high‐resolution, whole‐plant transpiration rate (TR) responses to increasing vapour pressure deficit (VPD) and nocturnal TR (TRN) dynamics among 25 local barley genotypes, using a novel phenotyping system. These traits were specifically selected because they exist under modalities enabling the expression of both strategies. The genotypes were selected from locations spread across a large aridity gradient represented by temperature and precipitation data spanning 30 years. Here, we uncovered a substantial diversity in TR responses to VPD where slopes of the linear responses correlated negatively with local maximal temperatures, pointing to opposite drought tolerance strategies. Low canopy conductance (low slopes) was associated with higher aridity, likely to enable water‐saving, while higher conductance was associated with wetter areas, likely to enable a more aggressive water use to maximize physiological activity. TRN was highly diverse and represented up to 15% of maximal daytime TR, pointing to the possibility of increasing water‐saving by reducing TRN. Furthermore, we detected pre‐dawn variation in TRN that negatively correlated with local precipitation, indicating that a tighter circadian control is associated with adaptation to drought, consistently with a circadian resonance mechanism. These findings indicate that canopy conductance and TRN are potentially beneficial to design drought‐tolerant barley germplasm adapted to different drought regimes taking place in the Middle‐East.
The role of professional commitment in improving nurses’ professional capabilities and reducing their intention to leave: Two‐wave surveys
Authors: Chang Hao‐Yuan , Lee I‐Chen , Chu Tsung‐Lan , Liu Ying‐Chen , Liao Yen‐Ni , Teng Ching‐I
Published: February 2019

Background

Social cognitive career theory (SCCT) can explain the mechanism underlying the formulation of nurse turnover intention. However, little is known about the role of professional commitment in such a mechanism.

Aims

The aim of this study was to explore how elements of SCCT have an impact on the three aspects of professional commitment and thus nurses’ intention to leave the profession.

Design

This study used surveys to collect two‐wave data.

Methods

The participants were sampled in all available units of a major medical centre in 2017. By using proportionate random sampling methods, we successfully followed up a representative sample of 524 full‐time nurses. Most participants (98.1%) were female. Items came from Cunningham et al.'s Self‐Efficacy Scale, Outcome Expectations Scale, Human Capital Scale and Vocational Interest Scale; Meyer et al.'s Professional Commitment Scale; and Teng et al.'s Turnover Intention Scale. Structural equation modelling was used to test the hypotheses.

Results

Self‐efficacy was positively related to outcome expectation. Outcome expectation was positively related to career interest. Career interest was positively related to affective professional commitment. Human capital was positively related to normative professional commitment. Affective professional commitment was positively related to intention to improve professional capabilities, which was further negatively related to intention to leave the profession.

Conclusion

Aspects of professional commitment are important process variables in the impact of self‐efficacy and outcome expectation on nurses’ turnover intention.
Adherence to oral antihypertensive medications, are all medications equal?
Authors: Shani Michal , Lustman Alex , Vinker Shlomo
Published: February 2019

Good medication adherence is a key factor in chronic disease management. Poor adherence is associated with adverse outcomes and high costs. We aimed to explore adherence rates among oral antihypertensive medications. The study included members of the Central District of Clalit Health Services in Israel aged between 40 and 75 years, who were diagnosed with hypertension before 2012 and who filled at least one prescription per year during 2012‐2014, for the following medications: hydrochlorothiazide, nifedipine, amlodipine, lercanidipine hydrochloride, atenolol, bisoprolol, angiotensin‐converting enzyme inhibitors (ACEI), angiotensin II receptor antagonists (ARBs), and statins. Purchase of at least nine monthly prescriptions during 2013 was considered as “good medication adherence.” We compared systolic blood pressure and LDL levels, according to medication adherence, for each medication and cross‐adherence rates between medications. The study included 31 530 subjects. The rates of good medication adherence varied widely among the medications investigated, ranging from 53% for statins and hydrochlorothiazide to 71% for amlodipine. Mean systolic BP and LDL levels were statistically significantly lower among persons with good, compared to lower adherence, for each of the medications investigated. Both advanced age and more chronic medications were associated with higher adherence rates for all medications tested. Poor adherence to any single medication was found to be associated with lower adherence to other medications. Different antihypertensive medications have different adherence rates. Since adherence to one medication is related to adherence to other medications, investing in medication adherence may be highly beneficial.