bluuebunny/crossref_metadata_2025 huggingface dataset:
Undiagnosed mandibular degloving following dental trauma
Authors: Costa Mendes Leonor , Vaysse Frédéric , Courtois Bruno , Marty Mathieu
Published: August 2020

A 12‐year‐old girl presented to the Department of Paediatric Dentistry of the Toulouse University Hospital 10 days after a facial injury, complaining of persistent pain and halitosis. Previous examinations only reported trauma of the upper incisors. Further clinical exploration showed an 8 cm laceration of the oral mucosa in the lower labial sulcus, 1.5 cm inferior to the gingival margin and exposing the symphyseal bone. The diagnosis of mental protuberance degloving was established. The treatment consisted of debridement of the wound, removal of the necrotic tissue, multiple plane sutures and antibiotics. Complete healing of the wound with no sensory deficit was achieved. Mental degloving injuries occur when a shearing force is applied to the soft tissues overlying the chin, stripping them from the labial bone. This type of wound is rare and can go undetected if a meticulous oral examination is not performed. Early management is essential so healing is not compromised.
Monarda fistulosa hydrolate as antimicrobial agent in artificial media for the in vitro rearing of the tachinid parasitoid Exorista larvarum
Authors: Dindo Maria Luisa , Modesto Monica , Rossi Chiara , Di Vito Maura , Burgio Giovanni , Barbanti Lorenzo , Mattarelli Paola
Published: August 2020

Exorista larvarum (L.) (Diptera: Tachinidae), a larval parasitoid of Lepidoptera, can be reared from egg to fecund adult on artificial media composed of crude components. The standard in vitro culture is performed in 24‐well plastic rearing plates. Exorista larvarum eggs, removed from superparasitized larvae of Galleria mellonella (L.) (Lepidoptera: Pyralidae), are individually placed in the wells, each containing a cotton swab soaked in liquid medium. The plates are then sealed until parasitoid puparium formation. To avoid contamination by microorganisms, the artificial medium is routinely supplemented with 0.01% solution of gentamicin. Experiments were carried out to assess whether this broad‐spectrum antibiotic may be replaced with hydrolate of Monarda fistulosa L. (Lamiaceae), which was selected due to its high in vitro activity against pathogenic microorganisms for humans and plants. The hydrolate was either supplemented to the artificial medium (0.5% wt/wt) (first experiment) or placed in an empty well (200 μl) of the rearing plate, to be supplied as saturated air due to evaporation (second experiment). In both experiments, a standard medium with gentamicin and an antimicrobial‐free medium were maintained as positive and negative controls, respectively. In the first experiment, in the hydrolate‐supplemented medium fewer E. larvarum completed egg‐to‐adult development than in the standard medium, but significantly more parasitoids developed from egg to adult compared to the antimicrobial‐free medium. No significant difference was found between the numbers of eggs laid by the females obtained from the standard medium vs. those from the hydrolate‐supplemented medium. In the second experiment, the hydrolate‐saturated air significantly decreased E. larvarum egg hatching, puparium formation, and female fecundity compared to the standard medium. In perspective, M. fistulosa hydrolate supplemented to the artificial media for E. larvarum may be considered as a promising candidate to replace the gentamicin solution, as suggested also by the microbiological analyses of the media, performed at various growth stages of the parasitoid in a separate trial. Conversely, the hydrolate‐saturated air treatment was deemed unsuitable.
The lentic and lotic characteristics of habitats determine the distribution of benthic macroinvertebrates in Mediterranean rivers
Authors: Buffagni Andrea
Published: August 2020

The importance of flow‐related factors to benthic organisms, as well as the role of habitat conditions in shaping aquatic communities during low‐flow periods, have been recognised. Despite this, the preferences of macroinvertebrates to the ratio of lentic to lotic habitats at the reach scale have not been accurately quantified in most instances.

Aquatic invertebrates and habitat features in a range of temporary rivers in Sardinia were investigated. The investigation focused on the flow‐related characteristics that contribute to defining the lentic–lotic condition of the river reaches. The relation of habitat features to benthic taxa distributions was assessed using multidimensional scaling. The main aim of the paper was to quantify the responses of taxa to the different lentic and lotic habitat conditions by applying hierarchical logistic regressions. Finally, taxon optima were aligned along the lentic–lotic gradient and the responses of different taxonomic groups compared.

Unbroken waves and imperceptible flow were correlated with benthic taxa variability, suggesting local hydraulics and turbulence have a major role in regulating community composition. The overall lentic–lotic character of the river reaches was also clearly related to the benthic taxa distribution. More than 80% of taxa were significantly related to the lentic–lotic gradient, and an asymmetrical response curve was the predominant model.

Benthic groups showed taxon optima clustered in different ranges of the lentic–lotic gradient. Odonata, Coleoptera, Hemiptera, and Mollusca preferred clearly lentic conditions. Diptera mainly ranged on the lotic side of the gradient, while Trichoptera were relatively uniformly distributed across the gradient. Ephemeroptera taxa clustered in intermediate lentic–lotic conditions, with two species preferring extremely lentic habitats. In general, optima converged at intermediate and extremely lentic conditions, presumably due, respectively, to the coexistence of different lentic and lotic features and to the highly diverse environmental characteristics under extremely lentic situations.

These results support the conclusion that dissimilar ecological factors act on benthic taxa along the lentic–lotic range and species favouring different lentic–lotic conditions are subjected to pressures of different nature. This should not be ignored when defining species preferences and studying community structure or relationships between species in Mediterranean rivers, which cyclically vary their habitat composition. In addition, the uneven distribution of optima of different groups along the lentic–lotic gradient might affect macroinvertebrate metrics when assessing ecological status or establishing reference conditions under variable climatic conditions.
Global impacts of fertilization and herbivore removal on soil net nitrogen mineralization are modulated by local climate and soil properties
Authors: Risch Anita C. , Zimmermann Stefan , Moser Barbara , Schütz Martin , Hagedorn Frank , Firn Jennifer , Fay Philip A. , Adler Peter B. , Biederman Lori A. , Blair John M. , Borer Elizabeth T. , Broadbent Arthur A. D. , Brown Cynthia S. , Cadotte Marc W. , Caldeira Maria C. , Davies Kendi F. , di Virgilio Augustina , Eisenhauer Nico , Eskelinen Anu , Knops Johannes M. H. , MacDougall Andrew S. , McCulley Rebecca L. , Melbourne Brett A. , Moore Joslin L. , Power Sally A. , Prober Suzanne M. , Seabloom Eric W. , Siebert Julia , Silveira Maria L. , Speziale Karina L. , Stevens Carly J. , Tognetti Pedro M. , Virtanen Risto , Yahdjian Laura , Ochoa‐Hueso Raul
Published: August 2020

Soil nitrogen (N) availability is critical for grassland functioning. However, human activities have increased the supply of biologically limiting nutrients, and changed the density and identity of mammalian herbivores. These anthropogenic changes may alter net soil N mineralization (soil net Nmin), that is, the net balance between N mineralization and immobilization, which could severely impact grassland structure and functioning. Yet, to date, little is known about how fertilization and herbivore removal individually, or jointly, affect soil net Nmin across a wide range of grasslands that vary in soil and climatic properties. Here we collected data from 22 grasslands on five continents, all part of a globally replicated experiment, to assess how fertilization and herbivore removal affected potential (laboratory‐based) and realized (field‐based) soil net Nmin. Herbivore removal in the absence of fertilization did not alter potential and realized soil net Nmin. However, fertilization alone and in combination with herbivore removal consistently increased potential soil net Nmin. Realized soil net Nmin, in contrast, significantly decreased in fertilized plots where herbivores were removed. Treatment effects on potential and realized soil net Nmin were contingent on site‐specific soil and climatic properties. Fertilization effects on potential soil net Nmin were larger at sites with higher mean annual precipitation (MAP) and temperature of the wettest quarter (T.q.wet). Reciprocally, realized soil net Nmin declined most strongly with fertilization and herbivore removal at sites with lower MAP and higher T.q.wet. In summary, our findings show that anthropogenic nutrient enrichment, herbivore exclusion and alterations in future climatic conditions can negatively impact soil net Nmin across global grasslands under realistic field conditions. This is an important context‐dependent knowledge for grassland management worldwide.
How to Measure Distance on a Digital Terrain Surface and Why it Matters in Geographical Analysis
Authors: Qiang Yi , Buttenfield Barbara P. , Joseph Maxwell B.
Published: August 2020

Distance is the most fundamental metric in spatial analysis and modeling. Planar distance and geodesic distance are the common distance measurements in current geographic information systems and geospatial analytic tools. However, there is little understanding about how to measure distance in a digital terrain surface and the uncertainty of the measurement. To fill this gap, this study applies a Monte‐Carlo simulation to evaluate seven surface‐adjustment methods for distance measurement in digital terrain model. Using parallel computing techniques and a memory optimization method, the processing time for the distances calculation of 6,000 simulated transects has been reduced to a manageable level. The accuracy and computational efficiency of the surface‐adjustment methods were systematically compared in six study areas with various terrain types and in digital elevation models in different resolutions. Major findings of this study indicate a trade‐off between measurement accuracy and computational efficiency: calculations at finer resolution DEMs improve measurement accuracy but increase processing times. Among the methods compared, the weighted average demonstrates highest accuracy and second fastest processing time. Additionally, the choice of surface adjustment method has a greater impact on the accuracy of distance measurements in rougher terrain.
Identifying mismatch repair‐deficient colon cancer: near‐perfect concordance between immunohistochemistry and microsatellite instability testing in a large, population‐based series
Authors: Loughrey Maurice B , McGrath Jason , Coleman Helen G , Bankhead Peter , Maxwell Perry , McGready Claire , Bingham Victoria , Humphries Matthew P , Craig Stephanie G , McQuaid Stephen , Salto‐Tellez Manuel , James Jacqueline A
Published: August 2020

Aims

Establishing the mismatch repair (MMR) status of colorectal cancers is important to enable the detection of underlying Lynch syndrome and inform prognosis and therapy. Current testing typically involves either polymerase chain reaction (PCR)‐based microsatellite instability (MSI) testing or MMR protein immunohistochemistry (IHC). The aim of this study was to compare these two approaches in a large, population‐based cohort of stage 2 and 3 colon cancer cases in Northern Ireland.

Methods and results

The study used the Promega pentaplex assay to determine MSI status and a four‐antibody MMR IHC panel. IHC was applied to tumour tissue microarrays with triplicate tumour sampling, and assessed manually. Of 593 cases with available MSI and MMR IHC results, 136 (22.9%) were MSI‐high (MSI‐H) and 135 (22.8%) showed abnormal MMR IHC. Concordance was extremely high, with 97.1% of MSI‐H cases showing abnormal MMR IHC, and 97.8% of cases with abnormal IHC showing MSI‐H status. Under‐representation of tumour epithelial cells in samples from heavily inflamed tumours resulted in misclassification of several cases with abnormal MMR IHC as microsatellite‐stable. MMR IHC revealed rare cases with unusual patterns of MMR protein expression, unusual combinations of expression loss, or secondary clonal loss of expression, as further illustrated by repeat immunostaining on whole tissue sections.

Conclusions

MSI PCR testing and MMR IHC can be considered to be equally proficient tests for establishing MMR/MSI status, when there is awareness of the potential pitfalls of either method. The choice of methodology may depend on available services and expertise.
Complex biological patterns of hematology parameters in childhood necessitating age‐ and sex‐specific reference intervals for evidence‐based clinical interpretation
Authors: Bohn Mary Kathryn , Higgins Victoria , Tahmasebi Houman , Hall Alexandra , Liu En , Adeli Khosrow , Abdelhaleem Mohammed
Published: August 2020

Introduction

Hematology laboratory parameters are among the most routinely ordered tests in support of adult and pediatric care. However, appropriate interpretation of test results has been a challenge in pediatrics since accurate and up‐to‐date reference intervals that reflect the dynamic physiological changes associated with growth and development have not been available. Critical gaps continue to exist in pediatric hematology reference intervals for modern laboratory platforms. To address this gap, this study establishes age‐ and sex‐specific reference intervals for 25 hematology parameters in the CALIPER cohort of healthy children and adolescents using a common platform, the Sysmex XN‐3000 analytical system.

Methods

Fresh whole blood samples collected from a total of 641 healthy children and adolescents (birth to <21 years) with informed consent were analyzed for 25 hematological parameters on the Sysmex XN‐3000 Hematology Analyzer. Age‐ and sex‐specific reference standards were calculated based on Clinical and Laboratory Standards Institute guidelines.

Results

Of the 25 analytes assessed, 19 required age‐partitioning and seven required sex‐partitioning (ie, red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, red blood cell distribution width—SD, red blood cell distribution width—CV, and monocyte percentage). Age‐ and sex‐specific differences mostly coincided with the onset of puberty.

Conclusion

This study establishes a comprehensive database of pediatric reference intervals for hematology parameters in the CALIPER cohort using the widely used Sysmex XN‐3000 analytical platform. These data highlight the dynamic hematological profile observed in healthy children and adolescents and the need for reference interval stratification by age and sex.
Cabozantinib in advanced renal cell carcinoma: A phase II, open‐label, single‐arm study of Japanese patients
Authors: Tomita Yoshihiko , Tatsugami Katsunori , Nakaigawa Noboru , Osawa Takahiro , Oya Mototsugu , Kanayama Hiroomi , Nakayama Kondoh Chihiro , Sassa Naoto , Nishimura Kazuo , Nozawa Masahiro , Masumori Naoya , Miyoshi Yasuhide , Kuroda Shingo , Tanaka Shingo , Kimura Akiko , Tamada Satoshi
Published: August 2020

Objectives

To evaluate the efficacy and safety of cabozantinib, through a bridging study to METEOR, in Japanese patients with advanced renal cell carcinoma who had progressed after prior tyrosine kinase inhibitor therapy.

Methods

This phase II, open‐label, single‐arm study (ClinicalTrials.gov registration number: NCT03339219) included adult Japanese patients with advanced renal cell carcinoma and measurable disease who had received one or more tyrosine kinase inhibitors. Patients received cabozantinib 60 mg orally once daily while there was clinical benefit, or until unacceptable toxicity or disease progression. The primary end‐point was objective response rate per Response Evaluation Criteria in Solid Tumors Version 1.1. Secondary end‐points included clinical benefit rate (complete or partial response, or ≥8‐week stable disease), progression‐free survival, overall survival and safety.

Results

Of the 35 patients enrolled, 68.6%, 22.9% and 8.6% had previously received one, two and three prior tyrosine kinase inhibitors, respectively. The median duration of cabozantinib exposure was 27.0 weeks (range 5.1–43.0 weeks). The objective response rate was 20.0% (90% confidence interval 9.8–34.3%), and the clinical benefit rate was 85.7% (95% confidence interval 69.7–95.2%). The 6‐month estimated progression‐free survival was 72.3% (95% confidence interval 53.3–84.6%); the median progression‐free survival and overall survival were not reached. All patients reported adverse events, which were manageable by supportive treatment or dose modification; two patients (5.7%) discontinued therapy due to adverse events.

Conclusions

The results showed that findings from METEOR can be extrapolated, and that cabozantinib 60 mg/day is a viable treatment option in Japanese patients with advanced renal cell carcinoma who had progressed after prior tyrosine kinase inhibitor therapy.
Patient and clinician experiences with an emergency department‐based mental health liaison nurse service in a metropolitan setting
Authors: Wand Timothy , Collett Gemma , Cutten Alexa , Buchanan‐Hagen Sally , Stack Amanda , White Kathryn
Published: August 2020

As part of a larger multi‐site translational research project this study explored patient and staff experiences, perspectives, and recommendations in relation to a mental health liaison nursing (MHLN) team established in the emergency department (ED) of a metropolitan hospital in New South Wales, Australia. Semi‐structured interviews were conducted with a sample of ED patients (n = 26), ED nurses (n = 10), ED consultants (n = 9), and members of the consultation–liaison psychiatry team (n = 5). Data were analysed thematically. Patients emphasized the numerous therapeutic qualities of the MHLN role, the promptness with which they were seen and the value of follow‐up. Privacy was identified as important, and some negative experiences were reported. Staff identified that the MHLN team are able to respond to a variety of ED presentations in a timely manner. There was recognition that the MHLN team needs to be integrated within the ED as a specialist resource that builds ED capacity. Consistent staffing of the MHLN team with designated clinicians was also considered essential. Integrating a nurse practitioner‐led MHLN team within the ED has demonstrated multiple benefits for patients, ED staff, and overall service provision. Incorporating a specialist mental health nursing service within the ED builds confidence in ED clinicians. Members of the psychiatry team also acknowledge the value of aligning the clinical governance of the MHLN team within the ED and the reduced workload this model of care has on their service provision to ED, freeing them up to concentrate on their broader general hospital role.
DoTrompe l'oeilsLook Right When Viewed from the Wrong Place?
Authors: FERRETTI GABRIELE
Published: August 2020

Picture perception and ordinary perception of real objects differ in several respects. Two of their main differences are: (1) Depicted objects are not perceived as present and (2) We cannot perceive significant spatial shifts as we move with respect to them. Some special illusory pictures escape these visual effects obtained in usual picture perception. First, trompe l'oeil paintings violate (1): the depicted object looks, even momentarily, like a present object. Second, anamorphic paintings violate (2): they lead to appreciate spatial shifts resulting from movement. However, anamorphic paintings do not violate (1): they are still perceived as clearly pictorial, that is, nonpresent. What about the relation between trompe l'oeil paintings and (2)? Do trompe l'oeils allow us to perceive spatial shifts? Nobody has ever focused on this aspect of trompe l'oeil perception. I offer the first speculation about this question. I suggest that, if we follow our most recent theories in philosophy and vision science about the mechanisms of picture perception, then, the only plausible answer, in line with phenomenological intuitions, is that, differently from nonillusory, usual picture perception, and similarly to ordinary perception, trompe l'oeil perception does allow us to perceive spatial shifts resulting from movement. I also discuss the philosophical implications of this claim.
Fine root and root hair morphology of cotton under drought stress revealed with RhizoPot
Authors: Xiao Shuang , Liu Liantao , Zhang Yongjiang , Sun Hongchun , Zhang Ke , Bai Zhiying , Dong Hezhong , Li Cundong
Published: August 2020

Fine roots (roots with a diameter of less than 2 mm) and root hairs are the primary absorbers of water and nutrients; however, the morphology of cotton fine roots and root hairs in response to drought stress has not yet been defined. To solve this problem, this study characterized a self‐made in situ root observation device (RhizoPot) with a scanner with a resolution of up to 4,800 DPI was used to observe the roots of cotton plants grown indoors under both well‐watered and drought stress conditions. RhizoPot provided healthy growth conditions for cotton, and fine roots as well as root hairs were successfully observed. Root length density increased significantly under drought stress, whereas the average root diameter decreased gradually with the extension of treatment time. Drought stress accelerated fine root death, and the diameter of the fine roots was positively correlated with root lifespan. Additionally, the root hair lifespan was negatively regulated by soil drought stress and was associated with the growth stage. This result suggests that cotton developed more slender fine roots and longer root hairs under drought stress, which accelerated the death process of both, in order to develop new fine roots. This process helps cotton absorb as much water as possible under drought stress.
Spike formation and seed setting of the main stem and tillers under post‐jointing drought in winter wheat
Authors: Lin Xiang , Li Ping , Shang Yunqiu , Liu Shuaikang , Wang Sen , Hu Xinhui , Wang Dong
Published: August 2020

To clarify the influence of post‐jointing drought on the ear‐bearing and seed‐setting characteristics of the main stem and tillers of winter wheat (Triticum aestivumL.), a pot experiment was conducted with cultivars “Shannong 29” (SN29) and “Heng 0628” (H0628), and five water regimes: mild drought (WR1) and severe drought (WR2) for 0–5 days after jointing, mild drought (WR3) and severe drought (WR4) for 0–10 days after jointing and adequate water supply as a control (CK). The present study focused on primary tillers (appear in the axils of main stem leaves: T1, T2, T3, T4, etc.), as well as on secondary tillers (appear from the bud in the axil of the prophyll: T10 and T20; appear in the axil of the first leaf of the primary tiller T1: T11). The yield components of tillers showed a downward trend with increasing tiller position and drought degree and duration, and the kernels per spike, single kernels weight and grain yield per spike of tillers T2, T3, T10 and T4 decreased more than those of the other tillers. These outcomes may be related to the spike developmental stages at the time of the drought period. Severe drought during the period from when the stamen primordium is first present (Waddington’s stage 4) to when the carpel extends around the three sides of the ovule (Waddington’s stage 5) significantly decreased the seed set of tillers, but short‐term (5 days) mild drought during this period and even a short‐term severe drought before Waddington’s stage 4 had little effect on the seed set of tillers. The ear‐bearing capacity of tillers was determined not only by the spike developmental stage, but also by the gap from the main stem and the competition of nutrition and space between tillers. Although the ear‐bearing rate of tillers T3 and T10 decreased rapidly after the short‐term mild drought, the increase in the ear‐bearing rate of tillers T20 and T11 effectively compensated for the loss of the number of spikes per plant. Therefore, the short‐term mild drought at the jointing stage had no significant effect on the grain yield of the two cultivars. The tillers T2, T3, T10 and T4 were sensitive to soil moisture in the jointing stage and had high plasticity. During this period, if timely irrigation improves soil moisture, it is expected to increase the ear‐bearing rate and seed set of these tillers, thereby increasing grain yield.
Sex‐related associations of high‐density lipoprotein cholesterol with aortic stiffness and endothelial glycocalyx integrity in treated hypertensive patients
Authors: Triantafyllidi Helen , Benas Dimitris , Schoinas Antonios , Varoudi Mary , Thymis John , Kostelli Gavriela , Birmpa Dionysia , Ikonomidis Ignatios
Published: August 2020

Smoking, a well‐recognized major cardiovascular (CV) risk factor, impairs endothelial function and increases aortic stiffness which indicates subclinical organ damage in hypertensive patients. Loss of endothelial glycocalyx (EG) integrity, as part of the endothelium, represents endothelial dysfunction. The authors aimed to investigate the role of increased HDL cholesterol levels (HDL‐C), which usually are considered protective against CV disease, in aortic stiffness and endothelial integrity in middle‐aged treated hypertensive patients regarding smoking habit. The authors studied 193 treated hypertensive patients ≥40 years (mean age = 61±11 years, 58% females), divided in four groups regarding sex and smoking. Increased perfusion boundary region of the 5‐9 μm diameter sublingual arterial microvessels (PBR5‐9) was measured as a noninvasive accurate index of reduced EG thickness. Aortic stiffness was estimated by carotid‐femoral pulse wave velocity (PWV). In the whole population, an inverse weak relationship was found between HDL‐C and PWV (r = −.15, P = .03) and PBR5‐9 (ρ = −.15, P = .03). Moreover, HDL‐C was negatively related to PBR5‐9 in males (r = −.29, P = .008) either smokers (r = −.35, P < .05) or non‐smokers (r = −.27, P < .05) and PWV in female non‐smokers (r = −.28, P = .009). In a multiple linear regression analysis, using age, weight, smoking, HDL‐C, and LDL‐C as independent variables, we found that HDL‐C independently predicts PWV in the whole population (β = −.14, P = .02) and PBR5‐9 in male hypertensive patients (β = −.28, P = .01). Higher HDL‐C levels are associated with reduced aortic stiffness in hypertensive patients, while they protect EG and subsequently endothelial function in middle‐aged, treated hypertensive male patients (either smokers or not).
Practical recommendations for systemic treatment in psoriasis in case of coexisting inflammatory, neurologic, infectious or malignant disorders (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis; part 2)
Authors: Lambert J.L.W. , Segaert S. , Ghislain P.D. , Hillary T. , Nikkels A. , Willaert F. , Lambert J. , Speeckaert R.
Published: August 2020

Background

Psoriasis patients carry an increased risk for associated comorbidities. Dermatologists have to be aware of the effects of systemic treatments not only on psoriasis but also on co‐occurring diseases. In case of other coexisting inflammatory diseases, the right psoriasis treatment may improve both disorders. For infectious and malignant disorders, some treatments have to be avoided as they may be harmful.

Objective

The primary objective of this project was to collect evidence for the creation of practice guidelines for systemic treatment of psoriasis (BETA‐PSO: Belgian Evidence‐based Treatment Advice in Psoriasis).

Methods

Evidence‐based recommendations were formulated using a quasi‐Delphi methodology after a systematic search of the literature and a consensus procedure involving eight psoriasis experts.

Results

Recommendations are given on the use of systemic treatment in psoriatic arthritis, inflammatory bowel disease, demyelinating disorders, hepatitis B and C, HIV and cancer.

Conclusion

This expert opinion is a practical guide for dermatologists when handling psoriasis patients with these specific conditions.
Risk of tuberculosis reactivation with interleukin (IL)‐17 and IL‐23 inhibitors in psoriasis – time for a paradigm change
Authors: Nogueira M. , Warren R.B. , Torres T.
Published: August 2020

Tuberculosis is an infectious disease with a major global impact, ranked in the top 10 mortality causes worldwide. In an immunocompetent individual, the host defence mechanisms control Mycobacterium tuberculosis infection and induce the latent form of the disease. However, in the presence of diseases or therapies, which exert an immunosuppressive effect, latent tuberculosis can be re‐activated. Psoriasis is an immune‐mediated, inflammatory disease, and its treatment has rapidly evolved over the last few years. It has long been recognized that the tumour necrosis factor (TNF)‐α inhibitors are associated with increased risk of reactivation of latent tuberculosis infection. Thus, international guidelines have been suggesting tuberculosis screening before starting the treatment with all biological agents since then. In addition, the institution of chemoprophylaxis in the presence of latent tuberculosis and the annual screening for tuberculosis thereafter have also been indicated. However, anti‐tuberculosis treatments can have significant side‐effects and there are currently several contraindications to their use. The risk benefit of starting anti‐tuberculous treatment should be carefully weighed up. The emergence of new biological drugs for the treatment of psoriasis, such as interleukin (IL)‐17 and IL‐23 inhibitors, has reignited the subject of tuberculosis reactivation as it is possible that IL‐17 and 23 blockade do not carry the same risk of TB reactivation as TNF‐α inhibitors. Although preclinical studies have shown that cytokines IL‐17 and IL‐23 have a possible role against infection with M. tuberculosis, data from clinical trials and post‐marketing surveillance with drugs that inhibit these cytokines appear to suggest that they are not crucial to this response. In this article, we review the available data on tuberculosis reactivation after the treatment of psoriasis with IL‐17 and IL‐23 inhibitors, and its possible impact on the way we currently manage latent tuberculosis infection before or after starting treatment with these new drugs.
Using a Projection IRT Method for Vertical Scaling When Construct Shift Is Present
Authors: Strachan Tyler , Cho Uk Hyun , Kim Kyung Yong , Willse John T. , Chen Shyh‐Huei , Ip Edward H. , Ackerman Terry A. , Weeks Jonathan P.
Published: August 2020

In vertical scaling, results of tests from several different grade levels are placed on a common scale. Most vertical scaling methodologies rely heavily on the assumption that the construct being measured is unidimensional. In many testing situations, however, such an assumption could be problematic. For instance, the construct measured at one grade level may differ from that measured in another grade (e.g., construct shift). On the other hand, dimensions that involve low‐level skills are usually mastered by almost all students as they progress to higher grades. These types of changes in the multidimensional structure, within and across grades, create challenges for developing a vertical scale. In this article, we propose the use of projective IRT (PIRT) as a potential solution to the problem. Assuming that a test measures a primary dimension of substantive interest as well as some peripheral dimensions, the idea underlying PIRT is to integrate out the secondary dimensions such that the model provides both item parameters and ability estimates for the primary dimension. A simulation study was conducted to evaluate the effectiveness of the PIRT as a method for vertical scaling. An example using empirical data from a measure of foundational reading skills is also presented.
Provider perceived barriers and facilitators to integrating routine outcome monitoring into practice in an urban community psychiatry clinic: A mixed‐methods quality improvement project
Authors: Van Wert Michael J. , Malik Mansoor , Memel Brenda , Moore Ryan , Buccino Daniel , Hackerman Florence , Kumari Suneeta , Everett Anita , Narrow William
Published: August 2020

Background and Aims

Although mental health clinics are under increasing pressure to demonstrate value and routine outcome monitoring (ROM) has become a mandated component of care, providers have been slow to adopt ROM into practice, with some estimating that less than 20% of mental health clinicians use it consistently in the United States. This article explores perceived barriers and facilitators to integrating ROM into practice among clinicians and administrators in a large urban US community psychiatry clinic.

Method

One hundred and thirty‐eight clinical and administrative staff were administered an anonymous web‐based survey to elicit attitudes towards ROM. Responses were summarized descriptively and qualitatively synthesized into a conceptual model using inductive thematic analysis.

Results

Common barriers to integration included insufficient time to collect and/or use measures, not knowing what measures to use, measures being difficult to access, and insufficient training. Facilitators included increased access/ease of use, training and support, measure relevance/validity, and accountability.

Conclusions

In order for psychiatry clinics to successfully implement ROM into practice, they must diagnose organization‐side barriers and translate this knowledge into actionable quality improvement initiatives ranging from the infrastructural to the cultural.
Revascularization Versus Medical Therapy in Patients Aged 80 Years and Older with Acute Myocardial Infarction
Authors: Phan Derek Q. , Rostomian Ara H. , Schweis Franz , Chung Joanie , Lin Bryan , Zadegan Ray , Lee Ming‐Sum
Published: August 2020

BACKGROUND/OBJECTIVES

Older patients are underrepresented in acute coronary syndrome clinical trials. We sought to evaluate the benefits of revascularization in patients aged 80 years and older presenting with acute myocardial infarction (AMI).

DESIGN

Retrospective study utilizing inverse probability of treatment weighting (IPTW).

SETTING

Single tertiary referral center for an integrated healthcare system in southern California.

PARTICIPANTS

Patients undergoing invasive coronary angiography for AMI between 2009 and 2019, and subsequently treated with percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or medical therapy alone.

MEASUREMENTS

All‐cause mortality, nonfatal myocardial infarction (MI), and repeated revascularization.

RESULTS

A total of 1,433 patients aged 80 years or older (median age = 83.5 years; 66% male) presenting with AMI who underwent treatment with PCI (50%), CABG (12%), or medical therapy alone (38%) were included. Those treated with medical therapy were more likely to be Black, had one or more chronic total occlusions in any vessel, had more comorbidities, and had lower left ventricular ejection fraction. Baseline characteristics were well balanced after IPTW adjustment. Median follow‐up was 2.6 years. Revascularization (PCI or CABG) was associated with reduced mortality (hazard ratio (HR) = 0.66; 95% confidence interval (CI) = 0.60–0.73) and nonfatal MI (HR = 0.68; 95% CI = 0.58–0.78), but an increased need for repeated revascularization (HR = 1.60; 95% CI = 1.15–2.23). Separately comparing PCI or CABG alone versus medical therapy yielded similar results. Revascularization was associated with lower mortality in all subgroups, except in Black patients and those with prior CABG.

CONCLUSION

Revascularization is superior to medical therapy in reducing all‐cause mortality and nonfatal MI in patients aged 80 years and older with AMI. Age alone should not preclude patients from potentially beneficial invasive therapies.
Novel concept for the epaxial/hypaxial boundary based on neuronal development
Authors: Nagashima Hiroshi , Koga Daisuke , Kusumi Satoshi , Mukaigasa Katsuki , Yaginuma Hiroyuki , Ushiki Tatsuo , Sato Noboru
Published: August 2020

Trunk muscles in vertebrates are classified as either dorsal epaxial or ventral hypaxial muscles. Epaxial and hypaxial muscles are defined as muscles innervated by the dorsal and ventral rami of spinal nerves, respectively. Each cluster of spinal motor neurons passing through dorsal rami innervates epaxial muscles, whereas clusters traveling on the ventral rami innervate hypaxial muscles. Herein, we show that some motor neurons exhibiting molecular profiles for epaxial muscles follow a path in the ventral rami. Dorsal deep‐shoulder muscles and some body wall muscles are defined as hypaxial due to innervation via the ventral rami, but a part of these ventral rami has the molecular profile of motor neurons that innervate epaxial muscles. Thus, the epaxial and hypaxial boundary cannot be determined simply by the ramification pattern of spinal nerves. We propose that, although muscle innervation occurs via the ventral rami, dorsal deep‐shoulder muscles and some body wall muscles represent an intermediate group that lies between epaxial and hypaxial muscles.
Sexual health care in cancer patients: A survey of healthcare providers' knowledge, attitudes and barriers
Authors: Wazqar Dhuha Youssef
Published: August 2020

Aims and objectives

To assess the knowledge and attitudes of healthcare providers regarding sexual health care in cancer patients in Saudi Arabia and explore possible barriers influencing their attitudes.

Background

A growing body of research emphasises the importance of healthcare providers addressing the sexual problems of cancer patients. The literature, however, shows that cancer treatment‐related sexual problems are not frequently discussed by healthcare providers as expected. In Saudi Arabia, sexual health care in oncology daily practice has not been addressed sufficiently.

Methods

A cross‐sectional correlational study was conducted with a convenience sample of 150 healthcare providers from a university teaching and referral hospital providing cancer and palliative care in Jeddah City, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Sexual Healthcare Attitudes and Knowledge survey. Descriptive and inferential statistics and Pearson's correlations were performed. A content analysis was used to enhance understanding and support study's findings.

Results

Participants had a poor knowledge related to sexual health care in cancer patients, and the low mean attitudes score also represents negative attitudes and higher levels of barriers. Participants had insufficient knowledge about assessment and evaluation of sexual health in cancer patients, and did not know about sexual dysfunction resulting from cancer and its treatment. Knowledge and attitudes had a significantly positive correlation.

Conclusion

The study findings indicate there is room for improvement in the sexual health‐related knowledge among oncology nurses, doctors and radiation oncologists. Helping healthcare providers overcome barriers to discussing cancer patients' sexual issues needs a careful evaluation of the knowledge, attitudes and barriers that keep them from discussing such issues.

Relevance to clinical practice

It is imperative to improve healthcare providers' sexuality knowledge about cancer patients through introducing sexual health‐based continuing education programmes, availability of resources (educational materials and clinical checklists) and training in oncology daily practice.
Sexuality amongst heterosexual men with morbid obesity in a bariatric surgery programme: A qualitative study
Authors: Granero‐Molina José , Torrente‐Sánchez María José , Ferrer‐Márquez Manuel , Hernández‐Padilla José Manuel , Ruiz‐Muelle Alicia , López‐Entrambasaguas Olga María , Fernández‐Sola Cayetano
Published: August 2020

Aim and Objectives

To describe and understand the experiences of sexuality amongst heterosexual men diagnosed with morbid obesity (MO) who are in a bariatric surgery programme.

Background

Morbid obesity is a chronic metabolic disease that affects men’s physical, psychological and sexual health. Evidence suggests that MO could be linked to anxiety, depression, low self‐esteem, sexual life and social disorders. Bariatric surgery is a reliable method for weight loss in patients with MO.

Design

This is a qualitative study based on Merleau‐Ponty’s phenomenology, and the COREQ checklist was employed to report on the current study.

Methods

Convenience and purposive sampling was carried out and included 24 in‐depth interviews with heterosexual men with MO in a bariatric surgery programme between October 2018–March 2019 in Spain.

Results

Two main themes emerged from the analysis: (a) a corporality which is judged and condemned; and (b) adapting sexual practices to bariatric surgery.

Conclusions

Men with MO reject a body that limits their physical, social and sexual life. A negative body image and low self‐esteem, which do not respond to the traditional masculine role or new masculinities, reduce men's self‐concept. Men with MO feel rejection, stigma and isolation. Support from their partner is fundamental to adapt.

Relevance to clinical practice

The results of the study draw attention to how heterosexual men with MO experience their sexuality in a bariatric surgery programme and the challenges nurses face. Recognising the problem, helping to develop coping strategies or referring to specialists in sexuality could improve the quality of life in patients and their partners.
Biochemical and molecular investigation of oxidative stress associated with urolithiasis induced by increased dietary calcium or protein in chickens
Authors: El Sebaei Mahmoud G. , Arafat Nagah , El‐Shafei Reham A. , El‐Adl Mohamed A. , Farag Amany , Aziza Abeer E. , Eladl Abdelfattah H.
Published: August 2020

This study was carried out to evaluate the effects of induced urolithiasis by high dietary calcium (Ca) or protein levels on biochemical analyte levels, redox status, selected inflammatory cytokines and histopathology in chickens. A total of 90 one‐day‐old white Hy‐Line chicks were fed basal control diets containing 20% crude protein (CP) and 1% Ca until they reached 44 days of age. After that, the birds were divided into three groups (30 birds per group). All management factors (light, temperature, ventilation, stock density and diet) were identical among the three groups throughout the study except for the dietary Ca and protein percentages. Group I was fed a control diet containing 20% CP and 1% Ca, group II was fed a high‐Ca diet containing 5% Ca, and group III was fed a high‐protein diet containing 25% CP. Our findings clearly demonstrated that dietary imbalance (caused by high‐Ca or high‐CP levels) per se in chickens was physiologically harmful, as it was accompanied by post‐mortem lesions; biochemical, redox status and histopathological alterations; and upregulation of inflammatory cytokines (interleukin (IL)‐1β and IL‐6). In particular, the birds fed the high‐Ca diet clearly exhibited the most obvious alterations in most of the endpoints. In conclusion, this study constitutes the first extensive investigation of the effects of high‐Ca or high‐protein diets induced urolithiasis on growth performance, redox status, inflammatory cytokine levels and pathological characterization in chickens.
Local and systemic levels of aMMP‐8 in gingivitis and stage 3 grade C periodontitis
Authors: Keles Yucel Zeynep Pinar , Afacan Beral , Emingil Gulnur , Tervahartiala Taina , Kose Timur , Sorsa Timo
Published: August 2020

The Objective

This study aimed to analyze active matrix metalloproteinase (aMMP‐8) levels in gingival crevicular fluid (GCF), saliva and serum in the context of new criteria of gingivitis and stage 3 grade C periodontitis.

The Background

Periodontal disease is an inflammatory process that can result in tooth loss and also is considered a modifying factor for systemic health. Matrix metalloproteinase (MMP)‐8 is the major collagenase of periodontal tissue breakdown.

Methods

Totally 83 systemically healthy and non‐smoker individuals consisting of 23 periodontally healthy, 20 gingivitis and 40 stage 3 periodontitis, were recruited to the study. Clinical periodontal examinations of probing depth (PD), clinical attachment loss (CAL), gingival index (GI), plaque index (PI) and bleeding on probing (BOP) were recorded; and GCF, saliva and serum samples were obtained. aMMP‐8 was measured by immunofluorometric assay (IFMA).

Results

GCF and serum aMMP‐8 levels were significantly increased in periodontitis and gingivitis compared to healthy ones (P < .001), whereas gingivitis and periodontitis patients showed similar levels of aMMP‐8 in GCF and serum (P > .05). Saliva levels of aMMP‐8 were higher in periodontitis patients than both gingivitis and healthy individuals (P < .001). There was no significant difference in salivary aMMP‐8 levels between gingivitis group and healthy controls (P > .05).

Conclusion

These findings support the involvement of aMMP‐8 in periodontal diseases and suggest that its local and systemic levels can reflect stage 3 grade C periodontitis. Moreover, aMMP‐8 in GCF and serum seems to have a potential to differentiate between gingivitis and periodontal health.
Protocol for assessment of the pupillary light reflex in dogs without chemical restraint: preliminary investigation
Authors: Graham K. L. , McCowan C. I. , White A.
Published: August 2020

Objective

To explore the use of a modified pupillometry technique in dogs without chemical restraint.

Materials and Methods

Following dark adaptation, pupillary light reflexes were assessed in six dogs with sudden acquired retinal degeneration syndrome, in the unaffected eye of eight dogs with unilateral primary glaucoma (“predisposed”), and in 11 healthy dogs. Responses to red, blue and white lights were recorded and relative pupil sizes subsequently determined based on video recordings of each test.

Results

Mean testing time was 2.3 minutes (range 1.8 to 3.1 minutes), excluding time for dark adaptation. Baseline pupil size in dogs with sudden acquired retinal degeneration syndrome was greater than in normal and predisposed eyes. Pupil constriction was reduced in predisposed compared to normal and sudden acquired retinal degeneration syndrome eyes when stimulated with high‐intensity blue light. Compared to normal eyes, those with sudden acquired retinal degeneration syndrome had reduced pupil constriction when stimulated with low‐ and high‐intensity red light, low‐intensity blue light and white light.

Clinical Significance

Quantitative measures of pupil function were obtained from healthy and diseased eyes without the need for chemical restraint. Further investigations are warranted to validate the technique and evaluate its use in the management of canine glaucoma.