bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral health‐related quality‐of‐life scores differ by socioeconomic status and caries experience
Authors: Chaffee Benjamin W. , Rodrigues Priscila Humbert , Kramer Paulo Floriani , Vítolo Márcia Regina , Feldens Carlos Alberto
Published: January 2017

Objectives

(i) Quantify the relative association between child dental caries experience and maternal‐reported child oral health‐related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience.

Methods

This study was a cross‐sectional analysis of children in southern Brazil (n=456, mean age: 38 months) participating in an existing health centre‐based intervention study. OHRQoL impact was quantified as mean score on the Brazilian Early Childhood Oral Health Impact Scale (ECOHIS) and compared over categories of caries experience (dmft: 0, dmft: 1‐4, dmft: ≥5). Adjusted ECOHIS ratios between caries categories were calculated using regression modelling, overall and within socioeconomic strata defined by maternal education, social class and household income.

Results

Caries prevalence (dmft >0) was 39.7%, mean ECOHIS score was 2.0 (SD: 3.5), and 44.3% of mothers reported OHRQoL impact (ECOHIS score >0). Increasing child caries experience was associated with worsening child and family quality of life: ECOHIS scores were 3.0 times greater (95% CI: 2.0, 4.4) for children with dmft ≥5 vs dmft=0, a pattern that persisted regardless of family socioeconomic status (P for interaction: all >0.3). However, adjusted for dental status and sociodemographic characteristics, mean ECOHIS scores were lower when reported by mothers of less educational attainment (ratio: 0.7; 95% CI: 0.5, 1.0), lower social class (ratio: 0.7; 95% CI: 0.5, 1.0) or in lower income households (ratio: 0.8; 95% CI: 0.6, 1.3).

Conclusion

Dental caries was associated with negative child and family experiences and lower OHRQoL across all social groups; yet, families facing greater disadvantage may report lesser quality‐of‐life impact at the same level of disease experience. Thus, subjective quality‐of‐life measures may differ under varying social contexts, with possible implications for service utilization, evaluating oral health interventions, or quantifying disease morbidity in low‐SES groups.
Role of inferior vena cava filters in transplant patients
Authors: Dowell Joshua D. , Castle Jordan C. , Spinner Jesse , Black Sylvester
Published: January 2017

Purpose

This study evaluates the selection, use, and risks of permanent and retrievable inferior vena cava filters (IVCFs) in patients who have undergone organ transplantation.

Materials and Methods

Single‐center retrospective review of 35 patients who had an IVCF placed following organ transplantation. Patient demographics, IVCF indication, and eligibility for retrieval were reviewed. Computed tomography (CT) studies showing the filter (n=22) were evaluated independently for IVCF adverse effects.

Results

Thirty‐two (91%) of 35 patients had retrievable IVCFs placed while three (9%) patients received permanent IVCFs. Filter retrieval was indicated in three of the 32 patients receiving retrievable filters and was performed in two cases. Patients were ineligible for retrieval due to short life expectancy, complications/contraindications to anticoagulation, extended filter dwell time, lost to follow‐up, and undetermined therapeutic value of anticoagulation.

Conclusion

Current practices of filter placement usually dictate placing a retrievable IVCF in transplant patients. However, transplant patients are unlikely to be eligible for filter retrieval especially in situations of advanced age and comorbidities. Given the low incidence of eligibility for retrieval in this patient population, these results suggest preferential placement of permanent filters may reduce the potential morbidity due to filter‐related complications, such as strut perforation, in transplant patients.
Gain of CD26 expression on the malignant T‐cells in relapsed erythrodermic leukemic mycosis fungoides
Authors: Cedeno‐Laurent Filiberto , Wysocka Maria , Obstfeld Amrom E. , Novoa Roberto A. , Vittorio Carmela C. , Kim Ellen J. , Weng Wen‐Kai , Rook Alain H.
Published: January 2017

Loss of CD26 surface expression on the circulating malignant T‐cell is the most widely accepted diagnostic marker in patients with leukemic cutaneous T‐cell lymphoma (CTCL). CTCL cases with reemergence of CD7 and/or CD26 surface expression are unusual and of uncertain prognosis. We report the case of an erythrodermic leukemic mycosis fungoides patient who had achieved temporary remission after several months on multimodality immunotherapy and extracorporeal photopheresis, but who relapsed with aggressive disease phenotypically characterized by CD4+ T‐cells with high CD26 expression. Polymerase chain reaction studies and high‐throughput sequencing analyses from peripheral blood mononuclear cells at presentation and relapse consistently showed an identical clonal T‐cell receptor suggesting evolution of her original malignant clone which lacked CD26 expression. Interestingly, quantitative expression of the sialomucin, CD164, mirrored her clinical picture, thus favoring its reliability as a novel biomarker in CTCL.
The art of disputation: dialogue, dialectic and debate around 800
Authors: van Renswoude Irene
Published: January 2017

It has often been noted that argumentation in the early Middle Ages was mainly based on written authority, while dialectical modes of reasoning were held in suspicion. Towards the end of the eighth century, however, dialectic was back in vogue at the court of Charlemagne. Logical reasoning played a significant role in theological discussions initiated by the court. This article explores the ‘rules of engagement’ for conducting a debate, and addresses the question of whether public disputation and dialectical enquiry could (again) have a part in the proceedings of councils around 800, after their alleged demise in late antiquity.
Enamel and dental anomalies in latent‐transforming growth factor beta‐binding protein 3 mutant mice
Authors: Morkmued Supawich , Hemmerle Joseph , Mathieu Eric , Laugel‐Haushalter Virginie , Dabovic Branka , Rifkin Daniel B. , Dollé Pascal , Niederreither Karen , Bloch‐Zupan Agnès
Published: January 2017

Latent‐transforming growth factor beta‐binding protein 3 (LTBP‐3) is important for craniofacial morphogenesis and hard tissue mineralization, as it is essential for activation of transforming growth factor‐β (TGF‐β). To investigate the role of LTBP‐3 in tooth formation we performed micro‐computed tomography (micro‐CT), histology, and scanning electron microscopy analyses of adult Ltbp3‐/‐ mice. The Ltbp3‐/‐ mutants presented with unique craniofacial malformations and reductions in enamel formation that began at the matrix formation stage. Organization of maturation‐stage ameloblasts was severely disrupted. The lateral side of the incisor was affected most. Reduced enamel mineralization, modification of the enamel prism pattern, and enamel nodules were observed throughout the incisors, as revealed by scanning electron microscopy. Molar roots had internal irregular bulbous‐like formations. The cementum thickness was reduced, and microscopic dentinal tubules showed minor nanostructural changes. Thus, LTBP‐3 is required for ameloblast differentiation and for the formation of decussating enamel prisms, to prevent enamel nodule formation, and for proper root morphogenesis. Also, and consistent with the role of TGF‐β signaling during mineralization, almost all craniofacial bone components were affected in Ltbp3‐/‐ mice, especially those involving the upper jaw and snout. This mouse model demonstrates phenotypic overlap with Verloes Bourguignon syndrome, also caused by mutation of LTBP3, which is hallmarked by craniofacial anomalies and amelogenesis imperfecta phenotypes.
APPROACHING THE GERMAN ANTHOLOGY, 1700–1850: AN INTRODUCTION
Authors: Ramtke Nora , Williams Seán M.
Published: January 2017

Although the anthology has its roots in the ancient world, it arose in German letters in the eighteenth century. While the nineteenth century can be called – quantitatively and terminologically – the heyday of the anthology, the eighteenth century was the dawn of its diversity. The present special number examines this variety, as represented in particular examples. The first and most obvious problem for our period is terminological. Once we overcome the heterogeneous terms for anthologies, however, we propose a focus on their functions. Central to these is an acknowledgement of an anthology's agenda, which can be applied or aesthetic, cultural‐political or poetological. Consequently, we contend that examining eighteenth‐century anthologies and collections into the mid‐nineteenth century contributes more broadly to an emergent body of scholarship on editorship and its relationship to the topic of authorship at a time when a commercial book market was becoming established, and for which the ‘modern author’ was increasingly plural in its manifestations.

Die Anthologie hat zwar ihre Wurzeln in der Antike, in der deutschsprachigen Literatur gewinnt die Sammelform jedoch erst im 18. Jahrhundert an Aktualität. Während das 19. Jahrhundert zahlenmäßig wie terminologisch als das eigentliche Jahrhundert der Anthologie angesehen werden kann, gilt es hier, das 18. Jahrhundert bis in die Mitte des 19. Jahrhunderts als Formierungsphase der deutschsprachigen Anthologie in den Blick zu nehmen. Das vorliegende Themenheft widmet sich dieser Vielfalt mit einer Reihe von exemplarischen Studien. Die folgende Einleitung stellt die deutschsprachige Anthologie von ca. 1700 bis 1850 als Forschungsgegenstand vor und unternimmt sowohl terminologische wie funktionale Abgrenzungsversuche, um sie im Spannungsverhältnis zu anderen Sammelformen zu thematisieren. Dabei wird dem ästhetischen, kulturellen und poetologischen Potenzial der anthologischen Sammlung Rechnung getragen. Die unternommene Neuperspektivierung der Anthologie des 18. Jahrhunderts bis in das 19. Jahrhundert hinein versteht sich im weiteren Sinne als Beitrag zu einem wachsenden Forschungsinteresse am Thema der Herausgeberschaft, das nicht zu trennen ist von Überlegungen zu Autorschaftskonzepten in einer Zeit, als sich ein literarischer Markt etablierte.
Novel tRNA function in amino acid sensing of yeast Tor complex1
Authors: Kamada Yoshiaki
Published: January 2017

TOR complex1 (TORC1), a master regulator of cell growth, is regulated by amino acids. Amino acids are fundamental nutrients, and 20 species of amino acids building proteins are not interchangeable with each other. Therefore, TORC1 should sense each amino acid individually. Mammalian mTORC1 is controlled by Rag GTPases and their regulators. However, Rag factors are dispensable for amino acid sensing by TORC1 in the budding yeast, suggesting an alternative mechanism of TORC1 regulation. Here, genetic investigation discovered the involvement of (aminoacyl‐)tRNA ((aa‐)tRNA) in TORC1 regulation. Biochemical TORC1 assay also showed that tRNA directly inhibits TORC1 kinase activity. Reducing cellular tRNA molecule desensitizes TORC1 inactivation by nitrogen starvation in vivo. Based on these results, I propose a model of the TORC1 regulatory mechanism in which free tRNA released from protein synthesis under amino acid starvation inhibits TORC1 activity. Therefore, TORC1 uses tRNA‐mediated mechanism and Rag factors in parallel to sense intracellular amino acids.
Trichoscopic clues for diagnosis of alopecia areata and trichotillomania in Asians
Authors: Khunkhet Saranya , Vachiramon Vasanop , Suchonwanit Poonkiat
Published: January 2017

Background

Trichoscopy has become a useful diagnostic tool for various hair and scalp diseases, including alopecia areata (AA) and trichotillomania (TTM), which are sometimes difficult to distinguish clinically.

Objectives

To describe trichoscopic findings of AA and TTM in an Asian population and to establish diagnostic clues for these conditions.

Methods

Trichoscopy was performed with a handheld dermoscope in 52 patients diagnosed with AA and 23 patients diagnosed with TTM. Trichoscopic images were then blindly evaluated.

Results

The trichoscopic features more frequently observed in AA than in TTM included exclamation mark hairs (AA 59.6%, TTM 26.1%), tapered hairs (AA 59.6%, TTM 4.3%), yellow dots (AA 46.2%, TTM 21.7%), and angulated hairs (AA 26.9%, TTM 0%) (P < 0.05). On the other hand, broken hairs of different lengths (TTM 100%, AA 3.8%), trichoptilosis (TTM 78.3%, AA 5.8%), V‐sign (TTM 43.5%, AA 3.8%), flame hairs (TTM 43.5%, AA 0%), and hair powder (TTM 13%, AA 1.9%) were more commonly demonstrated in TTM than in AA (P < 0.05).

Conclusions

Exclamation mark hairs indicate a diagnosis of AA but not pathognomonic. In addition, angulated hairs, fractured hairs forming a sharp angle along the hair shaft, appear to be typical for AA in Asians when differentiating from TTM. It is important to consider various trichoscopic findings together to establish the diagnosis of AA or TTM.
Digital mucous cyst: surgical closure technique based on self‐grafting using skin overlying the lesion
Authors: Di Chiacchio Nilton G. , Fonseca Noriega Leandro , Ocampo‐Garza Jorge , Di Chiacchio Nilton
Published: January 2017

Background

Digital mucous cysts or myxoid cysts are relatively common, benign pseudocysts of the digits typically located at the distal interphalangeal joints or in the proximal nail fold. There are several therapeutic modalities for its treatment ranging from conservative to surgical procedures; however, there is no consensus about the best approach.

Material and methods

We describe a surgical technique based on the excision of the digital mucous cyst and reconstruction using a self‐grafting from the overlying skin lesion.

Results

The use of the cyst's overlying skin as a partial cutaneous graft followed by a long‐term Brown's dressing, in this case, provided a satisfactory functional and esthetic result.

Conclusions

This technique is a new option for the reconstruction of digital mucous cyst defects that decreases the surgical time and avoids a graft removal of healthy skin and consequently a new scar.
Immobilisation of pectinases into PVA gel for fruit juice application
Authors: Cerreti Martina , Markošová Kristína , Esti Marco , Rosenberg Michal , Rebroš Martin
Published: January 2017

In this study, for the first time, the use of polyvinyl alcohol gel in the form of LentiKats® to immobilise pectinase was investigated and its application in fruit juice clarification was evaluated. Six pectolytic enzymes were tested for their polygalacturonase (PG) and pectin lyase (PL) activities. Panzyme YieldMASH and Panzyme Smash XXL exhibited maximum PG and PL activity, respectively (P < 0.05), in free and immobilised forms. The immobilised enzymes revealed a good adaptability to an acidic solution like fruit juice. Moreover, the immobilised Panzyme YieldMASH and Panzyme Smash XXL retained about 60% and 74% residual activity, respectively, in the second cycle and more than 30% during the third cycle. After that, both immobilised enzymes retained about 20% of their initial activity after repeating eight times without a significant decrease in the observed activity. The best result in terms of turbidity reduction was obtained in apple juice with immobilised Panzyme YieldMASH (about 80%), and the same % of turbidity reduction was successfully retained in the two following uses.
Sodium‐potassium niobate nanorods with various crystal structures and their application to nanogenerator
Authors: Xu HaiBo , Lee Tae‐Gon , Park Su‐Jin , Kim Bo‐Yun , Nahm Sahn
Published: January 2017

(Na1−xKx)NbO3 (NKN) nanorods with an orthorhombic (OR) structure, a rhombohedral (RH) structure, or a polymorphic phase (PP) structure, which contains both OR and RH structures, are prepared. The presence of RH and PP NKN nanorods is explained by the existence of OH− defects at the O2− sites of the NKN nanorods. The PP NKN nanorods grown on a Nb5+‐doped SrTiO3 substrate show the largest piezoelectric strain constant of 175 pm/V because they have more directions for dipole rotation than OR and RH NKN nanorods. Piezoelectric nanogenerators (NGs) are synthesized using composites consisting of NKN nanorods with various structures and polydimethylsiloxane. The largest open‐circuit output voltage is 35 V, and the short‐circuit current is 5.0 μA, which are obtained using the NG containing 0.7 g of PP NKN nanorods. Moreover, this NG shows a maximum output power of 16.5 μW for an external load of 10.0 MΩ.
Suppression of phosphor‐glass reactions in YAG:Ce phosphor‐embedded glasses
Authors: Shyu Jiin‐Jyh , Yang Chia‐Wei
Published: January 2017

For high‐power white LED applications, YAG:Ce‐based yellow phosphors were embedded in a low‐Tg Bi2O3–B2O5–ZnO–Sb2O5 glass (BiG) by sintering route. A high‐Tg silicate glass (SiG) was also used for comparison. Dense (porosity<2%) phosphor‐glass composites were obtained after sintered at 800°C (for SiG) and 325°C (for BiG). XRD quantitative analysis indicates that the loss of phosphor content is in the range of 2.5%‐22%, caused by partial dissolution of phosphor particles into the glass matrix during sintering. The element distribution across the interface and within the reaction zone between phosphor and glass was analyzed by TEM/SEM‐EDS. The intrinsic emission characteristic of YAG:Ce is nearly not altered, possibly resulted from the slight modification of the YAG phase during sintering. Thus the final emission intensity of the sintered body is mainly determined by the residual amount of the YAG:Ce phase. Replace the high‐Tg SiG glass by the low‐Tg BiG glass, prenitridize the YAG:Ce phosphor, and change the sintering atmosphere from air to N2 suppress the loss of phosphor during sintering. Therefore, the resulting loss of emission intensity of the phosphor‐embedded glass material can be reduced to only about 1.8%.
Bi2O3 nanoparticles incorporated porous TiO2 films as an effective p‐n junction with enhanced photocatalytic activity
Authors: Wei Na , Cui Hongzhi , Wang Canming , Zhang Guosong , Song Qiang , Sun Wenxia , Song Xiaojie , Sun Mingyuan , Tian Jian
Published: January 2017

Porous TiO2 films decorated with Bi2O3 nanoparticles are fabricated via alkali‐hydrothermal of titanium (Ti) plate by varying the reaction time. The amorphous TiO2 is transformed into anatase after annealing the films at 500°C in air. The p‐type Bi2O3 nanoparticles are successfully assembled on the surface of porous n‐type TiO2 films through the ultrasonic‐assisted successive ionic layer adsorption and reaction (SILAR) technique to form Bi2O3/TiO2 nanostructure by the two cycles. The obtained Bi2O3/TiO2 films are consisted of a well‐ordered and uniform porous structure with an average pore diameter of about 100‐200 nm containing homogeneously dispersed Bi2O3 nanoparticles of ~5 nm diameter. Moreover, the resultant composites present excellent photocatalytic performance toward methyl blue (MB) degradation under UV and visible light irradiation, which could be mainly ascribed to the enhanced light adsorption capacity of unique composite structure and the formation of p‐n heterojunctions in the porous Bi2O3/TiO2 films. This research is helpful to design and construct the highly efficient heterogeneous semiconductor photocatalysts.
Enhanced thermoelectric performance of n‐type Bi2O2Se by Cl‐doping at Se site
Authors: Tan Xing , Lan Jin‐le , Ren Guangkun , Liu Yaochun , Lin Yuan‐Hua , Nan Ce‐Wen
Published: January 2017

The n‐type polycrystalline Bi2O2Se1−xClx (0≤x≤0.04) samples were fabricated through solid‐state reaction followed by spark plasma sintering. The carrier concentration was markedly increased to 1.38×1020 cm−3 by 1.5% Cl doping. The maximum electrical conductivity is 213.0 S/cm for x=0.015 at 823 K, which is much larger than 6.2 S/cm for pristine Bi2O2Se. Furthermore, the considerable enhancement of the electrical conductivity outweighs the moderate reduction of the Seebeck coefficient by Cl doping, thus contributing to a high power factor of 244.40 μ·WK−2·m−1 at 823 K. Coupled with the intrinsically suppressed thermal conductivity originating from the low velocity of sound and Young's modulus, a ZT of 0.23 at 823 K for Bi2O2Se0.985Cl0.015 was achieved, which is almost threefold the value attained in pristine Bi2O2Se. It reveals that Se‐site doping can be an effective strategy for improving the thermoelectric performance of the layered Bi2O2Se bulks.
Is Japan Really a “Buy”? The Corporate Governance, Cash Holdings and Economic Performance of Japanese Companies
Authors: Kato Kazuo , Li Meng , Skinner Douglas J.
Published: January 2017

We investigate whether Japan's much‐touted governance reforms improve its firms’ management of cash, economic performance and valuation. Consistent with an improvement in governance since 2000, Japanese firms hold less cash and increase payouts to shareholders. Improvements in performance are associated with reductions in (excess) cash, reductions in the influence of the banks that traditionally sit at the center of horizontal keiretsu, and increases in the holdings of management and foreign investors. The market valuation of Japanese firms’ cash holdings was lower than for US firms during the 1990s but increased to levels closer to those of US firms in the 2000s. Collectively, the evidence suggests that performance improves in those Japanese companies that reform their governance practices. These findings have implications for other Asian economies, such as China, India and Korea, where there are ongoing discussions of whether improved governance can increase firm performance and valuation.
Selective peroxisome proliferator‐activated receptor‐α modulator K‐877 efficiently activates the peroxisome proliferator‐activated receptor‐α pathway and improves lipid metabolism in mice
Authors: Takei Kenta , Han Song‐iee , Murayama Yuki , Satoh Aoi , Oikawa Fusaka , Ohno Hiroshi , Osaki Yoshinori , Matsuzaka Takashi , Sekiya Motohiro , Iwasaki Hitoshi , Yatoh Shigeru , Yahagi Naoya , Suzuki Hiroaki , Yamada Nobuhiro , Nakagawa Yoshimi , Shimano Hitoshi
Published: January 2017

Aims/Introduction

Peroxisome proliferator‐activated receptor‐α (PPARα) is a therapeutic target for hyperlipidemia. K‐877 is a new selective PPARα modulator (SPPARMα) that activates PPARα transcriptional activity. The aim of the present study was to assess the effects of K‐877 on lipid metabolism in vitro and in vivo compared with those of classical PPARα agonists.

Materials and Methods

To compare the effects of K‐877 on PPARα transcriptional activity with those of the classical PPARα agonists Wy14643 (Wy) and fenofibrate (Feno), the cell‐based PPARα transactivation luciferase assay was carried out. WT and Ppara−/− mice were fed with a moderate‐fat (MF) diet for 6 days, and methionine–choline‐deficient (MCD) diet for 4 weeks containing Feno or K‐877.

Results

In luciferase assays, K‐877 activated PPARα transcriptional activity more efficiently than the classical PPARα agonists Feno and Wy. After being fed MF diet containing 0.001% K‐877 or 0.2% Feno for 6 days, mice in the K‐877 group showed significant increases in the expression of Ppara and its target genes, leading to marked reductions in plasma triglyceride levels compared with those observed in Feno‐treated animals. These K‐877 effects were blunted in Ppara−/− mice, confirming that K‐877 activates PPARα. In further experiments, K‐877 (0.00025%) and Feno (0.1%) equally improved the pathology of MCD diet‐induced non‐alcoholic fatty liver disease, with increased expression of hepatic fatty acid oxidation genes.

Conclusions

The present data show that K‐877 is an attractive PPARα‐modulating drug and can efficiently reduce plasma triglyceride levels, thereby alleviating the dysregulation of lipid metabolism.
Disentangling the effects of long‐term changes in precipitation and land use on hydrological response in a monsoonal catchment
Authors: Adnan N.A. , Atkinson P.M.
Published: January 2017

This research aimed to quantify the effects of precipitation and land use changes on the hydrological response (peak discharge and runoff volume) in the River Kelantan catchment, Malaysia. Two periods were studied, involving the years 1988 (lower hydrological response) and 2004 (greater hydrological response). Rainfall and land use observed for the year 1988 was used in the calibrated and validated model for 1988, but also used in the calibrated 2004 runoff model to simulate the impact of changes in these two factors on runoff generation. For the upstream gauge, differences in peak discharge and runoff volume were affected more by land use change compared to climate‐related changes (i.e. precipitation). However, changes in hydrologic response in the downstream catchment were much more associated with precipitation changes. From these findings, we suggest that both land use and climate changes (i.e. precipitation) contributed to changes in hydrologic response in the Kelantan monsoonal catchment, but that for the downstream catchment, which is more prone to flooding, with associated potential socio‐economic impacts, precipitation change is the major driver. The results have clear implications for planning and management decision‐making.
Treatment with infliximab for pediatric Crohn's disease: Nationwide survey of Japan
Authors: Hosoi Kenji , Ohtsuka Yoshikazu , Fujii Tohru , Kudo Takahiro , Matsunaga Nobuaki , Tomomasa Takeshi , Tajiri Hitoshi , Kunisaki Reiko , Ishige Takashi , Yamada Hiroyuki , Arai Katsuhiro , Yoden Atsushi , Ushijima Kosuke , Aomatsu Tomoki , Nagata Satoru , Uchida Keiichi , Takeuchi Kazuo , Shimizu Toshiaki
Published: January 2017

Background and Aim

Childhood‐onset inflammatory bowel disease (IBD) is characterized by extensive intestinal involvement and rapid early progression. Infliximab (IFX), cyclosporin (CYA), and tacrolimus (FK506) are increasingly used to treat pediatric IBD; however, their long‐term effects and adverse events have not been properly investigated in pediatric patients. The aim of this study was to characterize the effects of these biologics and immunomodulators on pediatric IBD patients in Japan. Additionally, we assessed IFX use in pediatric patients with Crohn's disease (CD).

Methods

A national survey of IFX, adalimumab, CYA, and FK506 use in pediatric IBD patients (< 17 years of age) was sent to 683 facilities in Japan from December 2012 to March 2013. Secondary questionnaires were sent to pediatric and adult practitioners with the aim of assessing the effectiveness and safety of IFX for pediatric CD patients.

Results

The response rate for the primary survey was 61.2% (N  =  418). Among 871 pediatric CD patients, 284 (31.5%), 24, 4, and 15 received IFX (31.5%), adalimumab, CYA, and FK506, respectively, from 2000 to 2012. According to the secondary survey, extensive colitis (L3, Paris classification) was diagnosed in 69.4% of pediatric CD patients who received IFX. Regarding the effectiveness of IFX in this population, 54.7% (99/181) of patients were in remission, and 42.0% (76/181) were on maintenance therapy. However, 32.0% (58/181) of patients experienced adverse events, and one patient died of septic shock.

Conclusions

Infliximab is reasonably safe and effective in pediatric CD patients and should therefore be administered in refractory cases.
Categorizing the Magnitude and Frequency of Exposure to Uncivil Behaviors: A New Approach for More Meaningful Interventions
Authors: Evans Dena
Published: January 2017

Purpose

To examine turnover intentions, as well as the prevalence and frequency of uncivil behaviors, from the perspective of registered nurses, respiratory therapists, and imaging professionals, using a new method to categorize exposure magnitude.

Design and Methods

Data were collected using the 22‐item Negative Acts Questionnaire‐Revised (NAQ‐R). Additional items, informed by Price and Mueller's causal model of turnover, were included, as were select demographic variables. The final sample included 170 healthcare professionals. Descriptive statistics were used to describe the sample, a chi‐square test was constructed to test for significant differences in exposure to uncivil behavior based on demographics, and Cochran‐Mantel‐Haenszel statistics were used to test associations between variables and calculation of raw sum scores to implement a new method of analysis for the NAQ‐R, allowing for categorization of exposure magnitude.

Findings

Exposure to uncivil behavior was reported more often among nursing staff than other healthcare professionals. Lack of exposure to uncivil behavior was a significant predictor of intention to stay. Perceptual differences were found between nurses prepared at the baccalaureate and associate degree levels. Lastly, no significant correlations between exposure to uncivil behavior and selected demographic variables were found, suggesting that exposure is not dependent upon age, race, unit type, or educational level.

Conclusions

Findings support prior research associating negative organizational climate with higher turnover intentions. Uncivil behavior was reported across the organization, most predominantly among units staffed with nurses. Finally, use of newly defined cutoff points for the NAQ‐R provide organizations with the ability to use both subjective and objective data to identify targets of uncivil behaviors to construct meaningful interventions.

Clinical Relevance

There is a need to develop more meaningful interventions to support targets of uncivil behaviors. Use of the NAQ‐R, coupled with the proposed cutoff scores, allows for the identification of targets, the magnitude of exposure, and the construction of meaningful primary, secondary, and tertiary intervention programs that may improve turnover and quality of care.
Clinical Study of the 3D‐Master Color System among the Spanish Population
Authors: Gómez‐Polo Cristina , Gómez‐Polo Miguel , Martínez Vázquez de Parga Juan Antonio , Celemín‐Viñuela Alicia
Published: January 2017

Purpose

To study whether the shades of the 3D‐Master System were grouped and represented in the chromatic space according to the three‐color coordinates of value, chroma, and hue.

Materials and Methods

Maxillary central incisor color was measured on tooth surfaces through the Easyshade Compact spectrophotometer using 1361 participants aged between 16 and 89. The natural (not bleached teeth) color of the middle thirds was registered in the 3D‐Master System nomenclature and in the CIELCh system. Principal component analysis and cluster analysis were applied.

Results

75 colors of the 3D‐Master System were found. The statistical analysis revealed the existence of 5 cluster groups. The centroid, the average of the 75 samples, in relation to lightness (L*) was 74.64, 22.87 for chroma (C*), and 88.85 for hue (h*). All of the clusters, except cluster 3, showed significant statistical differences with the centroid for the three‐color coordinates (p <0.001).

Conclusions

The results of this study indicated that 75 shades in the 3D‐Master System were grouped into 5 clusters following coordinates L*, C*, and h* resulting from the dental spectrophotometer Vita Easyshade compact. The shades that composed each cluster did not belong to the same lightness color dimension groups. There was no special uniform chromatic distribution among the colors of the 3D‐Master System.
Disparities in Supports for Student Wellness Promotion Efforts Among Secondary Schools in Minnesota
Authors: Larson Nicole , O'Connell Michael , Davey Cynthia S. , Caspi Caitlin , Kubik Martha Y. , Nanney Marilyn S.
Published: January 2017

ABSTRACT

BACKGROUND

We examined whether there are differences in the presence of supports for student wellness promotion (1) between schools in city, suburban and rural locations and, (2) among rural schools, according to distance from a metropolitan center.

METHODS

The analysis was conducted in a sample of 309 secondary schools using 2012 Minnesota School Health Profiles surveys and National Center for Educational Statistics Common Core Data. Scores for overall support addressed school health improvement coordination (range: 0‐29), collaboration on health education activities (range: 0‐5), and teachers' professional preparation (range: 0‐7).

RESULTS

Mean overall scores for health improvement coordination (10.5 ± 7.3), collaboration on health education activities (3.0 ± 1.5) and professional preparation (4.0 ± 1.9) indicated supports are lacking in schools across city, suburban, and rural locations. Comparison of overall scores did not identify disparities; however, weaknesses and strengths of particular relevance for rural schools were identified in examining specific aspects of support. For example, the proportion of rural schools having a written school improvement plan was 54.8% compared to 84.6% of city schools and 64.3% of suburban schools (p = .01).

CONCLUSIONS

Tailored training and technical assistance are needed to better support schools in implementing recommended wellness policies and practices.
Evaluation of the Potential of five Housekeeping Genes for Identification of Quarantine Pseudomonas syringae
Authors: Lu Songyu , Tian Qian , Zhao Wenjun , Hu Baishi
Published: January 2017

The Pseudomonas syringae species, containing approximately 60 pathovars, causes bacterial plant diseases on numerous crops and results in great economic losses. It is difficult to rapidly and accurately identify and detect P. syringae due to its complicated classification system. It has also been shown that housekeeping genes have great potential in phylogenetic analysis and classification of bacteria. In this study, phylogenetic analyses of five housekeeping genes, including 16S rRNA, rpoD, gapA, gltA and gyrB, were performed for 100 Pseudomonas strains. Our results showed that two housekeeping genes (rpoD and gapA) had the maximum ability in distinguishing the majority of Pseudomonas pathovars, whereas rpoD exhibited the best for precise and efficient detection of five P. syringae strains, which is of quarantine significance to China.
Grazing moderates increases in C3 grass abundance over seven decades across a soil texture gradient in shortgrass steppe
Authors: Augustine David J. , Derner Justin D. , Milchunas Daniel , Blumenthal Dana , Porensky Lauren M.
Published: January 2017

Questions

How does long‐term exclusion of cattle grazing influence plant community composition in a semi‐arid grassland? Can spatial variation in the effects of cattle grazing exclusion be explained by variation in soil texture?

Location

Shortgrass steppe, northeast Colorado, USA, in the North American Great Plains.

Method

We used 16 long‐term (72 yr) cattle exclosures to examine the effects of grazers on plant communities and evaluate whether grazer effects interact with soil texture.

Results

Although shortgrass steppe communities are relatively unaffected by grazing in the short‐term (one to two decades), exclusion of cattle grazing for seven decades caused a compositional shift from dominance by a C4 shortgrass (Bouteloua gracilis) to co‐dominance by a C3 midgrass (Pascopyrum smithii) and B. gracilis. The strength of this shift was highly variable across sites. Soil texture was correlated with the abundance of certain plant species, but did not explain variation in the magnitude of grazer effects. Grazed communities contained perennial and annual growth forms with a diversity of strategies to co‐exist with grazers and B. gracilis. Ungrazed communities included increased abundance of annual, ruderal forbs and three woody plant species. Grazing effects occurred against a backdrop of changing plant communities: during the past seven decades, C3 perennial graminoids and sub‐shrubs have increased in relative abundance in both grazed and ungrazed communities.

Conclusions

Our long‐term experiment shows that community responses to grazing in this semi‐arid grassland occur very slowly, but are predictable, with C4 shortgrasses eventually giving way to taller C3 grasses and ruderal forbs. Spatial variation in grazing effects across sites (and lack of a relationship with soil texture) may reflect the importance of fine‐scale heterogeneity in C3 grass abundance, and the slow rate at which taller C3 grasses can coalesce into mono‐dominant patches that outcompete C4 shortgrasses. Increased abundance of C3 species over the past seven decades, both in the presence and absence of grazing, may be related to recovery from the severe drought and dust storms of the 1930s as well as enhanced growth of C3 plants under increasing atmospheric [CO2].
Prevention and treatment of variceal haemorrhage in 2017
Authors: Brunner Felix , Berzigotti Annalisa , Bosch Jaime
Published: January 2017

Variceal haemorrhage is a major complication of portal hypertension that still causes high mortality in patients with cirrhosis. Improved knowledge of the pathophysiology of portal hypertension has recently led to a more comprehensive approach to prevent all the complications of this condition. Thus, optimal treatment of portal hypertension requires a strategy that takes into account the clinical stage of the disease and all the major variables that affect the risk of progression to the next stage and death. In patients with compensated liver disease, the correction of factors influencing the progression of fibrosis, in particular aetiologic factors, is now feasible in many cases and should be achieved to prevent the development or progression of gastroesophageal varices and hepatic decompensation. Once gastroesophageal varices have developed, non‐selective beta‐blockers remain the cornerstone of therapy. Carvedilol provides a greater decrease in portal pressure and is currently indicated as a first‐choice therapy for primary prophylaxis. The treatment of acute variceal haemorrhage includes a combination of vasoactive drugs, antibiotics and endoscopic variceal band ligation. In high‐risk patients, the early use of transjugular intrahepatic portosystemic shunt (TIPS) lowers the risk of re‐bleeding and improves survival. Transjugular intrahepatic portosystemic shunt is the choice for uncontrolled variceal bleeding; a self‐expandable metal stent or balloon tamponade can be used as a bridging measure. The combination of non‐selective beta‐blockers and endoscopic variceal band ligation reduces the risk of recurrent variceal bleeding and improves survival. In these cases, statins seem to further improve survival. Transjugular intrahepatic portosystemic shunt is indicated in patients who rebleed during secondary prophylaxis.
Special populations: treating hepatitis C in patients with decompensated cirrhosis and/or advanced renal impairment
Authors: Mücke Marcus M. , Mücke Victoria T. , Lange Christian M. , Zeuzem Stefan
Published: January 2017

Direct‐acting antivirals have revolutionized the treatment of hepatitis C. Sustained virological response rates of at least 95% have become common in the general population. However, along with the ageing of the HCV population, physicians face a growing group of HCV‐infected patients with advanced liver and/or renal impairment. The safety and efficacy of treatment remains a clinical challenge in these patients. This review focuses on the current state of knowledge and treatment regimens in patients with decompensated cirrhosis and severe renal impairment. It shows that distinct interferon‐free treatments can achieve favourable sustained virological response rates in these difficult‐to‐treat patients. Moreover, pitfalls and special considerations as well as new emerging challenges in an era of interferon‐free regimens will be presented in this article.
The epidemiology of non‐alcoholic fatty liver disease
Authors: Bellentani Stefano
Published: January 2017

The increase in Non‐alcoholic Fatty Liver Disease (NAFLD) and the imminent disappearance of chronic viral hepatitis thanks to new and effective therapies is motivating hepatologists to change their clinical approach to chronic liver disease. NAFLD‐cirrhosis or NAFLD‐Hepatocellular Carcinoma (HCC) are now the second cause of liver transplantation in the USA. This short‐review is focused to the epidemiology of NAFLD/Non‐alchoholic Steatohepatitis (NASH), including the definition of this disease which should be revised as well discussing the prevalence, risk factors for progression, natural history and mortality. NAFLD is considered to be the hepatic manifestation of the metabolic syndrome (MS). It affects 25‐30% of the general population and the risk factors are almost identical to those of MS. The natural history involves either the development of cardiovascular diseases or cirrhosis and HCC. HCC can also develop in NASH in the absence of cirrhosis (45% of cases). We conclude that an international consensus conference on the definition, natural history, policies of surveillance and new pharmacological treatments of NAFLD and NASH is urgently needed.
Therapies in non‐alcoholic steatohepatitis (NASH)
Authors: Oseini Abdul M. , Sanyal Arun J.
Published: January 2017

The hallmark of non‐alcoholic fatty liver disease (NAFLD) is excessive fatty accumulation in the hepatocytes, which may be an isolated event (non‐alcoholic fatty liver, NAFL) or accompanied by evidence of inflammation and cell injury with or without fibrosis (non‐alcoholic steatohepatitis, NASH). NASH, the more aggressive form of NAFLD, may progress to cirrhosis and hepatocellular carcinoma. Since NASH is estimated to overtake hepatitis C virus infection as the leading cause of liver transplantation in the US in the coming decade, and there are no current FDA‐approved therapies for this disease, the need to find appropriate therapeutic targets is now more urgent than ever before. Diet and other lifestyle modifications have always been difficult to maintain and this approach alone has not slowed the rising tide of the disease. While the results of traditional therapies such as vitamin E and pioglitazone have been significant for steatosis and inflammation, they have had no effect on fibrosis, which is the strongest indicator of mortality in this condition. However, the understanding of the pathogenesis and progression of NASH has evolved and several promising novel therapies to target and possibly reverse fibrosis are being evaluated, making the future outlook of NASH therapy more optimistic.
Treatment of chronic hepatitis B infection‐2017
Authors: Chen Guo‐Feng , Wang Cheng , Lau George
Published: January 2017

Since the registration of the first effective nucleoside analogue against the hepatitis B virus almost two decades ago, major progress has been made in the management of chronic hepatitis B infection. However, hepatitis B‐related morbidity and mortality remain a major global health threat. This is partly due to the escalating costs and the decrease in compliance related to the need for prolonged therapy for most patients who cannot be “cured”. New biomarkers such as quantitative hepatitis B surface antigen might help to determine if hepatitis B e antigen negative patients can be taken off nucleos(t)ide analogues. On the other hand, novel compounds that target the viral life cycle or modulate host immune response are in the pipeline. In the next few years, one should expect breakthrough advancement to be made leading to a “cure” for patients with chronic hepatitis B infection by inducing hepatitis surface antigen loss with or without the development of the hepatitis B surface antibody. In addition, attention and necessary actions should also be taken in patients with hepatitis B infection who are being treated with immunosuppressive therapy and direct anti‐viral (DAAs) agents for hepatitis C infection to prevent hepatitis from hepatitis B reactivation.
Non‐pharmacological interventions in non‐alcoholic fatty liver disease patients
Authors: Ratziu Vlad
Published: January 2017

Patients with non‐alcoholic fatty liver disease have unhealthy diets, sedentary behaviour and not enough physical activity. This lifestyle triggers liver disease and probably favours its progression. It also has significant deleterious effects on health and longevity and should therefore be corrected by first‐line therapy at all stages of the disease. However, important questions remain: is weight loss alone beneficial or do particular diets have beneficial effects beyond weight loss? Which specific micro‐ or macronutrients are clearly harmful? Does exercise without weight loss improve hepatic histology and what type of exercise is optimal? Does moderate or only vigorous exercise have metabolic and hepatic benefits? What is the efficacy of lifestyle measures outside of clinical trials? And most importantly, what is the turning point in the natural history of liver disease when non‐pharmacological measures should be combined with drug therapy?
The impact of direct antiviral agents on the development and recurrence of hepatocellular carcinoma
Authors: Reig María , Boix Loreto , Bruix Jordi
Published: January 2017

Direct antiviral agents mark a major progress for the treatment of chronic hepatitis C virus infection. The rate of cure is higher than 90% in most populations and the safety profile is good. However, like any treatment, there are potential unexpected adverse events. Several reports have indicated that antiviral therapy may be associated with the reactivation of hepatitis B virus or the emergence of herpes virus in a time‐related manner. Recently, several studies have described a potential unexpected incidence of hepatocellular carcinoma in treated patients, both in those without a prior history of cancer and those who have been successfully treated and were disease‐free for different periods of time. Furthermore, the emergence of cancer is also characterized by a more aggressive and faster progression to advanced stages, making treatment impossible. Thus, a careful risk‐benefit analysis must be made when considering antiviral treatment with the new agents in patients with hepatitis C virus.
From HCV To HBV Cure
Authors: Schinazi Raymond F. , Asselah Tarik
Published: January 2017

Approximately 170 million people are chronically infected with HCV and 350 million are chronically infected with HBV worldwide. It is estimated that more than one million patients die from complications related to chronic viral hepatitis, mainly HCC which is one of the most frequent cancers in many countries, especially Africa, the Middle East and Asia. HCV drug development has been impressive, and this revolution led to several direct‐acting antiviral agents achieving an HCV cure after only 6‐12 weeks. This progress could theorically lead to HCV global elimination making HCV and its consequences a rarity. HBV research and development programs can learn from the HCV experience, to achieve an HBV functional or sterilizing cure. This review will summarize key steps which have been realized for an HCV cure, and discuss the next steps to achieve for an HCV elimination. And also, how this HCV revolution has inspired scientists and clinicians to achieve the same for HBV.
Present in Love: Rethinking Barth on the Divine Perfections
Authors: McFarland Ian A.
Published: January 2017

While Karl Barth's identification of love and freedom (in that order) as the fundamental divine perfections was intended to eliminate any gap between God as revealed and God's eternal being, Barth's equation of divine freedom with decision fatally compromises this aim by reintroducing the spectre of a ‘hidden God’ behind the God revealed in Jesus. Moreover, it exacerbates a worryingly anthropomorphic model of divine action, already pronounced in older orthodox theologies, that is ill‐suited to upholding the causal integrity of the created order. Substituting presence for freedom as the foundational perfection paired with (and used to interpret) divine love maintains the benefits of Barth's relative prioritization of love while avoiding the problems that accompany the interpretation of divine freedom as decision. Specifically, it provides a model of divine action in which permission rather than decision emerges as the fundamental mode of willing whereby by God brings the world into being and sustains it in existence.
Cereal immunity against powdery mildews targets RNase‐Like Proteins associated with Haustoria (RALPH) effectors evolved from a common ancestral gene
Authors: Spanu Pietro D.
Published: January 2017

This article is a Commentary on Praz et al., 213: 1301–1314.