bluuebunny/crossref_metadata_2025 huggingface dataset:
Age is not a predictor of prognosis in metastatic cutaneous squamous cell carcinoma of the head and neck
Authors: Smith Joel A. , Virk Sohaib , Palme Carsten E. , Low Tsu‐Hui (Hubert) , Ch'ng Sydney , Gupta Ruta , Gao Kan , Clark Jonathan
Published: November 2016

Background

Metastatic cutaneous squamous cell carcinoma of the head and neck (cHNSCC) is more common in older patients. It is postulated that the age‐related decline in immunity plays a role in cancer predisposition and prognosis. We aimed to investigate the effect of age on outcomes in cHNSCC and compare these with the outcomes of patients with cHNSCC and known immunosuppression.

Methods

Patients with metastatic cHNSCC treated with curative intent were identified from a prospectively collated database of head and neck cancers at the Sydney Head and Neck Cancer Institute. Patients with cHNSCC with known immunosuppression provided a comparison group for analysis of disease‐specific outcomes.

Results

The study cohort includes 418 immunocompetent patients with metastatic cHNSCC (median age: 73 years (interquartile range: 65–81 years)) and the control cohort includes 24 patients with metastatic cHNSCC and immunosuppression (median age: 51 years (interquartile range: 42–62 years)). Increasing age was not associated with poorer disease‐free or disease‐specific survival. Patients in older age groups (70 years and over) had better disease‐specific outcomes than patients with long‐term immunosuppression. Patterns of disease failure did not differ between different age groups. The number of positive nodes and extra‐capsular spread were the only significant prognostic variables in multivariable analysis.

Conclusion

In the context of metastatic cHNSCC, age should not be considered as a marker of poor prognosis. Age should not be considered a surrogate marker of immune function considering the poorer outcomes seen in patients with immunosuppression. Older patients with metastatic cHNSCC should be considered candidates for standard treatment if otherwise medically fit.
Urban Agriculture in the Food‐Disabling City: (Re)defining Urban Food Justice, Reimagining a Politics of Empowerment
Authors: Tornaghi Chiara
Published: November 2016

Recent literature has pointed to the role of urban agriculture in self‐empowerment and learning, and in constituting ways to achieve food justice. Building on this work the paper looks at the potential and constraints for overcoming the residual and contingent status of urban agriculture. The first part of the paper aims to expand traditional class/race/ethnicity discussions and to reflect on global, cultural, procedural, capability, distributional and socio‐environmental forms of injustice that unfold in the different stages of urban food production. The second part reflects on how to bring forward food justice and build a politics of engagement, capability and empowerment. Three interlinked strategies for action are presented: (1) enhancing the reflexivity and cohesion of the urban food movement by articulating a challenge to neoliberal urbanism; (2) converging urban and agrarian food justice struggles by shaping urban agroecology; and (3) regaining control over social reproduction by engaging with food commoning.
Risk of incident Mycobacterium tuberculosis infection in patients with inflammatory bowel disease: a nationwide population‐based study in South Korea
Authors: Hong S. N. , Kim H. J. , Kim K. H. , Han S.‐J. , Ahn I. M. , Ahn H. S.
Published: November 2016

Background

The low incidence of Mycobacterium tuberculosis infection and lack of adequate controls have prevented researchers from estimating tuberculosis (TB) risk in inflammatory bowel disease (IBD) patients.

Aim

To evaluate the risk of incident TB among IBD patients.

Methods

Using the 2011–2013 data of the South Korean National Health Insurance (NHI) system, we calculated the incidence rates (IRs), standardised incidence ratio (SIR) and number needed to screen (NNS) for incident TB in IBD patients compared to the general population in terms of subtype, age, gender and IBD medications.

Results

The IR, SIR and NNS for TB in IBD patients were 223.9/100 000 person‐years, 2.64 (2.30–3.01) and 446.6 (392.8–517.6), respectively. The TB IR in Crohn's disease (CD) patients was significantly higher than that in ulcerative colitis (UC) patients (340.1/100 000 person‐years vs. 165.5/100 000 person‐years, respectively; P < 0.001). The SIR and NNS for TB among CD patients were 4.00 (3.59–4.45) and 604.2 (506.1–749.6), respectively; those among UC patients were 1.95 (1.66–2.27) and 294.0 (246.9–363.4). The TB IRs in IBD patients did not differ significantly by age or gender (Ptrend = 0.505 and P = 0.861, respectively). The TB IRs among IBD patients prescribed 5‐ASA, corticosteroids, immunomodulators and anti‐TNF‐α were 143.5, 208.5, 284.6 and 554.1 per 100 000 person‐years, respectively. Among IBD patients treated using anti‐TNF‐α, the TB IR was significantly higher than that among all IBD patients (P < 0.001); the SIR and NNS for TB were 6.53 (5.99–7.09) and 180.5 (144.6–240.1) respectively.

Conclusion

Clinicians should be aware of the increased risk of active tuberculosis in patients with IBD who are receiving anti‐TNF‐α therapy.
Microfinance as a Development and Poverty Alleviation Tool in Rural Bangladesh: A Critical Assessment
Authors: Ali Isahaque , Hatta Zulkarnain A. , Azman Azlinda , Islam Shariful
Published: November 2016

Poverty is multidimensional in nature and exists in every part of the world. Microfinance is considered one of the most important programs to achieve poverty reduction, particularly in Bangladesh. It has been estimated that nearly 45% of Bangladesh's population lives below the poverty line. This qualitative research study was conducted in order to determine the effectiveness of microfinance programs and the contributing factors to the high‐level of poverty among microfinance beneficiaries in the district of Bogra, Bangladesh. Study findings indicated that microfinance programs were ineffective as a result of high interest rates; insufficient loans; unproductive use of loans; corruption and poor skills of microfinance institution staff; weekly repayment schedules; and physical and mental harassment of poor women. Additionally, the lack of employment opportunities, education, healthcare facilities and social safety nets; natural disasters; the dowry system; and the rising cost of basic daily needs have also contributed to chronic poverty.
Population pharmacokinetics of temsirolimus and sirolimus in children with recurrent solid tumours: a report from the Children's Oncology Group
Authors: Mizuno Tomoyuki , Fukuda Tsuyoshi , Christians Uwe , Perentesis John P. , Fouladi Maryam , Vinks Alexander A.
Published: November 2016

Aims

Temsirolimus is an inhibitor of the mammalian target of rapamycin (mTOR). Pharmacokinetic (PK) characterization of temsirolimus in children is limited and there is no paediatric temsirolimus population PK model available. The objective of this study was to simultaneously characterize the PK of temsirolimus and its metabolite sirolimus in paediatric patients with recurrent solid or central nervous system tumours and to develop a population PK model.

Methods

The PK data for temsirolimus and sirolimus were collected as a part of a Children's Oncology Group phase I clinical trial in paediatric patients with recurrent solid tumours. Serial blood concentrations obtained from 19 patients participating in the PK portion of the study were used for the analysis. Population PK analysis was performed by nonlinear mixed effect modelling using NONMEM.

Results

A three‐compartment model with zero‐order infusion was found to best describe temsirolimus PK. Allometrically scaled body weight was included in the model to account for body size differences. Temsirolimus dose was identified as a significant covariate on clearance. A sirolimus metabolite formation model was developed and integrated with the temsirolimus model. A two‐compartment structure model adequately described the sirolimus data.

Conclusion

This study is the first to describe a population PK model of temsirolimus combined with sirolimus formation and disposition in paediatric patients. The developed model will facilitate PK model‐based dose individualization of temsirolimus and the design of future clinical studies in children.
Acute Treatment with Lauric Acid Reduces Blood Pressure and Oxidative Stress in Spontaneously Hypertensive Rats
Authors: Alves Naiane Ferraz Bandeira , de Queiroz Thyago Moreira , de Almeida Travassos Rafael , Magnani Marciane , de Andrade Braga Valdir
Published: November 2016

The effects of acute administration of lauric acid (LA), the most abundant medium‐chain fatty acid of coconut oil, on blood pressure, heart rate and oxidative stress were investigated in spontaneously hypertensive rats (SHR). Intravenous doses of LA reduced blood pressure in a dose‐dependent fashion (1, 3, 4, 8 and 10 mg/kg) in both SHR and Wistar Kyoto rats. LA (10−8 to 3 × 10−3 M) induced vasorelaxation in isolated superior mesenteric artery rings of SHR in the presence (n = 7) or absence (n = 8) of functional endothelium [maximum effect (ME) = 104 ± 3 versus 103 ± 4%]. After exposure to KCl (60 mM), LA also induced concentration‐dependent vasorelaxation (n = 7) compared to that under Phe‐induced contraction (ME = 113.5 + 5.1 versus 104.5 + 4.0%). Furthermore, LA‐induced vasorelaxation in vessels contracted with S(−)‐BayK8644 (200 nM), a L‐type Ca2+ channel agonist (ME = 91.4 + 4.3 versus 104.5 + 4.0%, n = 7). Lastly, LA (10−3 M) reduced NADPH‐dependent superoxide accumulation in the heart (18 ± 1 versus 25 ± 1 MLU/min/μg protein, n = 4, p < 0.05) and kidney (82 ± 3 versus 99 ± 4 MLU/min/μg protein, n = 4, p < 0.05). Our data show that LA reduces blood pressure in normotensive and hypertensive rats. In SHR, this effect might involve Ca+2 channels in the resistance vessels and by its capability of reducing oxidative stress in heart and kidneys.
The Role of Trust in CenteringPregnancy: Building Interpersonal Trust Relationships in Group‐Based Prenatal Care in The Netherlands
Authors: Kweekel Liselotte , Gerrits Trudie , Rijnders Marlies , Brown Patrick
Published: November 2016

Background

CenteringPregnancy (CP) is a specific model of group‐based prenatal care for women, implemented in 44 midwifery practices in The Netherlands since 2011. Women have evaluated CP positively, especially in terms of social support, and improvements have been made in birthweight and preterm‐birth outcomes; however, there is limited understanding as to why. The purpose of this study was to examine the mechanisms that create trusting relationships within CP to better understand CP outcomes and effectiveness.

Methods

A qualitative study was conducted using in‐depth interviews with 26 (former) CP participants, alongside observations of CP sessions. All interviews were transcribed and analyzed following open, axial, and selective coding.

Results

Most women characterized trust as a positive expectation about how others would respond to sensitive information that was shared within the group. Trust emerged within the data as a multidimensional concept and several preconditions seemed crucial in building trusting relations: vulnerability, communication, reciprocity, chemistry, and atmosphere. The facilitating of interpersonal trust among CP participants enhanced group processes, especially as a basis for social support by which women said they were more eager to share sensitive information in a trusting environment.

Conclusions

Processes of trust were interwoven within various CP group dynamics. Trust facilitated social support which in turn enabled reassurance and the building of women's self‐confidence.
Democratizing Journalism – How User‐Generated Content and User Communities Affect Publishers’ Business Models
Authors: Zeng Michael A. , Dennstedt Bianca , Koller Hans
Published: November 2016

Publishers, today, are struggling with their business model: Their efforts to convert traditional content into digital products seem to be insufficient as recipients expect more than simply the mere digitalization of content. Dissatisfied with solely being informed by selected journalists, modern recipients are often interested in acquiring information from various sources, in discussing with others, or even in contributing with their own content. Hence, recipients seem to evolve from being simply readers to contributors themselves. With regard to the established term ‘user‐generated content’, we refer to those co‐creating recipients as users. To underline these assumptions, the present study explores (1) users’ expectations of sources of content and (2) their willingness to provide their own content. Our findings show that both user‐generated content and professional journalists’ content is of value to users. Second, we show that users are mainly driven to contribute by their own expertise, welfare of others, and personal acceptance in the community. With this study, we consider mainly the changed user behaviour in order to derive implications of user involvement for future business models of publishers, in particular on the customer value proposition as well as key resources and key processes.
Health care provider responses to initial parental reports of autism spectrum disorder symptoms: results from a nationally representative sample
Authors: Barnard‐Brak Lucy , Richman David , Ellerbeck Kathryn , Moreno Rosario
Published: November 2016

Background

Health care provider (HCP) responses to initial parental report of autism spectrum disorder (ASD) symptoms were examined in relation to latency to diagnosis and child chronological age at diagnosis.

Method

Secondary data analyses were conducted for a sample of 1384 parents of children with ASD utilizing data from the National Survey of Children with Special Health Care Needs (NS‐CSHCN, 2009–2010 National Survey of Children with Special Health Care Needs, 2009) and the Centers for Disease Control and Prevention Pathways to Diagnosis and Services (CDC PDS, Survey of pathways to diagnosis and services, 2011).

Results

Approximately 44% of the sample experienced predominantly delayed HCP responses, 38% experienced predominantly proactive responses, while the remaining 18% experienced a relatively even mix of delayed and proactive responses across HCPs. With regard to outcomes correlated with the type of HCP response, individuals exposed to proactive HCPs were diagnosed with ASD almost a year earlier for child chronological age than individuals exposed to mixed HCPs. This difference increased beyond a year between individuals receiving proactive HCPs versus individuals experiencing delayed HCPs. Finally, after controlling for socioeconomic status, parent‐reported severity of ASD symptoms, and age at time of referral, proactive HCP was correlated with decreased time to diagnosis from parental first report of ASD symptoms.

Conclusions

Results are discussed with regard to increasing proactive HCP responses to parental first concerns of ASD symptomology versus a mix or delayed responses.
Individual Differences in Toddlers’ Prosociality: Experiences in Early Relationships Explain Variability in Prosocial Behavior
Authors: Newton Emily K. , Thompson Ross A. , Goodman Miranda
Published: November 2016

Latent class logistic regression analysis was used to investigate sources of individual differences in profiles of prosocial behavior. Eighty‐seven 18‐month‐olds were observed in tasks assessing sharing with a neutral adult, instrumentally helping a neutral adult, and instrumentally helping a sad adult. Maternal mental state language (MSL) and maternal sensitivity were also assessed. Despite differing motivational demands across tasks, we found consistency in children's prosocial behavior with three latent classes: no prosocial behavior, moderate prosocial behavior, and frequent instrumental helping across emotional situations. Maternal sensitivity, MSL, and their interaction predicted toddlers’ membership in the classes. These findings evidence moderate consistency in early prosocial behaviors and suggest that these capacities are motivated in early relationships with caregivers.
Cultural Influences on Toddlers’ Prosocial Behavior: How Maternal Task Assignment Relates to Helping Others
Authors: Köster Moritz , Cavalcante Lilia , Vera Cruz de Carvalho Rafael , Dôgo Resende Briseida , Kärtner Joscha
Published: November 2016

This cross‐cultural study investigates how maternal task assignment relates to toddlers’ requested behavior and helping between 18 and 30 months. One hundred seven mother–child dyads were assessed in three different cultural contexts (rural Brazil, urban Germany, and urban Brazil). Brazilian mothers showed assertive scaffolding (serious and insistent requesting), whereas German mothers employed deliberate scaffolding (asking, pleading, and giving explanations). Assertive scaffolding related to toddlers’ requested behavior in all samples. Importantly, assertive scaffolding was associated with toddlers’ helping in rural Brazil, whereas mothers’ deliberate scaffolding related to toddlers’ helping behavior in urban Germany. These findings highlight the role of caregivers’ socialization practices for the early ontogeny of helping behavior and suggest culture‐specific developmental pathways along the lines of interpersonal responsibility and personal choice.
Prosocial Motivation: Inferences From an Opaque Body of Work
Authors: Eisenberg Nancy , VanSchyndel Sarah K. , Spinrad Tracy L.
Published: November 2016

Because motivations for prosocial actions typically are unclear, sometimes even to actors but especially for observers, it is difficult to study prosocial motivation. This article reviews research that provides evidence regarding children's motives for prosocial behaviors. First, we present a heuristic model to classify motives on the dimension of reflecting altruistic (with the ultimate goal of benefiting another) to egoism (the ultimate goal of benefiting the self) goals; in addition, we briefly discuss classifying motives based on a continuum of morality. Next, we review findings indicating the existence of a number of different motives in our model and briefly discuss developmental issues, when possible. Future directions for the study of prosocial motivation are proposed.
The Motivational Foundations of Prosocial Behavior From A Developmental Perspective–Evolutionary Roots and Key Psychological Mechanisms: Introduction to the Special Section
Authors: Davidov Maayan , Vaish Amrisha , Knafo‐Noam Ariel , Hastings Paul D.
Published: November 2016

Prosocial behavior is versatile, multifaceted, and complex. This special section seeks to advance coherent, integrative understanding of prosocial development by addressing this topic through the prism of motivations. This conceptual Introduction presents key ideas that provide a framework for thinking about motivation for prosocial behavior and its development. It outlines the evolutionary roots of prosocial behavior, underscoring the interdependent roles of nature and nurture. This is followed by a discussion of several key psychological mechanisms reflecting different motivations for prosocial action (empathy for a distressed other, concern about another's goal, desire to act in accordance with internalized prosocial norms, and guilt). We discuss the critical components of each motivation and highlight pertinent contributions of the special section articles.
Puberty Predicts Approach But Not Avoidance on the Iowa Gambling Task in a Multinational Sample
Authors: Icenogle Grace , Steinberg Laurence , Olino Thomas M. , Shulman Elizabeth P. , Chein Jason , Alampay Liane P. , Al‐Hassan Suha M. , Takash Hanan M. S. , Bacchini Dario , Chang Lei , Chaudhary Nandita , Di Giunta Laura , Dodge Kenneth A. , Fanti Kostas A. , Lansford Jennifer E. , Malone Patrick S. , Oburu Paul , Pastorelli Concetta , Skinner Ann T. , Sorbring Emma , Tapanya Sombat , Uribe Tirado Liliana M.
Published: November 2016

According to the dual systems model of adolescent risk taking, sensation seeking and impulse control follow different developmental trajectories across adolescence and are governed by two different brain systems. The authors tested whether different underlying processes also drive age differences in reward approach and cost avoidance. Using a modified Iowa Gambling Task in a multinational, cross‐sectional sample of 3,234 adolescents (ages 9–17; M = 12.87, SD = 2.36), pubertal maturation, but not age, predicted reward approach, mediated through higher sensation seeking. In contrast, age, but not pubertal maturation, predicted increased cost avoidance, mediated through greater impulse control. These findings add to evidence that adolescent behavior is best understood as the product of two interacting, but independently developing, brain systems.
Young Children's Use of Surface and Object Information in Drawings of Everyday Scenes
Authors: Dillon Moira R. , Spelke Elizabeth S.
Published: November 2016

Pictorial symbols such as photographs, drawings, and maps are ubiquitous in modern cultures. Nevertheless, it remains unclear how children relate these symbols to the scenes that they represent. The present work investigates 4‐year‐old children's (N = 144) sensitivity to extended surface layouts and objects when using drawings of a room to find locations in that room. Children used either extended surfaces or objects when interpreting drawings, but they did not combine these two types of information to disambiguate target locations. Moreover, children's evaluations of drawings depicting surfaces or objects did not align with their use of such information in those drawings. These findings suggest that pictures of all kinds serve as media in which children deploy symbolic spatial skills flexibly and automatically.
Making meaningful connections: using insights from social pedagogy in statutory child and family social work practice
Authors: Ruch Gillian , Winter Karen , Cree Viv , Hallett Sophie , Morrison Fiona , Hadfield Mark
Published: November 2016

Reports into incidents of child death and serious injury have highlighted consistently concern about the capacity of social workers to communicate skilfully with children. Drawing on data collected as part of an Economic and Social Research Council funded UK‐wide research project exploring social workers' communicative practices with children, this paper explores how approaches informed by social pedagogy can assist social workers in connecting and communicating with with children. The qualitative research included data generated from 82 observations of social workers' everyday encounters with children. Social pedagogical concepts of ‘haltung’ (attitude), ‘head, heart and hands’ and ‘the common third’ are outlined as potentially helpful approaches for facilitating the intimacies of inter‐personal connections and enhancing social workers' capacity to establish and sustain meaningful communication and relationships with children in the face of austere social, political and organisational contexts.
Counterfactual Plausibility and Comparative Similarity
Authors: Stanley Matthew L. , Stewart Gregory W. , Brigard Felipe De
Published: November 2016

Counterfactual thinking involves imagining hypothetical alternatives to reality. Philosopher David Lewis (1973, 1979) argued that people estimate the subjective plausibility that a counterfactual event might have occurred by comparing an imagined possible world in which the counterfactual statement is true against the current, actual world in which the counterfactual statement is false. Accordingly, counterfactuals considered to be true in possible worlds comparatively more similar to ours are judged as more plausible than counterfactuals deemed true in possible worlds comparatively less similar. Although Lewis did not originally develop his notion of comparative similarity to be investigated as a psychological construct, this study builds upon his idea to empirically investigate comparative similarity as a possible psychological strategy for evaluating the perceived plausibility of counterfactual events. More specifically, we evaluate judgments of comparative similarity between episodic memories and episodic counterfactual events as a factor influencing people's judgments of plausibility in counterfactual simulations, and we also compare it against other factors thought to influence judgments of counterfactual plausibility, such as ease of simulation and prior simulation. Our results suggest that the greater the perceived similarity between the original memory and the episodic counterfactual event, the greater the perceived plausibility that the counterfactual event might have occurred. While similarity between actual and counterfactual events, ease of imagining, and prior simulation of the counterfactual event were all significantly related to counterfactual plausibility, comparative similarity best captured the variance in ratings of counterfactual plausibility. Implications for existing theories on the determinants of counterfactual plausibility are discussed.
Utility of endobronchial ultrasound‐guided transbronchial needle aspiration in diagnosing non‐specific inflammatory intrathorcacic lymphadenitis
Authors: Yang Huizhen , Wang Shenglan , Teng Jiajun , Han Baohui , Sun Jiayuan
Published: November 2016

Background and objective

Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) has emerged as a minimally invasive technique for diagnosing intrathoracic malignancies and some benignancies; however, there are no data available on the utility of EBUS‐TBNA for the diagnosis of non‐specific inflammatory intrathoracic lymphadenitis.

Methods

A prospective analysis was performed from 104 patients with enlarged lymphadenopathy suspected of non‐specific lymphadenitis referred for EBUS‐TBNA between October 2009 and March 2012. Rapid on‐site cytological evaluation was not adopted. Microbiological tests were carried out in all patients. Patients were excluded from the study if there was other diagnosis being defined.

Results

One hundred ninety‐one lesions were aspirated in 94 patients with enlarged mediastinal/hilar lymph nodes within reach of EBUS‐TBNA, which were diagnosed as non‐specific intrathorcacic lymphadenitis by pathology and clinical follow‐up. According to EBUS‐TBNA pathologies, 94 patients were categorized into four kinds: (i) inflammatory cell infiltrates and/or noncaseating necrosis in 38 cases; (ii) granuloma formed by epithelioid cells and/or fiber hyperplasia in 13 cases; (iii) lymph node tissue/lymphocyte without obvious abnormal lesions in 41 cases; (iv) inadequate sample in 2 cases. Bacterial and/or fungal smears and cultures were carried out in all 94 patients (100%), with pathogens being found in 4 (4.3%) cases. All patients (100%) underwent acid‐fast staining and culture for mycobacterium tuberculosis to exclude tuberculosis. No procedure‐related complication was observed.

Conclusions

EBUS‐TBNA can provide pathological and microbiological evidences for diagnosing non‐specific inflammatory intrathoracic lymphadenopathy, and it is a safe and effective first‐line investigation for ruling out malignancies and other benign diseases.
A case of pulmonary cryptococcosis with large pericardial effusion diagnosed using cervical lymph node biopsy
Authors: Liu Xuchun , Jia Wei , Huang Shubin , Sun Gengyun
Published: November 2016

Pulmonary cryptococcosis (PC) is a relatively rare infectious disease. It mainly involves the lungs; however, in some patients, the infection could spread to other parts of the body. PC mostly occurs in patients with immune deficiencies. However, PC infections have been reported in non‐immunocompromised patients. The diagnosis of PC is challenging in patients without immune deficiencies. Here, the case of a 27‐year‐old immunocompetent woman who was diagnosed with PC was report. She had unexplained fever and a history of close contact with poultry feathers. Lesions were observed in the lungs, pleural cavity, pericardium, and cervical lymph nodes. Biopsy of the cervical lymph nodes helped in the pathological diagnosis of PC. She was treated with fluconazole, and the lesions disappeared. They present this case to encourage detailed inquiry of medical history in such patients, improve the diagnostic awareness of clinicians, and help reduce the likelihood of misdiagnosis.
Botulinum toxin and safety issues in cerebral palsy
Authors: Yiannakopoulou Eugenia
Published: November 2016

This commentary is on the original article by Montastruc et al. on pages 329–334 of this issue.
Mandibular angle fractures: a comparative study between one‐ and two‐plate fixation
Authors: Monnazzi Marcelo Silva , Gabrielli Marisa Ap Cabrini , Gabrielli Mário Francisco Real , Trivellato Alexandre Elias
Published: November 2016

Background/Aim

The mandibular angle fracture is a challenging fracture to manage. Over time, the literature has shown many types of treatment modalities and different kinds of internal fixation. The aim of this study was to evaluate the outcomes and complications of mandibular angle fractures managed by Champy's technique and two‐plate fixation, over a period of 20 years.

Material and methods

The files of 149 patients with 155 angle fractures fulfilled the inclusion criteria and were chosen for this study. Data were collected regarding gender, age, race, date of trauma, addictions, etiology, signs and symptoms, fracture management, and complications.

Results

Prevalence was higher in males (82%), Caucasians (62%), and during the third decade of life (62%). Mean age was 26.5 years. The main cause was interpersonal violence, and the mean follow‐up period was 232 days. The main signs and symptoms were pain, edema, and mouth‐opening restriction. The most often associated fracture involved the mandibular condyle, and the most common complication was infection.

Conclusion

There was no difference between the two modalities of treatment. However, the one‐plate fixation technique had fewer complications.
Risk factors for onset of amyotrophic lateral sclerosis
Authors: Swash M. , de Carvalho M.
Published: November 2016

Click here to view the accompanying paper in this issue.
Adequate tacrolimus concentration for myasthenia gravis treatment
Authors: Kanai T. , Uzawa A. , Kawaguchi N. , Himuro K. , Oda F. , Ozawa Y. , Kuwabara S.
Published: November 2016

Background and purpose

A single, oral dose of 3 mg/day tacrolimus, approved for myasthenia gravis (MG) treatment in Japan, was shown to reduce steroid dose and anti‐acetylcholine receptor (AChR) antibody titers as well as to improve MG symptoms. However, no studies have investigated the association between tacrolimus concentration and its clinical efficacy in MG. In this study, we aimed to determine the optimal tacrolimus concentration for MG treatment.

Methods

The trough tacrolimus concentration in 51 patients with MG (positive for anti‐AChR antibody, n = 48; negative for anti‐AChR and anti‐muscle‐specific tyrosine kinase antibodies, n = 3) who received 3 mg/day tacrolimus for more than 1 year was measured using a chemiluminescent enzyme immunoassay. The clinical characteristics of patients with MG as well as the dose of prednisolone used before and after tacrolimus treatment were evaluated retrospectively.

Results

The median trough tacrolimus concentration was 5.4 (range, 2.9–7.6) ng/mL, which was correlated with ‘minimal manifestation or better status’ (P = 0.0190, r = 0.3273) and the reduction in anti‐AChR antibody 1 year after tacrolimus initiation (P = 0.0170, r = 0.3465). When the cut‐off value for tacrolimus was defined as 4.8 ng/mL using a receiver operating characteristic curve, patients with adequate tacrolimus concentration (≥4.8 ng/mL) showed more reduction in anti‐AChR antibody titers and more improvement in MG‐related activities in daily life scores. More patients with adequate tacrolimus concentration achieved ‘minimal manifestation or better status’ compared with those with low tacrolimus concentration.

Conclusions

An adequate tacrolimus concentration is required for better MG prognosis.
Label‐free multiphoton microscopy reveals altered tissue architecture in hippocampal sclerosis
Authors: Uckermann Ortrud , Galli Roberta , Leupold Susann , Coras Roland , Meinhardt Matthias , Hallmeyer‐Elgner Susanne , Mayer Thomas , Storch Alexander , Schackert Gabriele , Koch Edmund , Blümcke Ingmar , Steiner Gerald , Kirsch Matthias
Published: November 2016

The properties and structure of tissue can be visualized without labeling or preparation by multiphoton microscopy combining coherent anti‐Stokes Raman scattering (CARS), addressing lipid content, second harmonic generation (SHG) showing collagen, and two‐photon excited fluorescence (TPEF) of endogenous fluorophores. We compared samples of sclerotic and nonsclerotic human hippocampus to detect pathologic changes in the brain of patients with pharmacoresistant temporomesial epilepsy (n = 15). Multiphoton microscopy of cryosections and bulk tissue revealed hippocampal layering and micromorphologic details in accordance with reference histology: CARS displayed white and gray matter layering and allowed the assessment of axonal myelin. SHG visualized blood vessels based on adventitial collagen. In addition, corpora amylacea (CoA) were found to be SHG‐active. Pyramidal cell bodies were characterized by intense cytoplasmic endogenous TPEF. Furthermore, diffuse TPEF around blood vessels was observed that co‐localized with positive albumin immunohistochemistry and might indicate degeneration‐associated vascular leakage. We present a label‐free and fast optical approach that analyzes pathologic aspects of HS. Hippocampal layering, loss of pyramidal cells, and presence of CoA indicative of sclerosis are visualized. Label‐free multiphoton microscopy has the potential to extend the histopathologic armamentarium for ex vivo assessment of changes of the hippocampal formation on fresh tissue and prospectively in vivo.
Knowledge structures in a knowledge base
Authors: Li Zhaowen , Li Qingguo , Zhang Rongrong , Xie Ningxin
Published: November 2016

Rough set theory is a useful tool for dealing with imprecise knowledge. One of the advantages of rough set theory is the fact that an unknown target concept can be approximately characterized by existing knowledge structures in a knowledge base. This paper explores knowledge structures in a knowledge base. Knowledge structures in a knowledge base are firstly described by means of set vectors and relationships between knowledge structures divided into four classes. Then, properties of knowledge structures are discussed. Finally, group, lattice, mapping, and soft characterizations of knowledge structures are given.
Importance of advective mass transfer and sediment surface area for streambed microbial communities
Authors: Mendoza‐Lera Clara , Frossard Aline , Knie Matthias , Federlein Laura L. , Gessner Mark O. , Mutz Michael
Published: November 2016

Variability of flow and shear stress cause local sorting and a patchy distribution of grain size in streambed sediments. Sediment microbial communities can be affected by the resulting heterogeneity because grain size determines (i) the sediment surface area available for microbial colonisation and (ii) the hydraulic conductivity and hence advective mass transfer of solutes and redox partners. However, the relative influence of the two factors on sediment microbial communities is not clear.

We performed an experiment in 12 indoor flumes with three types of sediment: gravel (2–8 mm), a sand–gravel mixture (25 and 75% by mass) and sand (0.2–0.8 mm) in four flumes each. The sediments differed in both advective mass transfer (gravel > sand–gravel mixture = sand) and surface area (gravel < sand–gravel mixture < sand). We added a microbial inoculum to each flume. After 40 days of colonisation, we collected sediment samples to characterise the sediment microbial community by determining the abundance of bacteria and algae, respiration rates and potential enzyme activities.

The consistent pattern found across all microbial variables showed that grain size clearly influences sediment microbial communities through advective mass transfer, although an influence of sediment surface area cannot be ruled out: (i) all variables were highest in gravel when expressed per surface area but differed little between sand and the sand–gravel mixture and (ii) all variables were similarly high in gravel and sand or the sand–gravel mixture on a volumetric basis, in spite of a greatly reduced surface area in gravel.

Overall, our findings suggest that grain‐size distribution in streams should be taken into account in analyses of streambed microbial communities, especially if it has an effect on advective mass transfer.
Plants, microorganisms, and soil temperatures contribute to a decrease in methane fluxes on a drained Arctic floodplain
Authors: Kwon Min Jung , Beulig Felix , Ilie Iulia , Wildner Marcus , Küsel Kirsten , Merbold Lutz , Mahecha Miguel D. , Zimov Nikita , Zimov Sergey A. , Heimann Martin , Schuur Edward A. G. , Kostka Joel E. , Kolle Olaf , Hilke Ines , Göckede Mathias
Published: November 2016

As surface temperatures are expected to rise in the future, ice‐rich permafrost may thaw, altering soil topography and hydrology and creating a mosaic of wet and dry soil surfaces in the Arctic. Arctic wetlands are large sources of CH4, and investigating effects of soil hydrology on CH4 fluxes is of great importance for predicting ecosystem feedback in response to climate change. In this study, we investigate how a decade‐long drying manipulation on an Arctic floodplain influences CH4‐associated microorganisms, soil thermal regimes, and plant communities. Moreover, we examine how these drainage‐induced changes may then modify CH4 fluxes in the growing and nongrowing seasons. This study shows that drainage substantially lowered the abundance of methanogens along with methanotrophic bacteria, which may have reduced CH4 cycling. Soil temperatures of the drained areas were lower in deep, anoxic soil layers (below 30 cm), but higher in oxic topsoil layers (0–15 cm) compared to the control wet areas. This pattern of soil temperatures may have reduced the rates of methanogenesis while elevating those of CH4 oxidation, thereby decreasing net CH4 fluxes. The abundance of Eriophorum angustifolium, an aerenchymatous plant species, diminished significantly in the drained areas. Due to this decrease, a higher fraction of CH4 was alternatively emitted to the atmosphere by diffusion, possibly increasing the potential for CH4 oxidation and leading to a decrease in net CH4 fluxes compared to a control site. Drainage lowered CH4 fluxes by a factor of 20 during the growing season, with postdrainage changes in microbial communities, soil temperatures, and plant communities also contributing to this reduction. In contrast, we observed CH4 emissions increased by 10% in the drained areas during the nongrowing season, although this difference was insignificant given the small magnitudes of fluxes. This study showed that long‐term drainage considerably reduced CH4 fluxes through modified ecosystem properties.
Social enterprises with environmental objectives: saving traditional orchards in England and Germany
Authors: Keech Daniel
Published: November 2016

Social enterprises (SEs) re‐invest their profits towards a social mission. They have proliferated as post‐industrial economies try to meet social need with limited state funding. Scholarship has expanded accordingly, although SEs with primarily environmental objectives have been neglected. This article examines how SEs, in regions noted for wildlife‐rich orchards, fund nature conservation by marketing juice and/or cider, thereby attempting to revive economic possibilities for this traditional land use. A common thread between the SEs is their initiation by conservation organisations, and it is possible to group them within models of market intervention. Three models in particular are examined that reveal different approaches and degrees of success in orchard conservation. SE scholarship is marked by a wealth of case studies, and to avoid simply adding to this richness, the paper revisits Jens Beckert's ideas on the social order of markets. His theory that actors strive for stability through forms of co‐ordination in dynamic market ‘fields’ is applied to SEs aiming to produce positive conservation outcomes – or environmental order – from their market interventions. Within limits, social order advances understanding of environmental SE by identifying the multiple challenges they juggle, and revealing the environmental outcomes of SE engagement in markets.
Clinical characteristics and outcomes of patients with recurrent chronic hepatitis B after nucleos(t)ide analog withdrawal with stringent cessation criteria: A prospective cohort study
Authors: Liu Zhirong , Liu Feng , Wang Lei , Liu Youde , Zhang Meng , Li Tao
Published: November 2016

Aim

The aim of this study was to explore the clinical characteristics and outcomes of patients with recurrent chronic hepatitis B meeting the cessation criteria outlined by the 2008 Asian Pacific Association for the Study of the Liver guidelines.

Methods

In total, 223 chronic hepatitis B patients who met the cessation criteria and discontinued nucleos(t)ide analog therapy were prospectively included. They were monitored monthly during the first 4 months and every 3–6 months thereafter. Early relapse was defined as viral relapse (serum hepatitis B virus [HBV] DNA >104 copies/mL) confirmed within 3 months after cessation.

Results

Of the 38 hepatitis B e antigen (HBeAg)‐positive relapse cases, 44.7%, 65.8%, 76.3% and 89.5% occurred within 3 months, 6 months, 12 months, and 48 months, respectively; in the 49 HBeAg‐negative relapse cases, 44.9%, 51.0%, 77.6% and 91.8% occurred within 3, 6, 12 and 36 months, respectively. Time to undetectable HBV DNA was a predictive factor of early relapse. Viral relapses were accompanied by elevated alanine aminotransferase in 70 (80.5%) patients. A peak alanine aminotransferase 10 times over the upper limit of normal after relapse was observed in 15.8% of the HBeAg‐positive and 22.4% of the HBeAg‐negative patients. Hepatic decompensation and liver failure were not observed.

Conclusions

For HBeAg‐positive and HBeAg‐negative patients meeting stringent cessation criteria, at least 4 years and 3 years of close follow‐up are necessary. For those with a longer time to undetectable HBV DNA, more attention should be paid to the early stages after cessation. Nucleos(t)ide analog withdrawal in selected non‐cirrhotic patients is generally safe, although close monitoring and timely intervention are needed.
A comparative review of gerontological nursing citation data
Authors: Antunez Marilia Y. , Henry Marcia
Published: November 2016

Background

Gerontological nursing is a highly interdisciplinary specialty. English‐language bibliometric research is scarce.

Objectives

Study gerontological nursing literature to identify journals useful for nurses and researchers working with older adults, help librarians assist gerontological nursing authors to find publication outlets and make library collection decisions.

Methods

Using a combination of methods, the authors identified cited journals in the Journal of Gerontological Nursing (JGN) and Geriatric Nursing (GN) from 2008 to 2010 using part of the Nursing and Allied Health Resources (NAHRS) Section protocol. A list was generated and compared to the results of an earlier unpublished NAHRS study and an earlier review article. A second list was developed following set criteria of bibliometric indicators and journal lists.

Results

Zone 1 showed 28 journals, and Zone 2 had 1472 titles. Zone 1 journals were examined further based on the inclusion of certain bibliometrics and journal lists.

Discussion

Providing insight into the complementary use comparative review and citation mapping, this study reports an increase in gerontological nursing research from 2008 to 2010 across a diverse group of highly cited journals.

Conclusion

A list of new journal titles is presented to aid collection development and suggestions of places to publish gerontological research.
Identification and initial characterization of matrix metalloproteinases in the yellow fever mosquito, Aedes aegypti
Authors: Kantor A. M. , Dong S. , Held N. L. , Ishimwe E. , Passarelli A. L. , Clem R. J. , Franz A. W. E.
Published: November 2016

Aedes aegypti is a major vector for arboviruses such as dengue, chikungunya and Zika viruses. During acquisition of a viremic bloodmeal, an arbovirus infects mosquito midgut cells before disseminating to secondary tissues, including the salivary glands. Once virus is released into the salivary ducts it can be transmitted to another vertebrate host. The midgut is surrounded by a basal lamina (BL) in the extracellular matrix, consisting of a proteinaceous mesh composed of collagen IV and laminin. BL pore size exclusion limit prevents virions from passing through. Thus, the BL probably requires remodelling via enzymatic activity to enable efficient virus dissemination. Matrix metalloproteinases (MMPs) are extracellular endopeptidases that are involved in remodelling of the extracellular matrix. Here, we describe and characterize the nine Ae. aegypti encoded MMPs, AeMMPs 1−9, which share common features with other invertebrate and vertebrate MMPs. Expression profiling in Ae. aegypti revealed that Aemmp4 and Aemmp6 were upregulated during metamorphosis, whereas expression of Aemmp1 and Aemmp2 increased during bloodmeal digestion. Aemmp1 expression was also upregulated in the presence of a bloodmeal containing chikungunya virus. Using polyclonal antibodies, AeMMP1 and AeMMP2 were specifically detected in tissues associated with the mosquito midgut.
Co‐operative suppression of inflammatory responses in human dendritic cells by plant proanthocyanidins and products from the parasitic nematode Trichuris suis
Authors: Williams Andrew R. , Klaver Elsenoor J. , Laan Lisa C. , Ramsay Aina , Fryganas Christos , Difborg Rolf , Kringel Helene , Reed Jess D. , Mueller‐Harvey Irene , Skov Søren , van Die Irma , Thamsborg Stig M.
Published: November 2016

Interactions between dendritic cells (DCs) and environmental, dietary and pathogen antigens play a key role in immune homeostasis and regulation of inflammation. Dietary polyphenols such as proanthocyanidins (PAC) may reduce inflammation, and we therefore hypothesized that PAC may suppress lipopolysaccharide (LPS) ‐induced responses in human DCs and subsequent T helper type 1 (Th1) ‐type responses in naive T cells. Moreover, we proposed that, because DCs are likely to be exposed to multiple stimuli, the activity of PAC may synergise with other bioactive molecules that have anti‐inflammatory activity, e.g. soluble products from the helminth parasite Trichuris suis (TsSP). We show that PAC are endocytosed by monocyte‐derived DCs and selectively induce CD86 expression. Subsequently, PAC suppress the LPS‐induced secretion of interleukin‐6 (IL‐6) and IL‐12p70, while enhancing secretion of IL‐10. Incubation of DCs with PAC did not affect lymphocyte proliferation; however, subsequent interferon‐γ production was markedly suppressed, while IL‐4 production was unaffected. The activity of PAC was confined to oligomers (degree of polymerization ≥ 4). Co‐pulsing DCs with TsSP and PAC synergistically reduced secretion of tumour necrosis factor‐α, IL‐6 and IL‐12p70 while increasing IL‐10 secretion. Moreover, both TsSP and PAC alone induced Th2‐associated OX40L expression in DCs, and together synergized to up‐regulate OX40L. These data suggest that PAC induce an anti‐inflammatory phenotype in human DCs that selectively down‐regulates Th1 response in naive T cells, and that they also act cooperatively with TsSP. Our results indicate a novel interaction between dietary compounds and parasite products to influence immune function, and may suggest that combinations of PAC and TsSP can have therapeutic potential for inflammatory disorders.