bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential treatment mechanisms in a mindfulness‐based intervention for people with progressive multiple sclerosis
Authors: Bogosian Angeliki , Hughes Alicia , Norton Sam , Silber Eli , Moss‐Morris Rona
Published: May 2016

Objectives

To explore putative mediators of a mindfulness‐based intervention to decrease distress in people with multiple sclerosis (MS) and to explore the patients’ perspectives on this intervention.

Design

We used an explanatory mixed methods design incorporating quantitative data from a pilot randomized control trial and a qualitative interview study with people who completed the mindfulness intervention.

Methods

People with MS (n = 40) completed standardized measures of distress (outcome), and acceptance, decentring, self‐compassion, and self‐efficacy (potential mediators). Semi‐structured interviews (n = 15) of patients’ experiences of the mindfulness intervention were analysed deductively and inductively.

Results

Decentring post‐intervention explained 13% of the 3‐month change in distress and between 27% and 31% of concurrent changes in distress. Acceptance changed only slightly, and as a result, the indirect effect accounts for only 2% of future distress and between 3% and 11% of concurrent distress. Qualitative data showed that acceptance and self‐compassion needed more time to develop, whereas decentring could be implemented readily after being introduced in the sessions. Self‐efficacy also had a large mediating effect. Participants in their interviews talked about group dynamics and prior expectations as essential elements that determine their engagement with the course and their level of satisfaction.

Conclusions

Mindfulness interventions for people with a chronic progressive condition may benefit from focusing on helping them to accept daily challenges and teach them to recognize their thoughts and feelings, allowing time for acceptance and self‐compassion to develop. Group dynamics also play a fundamental role in the success of the mindfulness interventions.

Statement of Contribution

What is already known on this subject?

Mindfulness courses improve psychological well‐being for people with chronic conditions.

Mindfulness courses have been successful in improving psychological well‐being and symptom management for people with multiple sclerosis but we do not know how these courses work.

What does this study add?

Decentering and self‐efficacy appear to be key mechanisms leading to reduced distress.

Acceptance and self‐compassion may need more time and practice to develop.

Group dynamics and expectations of the mindfulness courses were also important elements of mindfulness.
Pharmacological profile of Ascaris suum ACR‐16, a new homomeric nicotinic acetylcholine receptor widely distributed in Ascaris tissues
Authors: Abongwa Melanie , Buxton Samuel K , Courtot Elise , Charvet Claude L , Neveu Cédric , McCoy Ciaran J , Verma Saurabh , Robertson Alan P , Martin Richard J
Published: May 2016

Background and Purpose

Control of nematode parasite infections relies largely on anthelmintic drugs, several of which act on nicotinic ACh receptors (nAChRs), and there are concerns about the development of resistance. There is an urgent need for development of new compounds to overcome resistance and novel anthelmintic drug targets. We describe the functional expression and pharmacological characterization of a homomeric nAChR, ACR‐16, from a nematode parasite.

Experimental Approach

Using RT‐PCR, molecular cloning and two‐electrode voltage clamp electrophysiology, we localized acr‐16 mRNA in Ascaris suum (Asu) and then cloned and expressed acr‐16 cRNA in Xenopus oocytes. Sensitivity of these receptors to cholinergic anthelmintics and a range of nicotinic agonists was tested.

Key Results

Amino acid sequence comparison with vertebrate nAChR subunits revealed ACR‐16 to be most closely related to α7 receptors, but with some striking distinctions. acr‐16 mRNA was recovered from Asu somatic muscle, pharynx, ovijector, head and intestine. In electrophysiological experiments, the existing cholinergic anthelmintic agonists (morantel, levamisole, methyridine, thenium, bephenium, tribendimidine and pyrantel) did not activate Asu‐ACR‐16 (except for a small response to oxantel). Other nAChR agonists: nicotine, ACh, cytisine, 3‐bromocytisine and epibatidine, produced robust current responses which desensitized at a rate varying with the agonists. Unlike α7, Asu‐ACR‐16 was insensitive to α‐bungarotoxin and did not respond to genistein or other α7 positive allosteric modulators. Asu‐ACR‐16 had lower calcium permeability than α7 receptors.

Conclusions and Implications

We suggest that ACR‐16 has diverse tissue‐dependent functions in nematode parasites and is a suitable drug target for development of novel anthelmintic compounds.
Radiographic Evaluation of Maxillary Sinus Lateral Wall and Posterior Superior Alveolar Artery Anatomy: A Cone‐Beam Computed Tomographic Study
Authors: Danesh‐Sani Seyed Amir , Movahed Ali , ElChaar Edgard S. , Chong Chan King , Amintavakoli Niloufar
Published: May 2016

Objective

The purpose of the current study is to assess the thickness of the maxillary sinus lateral wall in dentate and edentulous patients using cone beam computed tomography (CBCT). This study also provides information about the diameter, prevalence, and course of the posterior superior alveolar artery (PSAA), and its relation to the maxillary sinus floor.

Materials and Methods

Four hundred and thirty CBCT scans of the maxillofacial complex (860 maxillary sinuses) were reviewed. Measurements of the lateral wall of the maxillary sinus and PSAA were performed on the CBCT images.

Results

Statistical analysis showed that dental status (edentulous, non‐edentulous) of the patients had no significant effect on the lateral wall thickness. The mean thickness of the lateral wall of the maxillary sinus was 1.21 ± 1.07 mm at the second molar (M2), 1.98 ± 1.87 mm at the first molar (M1), 2.02 ± 1.53 mm at the second premolar (P2) and 2.16 ± 1.25 mm at the first premolar (P1). There was statistically significant difference between the left and right sides of the maxillary sinus only at P2 (p =.043). Detection rate of the PSAA on CBCT was reported as 60.58%. The mean diameter of the artery was 1.17 mm (range 0.4–2.8 mm). There was no significant correlation between age and the size of the PSAA. The most frequent path of the PSAA was intraosseous (69.6%), followed by intrasinusal (24.3%) and superficial (6.1%). The overall mean distance of the PSAA from the floor of the maxillary sinus is 8.16 mm.

Conclusions

The results from this study suggest that using CBCT prior to the surgery provides valuable diagnostic information. However, undetected intraosseous canal in CBCT does not exclude its existence. Alteration in the lateral window design and the use of piezoelectric instruments are recommended if intraoperative complications are expected.
“Peri‐Implantitis”: A Complication of a Foreign Body or a Man‐Made “Disease”. Facts and Fiction
Authors: Albrektsson Tomas , Canullo Luigi , Cochran David , De Bruyn Hugo
Published: May 2016

Background

The discrepancy between some scientific views and the daily clinical experience with dental implants has made the topic of “periimplantitis” highly controversial, especially the discussion whether “periimplantitis” should even be considered a “disease” or whether marginal bone loss instead would represent a complication of having a foreign body placed in the oral cavity.

Purpose

The aim of the present paper was to present the outcomes from a consensus meeting on “peri‐implantitis” in Rome, Italy (January 8–10, 2016).

Materials and Methods

Seventeen clinical scientists were invited to, based on prepared reviews of the literature, discuss topics related to “periimplantitis.”

Results and conclusions

Oral implants may lose bone or even display clinical failure. However, progressive bone loss threatening implant survival is rare and limited to a percent or two of all implants followed up over 10 years or more, provided that controlled implant systems are being used by properly trained clinicians. There is very little evidence pointing to implants suffering from a defined disease entity entitled “peri‐implantitis.” Marginal bone loss around implants is in the great majority of cases associated with immune‐osteolytic reactions. Complicating factors include patient genetic disorders, patient smoking, cement or impression material remnants in the peri‐implant sulcus, bacterial contamination of the implant components and technical issues such as loose screws, mobile components or fractured materials. These reactions combine to result in cellular responses with the end result being a shift in the delicate balance between the osteoblast and the osteoclast resulting in bone resorption. However, the great majority of controlled implants display a foreign body equilibrium resulting in very high survival rates of the implants over long term of follow‐up.
Word Sense Induction with Closed Frequent Termsets
Authors: Kozlowski Marek , Rybinski Henryk
Published: May 2016

The article is devoted to the problem of word sense induction. We propose a method for inducing senses from a raw text corpus. The proposed sense induction algorithm (called SenseSearcher, or SnS) is based on closed frequent sets, and as a result, it provides a multilevel sense representation. To a large extent, it is a knowledge‐poor approach, as it does not need any kind of structured knowledge base about senses and there is no deep language knowledge embedded. By discovering a hierarchy of senses, the algorithm enables identifying subsenses (fine‐grained senses). SnS discovers not only frequent (dominating) senses but also infrequent ones (dominated). The method was evaluated in two main areas: lexicography and information retrieval. With the use of the SnS algorithm, we provide a tool able to induce from a textual corpus a structure of senses, with a varying number of granularity levels. In the area of information retrieval, SnS can be used for clustering search result, according to the discovered senses. The experiments have shown that SnS performs better than the methods participating in the SemEval2013 WSI Task 11 competition, and most of the known search result clustering methods.
A case of sarcoidosis with pleural involvement
Authors: Sunnetcioglu Aysel , Sertogullarindan Bunyamin , Batur Abdussamet , Bayram Irfan
Published: May 2016

Sarcoidosis is a chronic, multisystem inflammatory disorder of unknown etiology that is characterized by noncaseating granulomas. Although lung involvement is common in sarcoidosis, pleural involvement is rare. Pleural involvement may manifest as a pleural effusion, pneumothorax, pleural thickening and nodules, hydropneumothorax, hemothorax, or chylothorax. Here, we describe a case of sarcoidosis with pleural nodular thickening.
The effect of pulmonary rehabilitation on COPD exacerbation frequency per year
Authors: Sahin Hulya , Varol Yelda , Naz Ilknur , Aksel Nimet , Tuksavul Fevziye , Ozsoz Ayse
Published: May 2016

Objective

We aimed to investigate the effect of pulmonary rehabilitation (PR) on the number of exacerbations in chronic obstructive pulmonary diseases (COPD) patients.

Methods

The study included 82 patients referred to our hospital's PR Unit between June 2013 and June 2014. Patients were divided into two groups, including those with low exacerbation risk (low number of exacerbations) (Groups A + B) and those experiencing frequent exacerbations (Groups C+ D) according to the combined COPD assessment.

Results

Patients were included in a PR program that consisted of 16 sessions in total, held twice a week over a period of 2 months. After one year, patients were called to find out about their COPD exacerbation frequency. Groups presented similar characteristics in terms of age, BMI and smoking duration prior to the PR program (P > .05). The frequent exacerbators had lower scores in exercise capacity, arterial oxygenation, health‐related quality of life and anxiety (P < .05). However, both groups exhibited significantly improved scores in the perceived dyspnea, FEV1 percentage, arterial oxygenation, exercise capacity, quality of life and anxiety after pulmonary rehabilitation (P < .05). The number of post‐PR emergency referrals and hospitalization (P < .0001, P = .04), and depression score decreased significantly among the frequent exacerbators. Group 1 presented insignificant changes in the number of emergency referrals and hospitalizations (P < .05).

Conclusion

Notwithstanding disease severity, PR treatment is reported to have positive effects on COPD patients in terms of perceived dyspnea, exercise capacity, arterial oxygenation, quality of life, anxiety and depression. This study found reduced number of emergency referrals and hospitalization among COPD patients with frequent exacerbations after PR.
Outcome of pleurodesis using different agents in management prolonged air leakage following lung resection
Authors: Jabłoński Sławomir , Kordiak Jacek , Wcisło Szymon , Terlecki Artur , Misiak Piotr , Santorek‐Strumiłło Edyta , Lazarek Jerry , Kozakiewicz Marcin
Published: May 2016

Background and Aims

Prolonged air leaks (PAL) are a common problem after pulmonary resection. PAL can be a source of significant complications. One of the treatment options is chemical pleurodesis.

Material and Methods

The efficiency of three methods of treatment of PAL after lung resection was evaluated. In Iodine_ group aqueous iodine solution (lat.Tinctura Jodi) was applied intrapleurally (30 patients); in Doxycycline_group (34 patients) 200 mg of Doxycyclin was given and in Drainage_group 35 patients were applied Lidocaine solution only.

Results

The group investigated was similar with regard to age [F = 0.04, P = 0.96] and the amount of air leakage (approx. 462 mL/min). The shortest drainage time and hospital stay was observed in the Iodine_group [10.57, P < 0.001]. However, this therapy was connected with strongly perceptible chest pain (P < 0.0001]). The number of case of pneumothorax recurrence was low and it was the same was seen in other methods of treatment [F = 0.87, P = 0.42]. Allergic reactions were not observed. The number of episodes of tachycardia, hypotension, dyspnea, pneumonia, subcutaneus empyema, fluid collection, emphysema, pneumothorax recurrence and number of re‐thoracotomies were statistically similar in all three methods of treatment.

Conclusion

Iodine pleurodesis can be considered as one of possible treatment methods of PAL after lung resection as it showed favorable results compared with Doxycycline pleurodesis or drainage alone regarding duration of air leakage, hospitalization and pneumothorax recurrence with only slightly increased pleural pain.
Plattenepithelkarzinom in Verbindung mit einer roten Tätowierung
Authors: Schmitz Inge , Prymak Oleg , Epple Matthias , Ernert Carsten , Tannapfel Andrea
Published: May 2016

Hintergrund und Ziele

Obwohl Tätowierungen in den letzten Jahren außerordentlich beliebt geworden sind, wurde in der Literatur bisher nur über wenige Fälle schwerer Reaktionen berichtet, die zu einer malignen Transformation führten. Dies steht im Kontrast zu der praktisch unüberschaubaren Zahl an Tätowierungen weltweit. Die Zusammensetzung der für Tätowierungen verwendeten Farbstoffe variiert stark, und selbst gleiche Farbtöne können unterschiedliche Komponenten enthalten. Das Ziel unserer Studie war es zu untersuchen, auf welche Weise Tätowierungen möglicherweise Hautkrebs auslösen können.

Patienten und Methoden

Wir berichten über den seltenen Fall einer 24‐jährigen Frau, bei der sich sieben Monate nachdem sie eine Tätowierung auf dem Fußrücken erhalten hatte in unmittelbarer Nähe des verwendeten roten Farbstoffs ein Plattenepithelkarzinom entwickelte. Die Komplikationen begannen mit einer unspezifischen Schwellung. Die Läsion wurde histologisch untersucht. Die Zusammensetzung des inkorporierten Farbstoffs wurde mittels Rasterelektronenmikroskopie in Kombination mit energiedispersiver Elementanalyse analysiert. Zur weiteren Charakterisierung wurden Thermogravimetrie und Pulverdiffraktometrie eingesetzt.

Ergebnisse und Schlussfolgerungen

Der Tätowierungsfarbstoff enthielt hauptsächlich Bariumsulfat; Spuren von Al, S, Ti, P, Mg und Cl ließen sich ebenfalls nachweisen. Bei der Analyse zeigten sich Pigmentgranula unterschiedlicher Größe. In seltenen Fällen kann Tätowierungstinte karzinogene Effekte haben, die multifaktoriell zu sein scheinen.
Retrospektive Analyse von56 Weichteildefekten nach einzeitiger Rekonstruktion unter Verwendung von Dermisersatzpräparaten
Authors: Gümbel Denis , Ackerl Martin , Napp Matthias , Daeschlein Georg , Spranger Nikolai , Stope Matthias B. , Ekkernkamp Axel , Matthes Gerrit
Published: May 2016

Hintergrund

Der Verschluss von Wunden mit ausgeprägtem Weichteilschaden stellt eine chirurgische Herausforderung dar und erfordert häufig umfangreiche plastische Operationen sowie freie Lappenplastiken. Die Kombination von Dermisersatzpräparaten und Spalthauttransplantationen ist eine innovative Methode die zur Versorgung von komplexen Verletzungen der Extremitäten angewandt werden kann. Wir haben diese Technik in das Standard‐Handwerkszeug bei komplexen Verletzungen der Extremitäten aufgenommen. Die klinischen Ergebnisse von 56 behandelten Patienten werden vorgestellt.

Patienten und Methoden

In 44 Fällen (78,6 %) wurde die beschriebene Methode an Defekten der unteren Extremitäten verwendet, einschließlich sieben Personen (12,5 %), die sich einer Stumpfdeckung nach Amputation unterzogen. Zwölf Defekte (21,4 %) befanden sich an den oberen Extremitäten. In zwei Fällen (3,6 %) wurde die Matriderm® ‐Matrix verwendet, um Nerven von unmittelbar angrenzenden chirurgischen Implantaten zu schützen.

Ergebnisse

Bei 41 Patienten (73,2 %) kam es zur Einheilung des Transplantats ohne Komplikationen. Fünfzehn Patienten (26,8 %) zeigten eine gestörte Wundheilung nach Defektverschluss, die unter konservativer Therapie zur Ausheilung gebracht werden konnte. Ein Patient (1,8 %) zeigte ein Transplantatversagen, was eine Revisionsoperation erforderlich machte. Umfangreiche plastische Rekonstruktionen mussten bei keinem Patienten angewandt werden.

Schlussfolgerungen

Bei Fällen, in denen ausgedehnte plastische Operationen nicht möglich oder nicht erwünscht sind, ist die Verwendung von Dermisersatzpräparaten in Kombination mit Spalthauttransplantationen eine vielversprechende Alternative zum Wundverschluss bei ausgedehnten Weichteilschäden.
Surgical treatment of melanoma in pregnancy: a practical guideline
Authors: Crisan Diana , Treiber Nicolai , Kull Thomas , Widschwendter Peter , Adolph Oliver , Schneider Lars Alexander
Published: May 2016

A tumor primarily requiring surgical treatment, newly diagnosed or preexisting melanoma during pregnancy is a clinical rarity. In such cases, the surgeon faces the challenge of having to decide on the appropriate therapeutic course of action. Based on our clinical experience and a review of the literature, we herein provide a guideline on how to practically deal with this rare clinical conundrum. In our experience, pregnant melanoma patients require thorough counseling with respect to their therapeutic options. They naturally tend to put their unborn child first, and are hesitant to consent to necessary surgery despite a potentially life‐threatening diagnosis. It is therefore crucial to clearly inform these patients that – based on existing medical experience – pregnancy by itself is no reason to hold off on any type of necessary melanoma surgery. However, various parameters such as preoperative imaging procedures, positioning on the operating table, monitoring, anesthesia, and perioperative medication require certain adjustments in order to comply with this special situation.
Chirurgische Behandlung von Melanomen in der Schwangerschaft: eine praktische Anleitung
Authors: Crisan Diana , Treiber Nicolai , Kull Thomas , Widschwendter Peter , Adolph Oliver , Schneider Lars Alexander
Published: May 2016

Als ein Tumor, der primär eine chirurgische Behandlung erfordert, ist ein neu diagnostiziertes oder vorbestehendes Melanom in der Schwangerschaft eine klinische Rarität. In solchen Fällen steht der Chirurg vor der Herausforderung, ein geeignetes therapeutisches Vorgehen festlegen zu müssen. Auf der Grundlage unserer klinischen Erfahrung und einer Übersicht über die Literatur geben wir in der vorliegenden Arbeit eine Anleitung für das praktische Vorgehen bei dieser seltenen klinischen Konstellation. Unserer Erfahrung nach müssen schwangere Melanom‐Patientinnen im Hinblick auf ihre therapeutischen Optionen ausführlich beraten werden. Naturgemäß setzen sie ihr ungeborenes Kind an die erste Stelle und zögern, der erforderlichen Operation zuzustimmen, obwohl bei ihnen eine möglicherweise lebensbedrohliche Erkrankung diagnostiziert worden ist. Daher ist es entscheidend, diese Patientinnen klar darüber zu informieren, dass, wie die vorliegenden medizinischen Erfahrungen zeigen, eine Schwangerschaft per se kein Grund ist, eine notwendige Melanom‐Operation aufzuschieben. Jedoch müssen bei einigen Parametern wie den präoperativen Bildgebungsverfahren, der Positionierung auf dem Operationstisch, der Überwachung, Anästhesie und der perioperativen Medikation bestimmte Anpassungen vorgenommen werden, um der speziellen Situation Rechnung zu tragen.
Consensus statement on the symptom‐based treatment of chronic venous diseases
Authors: Stücker Markus , Debus Eike Sebastian , Hoffmann Johannes , Jünger Michael , Kröger Knut , Mumme Achim , Ramelet Albert‐Adrien , Rabe Eberhard
Published: May 2016

Background

Chronic venous diseases are very common. Early symptoms such as a sensation of swelling and heaviness may occur without objectifiable findings, but are nevertheless perceived as bothersome. Progressive disease – marked by varicose veins and symptoms of chronic venous insufficiency – is associated with considerable impairment in quality of life.

Methods

The present consensus recommendations are based on publications in Pubmed‐listed journals as well as relevant international therapeutic guidelines on chronic venous diseases. Only conclusive randomized controlled trials (RCTs) and review articles/meta‐analyses were included.

Results

Symptom‐based treatment of chronic venous diseases is based on three therapeutic pillars with proven efficacy: invasive therapy, compression therapy, and oral pharmacological treatment. According to current therapeutic guidelines, invasive procedures aimed at restoring unimpaired venous blood flow as well as improving or eliminating pathological changes should be the first‐line approach. If an invasive approach is infeasible or undesirable, or if symptoms persist following a therapeutic intervention, optimal use of symptom‐based treatment options is recommended. Compression and pharmacological therapy may each be used as sole treatment or in combination. To guarantee maximum therapeutic success, individual treatment decisions should be made on a case‐by‐case basis.

Conclusions

Chronic venous diseases should be treated on the basis of individual pathophysiological disturbances. Symptom‐based treatment of chronic venous disorders encompasses invasive therapy, compression therapy, and oral pharmacological therapy. Considerations in choosing the appropriate treatment option should include both objective signs as well as subjective symptoms.
Konsensuspapier zur symptomorientierten Therapie der chronischen Venenerkrankungen
Authors: Stücker Markus , Debus Eike Sebastian , Hoffmann Johannes , Jünger Michael , Kröger Knut , Mumme Achim , Ramelet Albert‐Adrien , Rabe Eberhard
Published: May 2016

Hintergrund

Chronische Venenerkrankungen sind eine Volkskrankheit. Venöse Symptome wie Schwellungs‐ und Schweregefühl können bereits früh ohne sichtbaren Befund auftreten und werden als belastend erlebt. Ein Fortschreiten im Sinne einer objektivierbaren Varikose bzw. chronischen venösen Insuffizienz schränkt die Lebensqualität erheblich ein.

Methodik

Pubmed‐gelistete Publikationen sowie relevante Leitlinien zur Therapie chronischer Venenkrankheiten bilden die Basis der vorliegenden Konsensusempfehlungen. Inkludiert in die Bewertung wurden ausschließlich aussagekräftige randomisierte Studien (RCT) und Übersichtsarbeiten (Reviews/Metaanalysen).

Ergebnisse

Die symptomorientierte Behandlung chronischer Venenerkrankungen stützt sich auf drei Säulen mit nachgewiesener Wirksamkeit: invasive Therapie, Kompressionstherapie und orale medikamentöse Therapie. Gemäß Empfehlungen aktueller Leitlinien sollte zunächst eine Sanierung des venösen Gefäßbetts erwogen werden, um einen störungsfreien venösen Blutfluss wiederherzustellen und Symptome und pathologische Veränderungen zu beseitigen oder zu bessern. Ist ein invasiver Eingriff nicht möglich bzw. nicht erwünscht oder bestehen nach einem Eingriff noch Restsymptome, gilt es, die symptomatischen Therapieoptionen optimal auszuschöpfen. Kompressionstherapie und medikamentöse Therapie können allein oder in Kombination angewendet werden. Welche Strategie den größten Erfolg verspricht, ist individuell zu entscheiden.

Schlussfolgerungen

Chronische Venenerkrankungen sollten auf der Basis der individuellen pathophysiologischen Störung behandelt werden. Sie symptomorientierte Behandlung chronischer Venenerkrankungen fußt auf der invasiven Therapie, der Kompressionstherapie und der medikamentösen Therapie. Bei der Indikationsstellung sind objektive Symptome ebenso wie subjektive Beschwerden zu berücksichtigen.
Pathophysiological basis of systemic treatments in psoriasis
Authors: Volc Sebastian , Ghoreschi Kamran
Published: May 2016

Over the past 15 years, the spectrum of systemic antipsoriatic treatments has dramatically expanded. Until the end of the last millennium, systemic therapy had been restricted to four oral agents: methotrexate, cyclosporine, acitretin, and fumaric acid esters. Today, there are additionally seven biologics and one new oral antipsoriatic drug, as well as the first available biosimilars. Six more biologics with novel target structures and at least four biosimilars are currently being developed (phase III). This progress has been based on new insights into the pathogenesis of psoriasis, in which tumor necrosis factor and especially Th17 immune responses with their associated cytokines interleukin 23 and 17 play a key role. The development of new‐generation biologics as well as immunomodulatory small molecules can be attributed to these pathophysiological findings. Phosphodiesterase 4 inhibitors, dimethyl fumarate, and Janus kinase inhibitors all interact with Th17 immune responses. Some of these drugs are in advanced clinical development and are also beneficial in psoriatic arthritis. Today, psoriasis and psoriatic arthritis therefore rank among the most readily treatable inflammatory autoimmune disorders. Dermatology is increasingly becoming a specialty of modern targeted immunotherapies.
Efficacy of insurance for organisational disaster recovery: case study of the 2010 and 2011 Canterbury earthquakes
Authors: Brown Charlotte , Seville Erica , Vargo John
Published: May 2016

Insurance is widely acknowledged to be an important component of an organisation's disaster preparedness and resilience. Yet, little analysis exists of how well current commercial insurance policies and practices support organisational recovery in the wake of a major disaster. This exploratory qualitative research, supported by some quantitative survey data, evaluated the efficacy of commercial insurance following the sequence of earthquakes in Canterbury, New Zealand, in 2010 and 2011. The study found that, generally, the commercial insurance sector performed adequately, given the complexity of the events. However, there are a number of ways in which insurers could improve their operations to increase the efficacy of commercial insurance cover and to assist organisational recovery following a disaster. The most notable of these are: (i) better wording of policies; (ii) the availability of sector‐specific policies; (iii) the enhancement of claims assessment systems; and (iv) risk‐based policy pricing to incentivise risk reduction measures.
Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo
Authors: Albutt Katherine , Kelly Jocelyn , Kabanga Justin , VanRooyen Michael
Published: May 2016

Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences.
Culture, local capacity, and outside aid: a community perspective on disaster response after the 2009 tsunami in American Sāmoa
Authors: Binder Sherri Brokopp , Baker Charlene K.
Published: May 2016

Research on diverse cultural contexts has indicated that aid organisations often fail to leverage local, culturally‐grounded resources and capacities in disaster‐affected communities. Case‐study methodology was employed to explore the relationship between local and external disaster response efforts in American Sāmoa following the earthquake and tsunami on 29 September 2009 in the southern Pacific Ocean, with a specific focus on the role of culture in defining that relationship. Interview and focus group data from 37 participants, along with observational data, suggested that the local response to the event was swift and grounded in Samoan cultural systems and norms. External aid was viewed as helpful in some respects, although, on the whole, it was seen as a disruption to village hierarchies, social networks, and local response efforts. The study discusses the implications for the role of outside aid in diverse cultural contexts, and makes suggestions for improving the ecological fit of post‐disaster interventions.
Hurricane Katrina‐linked environmental injustice: race, class, and place differentials in attitudes
Authors: Adeola Francis O. , Picou J. Steven
Published: May 2016

Claims of environmental injustice, human neglect, and racism dominated the popular and academic literature after Hurricane Katrina struck the United States in August 2005. A systematic analysis of environmental injustice from the perspective of the survivors remains scanty or nonexistent. This paper presents, therefore, a systematic empirical analysis of the key determinants of Katrina‐induced environmental injustice attitudes among survivors in severely affected parishes (counties) in Louisiana and Mississippi three years into the recovery process. Statistical models based on a random sample of survivors were estimated, with the results revealing significant predictors such as age, children in household under 18, education, homeownership, and race. The results further indicate that African‐Americans were more likely to perceive environmental injustice following Katrina than their white counterparts. Indeed, the investigation reveals that there are substantial racial gaps in measures of environmental injustice. The theoretical, methodological, and applied policy implications of these findings are discussed.
Sublingual administration improves systemic exposure of tacrolimus in kidney transplant recipients: comparison with oral administration
Authors: Federico Stefano , Carrano Rosa , Sabbatini Massimo , Nappi Riccardo , Russo Luigi , Apicella Luca , Balletta Mario Maria , Santangelo Michele , Mosca Teresa , Tarantino Giovanni , Capone Domenico
Published: May 2016

Background

Tacrolimus (TCR) is an immunosuppressive drug used by oral administration. Intravenous (IV) TCR administration is required under conditions of gastrointestinal diseases or abdominal surgery at the onset of paralytic ileus. The infusion formulation needs a large dilution and therefore a careful technical management during continuous infusion by 24 h and may determine anaphylaxis, cardiac arrhythmia, QT prolongation and torsades de pointes. Sublingual (SL) TCR administration was suggested as an alternative route.

Design

The aim of this study was to compare in the same kidney transplanted patients the TCR pharmacokinetic profiles by both the routes coupled with the pharmacoeconomic analysis. The study enrolled eight subjects undergoing renal transplantation and treated with TCR and methylprednisolone. TCR was administered by oral route at the scheduled dosage while the 50% of oral dosage was used by SL route, taking into account the absence of liver first pass.

Results

Except for AUC, which resulted significantly increased after oral administration, all exposure parameters were not significantly different between the two routes of administration. Analysis of dose‐adjusted exposure parameters showed significant increases in AUC and Cmin after SL administration confirming a better bioavailability of the SL route compared with oral route. Cost saving was obtained using the SL rather than the IV route of TCR delivery.

Conclusion

When oral administration of TCR is not advised, SL delivery represents an attractive option to IV administration.
INTERNATIONAL TAX COMPETITION AND THE DEFICIT BIAS
Authors: Arcalean Calin
Published: May 2016

I analyze the dynamic effects of tax competition on public budget deficits. I find that stronger tax competition leads to a fiscal deficit bias at the early stages of financial liberalization. When countries differ in terms of capital mobility, further liberalization leads to external imbalances and diverging fiscal deficits while corporate tax rates converge. Consistent with theory, I find that stronger tax competition increases deficits in a sample of OECD countries, controlling for tax revenues and other standard determinants of fiscal deficits. (JEL E62, F62)
FREE TRADE AGREEMENTS AS DYNAMIC FARSIGHTED NETWORKS
Authors: Lake James
Published: May 2016

In the presence of multilateral negotiations, are Free Trade Agreements (FTAs) necessary for, or will they prevent, global free trade? I answer this question using a dynamic farsighted model of network formation among asymmetric countries. Ultimately, FTAs prevent global free trade when there are two larger countries and one smaller country but FTAs can be necessary for global free trade when there are two smaller countries and one larger country. The model provides insights into the dynamics of recent real‐world negotiations and recent results in the literature on the empirical determinants of trade agreements. (JEL C71, F12, F13)
Craniocervical manual lymphatic drainage and its impact on intracranial pressure – a pilot study
Authors: Roth C. , Stitz H. , Roth C. , Ferbert A. , Deinsberger W. , Pahl R. , Engel H. , Kleffmann J.
Published: May 2016

Background and purpose

Theoretical considerations and the results of animal studies indicate that manual lymphatic drainage (MLD) might have an impact on intracranial pressure (ICP). There is a lack of clinically qualitative investigations on patients with severe cerebral diseases.

Methods

Between April 2013 and January 2015 a prospective observational study was performed on patients who were undergoing intracranial pressure measurement and treatment with MLD. ICP, cerebral perfusion pressure, mean arterial pressure (MAP), heart rate and oxygen saturation were recorded continuously 15 min before the procedure, during MLD (22 min) and for 15 min after the procedure. For analysis the data treatment units were divided into two groups: patients with a mean baseline ICP <15 mmHg (group 1) and patients with a mean ICP ≥15 mmHg before MLD (group 2).

Results

A total of 133 treatment units (61 patients) were analysed (group 1 n = 99; group 2 n = 34). The mean baseline ICP was 10.4 mmHg overall, and 8.3 mmHg and 18.6 mmHg respectively in group 1 and group 2; ICP significantly decreased during therapy with MLD and this persisted during the follow‐up period in group 2. MAP did not show any significant differences between the different periods.

Conclusions

Our data showed a significant reduction of ICP during therapy with craniocervical MLD in patients with severe cerebral diseases.
Corpus callosotomy outcomes in pediatric patients: A systematic review
Authors: Graham David , Tisdall Martin M. , Gill Deepak
Published: May 2016

Objective

Corpus callosotomy is a palliative neurosurgical treatment for patients with either generalized or multifocal refractory epilepsy and injurious drop attacks. This report aims to systematically review the pediatric literature.

Methods

Medline, Embase, Web of Knowledge, and Scopus were searched systematically for published articles on treatment outcomes of corpus callosotomy for refractory epilepsy. Studies were included if the patient population was younger than 18 at the time of surgery and median follow‐up was >1 year. Studies were excluded if resective surgery was also performed.

Results

A total of 12 articles met inclusion criteria. All articles were retrospective case series, with the exception of one being a prospectively designed retrospective case series. There was very little agreement among authors on the definition of a good seizure outcome. Articles that used the Engel classification found that 88.2% of total corpus callosotomy patients had a worthwhile reduction in seizures compared with 58.6% of patients who underwent anterior corpus callosotomy (p < 0.05). Drop attacks improved from corpus callosotomy more than other generalized seizure types. Reported complications were minor in all but one patient, and one death was reported. Transient disconnection syndrome was significantly more likely in total corpus callosotomy than in anterior corpus callosotomy (12.5% vs. 0%; p < 0.05). Improvements in quality of life, behavior, and intelligence/development quotient, as well as parental satisfaction, were generally correlated with seizure outcome. There was no postcallosotomy change in the number of antiepileptic drugs.

Significance

Total corpus callosotomy was significantly more likely to result in a reduction in seizures. Anterior corpus callosotomy was unlikely to result in disconnection syndrome. Although all of the papers drew a similar conclusion, the quality of evidence was low. At best, the evidence raises the hypothesis that corpus callosotomy is a safe and effective treatment for refractory generalized epilepsy. It is clear that a case–control or randomized trial is warranted.
ADHD in childhood epilepsy: Clinical determinants of severity and of the response to methylphenidate
Authors: Rheims Sylvain , Herbillon Vania , Villeneuve Nathalie , Auvin Stéphane , Napuri Silvia , Cances Claude , Berquin Patrick , Castelneau Pierre , Nguyen The Tich Sylvie , Villega Frédéric , Isnard Hervé , Nabbout Rima , Gaillard Ségolène , Mercier Catherine , Kassai Behrouz , Arzimanoglou Alexis ,   the investigators of the Paediatric Epilepsy REsearch NEtwork (PERENE)
Published: May 2016

Objective

Attention‐deficit/hyperactivity disorder (ADHD) is commonly observed in children with epilepsy. However, factors associated with the development of ADHD and which might help to guide its therapeutic management, remain an issue of debate.

Methods

We conducted a multicenter prospective observational study that included children, aged 6–16 years, with both epilepsy and ADHD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM‐IV) criteria. After inclusion, patients entered a 12–16 week follow‐up period during which they were either treated with methylphenidate or they did not receive specific ADHD treatment. ADHD was evaluated with the ADHD Rating Scale‐IV.

Results

One hundred sixty‐seven patients were included, of which 91 were seizure‐free during the preinclusion baseline period. At inclusion, the ADHD Rating Scale‐IV total score was 30.4 ± (standard deviation) 9.2, the inattentive subscore was 17.3 ± 4.4, and the hyperactive subscore was 13.2 ± 6.6. We did not detect any difference of ADHD Rating Scale‐IV scores across patients' age or gender, age at epilepsy onset, epilepsy syndrome, seizure frequency, or number of ongoing antiepileptic drugs. Methylphenidate was initiated in 61 patients, including 55 in whom a follow‐up evaluation was available. At the last follow‐up, 41 patients (75%) treated with methylphenidate and 39 (42%) of those who did not received ADHD therapy demonstrated ≥25% decrease of ADHD Rating Scale‐IV total score (p < 0.001). Response to methylphenidate was greater in girls but was not influenced by any epilepsy‐related variables.

Significance

We did not detect any epilepsy‐related factor associated with the severity of ADHD. Twenty‐five percent of patients did not respond to methylphenidate. A better understanding of the pathologic process that underlies ADHD development in childhood epilepsy might be required to improve therapeutic strategies.
Distribution ranges and spring phenology explain late frost sensitivity in 170 woody plants from the Northern Hemisphere
Authors: Muffler Lena , Beierkuhnlein Carl , Aas Gregor , Jentsch Anke , Schweiger Andreas H. , Zohner Constantin , Kreyling Juergen
Published: May 2016

Aim

Cold events determine the distributional range limits of woody species. Despite global warming, the magnitude of late frost events in boreal and temperate regions is not expected to change. Hence, the risk for late spring frost damage of woody species may increase with an earlier onset of the growing season. Here, we investigated biogeographical, phenological and phylogenetic effects on late frost sensitivity.

Location

Ecological‐Botanical Gardens Bayreuth, Germany (49°55′45″ N, 11°35′10″ E).

Methods

We inspected 170 woody species in the Ecological‐Botanical Gardens from across the entire Northern Hemisphere for frost damage after an extreme late frost event in May 2011 (air temperature −4.3 °C after leaf unfolding of all species). Distribution range characteristics, climatic parameters of place of origin and phenological strategy were linked to sensitivity to the late frost event.

Results

The northern distribution limit and the range in continentality across the distributional ranges correlated negatively with a taxon's late frost sensitivity (pseudo‐R2 = 0.42, pseudo‐R2 = 0.33, respectively). Sensitivity to the late frost event was well explained by the climatic conditions within species’ native ranges (boosted regression trees; receiver operating characteristic 0.737). Average (1950–2000) May minimum temperature in species’ native ranges was the main explanatory variable of late frost sensitivity (51.7% of explained variance). Phylogenetic relatedness explained additional variance in sensitivity to the late frost event. Sensitivity to the late frost event further correlates well with species phenological strategy. Frost‐tolerant species flushed on average 2 weeks earlier than frost‐sensitive species.

Main conclusions

Range characteristics and the prevalent climatic parameters across species native ranges are strongly related to their susceptibility to late spring frost damage. Further, more late frost‐sensitive species unfolded their leaves later than more tolerant species and late frost tolerance is phylogenetically conserved. Thus, late frost sensitivity may challenge natural and human‐assisted migration of woody species under global warming.
Diagnostic phrasing is independently correlated with the decision to treat for graft‐versus‐host disease: retrospective review of colon biopsies with rare apoptosis
Authors: Rowan Daniel J , Hartley Christopher P , Carrillo‐Polanco Luis F , Oshima Kiyoko , Hagen Catherine E
Published: May 2016

Aims

The risks of immunosuppression and the non‐specific nature of rare crypt apoptosis has led to debate over the lower threshold for histological diagnosis of colonic graft‐versus‐host disease (GVHD). A recent study proposed the diagnostic category of indeterminate for GVHD (iGVHD) for cases with six or fewer apoptotic bodies per 10 crypts. Our aim was to assess colon biopsies with iGVHD histology to determine whether the diagnosis was retrospectively predictive of the decision to treat, and to correlate these findings with endoscopic and clinical findings.

Methods and results

A retrospective search was performed for colonic biopsies taken to evaluate for GVHD from 2008 to 2014. Biopsies were blindly reviewed for the maximum number of apoptotic bodies per 10 contiguous crypts, evidence of crypt dropout, and ulceration. Clinical information was collected through chart review. One hundred and twenty‐two biopsies from 84 transplant patients were included. Forty‐seven cases met the histological criteria for iGVHD. Patients with an original diagnosis of iGVHD were more likely to be managed conservatively than those with a diagnosis of grade 1 GVHD (25% versus 0%). Eight symptomatic patients reclassified as iGVHD had resolution of symptoms without increased immunosuppression. A clinicopathologically similar group of 10 patients with iGVHD histology, normal or subtle endoscopic findings and no evidence of GVHD at other organ sites were treated with increased immunosuppression. On multivariate analysis, the original diagnostic category was the most significant predictor of the decision to treat.

Conclusion

The use of the diagnostic category iGVHD alerts clinicians to the presence of minimal crypt apoptosis, and allows treatment based on clinical judgement.
Optimisation of antioxidant hydrolysate production from sweet potato protein and effect of in vitro gastrointestinal digestion
Authors: Zhang Miao , Mu Tai‐Hua
Published: May 2016

In this study, response surface methodology (RSM) was applied to optimise antioxidant hydrolysate production from sweet potato protein (SPP). The effects of enzyme‐to‐substrate ratio, pH value and reaction temperature on ·OH radical scavenging activity and Fe2+‐chelating activity of antioxidant hydrolysates from SPP were investigated. The maximum ·OH radical scavenging activity (40.10%) and Fe2+‐chelating activity (74.37%) of SPP hydrolysates (SPPH) were obtained at an enzyme‐to‐substrate ratio of 4%, pH value of 7.8 and reaction temperature of 57 °C, which was in agreement with the predicted value (40.11% and 74.83%, respectively) estimated by RSM. The simulated in vitro gastrointestinal digestion (GID) dramatically modified molecular weights distribution, increased peptide (<3 kDa) concentration and highly retained antioxidant activity of SPPH, indicating potentially utilisation of SPPH as a functional supplement in food system.