bluuebunny/crossref_metadata_2025 huggingface dataset:
Antenatal hydronephrosis and fetal urine sampling
Authors: Beksac Mehmet Sinan , Beksac Alp Tuna , Tanacan Atakan , Mumusoglu Sezcan , Katlan Doruk , Celik Hasan Tolga
Published: January 2019

The aim of this study is to evaluate the significance of renal pelvis aspiration (RPA) in the management of antenatal hydronephrosis (AHN). This study enrolled 15 AHN cases (one twin pregnancy) that necessitated RPA for AHN. Chromosomal abnormalities, gene disorders, and additional life‐threatening congenital abnormalities were eliminated prior to intrauterine interventions. Urine analysis were performed for the evaluation of renal function. Normal renal function was observed in six neonates/infants (40%) (group 1), whereas impaired renal function and various type of urinary system anomalies were observed in 9 neonates/infants (60%) (group 2) during the short‐term and longitudinal follow‐up periods. There were statistically significant differences in the oligohydroamniosis rate, mean fetal urine sodium value, mean fetal urine β2‐microglobulin, mean gestational week at birth, and mean birthweight values between the groups (P = 0.007, P < 0.001, P = 0.035, P < 0.001, and P = 0.001, respectively). Renal pelvis aspiration and urine analysis were substantial for the management of AHN in necessary cases. β2‐microglobulin and sodium are clinically useful markers to detect the presence of severe renal damage due to obstructive uropathy and thus, important adjuvants in the proper selection of fetuses for further antenatal interventions.
MRX93 syndrome (BRWD3 gene): five new patients with novel mutations
Authors: Tenorio Jair , Alarcón Pablo , Arias Pedro , Ramos Feliciano J. , Campistol Jaume , Climent Salvador , García‐Miñaur Sixto , Dapía Irene , Hernández Alicia , Nevado Julián , Solís Mario , Ruiz‐Pérez Víctor L. ,   The Sogri Consortium, Lapunzina Pablo
Published: January 2019

Overgrowth syndromes (OGS) comprise a heterogeneous group of disorders whose main characteristic is that either the weight, height, or head circumference are above the 97th centile or 2 to 3 SD above the mean for age and sex. Additional features, such as facial dysmorphism, developmental delay or intellectual disability (ID), congenital anomalies, neurological problems and an increased risk of neoplasia are usually associated with OGS. Genetic analysis in patients with overlapping clinical features is essential, to distinguish between two or more similar conditions, and to provide appropriate genetic counseling and recommendations for follow up. In the present paper, we report five new patients (from four unrelated families) with an X‐linked mental retardation syndrome with overgrowth (XMR93 syndrome), also known as XLID‐BRWD3‐related syndrome. The main features of these patients include ID, macrocephaly and dysmorphic facial features. XMR93 syndrome is a recently described disorder caused by mutations in the Bromodomain and WD‐repeat domain‐containing protein 3 (BRWD3) gene. This article underscores the importance of genetic screening by exome sequencing for patients with OGS and ID with unclear clinical diagnosis, and expands the number of reported individuals with XMR93 syndrome, highlighting the clinical features of this unusual disease.
Modelling spatial biodiversity in the world’s largest mangrove ecosystem—The Bangladesh Sundarbans: A baseline for conservation
Authors: Sarker Swapan Kumar , Reeve Richard , Paul Nirmal K. , Matthiopoulos Jason
Published: January 2019

Aim

Mangrove forests are among the most threatened and rapidly vanishing, but poorly understood ecosystems. We aim to uncover the variables driving mangrove biodiversity and produce baseline biodiversity maps for the Sundarbans world heritage site—the Earth's largest contiguous mangrove ecosystem.

Location

The Bangladesh Sundarbans, South Asia.

Methods

We collected species abundance, environmental and disturbance data from 110 permanent sample plots (PSPs) covering the entire Bangladesh Sundarbans (6,017 km2). We applied generalized additive models to determine the key variables shaping the spatial distributions of mangrove diversity and community composition. Biodiversity maps were constructed using covariate‐driven habitat models, and their predictive performances were compared with covariate‐free (i.e., direct interpolation) approaches to see whether the inclusion of habitat variables bolster spatial predictions of biodiversity or whether we can rely on direct interpolation approaches when environmental data are not available.

Results

Historical forest exploitation, disease, siltation and soil alkalinity were the key stressors causing loss of alpha and gamma diversity in mangrove communities. Both alpha and gamma diversity increased along the downstream‐to‐upstream and riverbank‐to‐forest interior gradients. Mangrove communities subjected to intensive past tree harvesting, disease outbreaks and siltation were more homogeneous in species composition (beta diversity). In contrast, heterogeneity in species composition increased along decreasing salinity and downstream‐to‐upstream gradients. We find that the surviving biodiversity hotspots (comprising many globally endangered tree species) are located outside the established protected area network and hence open to human exploitation. We therefore suggest bringing them immediately under protected area management.

Main conclusions

We provide the first habitat‐based modelling and mapping of alpha, beta and gamma diversity in threatened mangrove communities. In general, habitat‐based models showed better predictive ability than the covariate‐free approach. Nevertheless, the small margin of differences between the approaches demonstrates the utility of direct interpolation approaches when environmental data are unavailable.
Ubiquitin‐specific protease 7 (USP7) is essential for endometrial stromal cell decidualization in mice
Authors: Gao Yue , Wang Yaqin , Zhou Chan , Kong Shuangbo , Lu Jinhua , Wang Haibin , Yang Jing
Published: January 2019

Ubiquitin‐specific protease 7 (USP7), a member of the deubiquitinating (DUB) enzyme family, regulates protein stability and has a well‐characterized function in tumorigenesis. Given its critical role in growth and development, it was speculated to be involved in modulating processes in the female reproductive system but its exact role has not been elucidated. Decidualization is one of the key processes in pregnancy and aberrant decidualization is a cause of pregnancy failure. The uterine endometrium layer undergoes significant structural and functional changes during decidualization in preparation for and after embryo implantation. Here, we hypothesized that USP7 could be involved in mediating endometrial stromal cell (ESC) decidualization and set out to determine its function with a primary stromal cell culture. Using in situ hybridization and immunohistochemical techniques, we observed increased USP7 expression during uterine decidualization and found that it was predominantly localized to the decidual zone in the post‐implantation uterus. Since the ovarian hormones, progesterone (P4) and estrogen (E2), function in promoting stroma decidualization, we investigated their relationship with USP7 expression and found that they exert minimal influence. Moreover, increased USP7 expression observed during deciduoma development was found to be independent of blastocyst attachment. Using a specific USP7 inhibitor, HBX19818, we demonstrated an additional novel role for USP7 in endometrial stroma decidualization in mice during early pregnancy. Our findings could potentially be applied towards future research and development in female infertility.
The mysterious “double” arch
Authors: Gopalakrishnan Arun , Sivasubramonian Sivasankaran , Valaparambil Ajitkumar
Published: January 2019

A child with cyanosis and heart failure was noted to have two different vascular arches of similar caliber on echocardiography. A systematic analysis of the rhythm and flow patterns revealed the mysterious “double” arch.
Predicting clinical progression in multiple sclerosis after 6 and 12 years
Authors: Dekker I. , Eijlers A. J. C. , Popescu V. , Balk L. J. , Vrenken H. , Wattjes M. P. , Uitdehaag B. M. J. , Killestein J. , Geurts J. J. G. , Barkhof F. , Schoonheim M. M.
Published: January 2019

Background and purpose

To predict disability and cognition in multiple sclerosis (MS) after 6 and 12 years, using early clinical and imaging measures.

Methods

A total of 115 patients with MS were selected and followed up after 2 and 6 years, with 79 patients also being followed up after 12 years. Disability was measured using the Expanded Disability Status Scale (EDSS); cognition was measured only at follow‐up using neuropsychological testing. Predictors of interest included EDSS score, baseline brain and lesion volumes and their changes over 2 years, baseline age, clinical phenotype, sex and educational level.

Results

Higher 6‐year EDSS score was predicted by early EDSS score and whole‐brain volume changes and baseline diagnosis of primary progressive MS (adjusted R2 = 0.56). Predictors for 12‐year EDSS score included larger EDSS score changes and higher T1‐hypointense lesion volumes (adjusted R2 = 0.38). Year 6 cognition was predicted by primary progressive MS phenotype, lower educational level, male sex and early whole‐brain atrophy (adjusted R2 = 0.26); year 12 predictors included male sex, lower educational level and higher baseline T1‐hypointense lesion volumes (adjusted R2 = 0.14).

Conclusions

Patients with early signs of neurodegeneration and a progressive disease onset were more prone to develop both disability progression and cognitive dysfunction. Male sex and lower educational level only affected cognitive dysfunction, which remains difficult to predict and probably needs more advanced imaging measures.
Leptospirosis: An important infectious disease in North American horses
Authors: Divers T. J. , Chang Y.‐F. , Irby N. L. , Smith J. L. , Carter C. N.
Published: January 2019

North American horses are commonly exposed to Leptospira organisms. Leptospira Bratislava is the most common infecting serovar but this serovar has not been confirmed to cause clinical disease in North American horses. Leptospira Pomona type kennewicki is responsible for most of the clinical diseases (leptospirosis) in North American horses. Leptospirosis is most commonly associated with diseases of the placenta and fetus, the kidneys and the eyes in horses. In‐utero infections in pregnant mares may result in abortion, neonatal illness or birth of an antibody positive healthy foal. Acute renal failure in younger horses and recurrent uveitis in adult horses are other well documented clinical syndromes of leptospirosis. Abortions, neonatal disease and acute renal failure are caused by a subacute infection, while horses with Leptospira associated recurrent uveitis develop ocular disease months or years after the initial Leptospira infection. Diagnosis of Leptospirosis is made by a combination of antigen or antibody testing methods. Mares that abort following Leptospira infection have no additional clinical signs at the time of abortion but may shed the offending Leptospira spp. in the urine for several weeks. Antibiotic treatments are sometimes used in hopes of decreasing Leptospira shedding in infected horses or prophylactically in exposed pregnant mares but documentation of efficacy is lacking. Horses with Leptospira ‐ associated acute renal failure can be successfully treated with antibiotics and supportive care. Recurrent uveitis is commonly associated with leptospirosis in North American horses and although horses may have chronic intraocular infection triggering an immune disease, systemic antimicrobial therapy has not been effective in eliminating the organism from the eye. An equine approved Leptospira Pomona type kennewicki vaccine is now available in North America.
In vitro antimicrobial activity against equine Lawsonia intracellularis strains
Authors: Pereira C. E. R. , Resende T. P. , Vasquez E. , Marshall‐Lund L. , Guedes R. M. C. , Gebhart C. J.
Published: January 2019

Background

Lawsonia intracellularis is the aetiologic agent of equine proliferative enteropathy (EPE). This emerging equine disease leads to diarrhoea, severe protein loss and can result in death if left untreated. Timely treatment of EPE is critical for recovery from the disease, and hence, information about antimicrobial susceptibilities of equine L. intracellularis strains to antimicrobials used in horses is needed. However, L. intracellularis is an obligate intracellular bacterium and so must be isolated and maintained in cell cultures.

Objectives

To determine the in vitro antimicrobial activity of 14 antimicrobials against two equine L. intracellularis strains.

Study design

In vitro experiments.

Methods

This study was designed to compare the relative in vitro susceptibility of each strain of L. intracellularis to different antimicrobials which included metronidazole, minocycline hydrochloride, erythromycin, cephalothin sodium salt, combination (4:1) of sulfamethazine and trimethoprim, chloramphenicol, rifampicin, penicillin, ampicillin, doxycycline hydrochloride, cefazolin sodium salt, clarithromycin, ceftiofur hydrochloride and enrofloxacin. The minimum inhibitory concentration (MIC) was based on intracellular and extracellular activity that inhibited 99% of L. intracellularis growth in cell culture as compared to the antimicrobial‐free control.

Results

Rifampicin and clarithromycin were the most active antimicrobials against the two L. intracellularis strains tested, with MICs of ≤0.125 when tested both intracellularly and extracellularly. Doxycycline, minocycline, erythromycin, chloramphenicol and enrofloxacin showed intermediate to high activity, and activity was generally higher when evaluating intracellular activity. Sulfamethazine/trimethoprim showed variable results. Ampicillin, penicillin and metronidazole had low to moderate activity. L. intracellularis was resistant to cefazolin, cephalothin and ceftiofur in in vitro conditions.

Main limitations

Only two equine isolates of L. intracellularis were available for this study due to the difficulty in isolating this obligate intracellular species from intestinal samples.

Conclusions

This is the first report of antimicrobial susceptibility patterns for equine L. intracellularis strains.
Regeneration of rete ridges in Lanyu pig (Sus scrofa): Insights for human skin wound healing
Authors: Lin Chein‐Hong , Chiu Po‐Yuan , Hsueh Yuan‐Yu , Shieh Shyh‐Jou , Wu Chia‐Ching , Wong Tak‐Wah , Chuong Cheng‐Ming , Hughes Michael W.
Published: January 2019

Rete ridges are important to the mechanical function of skin in animals with minimal hair, including humans. As mice do not exhibit rete ridges, the need for a quality animal model is pertinent. Here, we develop a Lanyu pig (Sus scrofa) full‐thickness wound model to explore tissue regeneration because the architecture and function are similar to humans and inbred genetic variants are available. Full‐ and partial‐thickness wounds were generated on the dorsum. Full‐thickness wounds at post‐wound day 57 exhibit severe scar with no signs of wound‐induced hair follicle neogenesis. Wound contraction is greater in the anterior/posterior relative to the medial/lateral axis. In wound beds, K14+ cells increased while K10+, p63+ and PCNA+ cells decreased compared to unwounded tissue. Epithelial β‐catenin is unchanged. The wound bed expresses more ColI, less ColIII and no elastin. Rete ridges do not form after full‐thickness wounding, but incompletely regenerate after partial‐thickness wounding. An alkaline phosphatase (ALP)+ cell population, not associated with hair follicles, is present at the bottom of the rete ridge basal layer in pig and human unwounded skin. These K5+/K10−/PCNA−/ALP+ epithelial cells are absent after full‐thickness wounding but reappear after partial‐thickness wounding, before invagination of new rete ridges. In summary, full‐thickness wounding on the dorsum of Lanyu pigs results in scar formation and perturbed molecular expression while partial‐thickness wounding permits limited rete ridge and papillary dermis regeneration. Future functional studies and further characterization will help contribute knowledge for the regenerative medicine field.
To what extent is drought‐induced tree mortality a natural phenomenon?
Authors: Fensham Roderick J. , Laffineur Boris , Allen Craig D.
Published: January 2019

Aim

Catastrophic forest mortality due to more extreme rainfall deficits and higher temperatures under future climate scenarios has been predicted. The aim of this study is to explore the magnitude of historical drought‐induced tree mortality under pre‐warming conditions.

Location

North‐eastern Australia.

Time period

1845–2017.

Major taxa studied

Trees.

Methods

Field survey, historical analysis and climate analysis.

Results

We present evidence of 18%–30% tree mortality from recent droughts across three regions of north‐eastern Australia with rainfall deficits less severe than earlier historical droughts. The corrected temperature record represents modest warming at the stations with long records in the vicinity of the study areas. In terms of rainfall deficit the most severe drought on record occurred in the early 20th century, and historical evidence confirms that this drought and earlier droughts before the advent of pastoralism coincided with substantial tree mortality.

Main conclusions

Dramatic declines in woody biomass in response to drought historically occurred more than once a century and are a natural phenomenon in semi‐arid Australia. The magnitude of drought‐induced tree mortality under natural climate fluctuations requires further investigation in other continents. Widespread drought‐induced tree mortality is not just a recent global change phenomenon and has been underestimated as a natural ecological process. However, even more severe forest die‐off events from more extreme hotter droughts are predicted if Earth’s warming proceeds as currently projected.
The paleobiogeographical significance of the Silurian and Devonian trilobites of Japan
Authors: Stocker Christopher P. , Siveter Derek J. , Lane Philip D. , Williams Mark , Oji Tatsuo , Wallis Simon R. , Tanaka Gengo , Komatsu Toshifumi , Siveter David J. , Vandenbroucke Thijs R. A.
Published: January 2019

Six major groups of trilobites from the Silurian and Devonian of Japan are evaluated for their paleobiogeographical signature. Silurian illaenids and scutelluids show four generic‐level and at least two species‐level links with the Australian segment of the Gondwana paleocontinent; encrinurids also indicate two generic‐level links with Australia and also the South China paleocontinent; whilst Devonian phacopids, and possibly proetids, suggest at least two generic‐level links with the North China paleocontinent. These different patterns may reflect the fragmentary biostratigraphical record of Japanese trilobites, but they also appear to reflect paleoenvironmental parameters associated with lithofacies, and paleoecology. Thus, Japanese assemblages of proetids and phacopids occurring in deep‐water clastic lithofacies have counterparts in similar settings in North China, and Japanese scutelluids and illaenids are strongly associated with shallow marine carbonate lithofacies that are similar to those of their occurrences in Australia. Japanese encrinurids occur in carbonate rocks indicative of shallow marine settings in the Kurosegawa Terrane, and they demonstrate a consistent paleobiogeographical affinity with Australia and South China. Larval ecology cannot be directly assessed for Japanese trilobite groups. However, proetids have consistently been shown to have planktonic protaspides, whereas illaenids, scutelluids, and encrinurids have benthic protaspides. Planktonic protaspides would have a greater propensity for distribution in ocean currents than benthic ones, and therefore may be of more limited paleobiogeographical utility. The combined data from the six different groups indicates that the complex paleobiogeographical patterns of the Japanese trilobite assemblages need to be interpreted with caution, and similarity of taxa does not necessarily denote paleogeographical proximity to other regions.
Early rapid weight gain among formula‐fed infants: Impact of formula type and maternal feeding styles
Authors: Mennella J. A. , Papas M. A. , Reiter A. R. , Stallings V. A. , Trabulsi J. C.
Published: January 2019

Background

What and how infants are fed are considered important determinants for the risk factor of early rapid gain weight.

Objectives

We conducted secondary analyses on data from a randomized clinical trial, wherein infants randomized to feed cow milk formula had double the incidence of early rapid weight gain than those fed extensively hydrolyzed protein formula, to determine whether maternal feeding styles had independent effects or interactive effects with infant formula type on early rapid weight gain.

Methods

Anthropometry and feeding patterning (number of daily formula feeds) were measured monthly, and maternal feeding styles were measured at 0.5, 3.5, and 4.5 months. Longitudinal models were fitted using generalized estimating equations and separate logistic models conducted.

Results

The treatment groups did not differ in formula feeding patterning or in maternal feeding styles, which were stable across the first 4.5 months. Feeding styles had no significant effects on early rapid weight gain and did not interact with formula group. However, type of infant formula had a direct and independent impact on early rapid weight gain (P = 0.003).

Conclusions

The type of infant formula had a differential impact on early rapid weight gain independent of maternal feeding style, highlighting the self‐regulatory capabilities of infants.
Domain structure and evolution in ZnO‐modified Pb(Mg1/3Nb2/3)O3–0.32PbTiO3 ceramics
Authors: Wang Rui‐Xue , Zhang Ji , Li Kai , Sun Lei , Yang Bin , Chen Yan‐Bin , Luo Zhen‐Lin , Wang Yaojin , Zhang Shan‐Tao
Published: January 2019

The doping of ZnO is efficient to improve the piezoelectric property and thermal stability of Pb(Mg1/3Nb2/3)O3–PbTiO3 (PMN–PT) based ceramics. However, the underlying physics, especially the local domain structures of the ZnO modified PMN–PT ceramics, which is strongly associated with the electric properties, is not clear yet. In this paper, we investigated the local domain structures and their evolution as a function of x in PMN–0.32PT:xZnO ceramics. It was found that, the domain evolution is mainly caused by the growth of grain size induced by the sintering aiding effect of ZnO at x < 0.04, and the domain evolution can be attributed to the phase transition induced by the partial replacement of Mg2+ by Zn2+ in the B‐site of PMN–PT lattice at x > 0.06. Furthermore, we also investigated the domain structure evolution as functions of temperature and local external electric field in PMN–0.32PT:0.06ZnO ceramics, which exhibited superior piezoelectric property relative to other compositions. We found that the irregular nanodomains are more stable at high‐temperature range, and the regular non‐180° domains exhibited more complex rotation behavior under local electric field, which probably leads to the thermal stability and piezoelectric property enhancement in the ZnO‐modified PMN–0.32PT ceramics.
Elasticity, hardness, and fracture toughness of sodium aluminoborosilicate glasses
Authors: Januchta Kacper , To Theany , Bødker Mikkel S. , Rouxel Tanguy , Smedskjaer Morten M.
Published: January 2019

Due to an increasing demand for oxide glasses with a better mechanical performance, there is a need to improve our understanding of the composition‐structure‐mechanical property relations in these brittle materials. At present, some properties such as Young's modulus can to a large extent be predicted based on the chemical composition, while others—in particular fracture‐related properties—are typically optimized based on a trial‐and‐error approach. In this work, we study the mechanical properties of a series of 20 glasses in the quartenary Na2O–Al2O3–B2O3–SiO2 system with fixed soda content, thus accessing different structural domains. Ultrasonic echography is used to determine the elastic moduli and Poisson's ratio, while Vickers indentation is used to determine hardness. Furthermore, the single‐edge precracked beam method is used to estimate the fracture toughness (KIc) for some compositions of interest. The compositional evolutions of Vickers hardness and Young's modulus are in good agreement with those predicted from models based on bond constraint density and strength. Although there is a larger deviation, the overall compositional trend in KIc can also be predicted by a model based on the strength of the bonds assumed to be involved in the fracture process.
Infrared‐to‐ultraviolet light‐absorbing BaTiO3‐based ferroelectric photovoltaic materials
Authors: Wu Liyan , Akbashev Andrew R. , Podpirka Adrian A. , Spanier Jonathan E. , Davies Peter K.
Published: January 2019

Ferroelectric oxides have been demonstrated to be promising in developing emerging photovoltaic technologies because of the various mechanisms that allow above‐band‐gap photovoltages and higher efficiencies. However, the wide band gaps of conventional ferroelectric oxides (2.7‐4 eV) limit their utilization of the solar spectrum. Here the phase stability, absorption properties, ferroelectric, and photovoltaic responses of Ni‐ and Ni‐Nb‐substituted BaTiO3 were explored to evaluate their potential as visible‐light‐absorbing photovoltaic materials. Although the acceptor substitution of Ni2+ stabilized a hexagonal 6H polymorph in both systems, post‐annealing treatments allowed restoration of a tetragonal 3C phase for Ba(Ti0.99Ni0.01)O2.99 and (0.9)BaTiO3‐(0.1)Ba(Ni1/2Nb1/2)O2.75. The oxygen vacancies accompanying the Ni and Ni‐Nb substitutions significantly lower the optical band gap of BaTiO3 to ~1.5 eV and the visible light absorption can be systematically tuned between 380 and 1000 nm by varying the Ni:Nb ratio. Room temperature ferroelectricity was observed in Ba(Ti0.99Ni0.01)O2.99 with a saturation polarization = 18 μC/cm2 and remnant polarization = 1 μC/cm2. The Ni‐Nb substituted composition (0.9)BaTiO3‐(0.1)Ba(Ni1/2Nb1/2)O2.75 shows a ferroelectric response with a remnant polarization of 5 μC/cm2 at 77 K, which gradually decreases as temperature increases. Both compositions exhibit ferroelectrically switchable photoresponses under an AM 1.5 G sunlight simulator; the highest switchable steady‐state current of 8 nA/cm2 observed for (0.9)BaTiO3‐(0.1)Ba(Ni1/2Nb1/2)O2.75 exceeds those reported in previous studies of BaTiO3 ceramic samples (J Solid State Chem, 1975; 12: 193; Jpn J Appl Phys, 2013; 52: 09KF03).
Intelligibility, Moral Loss and Injustice
Authors: Laborde Cécile
Published: January 2019

In Liberalism's Religion, I analyse the specific conception of religion that liberalism relies upon. I argue that the concept of religion should be disaggregated into its normatively salient features. When deciding whether to avert undue impingements on religious observances, or to avoid any untoward support of such observances, liberal states should not deal with ‘religion’ as such but, rather, with relevant dimensions of religious phenomena. States should avoid religious entanglement when ‘religion’ is epistemically inaccessible, socially divisive and/or comprehensive in scope. In turn, states should show special deference to religious observances insofar as they exhibit what I call integrity – whether personal or collective. The upshot of this interpretive strategy is that liberal law need not recognise religion as such. As a result, there are gaps between the liberal construal of disaggregated religion and the lived experience of religion as a uniquely integrated experience. Are these gaps morally regrettable? Are they unjust?
Incorporating antibiotics into platelet‐rich fibrin: A novel antibiotics slow‐release biological device
Authors: Polak David , Clemer‐Shamai Navit , Shapira Lior
Published: January 2019

Background

The aim of the present in vitro study was to explore the possibility of using platelet‐rich fibrin (PRF) as a local sustained released device for antibiotics.

Materials and methods

Platelet‐rich fibrin was prepared with the addition of antibiotics (5 mg/ml metronidazole; 150 mg/ml clindamycin; 1 mU/ml penicillin) or saline prior to centrifugation, while collagen sponges served as control. PRFs anti‐bacterial properties were examined in an anti‐biogram assay with Staphylococcus aureus or Fusobacterium nucleatum at different time intervals after PRF preparation.

Results

The addition of antibiotic solutions at volumes of 2 or 1 ml led to significant changes in PRF's physical properties, while the addition of 0.5 ml solution did not. PRF with saline showed minor anti‐bacterial activity, while all PRFs with antibiotics showed significant anti‐bacterial activity (p < 0.05). No differences were observed between raw (clot) and pressed (membrane) forms of PRF. Collagen sponges with and without antibiotics showed similar results to PRF. PRF and collagen sponges with antibiotics preserved their anti‐bacterial properties 4 days after preparation.

Conclusions

Platelet‐rich fibrin incorporated with antibiotics showed long‐term anti‐bacterial effect against F. nucleatum and S. aureus. This modified PRF preparation may be used to reduce the risk of post‐operative infection in addition to the beneficial healing properties of PRF.
Traumatic occlusion aggravates bone loss during periodontitis and activates Hippo‐YAP pathway
Authors: Pan Weiyi , Yang Li , Li Jinle , Xue Lili , Wei Wei , Ding Handong , Deng Shibing , Tian Ye , Yue Yuan , Wang Min , Hao Liang , Chen Qianming
Published: January 2019

Aim

This study aimed at exploring changes in YAP expression and their effect on periodontitis (PD) combined with traumatic occlusion (TO).

Materials and Methods

BALB/cJ mice were used to establish a PD model by local administration of Porphyromonas gingivalis (P.g, ATCC 33277) and a TO model by occlusal elevation (OE) using composite resin bonding on the bilateral maxillary molar. The mouse fibroblast cell line (L929) and pre‐osteoblast cell line (MC3T3‐E1) were subjected to cyclic tensile/compressive stress and inflammatory stimuli (lipopolysaccharide from Escherichia coli) to verify in vivo results.

Results

Severe bone resorption was observed by microCT scanning in OE with P.g group, when compared to OE only and P.g only groups. Mechanical stress caused by OE activated the Hippo‐YAP pathway in periodontal tissues and upregulated the expression of JNK/AP‐1. OE with P.g further promoted the expression of YAP and JNK/AP1, leading to the upregulation of the JNK/AP‐1 related inflammatory cytokines TNF‐α and IL6. Similar results were obtained when osteoblasts were subjected to mechanical stress in vitro.

Conclusions

Our study demonstrated that periodontitis with TO caused severe inflammation‐induced bone resorption. Activation of YAP and upregulation of JNK/AP‐1 induced by TO potentially aggravated the symptoms of PD.
The status of workers and platforms in the sharing economy
Authors: Hagiu Andrei , Wright Julian
Published: January 2019

We consider whether workers who provide their services through online platforms, such as Handy and Uber, should be classified as independent contractors or employees. Using a formal economic model, we show how being too strict or too liberal in classifying workers as independent contractors (relative to the actual degree of control workers have) can be detrimental, not just to firms and welfare, but sometimes to the workers themselves. We also use the model to explore the extent to which an intermediate classification of workers between employees and independent contractors may lead to better outcomes. The intermediate classification is meant to apply to firms that retain control of some actions while their workers control others, as is the case for many online platforms.
The importance of consumer multihoming (joint purchases) for market performance: Mergers and entry in media markets
Authors: Anderson Simon P. , Foros Øystein , Kind Hans Jarle
Published: January 2019

Consumer “multihoming” (watching two TV channels, or buying two news magazines) has surprisingly important effects on market equilibrium and performance in (two‐sided) media markets. We show this by introducing consumer multihoming and advertising finance into the classic circle model of product differentiation. When consumers multihome (attend more than one platform), media platforms can charge only incremental value prices to advertisers. Entry or merger leaves consumer prices unchanged under consumer multihoming, but leaves advertiser prices unchanged under single‐homing: Multihoming flips the side of the market on which platforms compete. In contrast to standard circle results, equilibrium product variety can be insufficient under multihoming.
Comparative histochemical analysis of intestinal glycoconjugates in the blunthead pufferfish Sphoeroides pachygaster and grey triggerfish Balistes capriscus (Teleostei: Tetraodontiformes)
Authors: Carlucci Roberto , Mentino Donatella , Semeraro Daniela , Ricci Pasquale , Sion Letizia , Scillitani Giovanni
Published: January 2019

The localization of intestinal glycoconjugates of the blunthead pufferfish Sphoeroides pachygaster and the grey triggerfish Balistes capriscus from the north‐western Ionian Sea was analysed by histochemical methods (PAS, AB pH 2.5, HID) and lectin binding experiments (WGA, LFA, SBA, sialidase‐SBA, PNA, sialidase‐PNA, ConA, AAA, UEA‐I, LTA) to assess how evolutionary loss of a functional stomach in S. pachygaster affects intestinal secretions relative to the B. capriscus, which retains the plesiomorphic gastric condition. Sphoeroides pachygaster had a lower content of acid mucins but more complex sialylation patterns than B. capriscus. GalNAc and GlcNAc residuals were present in both, but GalNAc residuals in S. pachygaster were subterminal to sialic acid. Balistes capriscus lacked galactosylated residuals and its enterocytes had a glycocalyx that differed in composition between the small intestine and the rectum and was missing from S. pachygaster. Functional and ecological implications of these findings are discussed.
Comparing cost‐effectiveness of surface water flood management interventions in a UK catchment
Authors: Webber James L. , Fu Guangtao , Butler David
Published: January 2019

Despite significant consequences caused by recent events, surface water flooding has historically been of lower priority relative to fluvial and coastal risks in UK flood management. Legislation and research proposes a variety of innovative interventions to address this; however, widespread application of these remains a challenge due to a number of institutional, economic, and technical barriers. This research applies a framework capable of fast and high‐resolution assessment of intervention cost‐effectiveness as an opportunity to improve available evidence and encourage uptake of interventions through analysing permutations of type, scale, and distribution in urban catchments. Fast assessment of many scenarios is achieved using a cellular automata flood model and a simplified representation of interventions. Conventional and green strategies are examined across a range of design standard and high‐magnitude rainfall events in an urban catchment. Results indicate high‐volume rainwater capture interventions demonstrate a significant reduction in estimated annual damage costs, and localised surface water drainage interventions exhibit high cost‐effectiveness for damage reduction. Analysis of performance across a wide range of return periods enhances available evidence for option comparison decision support and provides a basis for future resilience assessment of interventions.
Psychoactive Medications and Adverse Outcomes among Older Adults Receiving Hemodialysis
Authors: Ishida Julie H. , McCulloch Charles E. , Steinman Michael A. , Grimes Barbara A. , Johansen Kirsten L.
Published: January 2019

BACKGROUND

Guidelines recommend avoidance of several psychoactive medications such as hypnotics in older adults due to their adverse effects. Older patients on hemodialysis may be particularly vulnerable to complications related to use of these agents, but only limited data are available about the risks in this population.

OBJECTIVES

To evaluate the association between the use of psychoactive medications and time to first emergency department visit or hospitalization for altered mental status, fall, and fracture among older patients receiving hemodialysis.

DESIGN

Observational cohort study.

SETTING

National registry of patients receiving hemodialysis (US Renal Data System).

PARTICIPANTS

A total of 60 007 adults 65 years or older receiving hemodialysis with Medicare Part D coverage in 2011.

MEASUREMENTS

The predictors were use of sedative‐hypnotics and anticholinergic antidepressants (modeled as separate time‐varying exposures). The outcomes were time to first emergency department visit or hospitalization for altered mental status, fall, and fracture (modeled separately).

RESULTS

Overall, 17% and 6% used sedative‐hypnotics and anticholinergic antidepressants, respectively, in 2011. In multivariable‐adjusted Cox regression, anticholinergic antidepressant use was associated with a 25%, 27%, and 39% higher hazard of altered mental status, fall, and fracture, respectively, compared with no use. Use of sedative‐hypnotics was not associated with adverse outcomes.

CONCLUSION

Anticholinergic antidepressants were associated with adverse outcomes in older hemodialysis patients, and alternative treatments should be considered. Sedative‐hypnotics were not associated with the risks evaluated in this study, but further investigation of the harms of this class of agents is warranted before their recommendation as a treatment option for insomnia in this population. J Am Geriatr Soc 67:449–454, 2019.
Interventions for sleep difficulties in adults with an intellectual disability: a systematic review
Authors: Shanahan P. J. , Palod S. , Smith K. J. , Fife‐Schaw C. , Mirza N.
Published: January 2019

Background

Current literature highlights higher prevalence rates of sleep difficulties amongst adults with an intellectual disability. However, no synthesis has been conducted to assess the effectiveness of existing interventions in this population. Thus, the aim of this review was to assess the effectiveness of sleep interventions in adults with an intellectual disability (ID).

Method

Eight databases were searched to identify interventions for sleep difficulties amongst adults with an ID. The study quality was assessed with the Risk Of Bias In Non‐randomised Studies – of Interventions. Nine studies (n = 97) were eligible for inclusion in the review.

Results

There was a notable study on heterogeneity in terms of the population, study design, intervention studied, sleep assessment and outcome assessments used. Eight of the nine studies reported improvement in sleep following intervention. However, these findings need additional support as only 97 participants involving a variety of interventions and measurement systems were used across all studies. Furthermore, eight of the nine studies had serious to critical risk of bias. The only study identified as having low risk of bias was a placebo‐controlled randomised controlled trial for the use of melatonin.

Conclusions

This review highlights the need for objective measures such as actigraphy and studies with greater experimental control investigating sleep interventions in adults with ID.
Adults with Down syndrome: a comprehensive approach to manage complexity
Authors: Carfì A. , Vetrano D. L. , Mascia D. , Meloni E. , Villani E. R. , Acampora N. , Brandi V. , Fries B. E. , Martin L. , Bernabei R. , Onder G.
Published: January 2019

Background

Down syndrome (DS) is characterised by premature ageing that affects selected organ systems, and persons with this condition can present patterns of co‐morbidities and deficits often observed in the older population without DS. However, information on the characteristics of adult persons with DS is limited.

The objective of the study is to describe characteristics of adults with DS collected with a standardised, comprehensive assessment instrument.

Methods

Cross‐sectional study.

Four hundred thirty adults with DS (age range 18/75 years) from three countries (Italy, n = 95; USA, n = 175; and Canada, n = 160).

A standardised assessment instrument (interRAI intellectual disability) was used to assess sample characteristics.

Results

Mean age ranged from 35.2 (standard deviation 12.0) years in the US sample to 48.8 (standard deviation 9.0) years in the Canadian sample. Most participants in the Italian and US sample were living in private homes, while more than half of those in the Canadian sample were institutionalised. Prevalences of geriatric conditions, including cognitive deficits, disability in the common activities of daily living, symptoms of withdrawal or anhedonia, aggressive behaviour, communication problems, falls and hearing problems were high in the study sample. Gastrointestinal symptoms, skin and dental problems and obesity were also frequently observed.

Conclusions

Adults with DS present with a high level of complexity, which may suggest the need for an approach based on a comprehensive assessment and management that can provide adequate care. Further research is needed to understand better the effectiveness of such an approach in the DS population.
Motivations, Beliefs, and Expectations of Spanish Nurses Planning Migration for Economic Reasons: A Cross‐Sectional, Web‐Based Survey
Authors: Gea‐Caballero Vicente , Castro‐Sánchez Enrique , Díaz‐Herrera Miguel Ángel , Sarabia‐Cobo Carmen , Juárez‐Vela Raúl , Zabaleta‐Del Olmo Edurne
Published: January 2019

Purpose

Migration of nurses is not a new or recent event. During the past few decades, nursing migration flows have been a constant trend worldwide. The main objective of this study was to explore the motivations, beliefs, and expectations that Spanish nurses had when considering migration to another country in the near future.

Design

Cross‐sectional, Internet survey of Spanish nurses planning migration for professional reasons.

Methods

Ad hoc, web‐based questionnaire following the Nurses Early Exit Study guidelines.

Findings

One hundred seventy‐two nurses responded. Fifty percent of the participants intended to emigrate in the following 6 months and had chosen the United Kingdom as their destination. The most important drivers of migration were unemployment or precarious employment, and professional development. Fifty‐eight percent of the participants were very afraid of experiencing discrimination or rejection.

Conclusions

This first study conducted in Spain directly exploring determinants of nurse migration highlighted globalization‐driven factors and specific acculturation fears.

Clinical Relevance

Employment uncertainty and professional development remain key push drivers for migration of Spanish nurses. Discrimination and rejection due to migrancy were concerns for 60% of the participants.
Effect of Fabrication Technique on the Marginal Discrepancy and Resistance of Lithium Disilicate Crowns: An In Vitro Study
Authors: Sadid‐Zadeh Ramtin , Li Rui , Miller Lorin M. , Simon Michael
Published: January 2019

Purpose

To evaluate the impact of fabrication technique on the marginal fit and resistance of lithium disilicate crowns.

Materials and Methods

Twelve ivorine molars were prepared to receive lithium disilicate crowns. The preparations were digitally recorded using an intraoral scanner, and the crowns were designed following the anatomy of an unprepared tooth using a design software. The designed crowns were fabricated using 3 techniques: (1) milling from lithium disilicate blocks using a 3‐axis milling machine (3XM), (2) milling from lithium disilicate blocks using a 5‐axis milling machine (5XM), and (3) milling from resin‐wax billet using a 5‐axis milling machine, followed by heat‐pressing the pattern into lithium disilicate (5XWP). For the control group, the wax patterns were fabricated by one lab technician, and the crowns were fabricated by heat‐pressing the pattern into lithium disilicate (CWP). After sintering, the crowns were secured on their associated preparations using an elastomeric material. The marginal gap of each crown was then measured at 14 defined locations through analyses of 20× images captured with a stereomicroscope. The marginal integrity and resistance to rotation of each crown were assessed by 2 calibrated practitioners. Differences in outcomes by fabrication technique were assessed using Wilcoxon, Kruskal Wallis, and Fisher's exact tests, as appropriate (α = 0.05).

Results

Crowns fabricated using digital workflows (3XM, 5XM, 5XWP) had significantly smaller mean marginal gaps compared to the CWP group (p = 0.0001, p = 0.0002, p = 0.0001, respectively); however, 3XM group was the only group to exhibit significantly better marginal integrity than the CWP group (p = 0.0004). No significant difference (p = 0.6004) in the resistance to rotation of crowns was observed between groups.

Conclusions

Choice of fabrication technique and instrument may impact the marginal discrepancy of lithium disilicate crowns; however, all fabrication techniques analyzed produced crowns with acceptable marginal discrepancies.
Obtaining information from family caregivers to inform hospital care for people with dementia: A pilot study
Authors: Toye Christine , Slatyer Susan , Quested Eleanor , Bronson Mary , Hill Andrew , Fountaine Janet , Uren Hannah V. , Troeung Lakkhina , Maher Sean
Published: January 2019

Aim

We aimed to implement a systematic nurse–caregiver conversation, examining fidelity, dose and reach of implementation; how implementation strategies worked; and feasibility and mechanisms of the practice change.

Background

Appropriate hospital care for people living with dementia may draw upon: information from the patient and family caregiver about the patient's perspective, preferences and usual support needs; nursing expertise; and opportunities the nurse has to share information with the care team. Within this context, planned nurse–caregiver communication merits further investigation.

Methods

In Phase I, we established the ward staff's knowledge of dementia and Alzheimer's disease, prepared seven nurse change leaders, finalised the planned practice change and developed implementation plans. In Phase II, we prepared the ward staff during education sessions and leaders supported implementation. In Phase III, evaluations were informed by interviews with change leaders, follow‐up measures of staff knowledge and a nurse focus group. Qualitative data were thematically analysed. Statistical analyses compared nurses' knowledge over time.

Results

Planned practice change included nurses providing information packs to caregivers, then engaging in, and documenting, a systematic conversation. From 32 caregivers, 15 received information packs, five conversations were initiated, and one was completed. Knowledge of dementia and Alzheimer's disease improved significantly in change leaders (n = 7) and other nurses (n = 17). Three change leaders were interviewed, and six other nurses contributed focus group data. These leaders reported feeling motivated and suitably prepared. Both nurses and leaders recognised potential benefits from the planned conversation but viewed it as too time‐consuming to be feasible.

Conclusions

The communication initiative and implementation strategies require further tailoring to the clinical setting. A caregiver communication tool may be a helpful adjunct to the conversation. Implementation may be enhanced by more robust stakeholder engagement, change leader inclusion in the reference group and an overarching supportive framework within which change leaders can operate more effectively.

Implications for Practice

Nurse‐caregiver communication in this context requires inititatives tailored to the clinical setting with input from all stakeholders.