bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of contact allergy to metals in the European general population with a focus on nickel and piercings: The EDEN Fragrance Study
Authors: Schuttelaar Marie L. A. , Ofenloch Robert F. , Bruze Magnus , Cazzaniga Simone , Elsner Peter , Gonçalo Margarida , Naldi Luigi , Svensson Åke , Diepgen Thomas L.
Published: April 2018

Background

Studies on sensitization to metals in the general population are scarce.

Objectives

To determine the prevalence of sensitization to metals in the general population, and factors associated with nickel sensitization.

Methods

In 5 European countries (The Netherlands, Germany, Italy, Portugal and Sweden), a random sample (N = 3119) from the general population (aged 18‐74 years) was patch tested and interviewed by use of a questionnaire on exposure to metals, piercing, and jewellery.

Results

Overall, the age‐standardized prevalences of sensitization to nickel, cobalt and chromium were, respectively, 14.5%, 2.1%, and 0.8%. The highest prevalence of nickel sensitization was seen in Portugal (18.5%) and the lowest (8.3%) in Sweden. The prevalence of cobalt sensitization varied between 3.8% (The Netherlands) and 0.9% (Italy), and the prevalence of chromium sensitization varied between 1.3% (Portugal) and 0.2% (Sweden). Significant associations were observed between nickel allergy and female sex (odds ratio [OR] 5.19; 95% confidence interval [95%CI]: 3.99‐6.74), past piercing use (OR 3.86; 95%CI: 2.85‐5.24), and currently having ≥3 piercings (OR 5.58; 95%CI: 4.02‐7.76).

Conclusions

The prevalence of sensitization to metals in the European general population was high, mostly because of nickel. The lowest prevalence of contact allergy to nickel and chromium observed in Sweden supports the effectiveness of long‐standing regulation.
Potential of Krebs von den Lungen‐6 as a predictor of relapse in interstitial pneumonia with anti‐aminoacyl tRNA synthetase antibodies‐positive dermatomyositis
Authors: Isoda Kentaro , Kotani Takuya , Takeuchi Tohru , Konma Junichi , Ishida Takaaki , Hata Kenichiro , Otani Kenichiro , Fujiwara Hiroshi , Shoda Takeshi , Makino Shigeki , Arawaka Shigeki
Published: April 2018

Objective

To identify a predictor of relapse in interstitial pneumonia (IP) in patients with anti‐aminoacyl tRNA synthetase antibodies‐positive dermatomyositis (ARS‐DMIP).

Methods

This retrospective cohort study comprised 27 ARS‐DMIP patients. We compared clinical and laboratory findings between the relapse and non‐relapse groups during 2 years after treatment initiation to find predictors of relapse in IP. Candidate predictors were further assessed by analysing the relationship with the relapse of IP.

Results

One patient with ARS‐DMIP died. About 7 (26.9%) of the remaining 26 patients with ARS‐DMIP had a relapse of IP. We found that the levels of serum Krebs von den Lungen‐6 (KL‐6) in the relapse group were significantly higher than those in the non‐relapse group at the time points before treatment (P = .046) and after treatments, including 6 (P = .004), 12 (P = .013), 18 (P = .003) and 24 months (P < .001). The KL‐6 values that maximised the area under the ROC curve were 2347 U/mL before treatment, 622 U/mL after 6 months and 468 U/mL after 12 months. The relapse rates after 104 weeks were significantly higher in patients with KL‐6 levels ≥2400 U/mL before treatment (P = .014), ≥600 ng/mL after 6 months (P < .005) and ≥470 U/mL after 12 months (P = .010).

Conclusion

These findings suggest that the levels of KL‐6 before and after treatment in ARS‐DMIP may represent the disease activity of IP, and they may be useful as the predictor of relapse in IP in patients with ARS‐DMIP.
Osteosarcoma mimic in the breast: A recurrent malignant phyllodes tumour harbouring MED12 and hTERT mutations
Authors: Tokoyoda M. , Adachi S. , Ishida Y. , Yamazaki K.
Published: April 2018

Malignant phyllodes tumours are composed of a mixture of benign epithelial and malignant stromal components, of which the latter may show heterologous sarcomatous features. If cytological smears have little or no epithelial component, the preoperative cytodiagnosis of phyllodes tumour can be difficult. However, in the present case, mutational analysis of the cytological specimen revealed somatic mutations involving MED12 and hTERT genes, indicating that the tumour was a phyllodes tumour.
Genetics of gallstone disease
Authors: Rebholz Charlotte , Krawczyk Marcin , Lammert Frank
Published: April 2018

Background

Gallstone disease (GD) belongs to the most frequent disorders in gastroenterology and causes high costs in our health‐care systems. Gallstones are uncommon in children but frequent in adults, in particular in women, and are triggered by exogenous risk factors. Here, we summarize the current knowledge concerning the contribution of inherited predisposition to gallstone risk.

Design

In this review, we present the current data and recent research on the genetics of gallstone disease.

Results

Several GD‐predisposing gene variants have been reported, with most prominent effects being conferred by a common variant (p.D19H) of the hepatic and intestinal cholesterol transporter ABCG5/G8. A smaller group of patients might develop gallstones primarily due low phosphatidylcholine concentrations in bile as a result of loss‐of‐function mutations of the ABCB4 transporter (low phospholipid‐associated cholelithiasis syndrome). Regardless of the origin, the risk factors for gallstones lead to the supersaturation of bile with insoluble compounds, in particular cholesterol. As result, cholesterol stones develop and present the most frequent type of gallstones. Laparoscopic cholecystectomy with low morbidity and mortality is currently the most common and effective method for the therapy of symptomatic gallbladder stones.

Conclusions

Gallstone disease represents a multifactorial condition and previous studies have identified the major genetic contributors to gallstone formation. The increasing knowledge about the pathomechanisms of hepatobiliary metabolism and GD as well as the identification of additional risk factors might help to overcome the current invasive therapy by specific lifestyle intervention and precise molecular treatment.
Psychosocial impact, perceived stress and learning effect in undergraduate dental students during transition from pre‐clinical to clinical education
Authors: Frese C. , Wolff D. , Saure D. , Staehle H. J. , Schulte A.
Published: April 2018

Introduction

This study aimed to develop a suitable instrument for a comprehensive quantitative and qualitative assessment of perceived psychosocial impact, levels of stress and learning effect in undergraduate dental students during the transition from pre‐clinical to clinical education. These findings might improve curricular structures and didactic organisation during this period.

Materials and methods

At the beginning of their first clinical year, undergraduate dental students were asked to complete an anonymous forty‐item questionnaire. Two hundred and seventy‐six undergraduate dental students were willing to participate and completed the questionnaire and participated during the years 2011‐2016.

Results

The response rate was between 45% and 96%. Correlational analysis (Spearman‐Rho) in the field of psychosocial impact showed the dental teacher to be the most important multiplier of students' feelings. If the students feel that their teacher acts cooperatively, positive items increase and negative items decrease significantly (P < .0001). Also, students who report high levels of stress are affected significantly in their psychosocial interaction (P < .0001). Wilcoxon test yielded highest levels of stress in endodontology during the first weeks (P < .0001). During the same period, the greatest learning increment was seen for diagnostics and caries excavation.

Conclusion

In conclusion, teaching of undergraduate dental students during the transition period from pre‐clinical to clinical education can be positively influenced by a supportive learning environment and by specific chronological modifications in the curriculum. Students should start their clinical training with diagnostics, preventive dentistry and initial periodontal treatment. Due to high levels of perceived stress, endodontology should be introduced later in the clinical curriculum.
Postictal suppression and seizure durations: A patient‐specific, long‐term iEEG analysis
Authors: Payne Daniel E. , Karoly Philippa J. , Freestone Dean R. , Boston Ray , D'Souza Wendyl , Nurse Ewan , Kuhlmann Levin , Cook Mark J. , Grayden David B.
Published: April 2018

Objective

We report on patient‐specific durations of postictal periods in long‐term intracranial electroencephalography (iEEG) recordings. The objective was to investigate the relationship between seizure duration and postictal suppression duration.

Methods

Long‐term recording iEEG from 9 patients (>50 seizures recorded) were analyzed. In total, 2310 seizures were recorded during a total of 13.8 years of recording. Postictal suppression duration was calculated as the duration after seizure termination until total signal energy returned to background levels. The relationship between seizure duration and postictal suppression duration was quantified using the correlation coefficient (r). The effects of populations of seizures within patients, on correlations, were also considered. Populations of seizures within patients were distinguished by seizure duration thresholds and k‐means clustering along the dimensions of seizure duration and postictal suppression duration. The effects of bursts of seizures were also considered by defining populations based on interseizure interval (ISI).

Results

Seizure duration accounted for 40% of postictal suppression duration variance, aggregated across all patients and seizures. Seizure duration accounted for more than 25% of the variance in postictal suppression duration in 2 patients and accounted for less than 25% in the remaining 7. In 3 patients, heat maps showed multiple distinct postictal patterns indicating multiple populations of seizures. When accounting for these populations, seizure duration accounted for less than 25% of the variance in postictal duration in all populations. Variance in postictal suppression duration accounted for less than 10% of ISI variance in all patients.

Significance

We have previously demonstrated that some patients have multiple seizure populations distinguishable by seizure duration. This article shows that different seizure populations have distinct and consistent postictal behaviors. The existence of multiple populations in some patients has implications for seizure management and forecasting, whereas the distinct postictal behaviors may have implications for sudden unexpected death in epilepsy (SUDEP) prediction and prevention.
Nearly 200 years of sustained selection have not overcome the leaf area–stem size relationship in the poinsettia
Authors: Trejo Laura , Rosell Julieta A. , Olson Mark E.
Published: April 2018

Organismal parts often covary in their proportions, a phenomenon known as allometry. One way of exploring the causes of widespread allometric patterns is with artificial selection, to test whether or not it is possible to move populations into “empty” allometric space not occupied by the wild type. Domesticated organisms have been subject to many generations of selection, making them ideal model systems. We used the domesticated Christmas poinsettiaEuphorbia pulcherrimain combination with wild populations to examine the origin of the proportionality between leaf area and stem size, which scales predictably across nearly all plants. In accordance with the stated aims of breeders to produce more compact plants, we predicted that domesticated poinsettias would have greater leaf area for a given stem volume than the tall, lanky wild ancestors. Our data rejected this prediction, showing instead that domesticates have leaf area–stem volume relationships identical to the wild ancestors. Presumably the metabolic dependence between stems and leaves makes the leaf area–stem volume relationship difficult to overcome. The relative fixity of this relationship leads to predictable covariation in other traits: The fuller outlines of domestic poinsettias involve significantly shorter internodes, and given a constant leaf area–stem volume relationship, smaller individual leaf areas. At the same time, domestic poinsettias are subject to selection favoring breakage resistance, which is achieved via thicker stems for a given length rather than stiffer stem tissue resistance to bending. Our results show that domesticated poinsettias differ from wild plants in a suite of traits including leaf size, internode distances, and stem length–diameter relations, but despite over 200 years of selection favoring rounded outlines, there has been no change in the total leaf area–stem volume relationship, helping to predict which changes are likely achievable and which will not be under continued artificial selection and in the wild.
Habitat disruption and the identification and management of functional trait changes
Authors: Kelley Jennifer L , Grierson Pauline F , Collin Shaun P , Davies Peter M
Published: April 2018

Aquatic ecosystems are facing escalating threats from urbanization, habitat loss and projected impacts of climate change, which both individually and in combination have the potential to fundamentally alter ecosystem functioning. While it is well established that habitat disturbances can affect the composition and diversity of aquatic communities, only recently have studies considered whether such impacts result in changes in species’ functional traits. We consider how functional traits of freshwater and marine fishes respond to environmental change, and how shifts in the expression of these traits can impact community dynamics and key ecological processes, including trophic interactions and nutrient transfer. We find that a multitude of functional traits, including behavioural and sensory traits, is sensitive to habitat disturbances. We demonstrate how these trait changes can be used to reveal hidden “ecological diversity” as well as serving as early indicators of environmental perturbation. We conclude that management strategies that consider the fundamental biological responses of fishes to habitat disturbance will be particularly effective in determining causal relationships within the ecological network. While detailed information on trait function is often lacking, even some general understanding of trait function and importance will facilitate targeted and efficient ecosystem management. We urge fisheries biologists and aquatic ecosystem managers to consider the role of functional traits in facilitating effective habitat restoration and management.
Considering Destructive Interparental Conflict and Intimate Partner Abuse: Is there a Difference?
Authors: Kopystynska Olena , Beck Connie J.
Published: April 2018

Building on existing evidence that destructive interparental conflict and intimate partner abuse (IPA) share research methodology and predict the same adjustment difficulties across numerous areas of child development, this article brings awareness to differences in terminology across disciplines and the impact these nuanced differences may have on families. We begin by identifying two main streams of scholarships followed by a discussion of research methodology similarities and differences. Important implications of differences in naming conventions for practitioners, legal and academic scholars, and victims are then discussed. Finally, we encourage professionals from both scholarships to consider referencing the other's terminology and using comprehensive assessments to better promote the well‐being of families.
Do Business Borrowers Benefit from Bank Bailouts?: The Effects of TARP on Loan Contract Terms
Authors: Berger Allen N. , Makaew Tanakorn , Roman Raluca A.
Published: April 2018

We investigate benefits to business borrowers from bank bailouts, specifically the Troubled Asset Relief Program (TARP). Applying difference‐in‐difference methodology to loan‐level data, we find more favorable borrower contract terms in five dimensions, spread, amount, maturity, collateral, and covenants, suggesting increased credit supply at the intensive margin by bailed‐out banks. Findings are robust to dealing with endogeneity and other issues. Riskier borrowers benefit more, consistent with moral hazard exploitation. Small and unlisted borrowers benefit less, suggesting fewer benefits for financially constrained firms. Benefits accrue to both relationship and nonrelationship borrowers. Results contribute to the research and policy debates on bank bailouts.
Repetitive and compulsive‐like behaviors lead to cognitive dysfunction in Disc1Δ2‐3/Δ2‐3 mice
Authors: Wulaer B. , Nagai T. , Sobue A. , Itoh N. , Kuroda K. , Kaibuchi K. , Nabeshima T. , Yamada K.
Published: April 2018

Disrupted‐in‐schizophrenia 1 (Disc1) is a key molecular driver for the biology of mental diseases. In order to investigate its role in brain function, we previously generated mice lacking exons 2 and 3 of Disc1 on a C57BL/6J genetic background (Disc1Δ2‐3/Δ2‐3 mice), which have a deficiency of the full‐length Disc1 protein. In the present study, we examined the role of Disc1 in cognitive function using a touchscreen‐based visual discrimination (VD) task in which mice had to discriminate 1 of 2 stimuli simultaneously displayed on the screen and received a liquid reward. Disc1Δ2‐3/Δ2‐3 mice showed impaired performance in the VD task, and this was mainly attributed to the perseverative response being significantly stronger than that in wild‐type (WT) mice. Furthermore, the numbers of marbles buried in the marble burying test and nestlets shredded in the nestlet shredding test by Disc1Δ2‐3/Δ2‐3 mice were significantly higher than those by WT mice, suggesting perseverative/compulsive behaviors by Disc1Δ2‐3/Δ2‐3 mice. A treatment with clozapine ameliorated behavioral deficits in the VD and marble burying tasks. c‐Fos expression was significantly stronger in the dorsomedial striatum (DMS), but not the dorsolateral striatum (DLS) after the first VD session in Disc1Δ2‐3/Δ2‐3 mice than in WT mice. The treatment of mice that had previously expressed hM3Dq in the DMS with clozapine‐N‐oxide (CNO) impaired performance in the VD task. These results suggest that cognitive impairments accompanied by perseverative/compulsive behaviors in Disc1Δ2‐3/Δ2‐3 mice are associated with hyperactivity of the DMS.
Disturbance from traditional fire management in subalpine heathlands increases Afro‐alpine plant resilience to climate change
Authors: Johansson Maria U. , Frisk Carl A. , Nemomissa Sileshi , Hylander Kristoffer
Published: April 2018

Species are often controlled by biotic factors such as competition at the warm edge of their distribution range. Disturbances at the treeline, disrupting competitive dominance, may thus enable alpine species to utilize lower altitudes. We searched for evidence for range expansion in grazed, fire‐managed Ethiopian subalpine Erica heathlands across a 25‐year chronosequence. We examined vascular plant composition in 48 plots (5 × 5 m) across an altitudinal range of 3,465–3,711 m.a.s.l. and analyzed how community composition changed in relation to increasing competition over time (using a Shade index based on Erica shrub height and cover) and altitude. Species‘ habitats and altitudinal ranges were derived from literature. Time since fire explained more variation (r2 = .41) in species composition than altitude did (r2 = .32) in an NMDS analysis. Community‐weighted altitudinal optima for species in a plot decreased strongly with increasing shade (GLM, Standardized Regression Coefficient SRC = −.41, p = .003), but increased only weakly with altitude (SRC = .26, p = .054). In other words, young stands were dominated by species with higher altitudinal optima than old stands. Forest species richness increased with Log Shade index (SRC = .12, p = .008), but was unaffected by altitude (SRC = −.07, p = .13). However, richness of alpine and heathland species was not highest in plots with lowest Shade index, but displayed a unimodal pattern with an initial increase, followed by a decrease when shading increased (altitude was not significant). Our results indicate that disturbance from the traditional patch burning increases the available habitat for less competitive high‐altitude plants and prevents tree line ascent. Therefore, maintaining, but regulating, the traditional land use increases the Afro‐alpine flora's resilience to global warming. However, this system is threatened by a new REDD+ program attempting to increase carbon storage via fire suppression. This study highlights the importance of understanding traditional management regimes for biodiversity conservation in cultural landscapes in an era of global change.
Forage types and origin of manure in codigestion affect methane yield and microbial community structure
Authors: Ahlberg‐Eliasson K. , Liu T. , Nadeau E. , Schnürer A.
Published: April 2018

In farm‐scale biogas systems, different kinds of manure are the most important substrate for anaerobic digestion, but result in low biogas yields. Biogas production can be increased by complementing the manure with forage crops, in codigestion. The aim of this study was to evaluate grass‐clover (GCS) and whole‐crop barley silages (WCB) in codigestion with manure from organic and conventional dairy production systems on biogas production, microbial community, degree of degradation and gas quality at different organic loading rates by addition of soya bean meal and wheat grain, which are rich in protein and starch. Four continuous stirred anaerobic laboratory‐scale reactors were used, and the codigestion resulted in additive effects on biogas production, but no synergistic effects. The highest biogas yield was obtained in reactors receiving WCB independently of manure types, for both experiments (7,416 ml/day and 10,978 ml/day respectively). The degradation efficiency, measured as the reduction in volatile solids was, on average, six percentage units higher in the reactors receiving manure from conventional compared with organic dairy cows, probably because of a higher concentration of undigested fibre and proteins in conventional cow manure. Microbiological analysis by illumina sequencing illustrated low impact of both manure types on the reactor community and only small differences between the reactors receiving GCS and WCB. However, addition of soya bean meal and wheat grain changed the community in all reactors. The ratio between Firmicutes and Bacteroidetes was comparably higher in reactors having the highest gas production and methane yield.
Does Shale Energy Development Mean More Crime? The Case of the Bakken Oil Boom
Authors: Lim Siew Hoon
Published: April 2018

The rise and fall of shale oil production in recent years have led to tremendous economic growth and challenges to shale communities in the U.S. In this study, we attempt to address the inconsistent results in previous studies and shed light on the relationship between rural crimes and shale oil development at the Bakken using county‐level data for Montana and North Dakota from 2000 through 2014. Our results indicated statistically significant evidence of increased aggravated assaults, burglaries, larcenies, and motor vehicle thefts in shale‐oil producing counties during the boom. However, the regression results suggest that the rise in certain violent crime, such as murder, rape, and robbery, is not statistically attributable to the shale oil boom or oil activity, but to increased population in the two states. The crime effect of the boom also grew larger especially after 2008. The results point to some evidence of social disruption in rural communities undergoing rapid shale oil development. More importantly, the Bakken's crime experience also suggests a number of critical needs for shale energy regions nationwide.
When the gods are angry: volcanic crisis and eruption at Bali's great volcano
Authors: Gertisser R. , Deegan F.M. , Troll V.R. , Preece K.
Published: April 2018

In November 2017, Bali's ‘great volcano’, Gunung Agung, erupted for the first time since 1963—leading to the evacuation of nearly 150 000 people from a preliminary danger zone within a radius of 9–12 km from the summit. Since the phreatic onset of the eruption on 21 November, intermittent magmatic (Vulcanian) explosions continued to threaten local residents and disrupt air traffic to and from Indonesia's favourite tourist destination. Whereas the opening of the eruption seems to have been less energetic than the opening of the 1963 events, as of January 2018, the volcanic Alert Level for Agung remains at the highest level. Indeed, it remains unclear at this point what course the eruption will take and how long it will last, and the possibility remains that the eruption may turn more energetic in the months to come.
Doing gender in the ‘new office’
Authors: Hirst Alison , Schwabenland Christina
Published: April 2018

This paper investigates how gender is performed in the context of an office setting designed to promote intensive, fluid networking. We draw on an ethnographically oriented study of the move of staff into a new office building constructed primarily from glass, and incorporating open plan offices, diverse collective areas and walking routes. Although the designers aimed to invoke changes in the behaviour of all staff, they conceptualized these changes in masculine terms. We therefore analyse the gender norms materialized by the workspaces of the ‘new office’ and how women responded to these. We suggest that the new office encourages an image of the ideal worker which brings together ways of acting and interacting that have been characterized as both masculine and feminine — active movement and spontaneous encounters, but also intensive face‐to‐face interaction and deep relationship‐building. Women are driven into this mode of working in an uncompromising, almost aggressive way, but a straightforward gender‐based dynamic does not emerge in their responses, with conventional gender characteristics being reshuffled and recombined.
Defining extended half‐life rFVIII—A critical review of the evidence
Authors: Mahlangu J. , Young G. , Hermans C. , Blanchette V. , Berntorp E. , Santagostino E.
Published: April 2018

Introduction

Recent haemophilia treatment advances include new recombinant FVIII (rFVIII) products with improved pharmacokinetic (PK) properties that aim to reduce the burden of prophylaxis. These treatments are commonly referred to as extended half‐life rFVIII products (EHL rFVIII). There is no uniform definition of what constitutes an EHL rFVIII. Such a definition would help physicians, patients and funders understand the properties of standard and EHL rFVIIIs and thus provide clarity when selecting an EHL in clinical settings.

Aim

To critically assess the published evidence on new and emerging rFVIII products in order to propose a definition to classify EHL rFVIIIs.

Methods

We systematically searched PubMed, EMBASE and regulatory authorities (FDA/EMA/Health Canada) websites for publications and regulatory submissions describing prospective crossover PK studies evaluating rFVIIIs that demonstrate improved PK parameters in adults and adolescents with severe haemophilia A.

Results

Following critical analyses of the published data, we developed a holistic approach to defining rFVIIIs as EHLs, which requires all of the following: (i) using technology designed to extend rFVIII half‐life; (ii) lacking bioequivalence with a standard rFVIII comparator—above the FDA/EMA cut‐off of 125% for the 90% confidence intervals for area under the curve ratio; and (iii) having an extended half‐life ratio measured in a PK comparator crossover study.

Conclusion

In this systematic review, a pragmatic definition of EHL rFVIII has been proposed that should provide better clarity in clinical discussions surrounding the appropriate use of rFVIII products. At present, only products using PEGylation or Fc fusion half‐life extension technology meet the proposed criteria for definition of EHL rFVIII.
Teaching & Learning Tips 7: small‐group discussion
Authors: Lemoine Elizabeth R. , Rana Jasmine , Burgin Susan
Published: April 2018

Challenge: The success of a small‐group discussion depends in large part on the effectiveness of the facilitator or small‐group tutor. How can a facilitator successfully manage diverse views and knowledge bases of participants while also contributing as a member of the group? Herein, we provide tips for managing small‐group discussions that can be applied widely in dermatology didactics.
Therapeutic prospects of targeting myeloid‐derived suppressor cells and immune checkpoints in cancer
Authors: Toor Salman M , Elkord Eyad
Published: April 2018

Immune evasion is a characteristic of most human malignancies and is induced via various mechanisms. Immunosuppressive cells, including myeloid‐derived suppressor cells (MDSC) and regulatory T cells (Treg), are key mediators in assisting tumors to escape immune surveillance. Expansion of MDSC, Treg and elevated levels of immune checkpoints (IC) are frequently detected in the tumor microenvironment and periphery of cancer patients. Various therapeutic agents have been shown to target MDSC and to block IC for inducing anti‐tumor immunity and reversal of tumor immune escape. Importantly, some recent studies have shown that MDSC targeting improves the efficacy of IC blockade in cancer therapy. However, there is a pressing need to improve our understanding of the distinct role of these cells to develop combination therapy that attacks tumor cells from all frontiers to improve cancer therapeutics. Herein, we discuss the role of MDSC in cancer progression, interactions with IC in the context of anti‐cancer immunity and the current therapeutic strategies to target MDSC and block IC in cancer.
Anaesthetic efficacy of articaine versus lidocaine in children's dentistry: a systematic review and meta‐analysis
Authors: Tong Huei Jinn , Alzahrani Fatma Salem , Sim Yu Fan , Tahmassebi Jinous F. , Duggal Monty
Published: April 2018

Background

Over the last few years, numerous reviews and studies have awarded articaine hydrochloride local anaesthetic (LA) a superior reputation, with outcomes of different studies demonstrating a general tendency for articaine hydrochloride to outperform lidocaine hydrochloride for dental treatment. Nevertheless, there seems to be no clear agreement on which LA solution is more efficacious in dental treatment for children. There is no previous publication systematically reviewing and summarising the current best evidence with respect to the success rates of LA solutions in children.

Aims

To evaluate the available evidence on the efficacy of lidocaine and articaine, used in paediatric dentistry.

Design

A systematic search was conducted on Cochrane CENTRAL Register of Controlled Trials, MEDLINE (OVID; 1950 to June 2017), Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCOhost; 1982 to June 2017), EMBASE (OVID; 1980 to June 2017), SCI‐EXPANDED (ISI Web of Knowledge; 1900 to June 2017), key journals, and previous review bibliographies through June 2017. Original research studies that compared articaine with lidocaine for dental treatment in children were included. Methodological quality assessment and assessment of risk of bias were carried out for each of the included studies.

Results

Electronic searching identified 525 publications. Following the primary and secondary assessment process, six randomised controlled trials (RCT) were included in the final analysis. There was no difference between patient self‐reported pain between articaine and lidocaine during treatment procedures (SMD = 0.06, P‐value = 0.614), and no difference in the occurrence of adverse events between articaine and lidocaine injections following treatment in paediatric patients (RR = 1.10, P‐value = 0.863). Yet, patients reported significantly less pain post‐procedure following articaine injections (SMD = 0.37, P‐value = 0.013). Substantial heterogeneity was noted in the reporting of outcomes among studies, with the overall quality of majority of studies being at high risk of bias.

Conclusions

There is low quality evidence suggesting that both articaine as infiltration and lidocaine IAD nerve blocks presented the same efficacy when used for routine dental treatments, with no difference between patient self‐reported pain between articaine and lidocaine during treatment procedures. Yet, significantly less pain post‐procedure was reported following articaine injections. There was no difference in the occurrence of adverse events between articaine and lidocaine injections following treatment in paediatric patients.
Poverty alleviation through government‐led e‐commerce development in rural China: An activity theory perspective
Authors: Li Liang , Du Kui , Zhang Wei , Mao Ji‐Ye
Published: April 2018

This paper uses activity theoretic analyses to investigate the role of governments in developing rural e‐commerce ecosystems and the effects of such ecosystems on poverty alleviation. On the basis of a case study of Longnan, one of the poorest regions in China, this paper reports and analyses the various actions taken by local governments in nurturing, supporting, and regulating the development of a local rural e‐commerce ecosystem and using this ecosystem to transform poverty alleviation. Our study articulates a model of poverty alleviation through e‐commerce. By documenting and theorizing the mechanisms underlying rural e‐commerce development and poverty alleviation through e‐commerce as well as governments' role in developing and sustaining them, this paper contributes to establishing a “theory of the solution” to the grand challenge of poverty alleviation both in China and globally.
Catheter ablation of atrial fibrillation in heart failure with reduced ejection fraction
Authors: Malhi Nav , Hawkins Nathaniel M. , Andrade Jason G. , Krahn Andrew D. , Deyell Marc W.
Published: April 2018

Atrial fibrillation and heart failure are increasing in prevalence, and frequently coexist. Despite the desire to restore sinus rhythm in heart failure patients, large studies comparing rate control to pharmacologic rhythm control have failed to show superiority of either approach. This may in part be due to the inefficacy and higher risk of adverse effects with antiarrhythmic drugs in HF patients. As such, catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction has been increasingly explored as a treatment modality. We review the contemporary evidence regarding patient selection, efficacy, safety, and impact of catheter ablation on outcomes in patients with atrial fibrillation and heart failure with reduced ejection fraction.
Reply to: pyoderma gangrenosum: a clinical conundrum
Authors: Gupta A.S. , Greiling T.M. , Ortega‐Loayza A.G.
Published: April 2018

Linked article: This article is commented on by A. Abdelmaksoud, pp. e381–e382 in this issue. To view this article visit https://doi.org/10.1111/jdv.14983
Secukinumab treatment in new‐onset psoriasis: aiming to understand the potential for disease modification – rationale and design of the randomized, multicenter STEPIn study
Authors: Iversen L. , Eidsmo L. , Austad J. , de Rie M. , Osmancevic A. , Skov L. , Talme T. , Bachmann I. , van de Kerkhof P. , Stahle M. , Banerjee R. , Oliver J. , Fasth A.E.R. , Frueh J.
Published: April 2018

Background

To date, biological treatments have been assessed in subjects with a long‐term history of psoriasis and previous failures to systemic and topical therapies. In rheumatoid arthritis and other immune‐mediated inflammatory diseases, early intensive systemic treatment prolongs treatment‐free remission. We hypothesize that, by treating patients with psoriasis early with an effective systemic therapy, we may be able to alter the clinical outcome and the natural course of the disease. The STEPIn study (NCT03020199) investigates early intervention with secukinumab versus narrow‐band ultraviolet B (nb‐UVB) phototherapy in subjects with new‐onset psoriasis.

Objective

To determine whether early intervention with either nb‐UVB treatment or secukinumab in subjects with new‐onset plaque psoriasis might modify the natural course of the disease.

Methods

One hundred and sixty subjects aged 18–50 years with new‐onset (≤12 months) moderate‐to‐severe plaque psoriasis and naïve to systemic treatment and phototherapy will be randomized to secukinumab 300 mg or nb‐UVB. The Main Study has two treatment arms: Arm A1, subcutaneous secukinumab 300 mg at baseline, Weeks 1, 2, 3 and 4, and every 4 weeks thereafter until and including Week 52; Arm B1, one/two cycles of nb‐UVB for 12 weeks each (maximum 28‐week break between cycles). After treatment discontinuation, patients will be followed up and monitored for disease activity up to Week 208. A Mechanistic Sub‐study will assess immunological changes and pathogenic tissue‐resident memory T cells in skin biopsies.

Conclusions

STEPIn is the first study to investigate whether early intensive treatment in new‐onset psoriasis can modify the long‐term natural course of the disease and thus become a novel treatment strategy for patients with psoriasis.
Medically unexplained dermatologic symptoms and psychodermatology
Authors: Ferreira B.R. , Pio‐Abreu J.L. , Reis J.P. , Figueiredo A.
Published: April 2018

Linked article: This article is commentary on by D.J. Elpern, p. e449 in this issue. To view this article visit https://doi.org/10.1111/jdv.14981
Dermatoporosis and vitamin C deficiency
Authors: Kluger N.
Published: April 2018

Linked article: This article is commentary on by P. Humbert et al., pp. e383–e384 in this issue. To view this article visit https://doi.org/10.1111/jdv.14980
Accuracy of dermoscopic criteria for the differentiation between superficial basal cell carcinoma and Bowen's disease
Authors: Papageorgiou C. , Apalla Z. , Variaah G. , Matiaki F.C. , Sotiriou E. , Vakirlis E. , Lazaridou E. , Ioannides D. , Lallas A.
Published: April 2018

Background

The dermoscopic features of superficial basal cell carcinoma (sBCC) and Bowen's disease (BD) have been extensively investigated, and dermoscopy was shown to significantly improve their recognition. However, incorrectly diagnosed cases still exist, with a considerable number of sBCCs dermoscopically interpreted as BD. Our aim was to investigate the dermoscopic variability in sBCC and BD on different anatomic sites, to identify potent dermoscopic predictors for each diagnosis and to investigate the potential source of the inaccurate clinico‐dermoscopic diagnosis of some sBCCs.

Methods

Dermoscopic images of histopathologically diagnosed sBCC and BD were evaluated by three independent investigators for the presence of predefined criteria. Subsequently, three independent investigators with expertise in dermoscopy classified the tumours as sBCC or BD based on the dermoscopic image. Diagnostic accuracy scores were calculated and crude and adjusted odds ratios, and 95% confidence intervals were calculated by univariate and conditional multivariate logistic regression, respectively.

Results

A total of 283 lesions were included in the study (194 sBCCs and 89 BD). The main dermoscopic predictors of BD were dotted vessels (7.5‐fold) and glomerular vessels (12.7‐fold). The presence of leaf‐like areas/spoke‐wheel areas/concentric structures (OR = 0.027) and arborizing vessels (OR = 0.065) has predicted sBCC. Multivariate risk factors for sBCC misclassification were the location on lower extremities (OR = 5.5), the presence of dotted vessels (OR = 59.5) and the presence of large ulceration (OR = 6.4). In contrast, the presence of brown‐coloured pigmentation was a protective predictor for misdiagnosis (OR = 0.007). Finally, a subgroup analysis of lesions located on lower extremities revealed two additional potent predictors of sBCC: superficial fine telangiectasia (SFT) and whity shiny blotches/strands.

Conclusions

Dotted and glomerular vessels are strong predictors of BD. When located on the lower extremities, sBCC may also display dotted vessels, rendering its recognition problematic. On the latter anatomic site, clinicians should consider SFT and whity shiny blotches/strands as additional sBCC predictors.
Acne and nutrition: hypotheses, myths and facts
Authors: Claudel J.P. , Auffret N. , Leccia M.T. , Poli F. , Dréno B.
Published: April 2018

Acne is an inflammatory and multifactorial skin disease. Different external and internal factors, including air pollution, aggressive skincare products, medication, mechanical, hormonal and familial factors and, more recently, lifestyle and stress, have been suggested as having an impact on acne. Moreover, for many years nutrition was believed to cause or worsen acne. Over the last decades, however, it has become a dermatological doctrine that there is no direct association between diet and acne. Even if recent research has allowed to identify certain nutritional elements and behaviour that may impact on acne, including the excessive intake of dairy products and hyperglycaemic food, modern lifestyle nutrition, obesity and eating disorders, knowledge about the role of nutrition in the physiopathology of acne still remains sparse and hypotheses and myths continue to dominate the debate. Thus, further clinical and translational research is necessary to investigate and confirm the association between nutrition and acne.
Ultrastructure aspects of Brycon gouldingi (Teleostei, Characidae) related to swimming ability and feeding during larval development
Authors: Faustino F. , Makino L. C. , Neumann E. , Nakaghi L. S. O.
Published: April 2018

The larval ultrastructure of Brycon gouldingi related to swimming and feeding from hatching to total yolk absorption is described from scanning electron micrographs. Newly hatched larvae (time zero) had no mouth opening, undefined optic vesicles, an olfactory plate visible as a shallow depression, rudimentary gill arches, neural groove, embryonic fin and a primary neuromast in the dorsal region of the head. At the time of yolk absorption, 55 h post hatching, the larvae presented an optic vesicle comprising an optic cup and crystalline lens; a mouth with tongue, tapered teeth and taste buds; a ciliated olfactory cavity; branched gill arches; filled neural groove signalling central nervous system development; caudal, pectoral, dorsal and anal fins; and neuromasts distributed throughout the head and body. These characters are related to prey capture and swimming ability, key aspects of survival during the larval stage. The results of this study provide important information for exploitation and aquaculture of B. gouldingi.
Exploratory study on the relationship between smoking and other risk behaviours among young smokers
Authors: Ho Ka Yan , Li Ho Cheung William , Lam Katherine Ka Wai , Chan Sophia Siu Chee , Wang Man Ping , Chan Vivian Wai Fung , Xia Viveka Wei , Lam Tai Hing
Published: April 2018

Aims and objectives

To explore the relationship between smoking and other risk behaviours among Chinese young people in Hong Kong.

Background

There is growing concern about coexisting risk behaviours in young smokers. Information about smoking and other risk behaviours is crucial for developing interventions to promote smoking abstinence and adoption of healthy lifestyles. The relationship between smoking and other risk behaviours among Chinese young people in Hong Kong has not been explored.

Design

This is a mixed‐method retrospective population‐based study.

Methods

A retrospective population‐based study was conducted with 1,147 young smokers through Youth Quitline between November 2011–July 2016. Attitudes, behaviours and experiences related to smoking and risk behaviours among Chinese young smokers were examined in semi‐structured qualitative interviews with 30 participants randomly selected from the retrospective population‐based study.

Results

In total, 45.5% participants reported engaging in at least one other risk behaviour. The interviews revealed that drinking alcohol may have a significant impact on quitting smoking. In addition, smoking may be a gateway for more serious risk behaviours during adolescence. Low health awareness may explain the unhealthy lifestyles among young smokers.

Conclusions

This study bridges a gap in existing literature by exploring relationships between smoking and other risk behaviours among young people in Hong Kong.

Relevance to clinical practice

Given the interrelationships between smoking and other risk behaviours, a holistic approach should be used to promote smoking cessation and healthy lifestyles among young smokers. If young smokers improve their health and quit smoking at the same time, their physical and mental development will benefit as a secondary outcome.
A randomized, blinded, prospective clinical trial of postoperative rehabilitation in dogs after surgical decompression of acute thoracolumbar intervertebral disc herniation
Authors: Zidan Natalia , Sims Cory , Fenn Joe , Williams Kim , Griffith Emily , Early Peter J. , Mariani Chris L. , Munana Karen R. , Guevar Julien , Olby Natasha J.
Published: April 2018

Background

Experimental evidence shows benefit of rehabilitation after spinal cord injury (SCI) but there are limited objective data on the effect of rehabilitation on recovery of dogs after surgery for acute thoracolumbar intervertebral disc herniations (TL‐IVDH).

Objective

Compare the effect of basic and intensive post‐operative rehabilitation programs on recovery of locomotion in dogs with acute TL‐IVDH in a randomized, blinded, prospective clinical trial.

Animals

Thirty non‐ambulatory paraparetic or paraplegic (with pain perception) dogs after decompressive surgery for TL‐IVDH.

Methods

Blinded, prospective clinical trial. Dogs were randomized (1:1) to a basic or intensive 14‐day in‐house rehabilitation protocol. Fourteen‐day open field gait score (OFS) and coordination (regulatory index, RI) were primary outcomes. Secondary measures of gait, post‐operative pain, and weight were compared at 14 and 42 days.

Results

Of 50 dogs assessed, 32 met inclusion criteria and 30 completed the protocol. There were no adverse events associated with rehabilitation. Median time to walking was 7.5 (2 – 37) days. Mean change in OFS by day 14 was 6.13 (confidence intervals: 4.88, 7.39, basic) versus 5.73 (4.94, 6.53, intensive) representing a treatment effect of −0.4 (−1.82, 1.02) which was not significant, P=.57. RI on day 14 was 55.13 (36.88, 73.38, basic) versus 51.65 (30.98, 72.33, intensive), a non‐significant treatment effect of −3.47 (−29.81, 22.87), P = .79. There were no differences in secondary outcomes between groups.

Conclusions

Early postoperative rehabilitation after surgery for TL‐IVDH is safe but doesn't improve rate or level of recovery in dogs with incomplete SCI.