bluuebunny/crossref_metadata_2025 huggingface dataset:
Die follikulotrope Mycosis fungoides
Authors: Mitteldorf Christina , Stadler Rudolf , Sander Christian A. , Kempf Werner
Published: May 2018

Die follikulotrope (syn.: follikuläre oder pilotrope) Mycosis fungoides ist eine von der WHO und EORTC anerkannte Variante der klassischen Mycosis fungoides. Sie weist ein breites klinisches und histologisches Spektrum auf, entsprechend sind die Differenzialdiagnosen vielfältig. Neue Untersuchungen konnten zeigen, dass sich die Entität in zwei prognostisch unterschiedliche Gruppen aufteilen lässt. Beiden Gruppen sind durch Unterschiede sowohl in der Histologie als auch in der klinischen Manifestation gekennzeichnet. Die Therapie sollte somit an die unterschiedlichen Formen und Verläufe angepasst werden. In diesem Übersichtsartikel werden die klinischen und histologischen Manifestationsformen der follikulotropen Mycosis fungoides zusammengestellt sowie die neue Subgruppierung dargestellt. Zudem werden die wichtigsten Differenzialdiagnosen und mögliche Therapieoptionen diskutiert.
Semaglutide for type 2 diabetes mellitus: A systematic review and meta‐analysis
Authors: Andreadis Panagiotis , Karagiannis Thomas , Malandris Konstantinos , Avgerinos Ioannis , Liakos Aris , Manolopoulos Apostolos , Bekiari Eleni , Matthews David R , Tsapas Apostolos
Published: May 2018

Aims

To assess the efficacy and safety of semaglutide, a recently approved glucagon‐like peptide 1 receptor agonist (GLP‐1 RA) for type 2 diabetes.

Materials and methods

We searched major electronic databases and grey literature sources for randomized controlled trials comparing semaglutide with placebo or other antidiabetic agents. Primary outcome was change from baseline in HbA1c. Secondary endpoints included change from baseline in body weight, blood pressure, heart rate and incidence of hypoglycaemia, gastrointestinal adverse effects, pancreatitis and diabetic retinopathy.

Results

A total of 6 placebo‐controlled and 7 active‐controlled studies with subcutaneous semaglutide were included. We identified only 1 trial with oral semaglutide. Compared with placebo, subcutaneous semaglutide 0.5 and 1 mg reduced HbA1c by 1.01% (95% CI, 0.56‐1.47) and 1.38% (1.05‐1.70), respectively. Both doses demonstrated superior glycaemic efficacy compared to other antidiabetic agents, including sitagliptin, exenatide, liraglutide, dulaglutide and insulin glargine. Semaglutide also had a beneficial effect on body weight (mean difference vs placebo −4.11 kg, 95% CI −4.85 to −3.37 for semaglutide 1 mg) and systolic blood pressure. We did not observe increased hypoglycaemia rates with semaglutide; nevertheless, we noted an increased incidence of nausea, vomiting and diarrhoea. Cases of pancreatitis were infrequent and the odds ratio for diabetic retinopathy compared with placebo was 1.32 (95% CI, 0.98‐1.77).

Conclusions

Semaglutide is a potent once‐weekly GLP‐1 RA, significantly reducing HbA1c, body weight and systolic blood pressure. However, it is associated with increased incidence of gastrointestinal adverse events. Results for pancreatitis and retinopathy require further assessment in post‐approval pharmacovigilance studies.
The role of evidence in nutrition policy‐making in Ethiopia: Institutional structures and issue framing
Authors: Walls Helen , Johnston Deborah , Vecchione Elisa , Adam Abdulfatah , Parkhurst Justin
Published: May 2018

Malnutrition is the single greatest contributor to the global burden of morbidity and mortality, with most cases arising in low‐ and middle‐income countries. However, the multi‐sectoral nature of nutrition policy‐making adds considerable complexity to the implementation of effective programmes. This raises questions about why or how relevant policy change can come about within different country settings. This article examines multi‐sectoral nutrition policy‐making from the health sector perspective, specifically focusing on different sectoral perspectives and the role and use of evidence within this. Ethiopia provides a unique example of the challenging nature of multi‐sectoral nutrition policy‐making, even with a strong co‐ordinating infrastructure. In December 2014 we undertook 23 in‐depth semi‐structured interviews with stakeholders from key health sector organizations, along with a related documentary analysis. Participants represented a diverse range of perspectives, including government representatives, policy stakeholders, aid providers from multi‐lateral organizations and academic researchers. Our respondents described how nutrition framing in Ethiopia is changing, with greater consideration of overweight, obesity and non‐communicable diseases, as well as undernutrition and micronutrient deficiencies. However, overweight‐ and obesity‐related concerns are still less evident in key documents. Some health actors described the challenge of enacting structural policy changes when doing so requires engagement from the agriculture sector. While multi‐sectoral plans and infrastructure to address malnutrition are in place, respondents suggested that the mandate for addressing nutrition resting with the health sector was reinforced by the nature of evidence collected. This study of nutrition policy‐making in Ethiopia highlights the complex interaction of evidence within different conceptualisations of policy problems and responses. Despite Ethiopia's strategic framework and its progress in achieving terms of nutrition targets, it shares the challenge of countries elsewhere in addressing nutrition as a multi‐sectoral issue.
ADAM‐C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia
Authors: Charbonnel Clément , Jego Christophe , Jourda François , Vinsonneau Ulric , Garçon Philippe , Turlotte Guillaume , Rivière Jean François , Maurin Marion , Lubret Rémy , Meimoun Patrick , Akret Chrystelle , Cournot Maxime , Sokic Charles , Michel Laurent , Lescure Maryse , Kenizou David , Melay Marie , Fayard Maxime , Gallet Bruno , Fouche Rémi , Janin‐Manificat Luc , Dijoux Nicolas , Martin Anne Céline , Tho‐Agostini Aurélia , Mann Hubert , Ricard Cécile , Pico Fernando , Georges Jean Louis , Belle Loïc , Jourdain Patrick ,   the TEA TOAST investigators
Published: May 2018

Background and aim

The clinical utility of transesophageal echocardiography (TEE) after brain ischemia (BI) remains a matter of debate. We aimed to evaluate the clinical impact of TEE and to build a score that could help physicians to identify which patients should better benefit from TEE.

Methods

This prospective, multicenter, observational study included patients over 18 years old, hospitalized for BI. TEE findings were judged discriminant if the results showed important information leading to major changes in the management of patients. Most patients with patent foramen ovale were excluded. Variables independently associated with a discriminant TEE were used to build the prediction model.

Results

Of the entire population (1479 patients), 255 patients (17%) were classified in the discriminant TEE group. Five parameters were selected as predictors of a discriminant TEE. Accordingly, the ADAM‐C score could be calculated as follows: Score = 4 (if age ≥60) + 2 (if diabetes) + 2 (if aortic stenosis from any degrees) + 1 (if multi‐territory stroke) + 2 (if history of coronary artery disease). At a threshold lower than 3, the sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of detecting discriminant TEE were 88% (95% CI 85–90), 44% (95% CI 41–47), 21% (95% CI 19–27), and 95% (95% CI 94–97), respectively.

Conclusion

A simple score based on clinical and transthoracic echocardiographic parameters can help physicians to identify patients who might not benefit from TEE. Indeed, a score lower than 3 has an interesting NPV of 95% (95% CI 94–97).
Aortic valve hemodynamics in atrial fibrillation: Should the highest Doppler signal be used to estimate severity of aortic stenosis?
Authors: Alsidawi Said , Khan Sana , Pislaru Sorin V. , Nkomo Vuyisile T.
Published: May 2018

Grading severity of AS in AF is complicated by varying stroke volumes associated with fluctuating maximum velocities and pressure gradients across the aortic valve. Current guidelines recommend averaging five continuous‐wave peak velocity and mean gradient (MG) Doppler signals across the aortic valve when estimating severity of AS in AF. However, it is unknown when grading severity of AS how the average of multiple Doppler signals vs the highest Doppler signal in AF compares to the Doppler signals when the patient is in normal sinus rhythm. We present a series of patients with AS who had two echocardiograms performed within 2‐4 months of each other, one when in normal sinus rhythm and one when in AF, and compare the aortic valve hemodynamics associated with the two rhythms.
Comparison of transplant‐specific prognostic scoring systems in haploidentical transplantation for myelodysplastic syndrome
Authors: Shin Seung‐Hwan , Jeon Young‐Woo , Yoon Jae‐Ho , Yahng Seung‐Ah , Lee Sung‐Eun , Cho Byung‐Sik , Eom Ki‐Seong , Lee Seok , Kim Hee‐Je , Min Chang‐Ki , Cho Seok‐Goo , Kim Dong‐Wook , Lee Jong‐Wook , Min Woo‐Sung , Kim Yoo‐Jin
Published: May 2018

Objectives

We intended to identify the predictive abilities of recently published transplant‐specific prognostic scoring systems in patients with myelodysplastic syndrome (MDS) receiving haploidentical transplantation.

Methods

The outcomes of 73 patients with MDS receiving haploidentical transplantation were analyzed, according to the MTPSS, the TRI, and the CIBMTR scoring systems.

Results

The median age of patients at transplantation was 50 (range, 19‐69) years. The IPSS‐R cytogenetic risks of very good/good, intermediate, and poor/very poor were, respectively, observed in 35 (48.0%), 25 (34.2%), and 13 (17.8%) patients, including 4 (5.5%) with a monosomal karyotype. Pretransplant treatment failure and high (≥3) HCT‐CI were observed in 30 (41.1%) and 35 (48.0%) patients, respectively. With survivor’s median follow‐up of 42.3 months, the overall survival rate at 4 years of all patients was 65.5% (95% CI, 52.4‐75.9). The MTPSS (100%, 77.3%, 62.5%, and 42.0% at 4 years; P = .02) and the TRI (100%, 79.9%, 76.0%, and 17.1% at 4 years; P < .01) differentiate proportionally overall survival rates according to their 4 risk groups, whereas the CIBMTR scoring system did not (P = .17).

Conclusions

Our results suggest the potential ability of the MPTSS and the TRI as prognostic tools for patients with MDS receiving haploidentical transplantation.
Status epilepticus associated with acute encephalitis: long‐term follow‐up of functional and cognitive outcomes in 72 patients
Authors: Chen W. , Su Y. , Jiang M. , Liu G. , Tian F. , Ren G.
Published: May 2018

Background and purpose

Continued care in patients with encephalitis and prolonged status epilepticus (SE) is controversial. Limited data are available on the functional and cognitive outcomes.

Methods

In a prospective cohort study from 2007 to 2016, patients with acute encephalitis and SE were reviewed. Long‐term outcomes including motor disability (modified Rankin Scale, mRS), daily living skills (activities of daily living, ADL), cognitive ability (modified Telephone Interview for Cognitive Status, TICS‐M) and epilepsy sequelae were evaluated in survivors at the 12‐month follow‐up.

Results

At the 12‐month follow‐up, 72 patients were recruited who got a median score of 14 on the total ADL. 68% patients remained independent in their daily activities (mRS ≤ 2). Post‐SE symptomatic epilepsy was observed in 49% of patients. Sixty‐two patients achieved a median score of 40 on the TICS‐M and 14 on the TICS‐M Memory. Patients with autoimmune encephalitis were less prone to post‐SE symptomatic epilepsy (18% vs. 58%, P = 0.005) but had lower TICS‐M Memory score than those with viral encephalitis (8.5 vs. 15, P = 0.017). Compared to non‐refractory status epilepticus (non‐RSE), patients with RSE had a longer stay in the neurocritical care unit (39 vs. 26, P = 0.002), more in‐hospital complications and post‐SE symptomatic epilepsy (67% vs. 33%, P = 0.005). Long‐term outcomes including ADL, mRS and TICS‐M were not significantly different between patients with RSE and non‐RSE or between patients with long (≥4 h) and short (<4 h) duration of SE.

Conclusions

Survival with favorable functional recovery was promising after prolonged RSE in patients with acute encephalitis.
Can quantitative computed tomography detect bone morphological changes associated with catastrophic proximal sesamoid bone fracture in Thoroughbred racehorses?
Authors: Cresswell E. N. , McDonough S. P. , Palmer S. E. , Hernandez C. J. , Reesink H. L.
Published: May 2018

Background

Fracture of the proximal sesamoid bones continues to be the most common fatal musculoskeletal injury in US racehorses. Identifying factors that influence fracture risk could lead to screening techniques to reduce catastrophic injury rates and improve animal welfare.

Objectives

To identify morphological differences between proximal sesamoid bones of the contralateral limb of fracture and control horses and assess the feasibility of computed tomography (CT) to detect traits associated with proximal sesamoid bone fracture. We hypothesised that horses with proximal sesamoid bone fracture would have greater bone density.

Study design

Cross‐sectional cadaver morphological study.

Methods

Proximal sesamoid bone morphology was measured using high‐resolution micro‐CT images from 16 Thoroughbred racehorses (eight fracture, eight control) euthanised on New York racetracks. Nominal logistic regression models and receiver operating characteristic curves were created to assess the ability of CT‐derived morphological traits to accurately classify fracture horses vs. controls.

Results

Bone volume fraction was greater in the fracture group (90.39 ± 1.76%) as compared to controls (87.20 ± 2.79%, P<0.0001). Bone volume fraction, bone width, trabecular thickness and degree of anisotropy were significantly different between fracture and control horses. Receiver operating characteristic curves showed that a combined model that incorporates bone volume fraction and width can identify fracture from control horses with an area under the curve of 0.938, indicating high accuracy at classifying fracture horses from controls.

Main limitations

The number of horses per group is small, although the total number of sesamoids imaged is reasonable (n = 62). In vivo CT at the resolution performed in this study is currently unattainable; however, density and width could be measured with quantitative CT.

Conclusions

Differences in proximal sesamoid bone morphology were identified between fracture and control horses. As improved technology becomes accessible, quantitative CT could potentially be used as a clinical imaging technique to estimate proximal sesamoid bone fracture risk in Thoroughbred racehorses.
Peptidylarginine deiminases and deiminated proteins at the epidermal barrier
Authors: Cau Laura , Méchin Marie‐Claire , Simon Michel
Published: May 2018

Deimination or citrullination is a post‐translational modification catalysed by a family of calcium‐dependent enzymes called peptidylarginine deiminases (PADs). It corresponds to the transformation of arginine residues within a peptide sequence into citrulline residues. Deimination induces a decreased net charge of targeted proteins; therefore, it alters their folding and changes intra‐ and intermolecular ionic interactions. Deimination is involved in several physiological processes (inflammation, gene regulation, etc.) and human diseases (rheumatoid arthritis, neurodegenerative diseases, cancer, etc.). Here, we describe the PADs expressed in the epidermis and their known substrates, focusing on their role in the epidermal barrier function.
Moderate weather extremes alter phytoplankton diversity—A microcosm study
Authors: Bergkemper Victoria , Stadler Peter , Weisse Thomas
Published: May 2018

Moderate weather extremes are predicted to increase in frequency and intensity as a function of climate change. These extremes can result in sudden changes in temperature, light and nutrient levels, which may strongly affect the phytoplankton community in many lakes.

We conducted a microcosm experiment with eight freshwater algal species, representing different functional groups, to investigate the interactive effects of these environmental variables on a phytoplankton community typical of an oligo‐mesotrophic temperate lake.

We manipulated temperature (6, 16 and 26°C), light (18, 56, 132 μmol m−2 s−1) and soluble reactive phosphorus (0, 1, 5 μg/l) concentrations in a 3 × 3 × 3 factorial design and analysed treatment effects on algal biomass, species diversity (SDiv) and functional diversity (FDiv).

Strong temperature variations affected phytoplankton biomass and diversity more strongly than moderate changes in nutrient and light levels. In particular, SDiv and FDiv decreased significantly with increasing temperatures.

Our results support earlier findings that lake warming favours heterotrophic bacteria, relative to phytoplankton.

We conclude that sudden temperature increases as they typically occur in temperate lakes during heat waves may decrease phytoplankton diversity, leading to altered ecosystem functioning. In contrast, heavy rain events usually characterised by decreasing levels of temperature and light intensities, concurrent with increases in nutrient concentrations, may sustain high phytoplankton diversity.
Constraining estimates of global soil respiration by quantifying sources of variability
Authors: Jian Jinshi , Steele Meredith K. , Thomas R. Quinn , Day Susan D. , Hodges Steven C.
Published: May 2018

Quantifying global soil respiration (RSG) and its response to temperature change are critical for predicting the turnover of terrestrial carbon stocks and their feedbacks to climate change. Currently, estimates of RSG range from 68 to 98 Pg C year−1, causing considerable uncertainty in the global carbon budget. We argue the source of this variability lies in the upscaling assumptions regarding the model format, data timescales, and precipitation component. To quantify the variability and constrain RSG, we developed RSG models using Random Forest and exponential models, and used different timescales (daily, monthly, and annual) of soil respiration (RS) and climate data to predict RSG. From the resulting RSG estimates (range = 66.62–100.72 Pg), we calculated variability associated with each assumption. Among model formats, using monthly RS data rather than annual data decreased RSG by 7.43–9.46 Pg; however, RSG calculated from daily RS data was only 1.83 Pg lower than the RSG from monthly data. Using mean annual precipitation and temperature data instead of monthly data caused +4.84 and −4.36 Pg C differences, respectively. If the timescale of RS data is constant, RSG estimated by the first‐order exponential (93.2 Pg) was greater than the Random Forest (78.76 Pg) or second‐order exponential (76.18 Pg) estimates. These results highlight the importance of variation at subannual timescales for upscaling to RSG. The results indicated RSG is lower than in recent papers and the current benchmark for land models (98 Pg C year−1), and thus may change the predicted rates of terrestrial carbon turnover and the carbon to climate feedback as global temperatures rise.
Spindle cell rhabdomyosarcoma of bone with FUS–TFCP2 fusion: confirmation of a very recently described rhabdomyosarcoma subtype
Authors: Dashti Nooshi K , Wehrs Rebecca N , Thomas Brittany C , Nair Asha , Davila Jaime , Buckner Jan C , Martinez Anthony P , Sukov William R , Halling Kevin C , Howe Benjamin M , Folpe Andrew L
Published: May 2018

Aims

Rhabdomyosarcomas of bone are extremely rare, with fewer than 10 reported cases. A very rare subtype of spindle cell/sclerosing rhabdomyosarcoma harbouring a FUS–TFCP2 fusion and involving both soft tissue and bone locations has been reported very recently. We report only the fourth case of this unusual, clinically aggressive rhabdomyosarcoma.

Material and results

A previously well 72‐year‐old male presented with a destructive lesion of the mandible. Morphological and immunohistochemical study of a needle biopsy and the subsequent resection showed a spindle cell rhabdomyosarcoma. RNA‐seq, RT–PCR and FISH confirmed the presence of the FUS–TFCP2 fusion.

Conclusions

Spindle cell rhabdomyosarcomas carrying the FUS–TFCP2 fusion are very rare rhabdomyosarcoma variants with osseous predilection. The classification and differential diagnosis of this unusual molecular variant of spindle cell/sclerosing rhabdomyosarcoma are discussed.
Duplicated major histocompatibility complex class II genes in the tongue sole (Cynoglossus semilaevis)
Authors: Li C. , Jiang J. , Zhang Q. , Wang X.
Published: May 2018

The major histocompatibility complex (MHC) molecule plays an important role in the vertebrate immune system. However, we have a limited understanding of the MHC genomic structure in teleosts. Using gene cloning and family analysis, we isolate the MHC class II genes in the tongue sole (Cynoglossus semilaevis) and find that both class II A and class II B genes are duplicated (named Cyse‐DAA and Cyse‐DBA, Cyse‐DAB and Cyse‐DBB, respectively). The class II A genes consist of four exons with a highly conserved genomic structure, but each gene has unique and defining exon 2 and intron 2 sequences. The class II B genes have a conserved six‐exon genomic structure, with intron 3 splitting the β2 encoding region into two exons. Each class II B gene has unique variations in exon 2 and intron 1 sequences. The two class II A genes have similar expression patterns among tissues, with high levels in spleen and gill. Both class II B genes have similar patterns, with high expression in spleen, gill and intestine. The alleles of MHC class II have wide distribution and reliable inheritance in the families analysed. This indicates that the duplicated MHC genes are all classical class II genes. The class II gene duplication with divergent exon and intron sequences, but similar expression patterns in tongue sole provides new insights into MHC evolution.
Primary whole‐gland ablation for localized prostate cancer with high‐intensity focused ultrasound: The important predictors of biochemical recurrence
Authors: Chen Po Yen , Chiang Po Hui , Liu Yi Yang , Chuang Yao Chi , Cheng Yuan Tso
Published: May 2018

Objectives

To identify predictive factors of biochemical recurrence for patients undergoing high‐intensity focused ultrasound treatment for localized prostate cancer.

Methods

We retrospectively identified patients receiving whole‐gland prostate ablation with high‐intensity focused ultrasound for localized prostate cancer from 2009 to 2015. All the patients received pre‐high‐intensity focused ultrasound radical transurethral resection of the prostate. We included perioperative parameters as follows: age, preoperative prostate volume, stage of operation, initial prostate‐specific antigen, T stage, postoperative prostate‐specific antigen nadir, Gleason score, time to prostate‐specific antigen nadir and the presence of prostate‐specific antigen biochemical recurrence. Multivariable Cox regression and Kaplan–Meier analysis were used for investigating predictors of recurrence, and receiver operating characteristic analysis was used for the cut‐off values of prostate‐specific antigen nadir.

Results

Among 182 patients, 26.9% had prostate‐specific antigen biochemical recurrence after high‐intensity focused ultrasound during the median follow‐up period of 32.21 months. Gleason score ≥7 (Gleason score 7, hazard ratio 2.877, P = 0.027), stage ≥T2b (T2b, hazard ratio 3.16, P = 0.027) and prostate‐specific antigen nadir (hazard ratio 1.11, P < 0.001) were statistically significant, whereas there was no significance in prostate volume and initial prostate‐specific antigen. We posit that a cut‐off level of prostate‐specific antigen nadir 0.43 ng/mL might be considered as an independent predictive factor for prostate‐specific antigen biochemical recurrence in high‐intensity focused ultrasound patients in multivariate analysis (P < 0.001, hazard ratio 7.39, 95% confidence interval 3.56–15.37), and created a new nadir‐related prediction model for biochemical recurrence prediction.

Conclusions

Postoperative prostate‐specific antigen nadir of 0.43 ng/mL can be considered an important predictive factor for biochemical recurrence in primary whole‐prostate gland high‐intensity focused ultrasound treatment, and the nadir‐related prediction model might provide a reference for early salvage treatment. Furthermore, Gleason score ≥7, stage ≥T2b might be associated with unfavorable outcomes, although prostate volume and higher initial prostate‐specific antigen appear not to be associated with biochemical recurrence for the high‐intensity focused ultrasound treatment.
Nestling sex ratio is associated with both male and female attractiveness in rock sparrows
Authors: Cantarero Alejandro , Pilastro A. , Griggio M.
Published: May 2018

According to theory, in species in which male variance in reproductive success exceeds that of the females, sons are more costly to produce; females mated with high quality males or those in better condition should produce more sons. In monogamous species, however, the variance in the reproductive success of the two sexes is often similar and mate choice is often mutual, making predictions regarding sex allocation more difficult. In the rock sparrow Petronia petronia, both males and females have a sexually selected yellow patch on the breast, whose size correlates with individual body condition. We investigated whether the brood sex ratio co‐varies with the size of the yellow patch of the father and the mother in a sample of 173 broods (818 chicks) over 8 breeding seasons. While the size of the yellow patch of the mother and the father did not predict per se a deviation from the expected 1:1 sex ratio, brood sex ratios were predicted by the interaction of male and female yellow patch size. This result is surprising, as the ornament is sexually selected by both males and females as an indicator of quality in both sexes and should therefore be inherited by all offspring irrespective of their sex. It indirectly suggests that other sex‐specific traits associated with patch size (e.g. polygyny in males and fecundity in females) may explain the sex allocation bias observed in rock sparrows. Thus, female individual quality alone, as expressed through the size of the yellow patch, was not associated with the biases in sex ratios reported in this study. Our results rather suggest that sex allocation occurs in response to male attractiveness in interaction with female attractiveness. In other words, females tend to preferentially allocate towards the sex of the parent with more developed ornament within the pair.
Ultrasonography for noninvasive and real‐time evaluation of peri‐implant tissue dimensions
Authors: Chan Hsun‐Liang , Sinjab Khaled , Li Junying , Chen Zhaozhao , Wang Hom‐Lay , Kripfgans Oliver D.
Published: May 2018

Aim

Existing methods for evaluating marginal bone loss and tissue biotype around dental implants present with many limitations. The aim of this study was to examine the accuracy of high‐resolution, 3‐dimensional ultrasound to measure peri‐implant tissue dimensions.

Material and Methods

A 25‐MHz ultrasound probe prototype was used to scan peri‐implant tissues of 17 implants from seven fresh human cadavers. Four ultrasonic measurements were made as follows: the marginal bone level/thickness, and mucosal level/thickness. The readings were statistically compared to cone beam computed tomography (CBCT) and/or open bone measurements.

Results

The correlations (r) between the ultrasound and direct/CBCT readings of the four parameters ranged from 0.85 to 0.98 (p < 0.0001). The mean absolute difference in the four parameters between ultrasound‐direct and ultrasound‐CBCT ranged from 0.033 to 0.24 mm.

Conclusion

Encouraging evidence is shown that ultrasound can accurately measure peri‐implant tissue dimensions. Following clinical trial validations, ultrasound offers potential as a valuable tool to evaluate long‐term peri‐implant tissue stability without concerns of ionizing radiation and image artefacts around implants.
Sinus augmentation using rhBMP‐2/ACS in a mini‐pig model: Influence of an adjunctive ceramic bone biomaterial
Authors: Susin Cristiano , Lee Jaebum , Fiorini Tiago , de Freitas Rubens Moreno , Chiu Hsien‐Chung , Prasad Hari S. , Buxton Amanda N. , Wikesjö Ulf ME
Published: May 2018

Background

Recombinant human bone morphogenetic protein‐2 in an absorbable collagen sponge carrier (rhBMP‐2/ACS) has been shown to support significant bone formation when used to augment the maxillary sinus for implant dentistry. Nevertheless, bone biomaterials have been suggested to extend rhBMP‐2/ACS with limited support of the merits of such approaches.

Objectives

To evaluate local bone formation/dental implant osseointegration following implantation of rhBMP‐2/ACS combined with a ceramic bone biomaterial using a mini‐pig sinus augmentation model.

Methods

Twelve adult Göttingen mini‐pigs received rhBMP‐2/ACS (rhBMP‐2 adjusted to 0.43 mg/cc) alone or combined with an off‐the‐shelf biphasic ceramic (15%/85% HA/ß‐TCP) biomaterial at 3:1, 1:1 and 1:3 ratios randomized to contra‐lateral maxillary sinus sites yielding rhBMP‐2/ACS fractions of 100%, 75%, 50% and 25%, respectively. A 4‐cc implant volume was used for all sites. Two threaded dental implants (ø4.0 × 11.5 mm) were placed at each site. The animals were euthanized at 8 weeks for histologic analysis.

Results

Surgical execution and healing were generally uneventful, infraorbital local swelling was observed in all animals until suture removal. rhBMP‐2/ACS combined with the ceramic biomaterial did not significantly enhance local bone formation (range 9.0 ± 1.5 to 9.7 ± 2.1 mm) compared with rhBMP‐2/ACS alone (8.6 ± 1.1 mm; p > 0.05). Variations in rhBMP‐2/ACS to ceramic matrix ratios yielding rhBMP‐2 doses approximating 0.4, 0.9, 1.3 and 1.7 mg/sinus did not appreciably influence bone formation/osseointegration.

Conclusions

Whereas rhBMP‐2/ACS supports significant bone formation/osseointegration in the mini‐pig sinus augmentation model and thus appears an effective alternative for sinus augmentation procedures, adding a ceramic biomaterial to rhBMP‐2/ACS does not produce meaningful biological advantages.
Effect of guava and vitamin C supplementation on experimental gingivitis: A randomized clinical trial
Authors: Amaliya Amaliya , Risdiana Ajeng S. , Van der Velden Ubele
Published: May 2018

Objective

To study the effect of guava and synthetic vitamin C on the development of gingival inflammation during experimental gingivitis.

Material and methods

Participants were randomly assigned to three groups supplemented daily with either 200 g guava, 200 mg synthetic vitamin C or water. The study included a 14 days pre‐experimental period with oral hygiene instructions, scaling, prophylaxis and supplementation. Thereafter, experiment gingivitis was initiated, while continuing supplementation. At baseline, Day 7 and Day 14 of experimental gingivitis, Plaque Index (PlI) and Gingival Index (GI) were assessed. During the entire study, dietary fruit/vegetables intake was minimal.

Results

PlI increased in guava, vitamin C and control group (ΔPlI: 1.30, 1.61 and 1.79, respectively). However, the guava group developed significantly less plaque compared to the control group. The GI increase in both guava and vitamin C group was significantly less than the increase in the control group (ΔGI: 0.10, 0.24 and 0.87, respectively).

Conclusion

In a population of young nonsmoking adults, consumption of either 200 g guava/day or 200 mg synthetic vitamin C/day, prior to and during the oral hygiene abstention period, has a preventive effect on the development of experimental gingivitis as compared to the control group that developed the usual amount of experimental gingivitis.
Antepartum Care of Women Who Are Obese During Pregnancy: Systematic Review of the Current Evidence
Authors: Carlson Nicole S. , Leslie Sharon Lynn , Dunn Alexis
Published: May 2018

Introduction

Nearly 40% of US women of childbearing age are obese. Obesity during pregnancy is associated with multiple risks for both the woman and fetus, yet clinicians often feel unprepared to provide optimal antepartum care for this group of women. We collected and reviewed current evidence concerning antepartum care of women who are obese during pregnancy.

Methods

We conducted a systematic review using PRISMA guidelines. Current evidence relating to the pregnancy care of women with a prepregnancy body mass index of 30kg/m2 or higher was identified using MEDLINE databases via PubMed, Embase, and Web of Science Core Collection between January 2012 and February 2018.

Results

A total of 354 records were located after database searches, of which 63 met inclusion criteria. Topic areas for of included studies were: pregnancy risk and outcomes related to obesity, communication between women and health care providers, gestational weight gain and activity/diet, diabetic disorders, hypertensive disorders, obstructive sleep apnea, mental health, pregnancy imaging and measurement, late antepartum care, and preparation for labor and birth.

Discussion

Midwives and other health care providers can provide better antepartum care to women who are obese during pregnancy by incorporating evidence from the most current clinical investigations.
Unobtrusive Maintenance: Temporal Complexity, Latent Category Control and the Stalled Emergence of the Cleantech Sector
Authors: Zietsma Charlene , Ruebottom Trish , Slade Shantz Angelique
Published: May 2018

Disruptive innovation changes the basis of competition within an industry and poses substantial threats for market incumbents. While researchers have focused on whether incumbents can successfully adapt, we know little about how potentially disruptive innovation may be avoided. Studying clean technology in Canada, we examine incumbent resistance when potentially disruptive technologies are seen as socially beneficial. We identify actions taken by incumbents and other socio‐technical regime actors to respond to the issue while simultaneously enacting legitimate stabilizing mechanisms within the regime’s institutional infrastructure. Specifically, temporal and resource‐based actions led to temporal complexity for disruptive cleantech entrepreneurs, and evaluation structuring work led to latent control of the cleantech category, privileging incumbents and resulting in unobtrusive maintenance. Our findings contribute to the disruptive innovation and institutional theory literatures by showing how disruption may be stalled by the enactment of legitimate elements of the institutional infrastructure rather than direct institutional defence.
Central giant cell lesion of the jaws: An updated analysis of 2270 cases reported in the literature
Authors: Chrcanovic Bruno Ramos , Gomes Carolina Cavalieri , Gomez Ricardo Santiago
Published: May 2018

Purpose

To review all available data published on central giant cell lesion (CGCL) of the jaws into a comprehensive analysis of its clinical/radiological features, with emphasis on the predictive factors associated with its recurrence.

Methods

An electronic search was undertaken in 5 databases (February/2018), looking for reporting cases of CGCLs.

Results

A total of 365 publications were included, comprising 2270 lesions. CGCLs were more prevalent in women and the mandible. Cortical bone perforation occurred in 50% of the cases. Marginal/segmental resection was more often performed in larger lesions, and drug therapy was more frequent in small lesions. Recurrence was reported in 232 of 1316 cases (17.6%). The recurrence rate of the aggressive lesions (22.8%) after surgical treatment was higher than non‐aggressive lesions (7.8%). Four of 5 CGCLs showed partial/total regression with pharmacological treatment. Aggressive lesions showed a worse response to corticosteroids than non‐aggressive lesions. For the lesions submitted to surgery as the first treatment, curettage, enucleation, or marginal resection in relation to segmental resection, aggressive lesions, cortical bone perforation, and tooth root resorption were associated with increased recurrence rate. Recurrence related to a combination of surgical/pharmacological treatment could not be evaluated due to the variety of protocols.

Conclusions

Aggressive CGCLs recur more often than the non‐aggressive ones. Despite sometimes showing poor response to corticosteroid injection or surgical curettage, a combination of both treatment strategies should be considered in aggressive cases to reduce morbidities associated with radical surgery. The best protocol to manage aggressive and non‐aggressive lesions remains to be determined.
Trial of life: Well infants presenting more than 24 h after head injury with a scalp haematoma: A 10‐year review
Authors: Parameswaran Ahilan , Heitner Shmuel , Thosar Deepali , Fowler Adam , Marks Susan , O'Leary Fenton
Published: May 2018

Aim

To review the investigation, patterns of injury and short‐term outcomes of infants younger than 12 months of age who presented more than 24 h after head injury with an isolated scalp haematoma.

Methods

A retrospective chart review of infants who presented with a head injury to the emergency department of a major paediatric hospital between 2006 and 2016. Patients were included if they presented more than 24 h after the injury, were clinically well and had a documented scalp haematoma. Charts were abstracted using a standardised instrument to yield patient characteristics, mechanism of injury, imaging performed, identified injuries and patient outcome.

Results

A total of 2433 records were reviewed, with 157 included in the study. The mean age was 7.5 months (standard deviation 2.6). Of the patients, 14 had a documented palpable skull fracture; 43 patients had a skull X‐ray reported as a fracture; 13 patients had cranial ultrasounds with 3 reported as having a fracture; 124 patients had computed tomography head imaging, with 112 demonstrating a fracture; and 52 patients had acute intracranial abnormalities. There were nine unplanned representations (5.7%). No patients required any neurosurgical intervention.

Conclusions

Infants presenting after 24 h with isolated scalp haematomas had good short‐term outcomes despite a high prevalence of underlying injury on imaging. Expectant management, rather than imaging, may be a valid approach in this patient population. However, some of these injuries may have been the result of inflicted injury, and all of these patients require a robust assessment regardless of the decision to use a computed tomography scan.
Bioavailability of suppository acetaminophen in healthy and hospitalized ill dogs
Authors: Sikina E. R. , Bach J. F. , Lin Z. , Gehring R. , KuKanich B.
Published: May 2018

To determine the plasma pharmacokinetics of suppository acetaminophen (APAP) in healthy dogs and clinically ill dogs. This prospective study used six healthy client‐owned and 20 clinically ill hospitalized dogs. The healthy dogs were randomized by coin flip to receiveAPAPorally or as a suppository in crossover study design. Blood samples were collected up to 10 hr afterAPAPdosing. The hospitalized dogs were administeredAPAPas a suppository, and blood collected at 2 and 6 hr after dosing. Plasma samples were analyzed by ultra‐performance liquid chromatography with triple quadrupole mass spectrometry. In healthy dogs, oralAPAPmaximal concentration (CMAX=2.69 μg/ml) was reached quickly (TMAX=1.04 hr) and eliminated rapidly (T1/2 = 1.81 hr). SuppositoryAPAPwas rapidly, but variably absorbed (CMAX=0.52 μg/ml TMAX=0.67 hr) and eliminated (T1/2 = 3.21 hr). The relative (to oral) fraction of the suppository dose absorbed was 30% (range <1%–67%). In hospitalized ill dogs, the suppositoryAPAPmean plasma concentration at 2 hr and 6 hr was 1.317 μg/mland 0.283 μg/ml. Nonlinear mixed‐effects modeling did not identify significant covariates affecting variability and was similar to noncompartmental results. Results supported that oral and suppository acetaminophen in healthy and clinical dogs did not reach or sustain concentrations associated with efficacy. Further studies performed on different doses are needed.
Mobilizing Doubt: The Legal Mobilization of Climate Denialist Groups
Authors: Ley Aaron J.
Published: May 2018

The climate change countermovement (CCCM) deploys a broad repertoire of tactics in its effort to cast doubt on the science of climate change. One important yet understudied tactic is the effort by CCCM groups to use open records laws in scientifically uncertain areas to cast doubt on the accuracy of scientific information. This article explores the use of this tactic by CCCM groups and adds to the legal mobilization literature in three ways. First, it traces the origin of CCCM groups to the broader conservative legal movement of the 1970s that challenged the dominance of the liberal legal network. Second, it shows how CCCM groups waged an open records campaign against climate scientists in Virginia and Arizona, causing scientists to countermobilize by organizing their own legal campaigns. Finally, this article provides the first empirical evidence of the effect of CCCM Freedom of Information Act suits on the activities of university researchers. I find, through in‐depth personal interviews with twelve university researchers, that the experience of researchers who have been exposed to open records campaigns has been overwhelmingly negative, has caused them to change their methods of communication, and has imposed a new work burden that draws them away from other work responsibilities. I argue that the costs of these tactics are narrowly borne by a concentrated group of scientists whose production of knowledge is a public good that allows us to address the crosscutting and relentless problem of climate change.
Go ask Alisoun: Geoffrey Chaucer and Deafland (deafness as authority)
Authors: Robinson Carol L.
Published: May 2018

I would like to ask that scholars of medieval studies consider several factors in examining the relationship(s) between deafness, Deafland, and Geoffrey Chaucer—really consider what it means to be hearing disabled, to be deaf. The barrier between Chaucer scholars and the deaf is actually as simple as unawareness. This barrier might be understood in two ways: (1) as a wall between Chaucerians (both scholars and students) and Geoffrey Chaucer's text or (2) as a lack of full perspective, of complete comprehension, of that wall: its depth, its height, its volume, its density, and so forth. In other words, this barrier represents a difference in dimensions, as well as a difference between a priori appreciation and experiential understanding of the senses. To voice is not a measure of either vocalness or muteness of sounds. It is not a measure of one's ability or inability to speak. Voice is not measured in terms of sound at all. It is a measure of how fluent one is: is that individual fluent in a spoken language, fluent in a written language, fluent in a signed language? (Remember, in the Middle Ages, it was rather common for one to be fluent in one spoken language, such as Old Irish, and fluent in a specialized language, such as Latin—something not at all unfamiliar to those who are fluent in American Sign Language and written English today.) Chaucer's Wife of Bath's characterization makes for an interesting tie to members of Deafland (both those who do and do not sign) and to the uniqueness of visual–spatial perspectives contained within a predominately temporal–audio world, which has always given priority and privilege of sounded voice over signed voice (if the latter was permitted to exist at all). In the case of this complex character, this Wife of Bath, the likelihood of misunderstanding who she is, and what Chaucer intends us to see in her, is high. Alisoun seems to be a magic deaf person—in even some of the most unlikely of situations, such as from one end of a long line of pilgrims on horse—but actually, she is not. There is nothing magical about deafness, just as there is nothing magical about audism and other forms of discrimination.

Abstract in ASL (online): https://globalchaucers.wordpress.com/recordings/
Reading of the non‐template DNA by transcription elongation factors
Authors: Svetlov Vladimir , Nudler Evgeny
Published: May 2018

Unlike transcription initiation and termination, which have easily discernable signals, such as promoters and terminators, elongation is regulated through a dynamic network involving RNA/DNA pause signals and states‐rather than sequence‐specific protein interactions. A report by Nedialkov et al. () provides experimental evidence for sequence‐specific recruitment of elongation factor RfaH to transcribing RNA polymerase (RNAP) and outlines the mechanism of gene expression regulation by restraint (‘locking’) of the DNA non‐template strand. According to this model, the elongation complex pauses at the so called ‘operon polarity sequence’ (found in some long bacterial operons coding for virulence genes), when the usually flexible non‐template DNA strand adopts a distinct hairpin‐loop conformation on the surface of transcribing RNAP. Sequence‐specific binding of RfaH to this DNA segment facilitates conversion of RfaH from its inactive closed to its active open conformation. The interaction network formed between RfaH, non‐template DNA and RNAP locks DNA in a conformation that renders RNAP resistant to pausing and termination. The effects of such locking on elongation can be mimicked by restraint of the non‐template strand due to its shortening. This work advances our understanding of transcription regulation and has important implications for the action of general elongation factors, such as NusG, which lack apparent sequence‐specificity, as well as for the mechanisms of other linked processes, such as transcription‐coupled DNA repair.
Decreasing arsenic accumulation in rice by overexpressing OsNIP1;1 and OsNIP3;3 through disrupting arsenite radial transport in roots
Authors: Sun Sheng‐Kai , Chen Yi , Che Jing , Konishi Noriyuki , Tang Zhong , Miller Anthony J. , Ma Jian Feng , Zhao Fang‐Jie
Published: May 2018

Rice is a major dietary source of the toxic metalloid arsenic. Reducing arsenic accumulation in rice grain is important for food safety.

We generated transgenic rice overexpressing two aquaporin genes, OsNIP1;1 and OsNIP3;3, under the control of a maize ubiquitin promoter or the rice OsLsi1 promoter, and tested the effect on arsenite uptake and translocation.

OsNIP1;1 and OsNIP3;3 were highly permeable to arsenite in Xenopus oocyte assays. Both transporters were localized at the plasma membrane. Knockout of either gene had little effect on arsenite uptake or translocation. Overexpression of OsNIP1;1 or OsNIP3;3 in rice did not affect arsenite uptake but decreased root‐to‐shoot translocation of arsenite and shoot arsenic concentration markedly. The overexpressed OsNIP1;1 and OsNIP3;3 proteins were localized in all root cells without polarity. Expression of OsNIP1;1 driven by the OsLsi1 promoter produced similar effects. When grown in two arsenic‐contaminated paddy soils, overexpressing lines contained significantly lower arsenic concentration in rice grain than the wild‐type without compromising plant growth or the accumulation of essential nutrients.

Overexpression of OsNIP1;1 or OsNIP3;3 provides a route for arsenite to leak out of the stele, thus restricting arsenite loading into the xylem. This strategy is effective in reducing arsenic accumulation in rice grain.