bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of the psychometric properties of the Action Research Arm Test in neurorehabilitation
Authors: Pike Shannon , Lannin Natasha A. , Wales Kylie , Cusick Anne
Published: October 2018

Background/aim

The Action Research Arm Test (ARAT) measures upper limb activity limitations in people with acquired brain injuries. Evidence relating to the use of this test in neurorehabilitation is scattered. This review identifies, rates and synthesises evidence on the original 1981 ARAT use within neurorehabilitation. Psychometric properties are reviewed, including specific examination of participants with upper limb spasticity.

Methods

Systematic review of published articles describing psychometric properties and/or use of the original version of the ARAT in neurorehabilitation. COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN) search strategy, reporting and methodological checklist with criterion‐based appraisal of quality criteria for good measurement properties were applied. A best evidence synthesis for each psychometric property was completed.

Results

In 28 included studies, participants had suffered a stroke or traumatic brain injury, with 46% >6 months post‐injury. Six studies identified participants with upper limb spasticity. Methodological quality of psychometric properties ranged from poor to excellent. Best evidence synthesis determined moderate positive evidence for using the ARAT with people without limb spasticity: intra‐rater reliability (ICC 0.71 (95% CI 0.53–0.89) to 0.99 (95% CI 0.98, 0.99)); responsiveness (ROC curve 0.72–0.88, SRM 0.89); and regarding construct validity, it is a valid measure of activity limitation. Limited evidence for psychometric properties of the ARAT were found when used with people with upper limb spasticity for construct validity and responsiveness (ES 0.55–0.78). Gaps in evidence were found for inter and test–retest reliability, measurement error, content validity, structural validity, floor and ceiling effects.

Conclusions

The ARAT is an appropriate measure of activity limitation post‐stroke and should be considered for use with people with TBI; evidence for people with upper limb spasticity is limited. Gaps and mixed limited to moderate evidence for psychometric properties in neurorehabilitation mean further research is required.
MiR‐182 enhances radioresistance in non‐small cell lung cancer cells by regulating FOXO3
Authors: Chen Gang , Yu Lina , Dong Hui , Liu Zhihao , Sun Yahong
Published: October 2018

Upregulated in lung cancer, miRNA‐182 was found to be related to cancer proliferation and chemoresistance. However, there is no report on the role of miR‐182 in radioresistance, which is a main obstacle of radiotherapy. In this study, we aim to depict the effect of miR‐182 inhibition on cellular sensitivity to ionizing radiation. Our data confirm that miR‐182 is upregulated in lung cancers and tissues and that miR‐182 is responsive to irradiation. We also show that miR‐182 knockdown suppresses cell proliferation and increases cell apoptosis after irradiation. DNA damage remains unrepaired in miR‐182 knockdown cells, which results in cell cycle arrest. Finally, we find that FOXO3 is a direct target of miR‐182 and that overexpression of FOXO3 enhances radiation resistance in miR‐182 knockdown cells. In conclusion, our data suggest that miR‐182 might account for radioresistance in lung cancer and that miR‐182‐FOXO3 provides a novel radiosensitizing target.
Insight into the sulfur metabolism of Desulfurella amilsii by differential proteomics
Authors: Florentino Anna P. , Pereira Inês A. C. , Boeren Sjef , van den Born Michael , Stams Alfons J. M. , Sánchez‐Andrea Irene
Published: October 2018

Many questions regarding proteins involved in microbial sulfur metabolism remain unsolved. For sulfur respiration at low pH, the terminal electron acceptor is still unclear. Desulfurella amilsii is a sulfur‐reducing bacterium that respires elemental sulfur (S0) or thiosulfate, and grows by S0 disproportionation. Due to its versatility, comparative studies on D. amilsii may shed light on microbial sulfur metabolism. Requirement of physical contact between cells and S0 was analyzed. Sulfide production decreased by around 50% when S0 was trapped in dialysis membranes, suggesting that contact between cells and S0 is beneficial, but not strictly needed. Proteome analysis was performed under the aforementioned conditions. A Mo‐oxidoreductase suggested from genome analysis to act as sulfur reductase was not detected in any growth condition. Thiosulfate and sulfite reductases showed increased abundance in thiosulfate‐reducing cultures, while rhodanese‐like sulfurtransferases were highly abundant in all conditions. DsrE and DsrL were abundantly detected during thiosulfate reduction, suggesting a modified mechanism of sulfite reduction. Proteogenomics suggest a different disproportionation pathway from what has been reported. This work points to an important role of rhodaneses in sulfur processes and these proteins should be considered in searches for sulfur metabolism in broader fields like meta‐omics.
NaCl promotes antibiotic resistance by reducing redox states in Vibrio alginolyticus
Authors: Yang Jun , Zeng Zao‐Hai , Yang Man‐Jun , Cheng Zhi‐Xue , Peng Xuan‐Xian , Li Hui
Published: October 2018

The development of antibiotic resistance in Vibrio alginolyticus represents a threat to human health and fish farming. Environmental NaCl regulation of bacterial physiology is well documented, but whether the regulation contributes to antibiotic resistance remains unknown. To explore this, we compared minimum inhibitory concentration (MIC) of V. alginolyticus cultured in different media with 0.5%–10% NaCl, and found that the MIC increased as the NaCl concentration increased, especially for aminoglycoside antibiotics. Consistent with this finding, internal NaCl also increased, while intracellular gentamicin level decreased. GC–MS‐based metabolomics showed different distributions of pyruvate cycle intermediates among 0.5%, 4% and 10% NaCl. Differential activity of enzymes in the pyruvate cycle and altered expression of Na(+)‐NQR led to a reducing redox state, characterized by decreased levels of NADH, proton motive force (PMF) and ATP. Meanwhile, NaCl negatively regulated PMF as a consequence of the reducing redox state. These together are responsible for the decreased intracellular gentamicin level with the increased external level of NaCl. Our study reveals a previously unknown redox state‐dependent mechanism regulated by NaCl in V. alginolyticus that impacts antibiotic resistance.
A novel citrate synthase isoform contributes infection and stress resistance of the stripe rust fungus
Authors: Li Dan , Pang Lijing , Yuan Pu , Zheng Peijing , Huai Baoyu , Yao Mohan , Kang Zhensheng , Liu Jie
Published: October 2018

The early development of a rust fungus is dependent on the endogenous lipids stored in the urediniospores. After it establishes a parasitic relationship with the host, sugars absorbed from the host cells by haustoria become the primary nutrients. The tricarboxylic acid (TCA) cycle is essential to oxidize these nutrients. However, few studies have addressed the role of citrate synthase (CS), a rate‐limiting enzyme of the TCA cycle, during the infection process of rust fungi. In this study, a CS gene fromPuccinia striiformisf. sp.tritici(Pst),PsCS1, was cloned and characterized. Transcripts ofPsCS1and the enzyme activity of the CS were increased in the earlyPstinfection stage. Biochemical features and subcellular localization revealed thatPsCS1encoded a mitochondrial CS. Size exclusion chromatography, yeast two‐hybrid and bimolecular fluorescence complementation experiments confirmed that PsCS1 could form a functional homo‐octamer. The overexpression ofPsCS1enhanced the resistance ofEscherichia colito salt stress. The knockdown ofPsCS1using a host‐induced gene silencing (HIGS) system blockedPstgrowth in wheat. These results indicate that PsCS1 is required for nutrient metabolism inPstand contributes toPstinfection by regulating ATP production and the supply of carbon sources.
Mobilising evidence in public policy: The contribution of the evidence provider
Authors: Thornthwaite Louise , O'Neill Sharron
Published: October 2018

This article contributes to the conceptualisation of evidence‐based policy through providing a framework of the key factors that influence research utilisation, including those that shape the quality of evidence provided. We apply this framework to an analysis of public policy to regulate the remuneration of freight truck drivers to improve workplace safety in their industry. Recent policymaking concerning the regulation of truck drivers’ remuneration in Australia provides an opportunity to examine the quality and utilisation of research evidence by external evidence providers in opposing political contexts. This article suggests the need for informed and vigilant scrutiny of the contributions of evidence providers to government policymaking, particularly in the case of wicked policy problems about which there are sustained ideological differences that underpin problematisation, research interpretation, and conceivable policy solutions.
The patient‐centered dental home: A standardized definition for quality assessment, improvement, and integration
Authors: Damiano Peter , Reynolds Julie , Herndon Jill Boylston , McKernan Susan , Kuthy Raymond
Published: October 2018

Objective

To develop the first standardized definition of the patient‐centered dental home (PCDH).

Data Sources/Study Setting

Primary data from a 55‐member national expert panel and public comments.

Study Design

We used a modified Delphi process with three rounds of surveys to collect panelists’ ratings of PCDH characteristics and open‐ended comments. The process was supplemented with a 1‐month public comment period.

Data Collection/Extraction Methods

We calculated median ratings, analyzed consensus using the interpercentile range adjusted for symmetry, and qualitatively evaluated comments.

Principal Findings

Forty‐nine experts (89%) completed three rounds and identified eight essential PCDH characteristics, resulting in the following definition: “The patient‐centered dental home is a model of care that is accessible, comprehensive, continuous, coordinated, patient‐ and family‐centered, and focused on quality and safety as an integrated part of a health home for people throughout the life span.”

Conclusions

This PCDH definition provides the foundation for developing measures for research, care improvement, and accreditation and is aligned with the patient‐centered medical home. Consensus among a broad national expert panel—including provider, payer, and accreditation stakeholder organizations and experts in medicine, dentistry, and quality measurement—supports the definition's usability and its potential to facilitate medical‐dental primary care integration.
Partisanship and Popular Politics in a Cornish ‘Pocket’ Borough, 1660–1714†
Authors: Harris James
Published: October 2018

Historians have rarely considered the political views of electorates in small constituencies with strong proprietorial interests, or ‘pocket’ boroughs. However, through a detailed case study of the Cornish borough of Mitchell, this article reveals a rural settlement with a multifaceted and divided community, which experienced a high degree of partisan conflict during the later Stuart period as its inhabitants engaged in an ongoing struggle over the nature of the franchise. A group of often‐disenfranchised inhabitants launched a sustained and independent assault on the lord of the borough's limited franchise, in favour of an inhabitant‐based vote; they were opposed by a group which oscillated between loyalty to the borough's patron and attempts to secure its own influence. Party allegiances and political ideologies can occasionally be identified on both sides, but the franchise dispute did not always align with these divisions. The article argues that while partisan conflict occurred in ‘pocket’ boroughs, it took extraordinary circumstances for this to boil over and facilitate change – in Mitchell's case, these circumstances were the frequent elections to the Exclusion Parliaments, and the patron's self‐imposed exile in France. Yet even once a popular inhabitant‐based vote was established, the widened electorate still found it difficult to determine the outcome of elections, as the borough's patron and local gentry families soon reasserted their authority. Therefore, while the electorates of boroughs such as Mitchell were not supine or monolithic, their ability to actively participate in the electoral process was ultimately fragile.
Inhibition of miR‐24 suppresses malignancy of human non‐small cell lung cancer cells by targeting WWOX in vitro and in vivo
Authors: Wang Xue‐hai , Gan Chong‐zhi , Xie Jia‐yong
Published: October 2018

Background

We investigated the effect of micro‐RNA 24 (miR‐24) and WWOX on non‐small cell lung cancer (NSCLC) cell proliferation and migration in vitro and in vivo.

Methods

We performed bioinformatics analysis and 3′ untranslated region luciferase assay to investigate the direct target of miR‐24. Proliferation, apoptosis, and transwell invasion assays were employed to evaluate the effect of WWOX overexpression with pcDNA3‐WWOX and knocking down miR‐24 with miR‐24 small interfering RNA. Quantitative real‐time PCR, Western blot, and immunohistochemistry were also used to investigate miR‐24 and c‐Kit expression, and apoptosis and invasion‐related proteins. Finally, we constructed a tumor xenograft model in nude mice to confirm the effect of miR‐24 on NSCLC cell proliferation in vivo.

Results

According to our experimental data, miR‐24 inhibition could induce apoptosis by activating caspase 3 and suppress the viability and proliferation of NSCLC cells in vitro and in vivo. MiR‐24 downregulation could reduce the invasive ability of NSCLC cells by downregulating MMP9. WWOX was identified as a functional target of miR‐24. WWOX overexpression generated the same effect with antagonizing miR‐24, while blocking WWOX counteracted the tumor suppressive effect caused by miR‐24 inhibition. MiR‐24 may function as an oncogene and play an important role in the cell growth and migration of NSCLC.

Conclusions

Our findings enhance understanding of the miR‐24 regulatory network and the molecular mechanism that underlies the oncogenesis and development of NSCLC. Suppressing the effect of miR‐24 on cancer cells using a miR‐24 inhibitor may be an attractive therapeutic strategy against NSCLC.
Cannabidiol affects circadian clock core complex and its regulation in microglia cells
Authors: Lafaye Geneviève , Desterke Christophe , Marulaz Laurent , Benyamina Amine
Published: October 2018

Cannabis is often used by consumers for sleep disorders. Studies show that circadian rhythm could be affected by a misuse of cannabis. Recent research has connected the role of microglial cells with psychiatric disorders such as substance abuse. The aim was to show the effect of two major components of cannabis on circadian genes regulation in microglial cells. In BV‐2 microglial cells, cannabidiol (CBD) induces a deregulation of circadian genes with (P‐value = 0.039) or without (P‐value = 0.0015) lipopolisaccharides stimulation. CBD up regulated Arntl (P = 9.72E‐5) and down regulated Clock (P = 0.0034) in BV‐2 cells. Temporal expression of Arntl (light and dark P = 0.0054) and Clock (light and dark P = 0.047) was confirmed to have 24 hours light and dark rhythmic regulation in dissected suprachiasmatic nucleus as well as of Cb1 cannabinoid receptor (light and dark P = 0.019). In BV‐2 microglia cells, CBD also up regulated CRY2 (P = 0.0473) and PER1 (P = 0.0131). Other nuclear molecules show a deregulation of circadian rhythm in microglial cells by CBD, such as RORA, RevErbα, RORB, CREBBP, AFT4, AFT5 and NFIL3. Our study suggests that circadian rhythm in microglial cells is deregulated by CBD but not by THC. It is consistent with clinical observations of the use of therapeutic cannabis to treat insomnia.
HPA axis stress reactivity and hair cortisol concentrations in recently detoxified alcoholics and healthy controls with and without childhood maltreatment
Authors: Muehlhan Markus , Höcker Anja , Miller Robert , Trautmann Sebastian , Wiedemann Klaus , Lotzin Annett , Barnow Sven , Schäfer Ingo
Published: October 2018

Childhood maltreatment (CM) is a strong risk factor for alcohol dependence (AD) and is associated with a more severe course of the disease. Alterations of the hypothalamic‐pituitary‐adrenal (HPA) axis may play an important role in this relationship. The aim of the present study was to systematically investigate potential alterations in HPA functioning associated with AD diagnosis and CM. Four study groups were recruited: AD patients with (n = 29; 10♀) and without (n = 33; 8♀) CM and healthy controls with (n = 30; 20♀) and without (n = 38; 15♀) CM. Cumulative cortisol secretion was measured by hair cortisol concentration (HCC). To measure HPA axis response to the Trier social stress test (TSST), saliva and blood samples were analysed for adrenocorticotropic hormone (ACTH) and cortisol. In the AD groups, the period of hair growth covered acute alcohol consumption and withdrawal. The TSST was scheduled after completion of withdrawal. Irrespective of CM, higher HCCs and reduced ACTH and cortisol levels before and after TSST were observed in AD patients. The analyses did not reveal any differences between AD patients with and without CM. Healthy controls with CM had lower plasma cortisol levels compared with those without CM. The results suggest that AD is strongly related to HPA axis functioning, which may superimpose possible differences between AD patients with and without CM. Future studies should investigate whether biologically different subtypes of AD with and without CM can be identified in earlier stages or before the development of AD.
Gender‐ and cholesterol‐specific predictive value of body mass index in renal cell carcinoma: A multicenter study
Authors: Jeong Hyun Cheol , Bashraheel Fahad K. , Byun Seok‐Soo , Kwak Cheol , Hwang Eu Chang , Kang Seok Ho , Chung Jinsoo , Kim Tae‐Hwan , Kim Yong‐June , Hong Sung‐Hoo
Published: October 2018

Aim

Recently, there have been some reports on preoperative body mass index (BMI) and total cholesterol (TC) as a prognostic predictor for patients with renal cell carcinoma (RCC) but the topic is controversial and still poorly understood. So we analyzed the effects of BMI and TC on the prognosis of RCC.

Methods

Retrospective data from 1988 to 2015 were collected from eight centers with a total of 7,271 patients surgically treated for nonmetastatic RCC. Receiver operating characteristic curve analysis was analyzed and the highest Youden index was shown at 163.5 mg/dL. According to the Asian BMI criteria, patients were divided into normal BMI < 25 kg/m2 and high BMI ≥ 25 kg/m2. Kaplan‐Meier analysis, multivariate Cox regression model were performed to identify the overall survival (OS) and the recurrence‐free survival (RFS).

Results

Normal BMI and low TC group was associated with the shortest OS and RFS as compared to the other groups significantly. In the male patients, the results showed similar to the whole sample. But in the female, BMI had no effect on both OS and RFS. On multivariate Cox regression analysis, low TC was an independent predictor for OS in both genders. However, normal BMI was a significant prognostic factor in the males only.

Conclusion

Preoperative BMI and TC are good predictive factors for both OS and RFS significantly in RCC patients. Also, TC was an independent predictor for OS in all RCC patients; however, BMI was a significant predictor in males only.
Monitoring excess unplanned return to theatre following colorectal cancer surgery
Authors: Rasmussen Michael , Platell Cameron , Jones Mark
Published: October 2018

Background

To develop a risk‐adjustment model for unplanned return to theatre (URTT) outcomes following colorectal surgeries in Australia and New Zealand hospitals and apply top‐down and bottom‐up statistical process control methods for fair comparison of hospitals and surgeons’ URTT rates.

Methods

We analysed URTT outcomes from hospitals contributing data to the Bi‐National Colorectal Cancer Audit clinical registry between 2007 and 2016. Preoperative and intraoperative covariates were considered for risk adjustment. A risk‐adjusted rate funnel plot was prepared for between‐hospital comparisons and identification of outlying hospitals with unusually high rates of URTT. Cumulative observed‐minus‐expected charts with cumulative sum signals were then presented for surgeons within an outlying hospital.

Results

The study included 15 134 patients and 166 surgeons across 70 hospitals. The weighted average URTT rate was 5.2%. The risk‐adjustment model identified 12 preoperative and intraoperative variables that significantly raise the risk of URTT: male sex, American Society of Anesthesiologists score, emergency admissions, conversion entry, left hemicolectomy, total colectomy, proctocolectomy, lower anterior resection, ultra‐low anterior resection, abdominoperineal resection, organ resection and excess lymph nodes harvested. Right hemicolectomy significantly reduced risk of URTT. URTT rates were not found to significantly vary across seniority of operator; however, comparisons were limited by lack of data on junior operators. The funnel plot identified five hospitals as ‘possible outliers’ and hospital T was identified as a ‘definite outlier’. The cumulative observed‐minus‐expected charts with cumulative sum signals showed that within hospital T, one surgeon among three had a particularly bad run of URTTs.

Conclusion

Feedback from aggregated URTT outcomes using a risk‐adjusted rate funnel plot is enhanced when follow‐up examination of outlying hospitals is conducted with concurrent application of cumulative observed‐minus‐expected charts with cumulative sum signals.
Predicting post‐operative pancreatic fistulae using preoperative pancreatic imaging: a systematic review
Authors: Barreto Savio G. , Dirkzwager Ilse , Windsor John A. , Pandanaboyana Sanjay
Published: October 2018

Background

Post‐operative pancreatic fistulae (POPF) remain a major contributor to morbidity and mortality following pancreatic resection. Evidence for preoperative prediction of POPF based on cross‐sectional imaging has not been systemically reviewed. This review aimed to determine whether preoperative imaging modalities can accurately predict the development of POPF.

Methods

A systematic review of major reference databases was undertaken, according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines, up to May 2018.

Results

There were 18 studies (2150 patients), seven used magnetic resonance imaging (MRI), five used computed tomography (CT) scans, four used transabdominal ultrasonography and one study each used MRI and CT and endoscopic ultrasonography elastography. All were retrospective, single‐centre studies. Intensity of the pancreas signal relative to the spleen, liver or muscle was commonly used. Other studies compared signal intensity between unenhanced and post‐contrast‐enhanced pancreas, apparent diffusion coefficient values comparing normal parenchyma to fibrosis, perfusion fraction (f) of intravoxel incoherent motion diffusion‐weighted imaging, or utilized a muscle‐normalized signal intensity curve with signal intensity ratio or directly assessed pancreatic volume and duct width. Shear wave velocity measurement on transabdominal ultrasonography may reflect pancreas tissue fibrosis or stiffness and predict POPF. Most parameters used to predict the development of POPF were based on identifying imaging features of a fatty or fibrotic pancreas and main pancreatic duct diameter.

Conclusion

A number of different and highly promising parameters have been used for preoperative prediction of POPF using ultrasound, MRI, CT or both. Large multicentre prospective studies are needed to determine which parameters most accurately predict POPF, using standardized definitions and methodology.
Update on pharmacologically‐relevant vitamin D analogues
Authors: Jones Glenville , Kaufmann Martin
Published: October 2018

Pharmacologists have been interested in vitamin D since its metabolism was elucidated in the early 1970s. Despite the synthesis of thousands of vitamin D analogues in the hope of separating its calcemic and anti‐proliferative properties, few molecules have reached the market for use in the treatment of clinical conditions from psoriasis to chronic kidney disease. This review discusses vitamin D drugs, recently developed or still under development, for use in various diseases, but in particular bone disease. In the process we explore the mechanisms postulated to explain the action of these vitamin D analogues including action through the vitamin D receptor, action through other receptors e.g. FAM57B2 and dual action on transcriptional processes.
Age at diagnosis and the surgical management of small renal carcinomas: findings from a cross‐sectional population‐based study
Authors: White Victoria M. , Marco David J.T. , Bolton Damien , Papa Nathan , Neale Rachel E. , Coory Michael , Davis Ian D. , Wood Simon , Giles Graham G. , Jordan Susan J.
Published: October 2018

Objectives

To describe the use of partial nephrectomy (PN) for patients with stage T1a renal cell carcinoma (RCC) by age group (<65 and ≥65 years) in two Australian states.

Materials and Methods

All adults diagnosed with RCC in 2012 and 2013 were identified through population‐based cancer registries in the Australian states of Queensland and Victoria. For each patient, research assistants extracted patient, tumour and treatment data from medical records. Percentages of patients treated by PN were determined for the two age groups. Multivariable logistic regression analyses examined factors associated with PN. Clinicians treating RCC were sent surveys to assess attitudes towards PN.

Results

Data were collected on 956 patients (Victoria: n = 548; Queensland: n = 404) with stage T1a RCC. Of those undergoing surgery (n = 865), PN was more common for those aged <65 years (61%) than for those aged ≥65 years (44%), with this difference significant after adjusting for patient, tumour (odds ratio 0.50, 95% confidence interval 0.36–0.70). There were significant interactions between age and treatment centre volume (P < 0.05) and residential state (P < 0.05). PN was less likely for younger patients treated at lower‐volume hospitals (<24 patients a year) but hospital volume was not associated with PN for older patients. PN was less likely for older patients in Queensland than Victoria. In multivariable analyses, age was not related to laparoscopic surgery. Queensland clinicians were less likely than those from Victoria to agree that PN was the treatment of choice for most T1aN0M0 tumours (P < 0.001).

Conclusions

In Australia, patients aged > 65 years with small renal cancers were less likely to be treated by PN than younger patients. The variation in the surgical procedure used to treat older T1a RCC patients by state and hospital volume indicates that better evidence is needed to direct practice in this area.
Devitalization of adjacent teeth following maxillary sinus floor augmentation: A retrospective radiographic study
Authors: Beck Florian , Lauterbrunner Nina , Lettner Stefan , Stavropoulos Andreas , Ulm Christian , Bertl Kristina
Published: October 2018

Background

Elevation of the schneiderian membrane, during maxillary sinus floor augmentation (MSFA) may theoretically result in devitalization of adjacent teeth, which are in a close spatial relationship to the sinus floor.

Purpose

To assess retrospectively the probability of devitalization of teeth adjacent to the osteotomy site after MSFA in a relatively large number of patients.

Materials and Methods

All MSFA procedures, performed at a university oral surgery clinic within a time period of 10 years, were assessed on the following eligibility criteria: (1) presence of vital teeth (ie, not root canal treated and no periapical radiolucency on a panoramic radiograph taken just after MSFA), (2) presence of a 3 to 12 months postoperative radiograph of the teeth adjacent to the osteotomy site displaying the root apices, and (3) complete medical records up to at least 12 months postoperatively. The radiographs of the different time points were compared and any changes in the radiographic status of the adjacent teeth (eg, development of a periapical lesion, root canal treatment, etc.) were recorded and the spatial relationship of the adjacent teeth to the maxillary sinus classified.

Results

Out of 684 MSFAs, 257 fulfilled the inclusion criteria and involved 357 adjacent teeth, of which 221 presented close to and/or intimate relationship to the sinus. In only a single case, tooth vitality might have been lost due to the procedure. Thus, the probability for tooth devitalization for teeth with close to and/or intimate spatial relationship to the sinus floor ranged from 0.45% to 0.7%.

Conclusions

Even for teeth with apices very close to and/or intimately related to the sinus tooth devitalization after MSFA is an extremely rare complication; that is, the probability of tooth devitalization after MSFA is ≤0.7%.
Clinical outcomes of implants placed in ridge‐preserved versus nonpreserved sites: A 4‐year randomized clinical trial
Authors: Marconcini Simone , Giammarinaro Enrica , Derchi Giacomo , Alfonsi Fortunato , Covani Ugo , Barone Antonio
Published: October 2018

Background

Consistent bone changes occur after tooth removal, often compromising the success of implants placed within the socket left to natural healing The long‐term effect of ridge preservation on implant outcomes is still unclear.

Purpose

The aim of the study was to assess success and survival rates of implants placed in extraction sockets, with spontaneous healing, or grafted with cortical porcine bone, or collagenated corticocancellous porcine bone.

Materials and methods

Ninety patients in need for a single premolar/molar tooth extraction and an implant treatment were selected for the present study. Patients were randomly distributed among 3 groups: sites that healed naturally (ctrl), or sites that received ridge preservation with either cortical (cort) or collagenated corticocancellous porcine bone (coll). Three months after, all the experimental sites were reentered to insert implants. Marginal bone levels were recorded; soft tissues were analyzed and summarized with the Pink Esthetic Score (PES). Forty‐two patients out of 90 (initial cohort study) completed the entire follow‐up of 4 years.

Results

Cumulative survival and success rates for all implants were 100% at a 4‐year evaluation. Mean marginal bone loss (MBL) was 1.14 ± 0.23 mm in the cort group, 1.13 ± 0.29 mm in the coll group, and 1.92 ± 0.07 mm in the ctrl group. There were no significant differences between the 2 grafting materials but MBL was significantly greater in the nongrafted sites (P value < .001). The PES resulted significantly better (9.42 ± 0.75) for the cort group than for the coll group (8.53 ± 1.18) and ctrl group (6.07 ± 1.89) at 4‐year evaluation.

Conclusions

Ridge preservation was more effective than natural healing in preserving marginal bone and in achieving better esthetic outcomes around implants 4 years after placement. The cortical porcine bone showed better clinical outcomes than collagenated corticocancellous porcine bone.
Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses. A systematic review and meta‐analysis
Authors: Apaza Alccayhuaman Karol Alí , Soto‐Peñaloza David , Nakajima Yasushi , Papageorgiou Spyridon N. , Botticelli Daniele , Lang Niklaus P.
Published: October 2018

Objectives

To evaluate the implant failure, marginal bone loss (MBL), and other biological or technical complications of restorations supported by tilted and straight implants after at least 3 years in function.

Methods

Electronic and manual searches were performed in MEDLINE, Embase, Web of Science, and OpenGrey to identify clinical studies published up to December 2017. After duplicate study selection and data extraction, the risk of bias was assessed with the ROBINS‐I tool. Random‐effects meta‐analyses of relative risks (RRs) or mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by subgroup/sensitivity analyses and application of the GRADE approach.

Results

A total of 17 nonrandomized studies (eight prospective/nine retrospective) were included. The number of implants of the overall systematic review was 7,568 implants placed in 1,849 patients supporting either full‐arch or partial implant prostheses. No difference in the failure of tilted and straight implants was seen (eight studies; 4,436 implants; RR = 0.95; 95% CI = 0.70 to 1.28; p = 0.74), with the quality of evidence being very low due to bias and imprecision. Likewise, no difference in MBL was seen between tilted and straight implants (16 studies; 5,293 implants; MD = 0.03 mm; 95% CI = −0.03 to 0.10 mm; p = 0.32), with the quality of evidence being very low due to bias and inconsistency. Contradictory results regarding implant survival were found from prospective and retrospective studies, which could indicate bias from the latter.

Conclusions

Within the limitations of the present systematic review, no effect of implant inclination on implant survival or peri‐implant bone loss was found.
Reconstructive aspects: Summary and consensus statements of group 3. The 5th EAO Consensus Conference 2018
Authors: Sailer Irena , Mühlemann Sven , Kohal Ralf J. , Spies Benedikt C. , Pjetursson Bjarni E. , Lang Niklaus P. , Gotfredsen Klaus L. , Ellingsen Jan E. , Francisco Helena , Özcan Mutlu , Hassan Bassam , Esteve‐Pardo Guillem , Bardaji Javier A. , Kraus Riccardo D. , Wennerberg Ann
Published: October 2018

Objectives

The tasks of this working group were to evaluate the existing evidence on the efficiency and efficacy of the digital and conventional workflows for the fabrication of fixed implant reconstructions, to assess the performance of all‐ceramic fixed implant reconstructions and, finally, to evaluate the outcomes of internally and externally connected implant abutments and reconstructions.

Methods

Four reviews were available analyzing the current literature on the respective topics. One review dealt with the efficiency and efficacy of digital and conventional fabrication workflows. Two reviews analyzed the outcomes of all‐ceramic fixed implant reconstructions, one focusing on single‐implant reconstructions and the other evaluating multiple‐unit implant fixed dental prostheses (FDPs). The fourth review evaluated the clinical outcome on external, respectively, internal implant‐abutment connections. These reviews were the basis for the discussions within the group and at the plenary sessions.

Results

The present consensus report gives the consensus statements, the clinical recommendations, and the implications for future research as discussed and approved by the plenum of the consensus conference. The four manuscripts by Mühlemann et al., Rabel et al., Pieralli et al., and Pjetursson et al. are published as part of the journal supplement of the present EAO consensus conference.
A systematic review of the influence of the implant‐abutment connection on the clinical outcomes of ceramic and metal implant abutments supporting fixed implant reconstructions
Authors: Pjetursson Bjarni Elvar , Zarauz Cristina , Strasding Malin , Sailer Irena , Zwahlen Marcel , Zembic Anja
Published: October 2018

Objectives

The objective of this systematic review was to assess the influence of implant‐abutment connection and abutment material on the outcome of implant‐supported single crowns (SCs) and fixed dental prostheses (FDPs).

Methods

An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective and retrospective studies with a mean follow‐up time of at least 3 years. Patients had to have been examined clinically at the follow‐up visit. Failure and complication rates were analyzed using robust Poisson regression, and comparisons were made with multivariable Poisson regression models.

Results

The search provided 1511 titles and 177 abstracts. Full‐text analysis was performed for 147 articles resulting in 60 studies meeting the inclusion criteria. Meta‐analysis of these studies indicated an estimated 5‐year survival rate of 97.6% for SCs and 97.0% for FDPs supported by implants with internal implant‐abutment connection and 95.7% for SCs and 95.8% for FDPs supported by implants with external connection. The 5‐year abutment failure rate ranged from 0.7% to 2.8% for different connections with no differences between the types of connections. The total number of complications was similar between the two connections, yet, at external connections, abutment or occlusal screw loosening was more predominant. Ceramic abutments, both internally and externally connected, demonstrated a significantly higher incidence of abutment fractures compared with metal abutments.

Conclusion

For implant‐supported SCs, both metal and ceramic abutments with internal and external connections exhibited high survival rates. Moreover, implant‐supported FDPs with metal abutments with internal and external connections for also showed high survival rates.
Non‐motor difficulties in children with idiopathic clubfoot: can this impact brace adherence?
Authors: Chu Alice
Published: October 2018

This commentary is on the original article by Lööf et al. on pages 98–104 of this issue.
Impact of social deprivation, demographics and centre on HbA1c outcomes with continuous subcutaneous insulin infusion
Authors: Paisley A. N. , Beynon J. , Fullwood C. , Hindle A. , Alam T. , Urwin A. , Chapman A. , Morris J. , Thabit H. , Rutter M. K. , Leelarathna L.
Published: October 2018

Aims

To assess the impact of social deprivation, demographics and centre on HbA1c outcomes with continuous subcutaneous insulin infusion (CSII) in adults with Type 1 diabetes.

Methods

Demographic data, postcode‐derived English Index of Multiple Deprivation data and 12‐month average HbA1c (mmol/mol) pre‐ and post‐CSII were collated from three diabetes centres in the north west of England, University Hospital of South Manchester (UHSM), Salford Royal Foundation Hospital (SRFT) and Manchester Royal Infirmary (MRI). Univariable and multivariable regression models explored relationships between demographics, Index of Multiple Deprivation, centre and HbA1c outcomes.

Results

Data were available for 693 (78%) individuals (UHSM, n = 90; SRFT, n = 112; and MRI, n = 491) of whom 59% were women. Median age at CSII start was 39 (IQR 29.5–49.0) years and median diabetes duration was 20 (11–29) years. Median Index of Multiple Deprivation was 15 193 (6313–25 727). Overall median HbA1c improved from 69 to 64 mmol/mol (8.5% to 8.0%) within the first year of CSII. In multivariable analysis, higher pre‐CSII HbA1c was significantly associated with higher deprivation (P = 0.036), being female (P < 0.001), and centre (MRI; P = 0.005). Following pre‐CSII HbA1c adjustment, post‐CSII HbA1c or HbA1c change were not related to demographic factors and deprivation, but remained significantly related to the centre; UHSM and SRFT had larger reductions in HbA1c with CSII compared with MRI [median −7.0 (−0.6%) vs. −6.0 (−0.55%) vs. −4.5 (−0.45%) mmol/mol; P = 0.005].

Conclusions

Higher pre‐CSII HbA1c levels were associated with higher deprivation and being female. CSII improves HbA1c irrespective of social deprivation and demographics. Significant differences in HbA1c improvements were observed between centres. Further work is warranted to explain these differences and minimize variation in clinical outcomes with CSII.
Impact of maternal income on the risk of gestational diabetes mellitus in primiparous women
Authors: Rönö K. , Masalin S. , Kautiainen H. , Gissler M. , Raina M. , Eriksson J. G. , Laine M. K.
Published: October 2018

Aims

Findings concerning the impact of socio‐economic status on the risk of gestational diabetes mellitus (GDM) are inconclusive and little is known about the simultaneous impact of income and educational attainment on the risk of GDM. This study aims to assess the impact of maternal prepregnancy income in combination with traditional GDM risk factors on the incidence of GDM in primiparous women.

Methods

This is an observational cohort study including 5962 Finnish women aged ≥ 20 years from the city of Vantaa, Finland, who delivered for the first time between 2009 and 2015, excluding women with pre‐existing diabetes mellitus. The Finnish Medical Birth Register, Finnish Tax Administration, Statistics Finland, Social Insurance Institution of Finland and patient healthcare records provided data for the study. We divided the study population according to five maternal income levels and four educational attainment levels.

Results

Incidence of GDM decreased with increasing income level in primiparous women (P < 0.001 for linearity, adjusted for smoking, age, BMI and cohabiting status). In an adjusted two‐way model, the relationship was significant for both income (P = 0.007) and education (P = 0.039), but there was no interaction between income and education (P = 0.52).

Conclusions

There was an inverse relationship between both maternal prepregnancy taxable income and educational attainment, and the risk of GDM in primiparous Finnish women.
Treatment with incretins does not increase the risk of pancreatic diseases compared to older anti‐hyperglycaemic drugs, when added to metformin: real world evidence in people with Type 2 diabetes
Authors: Montvida O. , Green J. B. , Atherton J. , Paul S. K.
Published: October 2018

Aims

In people with metformin‐treated diabetes, to evaluate the risk of acute pancreatitis, pancreatic cancer and other diseases of the pancreas post second‐line anti‐hyperglycaemic agent initiation.

Methods

People with Type 2 diabetes diagnosed after 2004 who received metformin plus a dipeptidyl peptidase‐4 inhibitor (DPP‐4i, n = 50 095), glucagon‐like peptide‐1 receptor agonist (GLP‐1RA, n = 12 654), sulfonylurea (n = 110 747), thiazolidinedione (n = 17 597) or insulin (n = 34 805) for at least 3 months were identified in the US Centricity Electronic Medical Records. Time to developing acute pancreatitis, other diseases of the pancreas and pancreatic cancer was estimated, balancing and adjusting anti‐hyperglycaemic drug groups for appropriate confounders.

Results

In the DPP‐4i group, the adjusted mean time to acute pancreatitis was 2.63 [95% confidence intervals (CI) 2.38, 2.88] years; time to pancreatic cancer was 2.70 (2.19, 3.21) years; and time to other diseases of the pancreas was 2.73 (2.33, 3.12) years. Compared with DPP‐4i, the insulin group developed acute pancreatitis 0.48 years (P < 0.01) earlier and the GLP‐1RA group developed pancreatic cancer 3 years later (P < 0.01). However, with the constraint of no event within 6 months of insulin initiation, the risk of acute pancreatitis in the insulin group was insignificant. No other significant differences were observed between groups.

Conclusions

No significant differences in the risk of developing pancreatic diseases in those treated with various anti‐hyperglycaemic drug classes were found.
Small‐scale observation on the effects of burrowing activities of ants on soil hydraulic processes
Authors: Li T. C. , Shao M. A. , Jia Y. H. , Jia X. X. , Huang L. M. , Gan M.
Published: October 2018

Ants alter soil structure when making their nests and the fresh soil aggregates brought to the surface become available for erosion. However, the effects of burrowing activities of ants on soil hydrological processes are unclear. In this study, the effects of Tetramorium caespitum, Messor aciculatus and Camponotus japonicus nests on the preferential flow and soil surface hydrologic processes at a small scale were assessed on the Loess Plateau. Soil dyeing and rainfall simulation experiments were conducted to quantify the effects of ants' nests on runoff and water infiltration on slopes. The diameters of nest entrances for T. caespitum, M. aciculatus and C. japonicus were 0.19, 0.33 and 0.56 cm, respectively. The nests of M. aciculatus and C. japonicus promoted water infiltration, resulted in large soil water contents and decreased surface runoff. The turret‐like mounds around the nest entrances made by T. caespitum prevented the formation of soil preferential flow. The depths of dyeing in the soil with M. aciculatus and C. japonicus nests were 32.6 and 49.2 cm, respectively, which were significantly (P < 0.05) deeper than those in the soil with T. caespitum nests (10.0 cm) and no nest (10.3 cm). The unstable soil aggregates made by ants on the soil surface break down easily and encourage the loss of soil sediment. The results show that increasing the ant colonies, especially those with larger bodies, could be considered a strategy to increase water infiltration and soil water content in semiarid areas. In the meantime, the sediment loss cannot be neglected.

Highlights

This study evaluated the effects of hypogeal ants on soil erosion.

The turret‐like mounds of T. caespitum prevent the formation of preferential flow.

Ants with larger bodies made bigger nest entrances and resulted in more infiltration.

The burrowing activities of ants exacerbate soil erosion.
The earliest Welsh genealogies: textual layering and the phenomenon of ‘pedigree growth’
Authors: Guy Ben
Published: October 2018

This article examines the ways in which early medieval genealogical texts might be augmented over time in order to reflect changing political situations. Two early ninth‐century tracts from the kingdoms of Powys and Dyfed in Wales are taken as case studies. Textual and chronological problems with the tracts are discussed, and contexts are proposed for the circumstances of their composition. It is suggested that each of these tracts stands at the head of a process of ‘pedigree growth’, whereby, during the course of textual transmission, the genealogical content of each tract was extended both backwards and forwards in time.
Disease progression in blepharospasm: a 5‐year longitudinal study
Authors: Ferrazzano G. , Conte A. , Gigante A. , Defazio G. , Berardelli A. , Fabbrini G.
Published: October 2018

Background and purpose

The clinical manifestation of dystonic spasms in blepharospasm (BSP) patients may be heterogeneous. Whether the varying phenomenology of eyelid spasms becomes manifest sequentially during the course of the disease or aggregates in separate clusters according to different disease courses is still unclear. For this purpose, the clinical features in BSP patients were evaluated longitudinally over a 5‐year period and also the blink reflex recovery cycle was tested in a subgroup of BSP patients.

Methods

Sixty BSP patients were videotaped at time 0 and after approximately 5 years of follow‐up. Two experts in movement disorders, who were blinded to the video order, reviewed the videotapes and scored the severity of BSP using the Blepharospasm Severity Rating Scale. Changes in the R2 recovery index were also evaluated in 18 patients twice, i.e. upon enrolment and at the follow‐up.

Results

The severity of BSP worsened significantly over the 5‐year follow‐up period owing to the appearance or the increased duration and frequency of prolonged spasms. It was also found that the blink reflex recovery cycle worsened at follow‐up in comparison with the baseline.

Conclusions

This study shows that the disease progression of BSP is characterized by the appearance or worsening of prolonged spasms. Prolonged spasms are accompanied by changes in the excitability of brainstem interneurons. Aging‐related effects may exacerbate the pathophysiological mechanisms underlying spasms.