bluuebunny/crossref_metadata_2025 huggingface dataset:
“At‐risk” kidney: How surgical factors influence renal functional preservation after partial nephrectomy
Authors: Dagenais Julien , Bertolo Riccardo , Garisto Juan , Chavali Jaya , Kaouk Jihad
Published: February 2019

Objectives

To investigate the influence of surgical modifiable factors on chronic kidney disease upstaging in a contemporary cohort of patients with normal and “at‐risk” kidneys undergoing partial nephrectomy.

Methods

We reviewed 778 consecutive patients with (n = 634)/without (n = 144) chronic kidney disease or risk factors for chronic kidney disease in our institutional partial nephrectomy database. Chronic kidney disease upstaging was assessed using glomerular filtration rate measurements preoperatively and at 3–12 months postoperatively. Using a multivariate logistic regression, baseline clinicodemographic factors, and the operative measurements of excisional volume loss and warm and cold ischemia time on rates of chronic kidney disease upstaging were determined. Marginal effects were used to analyze the impact of ischemia time and generate interaction curves.

Results

Chronic kidney disease/risk factors for chronic kidney disease had equivalent rates of chronic kidney disease upstaging as the healthy kidney cohort (31.5% vs 38.2%, P = 0.15). Of the entire cohort, 2.8% were upstaged to stage IV–V chronic kidney disease. Multivariate analysis found a significant association between chronic kidney disease upstaging and excisional volume loss in both cohorts (no chronic kidney disease/risk factors for chronic kidney disease: odds ratio 1.63, P = 0.04; chronic kidney disease/risk factors for chronic kidney disease: odds ratio 1.42, P = 0.001). Only in the chronic kidney disease/risk factors for chronic kidney disease cohort, there was an association between ischemia type/duration and chronic kidney disease upstaging (odds ratio 1.04, P = 0.04). Warm ischemia began to predict an increased risk of chronic kidney disease upstaging at 17.6 min, which became statistically significant at 49 min.

Conclusions

Chronic kidney disease upstaging is common after partial nephrectomy. Although volume loss unequivocally affects rates of upstaging irrespective of baseline renal function, warm ischemia time disproportionately influences “at‐risk” kidneys. Therefore, strong consideration should be given to minimizing volume loss and using cold ischemia when extended clamp times are anticipated in “at‐risk” kidneys.
IL‐33 induces production of autoantibody against autologous respiratory epithelial cells: a potential mechanism for the pathogenesis of COPD
Authors: Li Qin , Hu Yue , Chen Yan , Lv Zhe , Wang Jingjing , An Gao , Du Xiaonan , Wang Huating , Corrigan Chris J. , Wang Wei , Ying Sun
Published: February 2019

The mechanisms underlying the chronic, progressive airways inflammation, remodelling and alveolar structural damage characteristic of human chronic obstructive pulmonary disease (COPD) remain unclear. In the present study, we address the hypothesis that these changes are at least in part mediated by respiratory epithelial alarmin (IL‐33)‐induced production of autoantibodies against airways epithelial cells. Mice immunized with homologous, syngeneic lung tissue lysate along with IL‐33 administered directly to the respiratory tract or systemically produced IgG autoantibodies binding predominantly to their own alveolar type II epithelial cells, along with increased percentages of Tfh cells and B2 B‐cells in their local, mediastinal lymph nodes. Consistent with its specificity for respiratory epithelial cells, this autoimmune inflammation was confined principally to the lung and not other organs such as the liver and kidney. Furthermore, the serum autoantibodies produced by the mice bound not only to murine, but also to human alveolar type II epithelial cells, suggesting specificity for common, cross‐species determinants. Finally, concentrations of antibodies against both human and murine alveolar epithelial cells were significantly elevated in the serum of patients with COPD compared with those of control subjects. These data are consistent with the hypothesis that IL‐33 contributes to the chronic, progressive airways obstruction, inflammation and alveolar destruction characteristic of phenotypes of COPD/emphysema through induction of autoantibodies against lung tissue, and particularly alveolar type II epithelial cells.
Asthma and oral changes in children: Associated factors in a community of southern Brazil
Authors: Rezende Gabriela , dos Santos Nathália Maria Lopes , Stein Caroline , Hilgert Juliana Balbinot , Faustino‐Silva Daniel Demétrio
Published: February 2019

Background

Asthma is a chronic disease that involves several healthcare services that need attention in relation to its treatment and prevention.

Aim

The objective of this study was to evaluate caries, erosion, and enamel defects in children with and without asthma.

Design

Cross‐sectional study, with a sample of 228 children ages 6‐12 years, stratified as asthmatic (n = 112) and non‐asthmatic (n = 116), at two Primary Health Units of the Community Health Service, Brazil. The evaluation consisted of an oral examination and a structured interview with parents/guardians, in addition to data from medical records. Data were analysed by Poisson regression with a robust error variance, all of them at a level of significance of P < 0.05.

Results

Of 112 asthmatic children, 63 (51.2%) had dental caries and 25 (53.2%) enamel defects. In the adjusted analysis, dental caries and use of salbutamol were associated (PR = 1.32, 95% CI = 1.01‐1.72). In addition, children who performed oral hygiene more than three times a day showed a greater prevalence (PR = 2.36, 95% CI = 1.02‐4.85) of dental erosion compared with children who performed it only once a day.

Conclusions

There is no evidence for an association between asthma, caries, erosion, and enamel defect in children aged from 6 to 12 years. There was, however, an association between dental caries and use of salbutamol.
Developing risk‐adjusted quality indicators for pressure ulcers in long‐term care hospitals in the Republic of Korea
Authors: Lee Yun J. , Kim Jung Y. , Dong Cha B. , Park Ok K.
Published: February 2019

Pressure ulcers result in financial losses, including the cost of unnecessary medical expenses because of extended hospital stays, treatment, and examination. This was a retrospective, observational, methodological study to develop quality indicators related to pressure ulcer development and validate risk adjustment factors for pressure ulcer development. We performed a literature review to develop risk adjustment factors, and an expert group performed a content validity test. To validate risk adjustment factors for pressure ulcer development using electronic medical records, 127 patients admitted to a long‐term care hospital in South Korea from June to September 2015 were enrolled in the study. Pressure ulcer risk factors were peripheral vascular disease, end‐stage disease, past pressure ulcer history, high risk group for pressure ulcer development, fever, haemoglobin, and albumin (all P < 0.05); only albumin (odds ratio: 0.210, P < 0.001) was significantly associated with pressure ulcer development as an independent risk factor. Further research with a large sample size is needed for the validation of risk adjustment factors. Risk‐adjusted quality indicators for pressure ulcer development can be used to evaluate the quality of nursing care and compare outcomes after preventive pressure ulcer care activities or between long‐term care hospitals.
Molecular dynamics investigation of the fracture mechanism of a glass‐ceramic containing cleavable crystals
Authors: Urata Shingo , Takato Yoichi , Maeda Kei
Published: February 2019

In this study on a novel glass‐ceramic containing hexagonal CaAl2Si2O8 crystals embedded in a SiO2–Al2O3–CaO glass, we used molecular dynamics simulations to unravel the toughening mechanism of the partially crystallized composite material. The crystalline phase is composed of alternate layers of SiO4/AlO4 tetrahedra and calcium ions. After careful modeling of crystals embedded in the glass matrix, we conducted crack propagation simulations using single‐notched models. We found that: (a) when a crack propagates parallel to the cleavable calcium layer, the glass‐ceramic breaks in a brittle way since the crack passes through the fragile interlayer promptly, (b) the stiffer SiO4/AlO4 oxide layer can inhibit crack propagation, and the crack is thus deflected to the interface between the crystal and the glass matrix; and (c) a calcium layer present between the glass matrix and the edge of the CaAl2Si2O8 crystal is more fragile than those inside the crystal, indicating that cracks prefer to travel along the glass‐crystal interface. These theoretical simulations successfully demonstrated that the anisotropy and the fragile feature of the crystals lead to microcrack toughening of the glass‐ceramic. In addition, we discuss deformation anisotropy in the microscale by constructing a larger model that includes randomly orientated multiple CaAl2Si2O8 crystals.
The effect of Fe‐acceptor doping on the electrical properties of Na1/2Bi1/2TiO3 and 0.94 (Na1/2Bi1/2)TiO3–0.06 BaTiO3
Authors: Steiner Sebastian , Seo In‐Tae , Ren Pengrong , Li Ming , Keeble David J. , Frömling Till
Published: February 2019

Na1/2Bi1/2TiO3 (NBT) based ceramics are amongst the most promising lead‐free ferroelectric materials. It was expected that the defect chemistry and the effect of doping of NBT would be similar to that observed for lead based materials, however, acceptor doping does not lead to ferroelectric hardening. Instead, high oxygen ionic conductivity is induced. Nevertheless, for solid solutions with BaTiO3 (BT), which are more relevant with respect to ferroelectric applications, such a drastic change of electrical properties has not been observed so far. To rationalize the difference in defect chemistry between NBT and its solid solution 94(Na1/2Bi1/2TiO3)–0.06 BaTiO3 (NBT–6BT) compositions with different concentrations of Fe‐dopant were investigated. The study illustrates that the materials exhibit very similar behavior to NBT, and extraordinarily high oxygen ionic conductivity could also be induced in NBT–6BT. The key difference between NBT–6BT and NBT is the range of the dependence of ionic conductivity with dopant concentration. Previous studies of NBT–6BT have not reached sufficiently high dopant concentrations to observe high conductivity. In consequence, the same defect chemical model can be applied to both NBT and its solid solutions. This will help to rationalize the effect of doping on ferroelectric properties of NBT‐ceramics and defect chemistry related degradation and fatigue.
Dental anxiety, oral health‐related quality of life, and general well‐being: A self‐determination theory perspective
Authors: Halvari Anne Elisabeth Münster , Halvari Hallgeir , Deci Edward L.
Published: February 2019

The aim of this study was to test a structural equation model (SEM) with the following hypotheses: (1) patients’ perceptions of oral health care professionals’ (i.e., dentists and dental hygienists) controlling interpersonal styles would positively predict patients’ dental anxiety through their basic psychological need frustration in treatment; (2) in turn, high dental anxiety would positively predict dysregulation of dental anxiety, which through a feedback loop contributes to perception of oral health care professionals’ controlling styles; and, (3) in addition, both dental anxiety and dysregulation of dental anxiety would predict poor Oral Health‐Related Quality of Life (OHRQoL) and subsequently poor general well‐being. A cross‐sectional study was conducted among 322 students at the University of Oslo. Participants responded to a survey with validated questionnaires. All variables in the model tested were acceptably normally distributed. The SEM did fit the data well and all hypotheses were supported. A bootstrapping procedure indicated that all indirect links in the model were supported. Analysis indicated that common method variance (CMV) did not seriously distort the results in this setting. Although the majority of oral health care professionals are perceived as being noncontrolling by their patients (51%), the proportion perceived as moderately (38%) or highly (11%) controlling represent a challenge for oral health care education and practice. It would be useful for oral health care professionals to be trained in avoiding a controlling treatment style.
Diatom β‐diversity in streams increases with spatial scale and decreases with nutrient enrichment across regional to sub‐continental scales
Authors: Leboucher Thibault , Budnick William R. , Passy Sophia I. , Boutry Sébastien , Jamoneau Aurélien , Soininen Janne , Vyverman Wim , Tison‐Rosebery Juliette
Published: February 2019

Aim

To quantify the relative contributions of local community assembly processes versus γ‐diversity to β‐diversity, and to assess how spatial scale and anthropogenic disturbance (i.e. nutrient enrichment) interact to dictate which driver dominates.

Location

France and the United States.

Time period

1993–2011.

Major taxa studied

Freshwater stream diatoms.

Methods

β‐diversity along a nutrient enrichment gradient was examined across multiple spatial scales. β‐diversity was estimated using multi‐site Sørensen dissimilarity. We assessed the relative importance of specialists versus generalists using Friedley coefficient, and the contribution of local community assembly versus γ‐diversity to β‐diversity across spatial scales, with a null model. Finally, we estimated the response of β‐diversity to environmental and spatial factors by testing the correlations between community, environmental and geographical distance matrices with partial Mantel tests.

Results

β‐diversity generally increased with spatial scale but the rate of increase depended on nutrient enrichment level. β‐diversity decreased significantly with increasing nutrient enrichment level due to the loss of specialist species. Local assembly was an important driver of β‐diversity especially under low nutrient enrichment. Significant partial Mantel correlations were observed between diatom β‐diversity and pure environmental distances under these conditions, highlighting the role of species sorting in local assembly processes. Conversely, in heavily enriched sites, only spatial distances were significantly correlated with β‐diversity, which indicated a substantial role of dispersal processes.

Main conclusions

Nutrient concentration mediated the expected increase in β‐diversity with spatial scales. Across spatial scales, β‐diversity was more influenced by local assembly processes rather than by γ‐diversity. Nutrient enrichment was associated with an overall decline in diatom β‐diversity and a shift in assembly processes from species sorting to dispersal, notably due to the elimination of some specialists and their subsequent replacement by generalists.
Small non‐coding RNA and colorectal cancer
Authors: Chen Hui , Xu Zhiying , Liu Deliang
Published: February 2019

Colorectal cancer (CRC) is the third most common malignance. Although great efforts have been made to understand the pathogenesis of CRC, the underlying mechanisms are still unclear. It is now clear that more than 90% of the total genome is actively transcribed, but lack of protein‐coding potential. The massive amount of RNA can be classified as housekeeping RNAs (such as ribosomal RNAs, transfer RNAs) and regulatory RNAs (such as microRNAs [miRNAs], PIWI‐interacting RNA [piRNAs], tRNA‐derived stress‐induced RNA, tRNA‐derived small RNA [tRFs] and long non‐coding RNAs [lncRNAs]). Small non‐coding RNAs are a group of ncRNAs with the length no more than 200 nt and they have been found to exert important regulatory functions under many pathological conditions. In this review, we summarize the biogenesis and functions of regulatory sncRNAs, such as miRNAs, piRNA and tRFs, and highlight their involvements in cancers, particularly in CRC.
The role of LINC00094/miR‐224‐5p (miR‐497‐5p)/Endophilin‐1 axis in Memantine mediated protective effects on blood‐brain barrier in AD microenvironment
Authors: Zhu Lu , Lin Meiqing , Ma Jun , Liu Wenjing , Gao Lili , Wei Shanshan , Xue Yixue , Shang Xiuli
Published: February 2019

The dysfunction of the blood‐brain barrier (BBB) is one of the main pathological features of Alzheimer's disease (AD). Memantine (MEM), an N‐methyl‐d‐aspartate (NMDA) receptor antagonist, has been reported that been used widely for AD therapy. This study was performed to demonstrate the role of the MEM in regulating BBB permeability in AD microenvironment as well as its possible mechanisms. The present study showed that LINC00094 was dramatically increased in Abeta1‐42‐incubated microvascular endothelial cells (ECs) of BBB model in vitro. Besides, it was decreased in MEM‐incubated ECs. Silencing LINC00094 significantly decreased BBB permeability, meanwhile up‐regulating the expression of ZO‐1, occludin and claudin‐5. Furthermore, silencing LINC00094 enhance the effect of MEM on decreasing BBB permeability in AD microenvironment. The analysis of the mechanism demonstrated that reduction of LINC00094 inhibited Endophilin‐1 expression by up‐regulating miR‐224‐4p/miR‐497‐5p, promoted the expression of ZO‐1, occludin and claudin‐5, and ultimately alleviated BBB permeability in AD microenvironment. Taken together, the present study suggests that the MEM/LINC00094/miR‐224‐5p (miR‐497‐5p)/Endophilin‐1 axis plays a crucial role in the regulation of BBB permeability in AD microenvironment. Silencing LINC00094 combined with MEM provides a novel target for the therapy of AD.
Atypical resting state neuromagnetic connectivity and spectral power in very preterm children
Authors: Kozhemiako Nataliia , Nunes Adonay , Vakorin Vasily A. , Chau Cecil M. Y. , Moiseev Alexander , Ribary Urs , Grunau Ruth E. , Doesburg Sam M.
Published: February 2019

Background

Children born very preterm often display selective cognitive difficulties at school age even in the absence of major brain injury. Alterations in neurophysiological activity underpinning such difficulties, as well as their relation to specific aspects of adverse neonatal experience, remain poorly understood. In the present study, we examined interregional connectivity and spectral power in very preterm children at school age, and their relationship with clinical neonatal variables and long‐term outcomes (IQ, executive functions, externalizing/internalizing behavior, visual‐motor integration).

Methods

We collected resting state magnetoencephalographic (MEG) and psychometric data from a cohort at the age of 8 years followed prospectively since birth, which included three groups: Extremely Low Gestational Age (ELGA, 24–28 weeks GA n = 24, age 7.7 ± 0.38, 10 girls), Very Low Gestational Age (VLGA, 29–32 weeks GA n = 37, age 7.7 ± 0.39, 24 girls), and full‐term children (38–41 weeks GA n = 39, age 7.9 ± 1.02, 24 girls). Interregional phase synchrony and spectral power were tested for group differences, and associations with neonatal and outcome variables were examined using mean‐centered and behavioral Partial Least Squares (PLS) analyses, respectively.

Results

We found greater connectivity in the theta band in the ELGA group compared to VLGA and full‐term groups, primarily involving frontal connections. Spectral power analysis demonstrated overall lower power in the ELGA and VLGA compared to full‐term group. PLS indicated strong associations between neurophysiological connectivity at school age, adverse neonatal experience and cognitive performance, and behavior. Resting spectral power was associated only with behavioral scores.

Conclusions

Our findings indicate significant atypicalities of neuromagnetic brain activity and connectivity in very preterm children at school age, with alterations in connectivity mainly observed only in the ELGA group. We demonstrate a significant relationship between connectivity, adverse neonatal experience, and long‐term outcome, indicating that the disruption of developing neurophysiological networks may mediate relationships between neonatal events and cognitive and behavioral difficulties at school age.
Reliability assessment and validation of the dermal pigmentation area and severity index: a new scoring method for acquired dermal macular hyperpigmentation
Authors: Kumaran M.S. , Dabas G. , Vinay K. , Parsad D.
Published: February 2019

Background

Dermal pigmentation area and severity score (DPASI) is a recently proposed scoring system for acquired dermal macular hyperpigmentation (ADMH).

Objective

To determine the reliability and validity of DPASI.

Methods

After standardized training, three researchers independently rated 55 patients with ADMH on two consecutive days within 1 week, to determine intra‐rater and inter‐rater reliability. Validation was performed by comparing DPASI with the physician global assessment score.

Results

Test–retest reliability of individual raters tested by Pearson's r showed good correlation for all three raters (r = 0.984, P < 0.0001; r = 0.983, P < 0.000 and r = 0.970, P < 0.0001). Inter‐rater agreement computed by intra‐class correlation coefficient also showed good correlation (ICC = 0.997, P < 0.0001). Internal consistency as measured by Cronbach's alpha was 0.997. The score faired well in face and content validity (I‐CVI of 0.87). On usability assessment, the scale had a median score of 4 on a scale from 1 to 5. The meantime taken to score the patients were 307.2 ± 83, 308.9 ± 84.4, 350.15 ± 91.8 s by three observers, respectively.

Conclusion

The DPASI is a reliable measure of ADMH severity. The use of dermoscopy decreases inter and intra‐observer variation resulting in a more objective score.
Reply to the comments on ‘The increasing incidence of frontal fibrosing alopecia. In search of triggering factors’
Authors: Rudnicka L. , Rakowska A.
Published: February 2019

Linked article: M.J. Harries et al. J Eur Acad Dermatol Venereol 2019; 33: e250–e251. https://doi.org/10.1111/jdv.15531.
Analysis of serum metabolite profiles in syphilis patients by untargeted metabolomics
Authors: Liu L.‐L. , Lin Y. , Zhuang J.‐C. , Ren J. , Jiang X.‐Y. , Chen M.‐H. , Chen W. , Luo X. , Yan J.‐H. , Niu J.‐J. , Yang T.‐C.
Published: February 2019

Background

Global metabolomics analysis can provide substantial information on energy metabolism, physiology, possible diagnostic biomarkers and intervention strategies for pathogens.

Objective

To gain a better understanding of the mechanisms of syphilis and analysis of serum metabolite profiles in syphilis patients.

Methods

We conducted an untargeted metabolomics analysis of serum from 20 syphilis patients and 20 healthy controls.

Results

A total of 2890 molecular features were extracted from each sample, and the peak intensity of each feature was obtained. Distinct differential metabolites were identified by principal component analysis, partial least squares‐discriminant analysis and hierarchical clustering analysis. Furthermore, five metabolites were identified as significantly different by Student's t‐test, including trimethylamine N‐oxide, l‐arginine, lysoPC(18:0), betaine and acetylcarnitine. KEGG analysis showed that these differential metabolites were in various pathways, including Chagas disease, fatty acid biosynthesis, primary bile acid biosynthesis, Salmonella infection, ABC transporters, glycerophospholipid metabolism and choline metabolism. Among them, trimethylamine N‐oxide was 3.922 times in patients with syphilis than healthy controls.

Conclusion

Trimethylamine N‐oxide may be used as an indicator to distinguish between syphilis patients and healthy controls. The changes in these metabolites suggest that Treponema pallidum affects the normal metabolic activity of host cells, providing some clues for elucidating the pathogenesis of T. pallidum.
Monitoring infection with Piscine myocarditis virus and development of cardiomyopathy syndrome in farmed Atlantic salmon (Salmo salar L.) in Norway
Authors: Svendsen Julie Christine , Nylund Stian , Kristoffersen Anja B. , Takle Harald , Fossberg Buhaug Julia , Jensen Britt Bang
Published: February 2019

An epidemiological study was carried out in Norway in 2015–2018, investigating the development of infection with Piscine myocarditis virus (PMCV) and development of cardiomyopathy syndrome (CMS) in farmed Atlantic salmon. Cohorts from 12 sites were followed and sampled every month or every other month from sea transfer to slaughter. PMCV was detected at all sites and in all sampled cages, and fish in six sites developed clinical CMS. The initial infection happened between 1 and 7 months post‐sea transfer, and the median time from infection with PMCV until outbreak of CMS was 6.5 months. Generally, fish from sites with CMS had higher viral titre and a higher prevalence of PMCV, compared to sites that did not develop clinical CMS. The virus persisted until the point of slaughter at most (11 out of 12) of the sites. The detection of PMCV in all sites suggests that PMCV is more widespread than previously known. Screening for PMCV as a tool to monitor impending outbreaks of CMS must be supported by observations of the health status of the fish and risk factors for development of disease.
Quality of Life with Late‐Stage Dementia: Exploring Opportunities to Intervene
Authors: Ernecoff Natalie C. , Lin Feng‐Chang , Wessell Kathryn L. , Hanson Laura C.
Published: February 2019

BACKGROUND/OBJECTIVES

In late‐stage dementia, families often prioritize quality of life (QoL) and comfort, yet little research examines factors impacting QoL. We sought to (1) describe temporal trends in QoL in late‐stage dementia, and (2) explore associations between patient characteristics, care interventions, and QoL.

DESIGN

Secondary analysis of data from the Goals of Care clinical trial.

SETTING

Twenty‐two nursing homes (NHs) in North Carolina.

PARTICIPANTS

Family decision makers for residents with late‐stage dementia.

MEASUREMENTS

Family‐reported QoL at baseline and at 9 months using the Alzheimer's Disease‐Related Quality of Life Instrument (ADRQL) with five subscales scored 0 to 100 (higher scores indicate better quality). Families reported demographics, primary goal of care, and described their perceptions of residents’ QoL. Chart reviews provided data on hospital transfers, treatment plans, and hospice enrollment. We ran mixed effects models of hypothesized variables and change in ADRQL over time.

RESULTS

The study sample was 241 dyads of residents with late‐stage dementia and family decision makers. Family‐reported ADRQL scores reflected moderately good QoL at baseline and at 9 months (69.1 vs 66.9; p = .106). Subscales for Awareness of Self (62.8; Global Deterioration Scale [GDS] = 5; 30.5; GDS = 7; p > .01) and Enjoyment of Activities (53.4; GDS = 5; 39.4; GDS = 7; p > .01) were lower in later stage disease. Qualitatively, family members associated better QoL for dementia with (1) activities, (2) opportunities to leave NH, (3) NH‐structured activities, (4) attentiveness in NH, and (5) passive interaction. ADRQL at 9 months was associated with later dementia stage and referral to hospice (p < .01). Age (p = .004) and hospice enrollment were significantly associated with a larger decrease in ADRQL over 9 months (p = .019). A primary goal of comfort was associated with a larger increase in ADRQL (p = .022).

CONCLUSION

Families judge QoL to be moderately good in late‐stage dementia. They perceive activities, opportunities to leave the NH, and quality of interpersonal care as ways to improve dementia‐specific QoL.
Colonoscopy in Nonagenarians Is Safe and May Be Associated with Clinical Benefit
Authors: Shafrir Asher , Koslowsky Benjamin , Wengrower Dov , Goldin Eran , Livovsky Dan M.
Published: February 2019

OBJECTIVES

Data regarding colonoscopy in patients older than 90 years old is scarce. Yet the number of colonoscopies done on nonagenarians is rising. We aimed to determine the yield, safety, and therapeutic benefits of colonoscopy in these patients.

DESIGN

Case‐control study of older patients who underwent colonoscopy.

SETTING

Gastroenterology institute at an academic medical center.

PARTICIPANTS

Patients older than 90 years (n = 128) compared with patients aged 80 to 89 years (n = 218) who underwent colonoscopy.

INTERVENTION

Colonoscopy.

MEASUREMENTS

Indication for the procedure, completion rates, adequacy of preparation, complications, colonoscopic findings, 30‐day mortality, advanced adenoma and carcinoma detection rate, treatment, and long‐term survival of patients diagnosed with colorectal cancer.

RESULTS

Mean ages were 83.3 and 92.2 years old. Nonagenarians were more likely to undergo a colonoscopy while hospitalized (56.2 vs 23.4%; P < .001) and to undergo the examination due to rectal bleeding or sigmoid volvulus (35.2 vs 25.2 and 10.9 vs 0.5%, respectively; P < .001) and less likely for surveillance or constipation (11.7 vs 25.7 and 0 vs 6.9%, respectively; P < .001). Completion rates and severe adverse events were comparable. The 30‐day mortality was 3.9% in nonagenarians and 0.4% in octogenarians (P = .02). Advanced adenomas and carcinoma were more common in nonagenarians (25.8 vs 16.5%, P = .03, and 14.8 vs 6.4%, P = .01, respectively). Increasing age, inpatient status, past polypectomy surveillance, and anemia were associated with higher rates of carcinoma. Half of the nonagenarians diagnosed with adenocarcinoma underwent surgery compared with 100% of octogenarians (P = .01). Among nonagenarians with colorectal cancer who died, mean survival was 605 (interquartile range = 11‐878) days in those who underwent surgery and 112 (48‐341) in those treated conservatively (P = .055 log‐rank test).

CONCLUSION

Colonoscopy in nonagenarians has a high yield and is generally safe. Colonoscopy findings lead to surgery in more than half of these patients and was associated with a median survival of 20 months.
Whole body sodium depletion modifies AT1 mRNA expression and serotonin content in the dorsal raphe nucleus
Authors: Porcari Cintia Yamila , Araujo Iracema Gomes , Urzedo‐Rodrigues Lilia , De Luca Laurival Antonio , Menani José Vanderlei , Caeiro Ximena Elizabeth , Imboden Hans , Antunes‐Rodrigues José , Reis Luís Carlos , Vivas Laura , Godino Andrea , Mecawi André Souza
Published: February 2019

Angiotensin II (Ang II) acts on Ang II type 1 (AT1) receptors located in the organum vasculosum and subfornical organ (SFO) of the lamina terminalis as a main facilitatory mechanism of sodium appetite. The brain serotonin (5‐HT) system with soma located in the dorsal raphe nucleus (DRN) provides a main inhibitory mechanism. In the present study, we first investigated the existence of Ang II AT1 receptors in serotonergic DRN neurones. Then, we examined whether whole body sodium depletion affects the gene expression of the AT1a receptor subtype and the presumed functional significance of AT1 receptors. Using confocal microscopy, we found that tryptophan hydroxylase‐2 and serotonin neurones express AT1 receptors in the DRN. Immunofluorescence quantification showed a significant reduction in 5‐HT content but no change in AT1 receptor expression or AT1/5‐HT colocalisation in the DRN after sodium depletion. Whole body sodium depletion also significantly increased Agtr1a mRNA expression in the SFO and DRN. Oral treatment with the AT1 receptor antagonist losartan reversed the changes in Agtr1a expression in the SFO but not the DRN. Losartan injection into either the DRN or the mesencephalic aqueduct had no influence on sodium depletion‐induced 0.3 mol L‐1 NaCl intake. The results indicate the expression of Agtr1a mRNA in the DRN and SFO as a marker of sodium depletion. They also suggest that serotonergic DRN neurones are targets for Ang II. However, the function of their AT1 receptors remains elusive.
A novel moisturizer with high sun protection factor improves cutaneous barrier function and the visible appearance of rosacea‐prone skin
Authors: Baldwin Hilary , Santoro Francine , Lachmann Nadege , Teissedre Sandrine
Published: February 2019

Background

Consensus guidelines advocate general skincare for rosacea patients.

Objectives

Two independent studies were performed to assess whether a tinted daily SPF‐30 facial moisturizer (DFM30) improves barrier function of dry skin and the efficacy and tolerability of DFM30 on rosacea‐prone skin.

Methods

In study 1, electrical capacitance (EC) and transepidermal water loss (TEWL) were measured at baseline, 2, 4, 8, and 24 hours after a single application of DFM30 and on a control site in 21 healthy females with dry skin. Study 2 evaluated 33 females with mild to moderate rosacea and nontransient erythema. Efficacy and tolerability after once‐daily DFM30 were assessed using a chromameter, image analysis of photographs, and trained rater and patient evaluations up to day 22.

Results

In study 1, EC showed statistically significant increases at 2, 4, and 8 hours, and TEWL showed statistically significant decreases 2, 4, 8, and 24 hours after DFM30 application to healthy females compared to baseline. In study 2, covering skin redness improved significantly after DFM30 application on day 1; 33.3% showed improved covering skin redness compared to baseline. Patients reported significantly less redness on day 8 than day 3. Feelings of dryness and tightness/tension were lower 30 minutes after first application. Feeling of dryness was lower than baseline after 3 days, 1 and 3 weeks. Image analysis suggested redness was significantly lower on day 22 compared to baseline. Chromameter readings showed significantly lower erythema on the cheek compared to baseline. All patients stated that DFM30 relieves and neutralizes visible redness who also indicated that they would purchase DFM30, and the product was well tolerated.

Conclusions

These studies show that DFM30 is suitable as part of the skincare regimens advocated by ROSacea COnsensus (ROSCO) for rosacea patients. DFM30 is an effective moisturizer that improves cutaneous barrier function and the appearance of rosacea‐prone skin.
New graduate nurses’ understanding and attitudes about patient safety upon transition to practice
Authors: Murray Melanie , Sundin Deborah , Cope Vicki
Published: February 2019

Aims

To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety.

Background

New graduate registered nurses’ transition is accompanied by a degree of shock which may be in tune with the described theory–practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care.

Design

Qualitative descriptive approach using semi‐structured interviews.

Methods

Data were collected during 2017–18 from 11 participants consenting to face‐to‐face or telephone semi‐structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1).

Results

Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses’ clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety.

Conclusion

Transition shock leaves new graduate registered nurses’ focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses.

Relevance to practice

Having an understanding of the new graduate registered nurses’ experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time.
Refining nursing practice through workplace learning: A grounded theory
Authors: Jantzen Darlaine
Published: February 2019

Aims and objectives

To examine how experienced registered nurses in direct patient care learn within the constantly changing contemporary healthcare environment. The key objectives were to examine educational interactions amongst workplace, nurse and nursing practice, with a focus on the influence of context.

Background

Registered nurses must maintain competence throughout their careers. The related ongoing learning is triggered by external demands and nurses’ internal motivation. Experienced nurses, poised to retire, have worked through the recent tumultuous changes in health care and therefore provide insight into how they sustained excellent patient care.

Design

The methodology for this study was a grounded theory informed by symbolic interactionism. EQUATOR guidelines for qualitative research (COREQ) applied.

Methods

Data collection entailed semi‐structured interviews with experienced nurses across diverse settings and participant observation on two acute care units. Analysis of data was conducted using three‐level coding, constant comparison, theoretical sampling and extensive memoing.

Results

Refining nursing practice begins during nursing education and early employment. Getting grounded involves establishing key capabilities, specifically becoming self‐aware, setting high standards, cultivating healthy apprehension and seeing the whole patient picture. Three catalysts for workplace learning are mentor‐guides, workplace camaraderie and a highly functional workplace team. Refining nursing practice includes both formal and informal learning; however, significant nursing expertise is developed through puzzling and enquiring, an iterative process of learning while nursing.

Conclusions

Facilitating the development of capabilities for nurses’ workplace learning during nursing education and early work experiences contributes to excellent patient care. Healthcare organisations need to value and support the unique contributions of mentor‐guides in the clinical setting and promote individuals’ development of expertise by nurturing camaraderie and developing highly functional workplace teams.

Relevance to clinical practice

Attending to the processes and catalysts for nurses’ workplace learning will contribute to excellent patient care.
Association between sleep bruxism and anxiety symptoms in adults: A systematic review
Authors: Polmann Helena , Domingos Fabio Luiz , Melo Gilberto , Stuginski‐Barbosa Juliana , Guerra Eliete Neves da Silva , Porporatti André Luís , Dick Bruce D. , Flores‐Mir Carlos , De Luca Canto Graziela
Published: February 2019

Background

The purpose of this systematic review was to evaluate the association between sleep bruxism (SB) and anxiety symptoms in adults.

Methods

A systematic review was performed and studies assessing SB by means of questionnaires, clinical examination and/or polysomnography (PSG), and validated questionnaires to assess anxiety, were included. Search strategies were developed for seven main electronic databases. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross‐Sectional Studies, and confidence in cumulative evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation criteria.

Results

Eight cross‐sectional studies were included, of which five were judged with low and three with moderate risk of bias. No association with SB was observed in three studies that investigated generic levels of anxiety, while other two papers that evaluated generic anxiety levels through the State‐Trait Anxiety Inventory (STAI) found a positive association with probable and definite SB in both STAI‐1 and STAI‐2 subscales. Only one study evaluated dental anxiety in particular and an association with probable SB was observed regarding very anxious or extremely anxious scores. Two studies assessed specific symptoms of anxiety using the panic‐agoraphobic spectra evaluation (PAS‐SR) questionnaire. Significantly higher PAS‐SR total scores were observed in both studies with regard to SB. No study with definitive assessment of SB was identified.

Conclusion

Current literature is controversial regarding an association between SB and generic symptoms of anxiety in adults. It seems that some specific symptoms of the anxiety disorders spectrum might be associated with probable SB.
Reticular and erosive oral lichen planus have a distinct metabolomic profile: A preliminary study using gas chromatography‐mass spectrometry
Authors: Cruz Aline Fernanda , Vitório Jéssica Gardone , Duarte‐Andrade Filipe Fideles , Diniz Marina Gonçalves , Canuto Gisele André Baptista , de Toledo Juliano Simões , Fonseca Felipe Paiva , Fernandes Ana Paula , André Leiliane Coelho , Gomes Carolina Cavaliéri , Gomez Ricardo Santiago
Published: February 2019

Background

Oral Lichen Planus is a chronic inflammatory disorder that affects the oral mucosa, with the reticular and erosive forms representing the primary clinical variants of the disease. Previous studies have shown that metabolic alterations may well be involved in the pathogenesis of the disease; however, the molecular mechanisms related to the clinicopathological differences between erosive and reticular forms remain unknown.

Methods

A comparative metabolomic analysis was performed on formalin‐fixed and paraffin‐embedded tissue samples of erosive (n = 6) and reticular (n = 10) oral lichen planus using gas chromatography‐mass spectrometry.

Results

The metabolomic analysis showed a distinct profile between the two clinical variants. Five metabolites (cyclohexanamine, glycine, mannitol/sorbitol, methyl palmitate and trehalose) were significantly diminished in erosive oral lichen planus as compared to the reticular form.

Conclusions

Reticular and erosive forms of oral lichen planus have a distinct metabolic profile. However, further studies using a large number of fresh tissue samples are necessary to confirm this data.
Has the euro sustainably increased home price co‐movement?
Authors: Miles William
Published: February 2019

A low level of co‐movement between different euro country housing markets creates difficulties for the ECB in setting monetary policy. Such co‐movement across eurozone countries has been the subject of a number of studies, using different methodologies and finding mixed results. In this study, we use endogenous break methods to explicitly test for whether the introduction of the euro has changed home value co‐movement. We also employ informal correlation analysis. Endogenous break results indicate no sustainable increase in co‐movement attributable to the euro, whereas correlation analysis is suggestive of a decrease in synchronization since the currency's introduction.
Easy and effective method to generate endotoxin-free chitosan particles for immunotoxicology and immunopharmacology studies
Authors: Lebre Filipa , Lavelle Ed C , Borges Olga
Published: February 2019

Objectives

The cationic biopolymer chitosan (CH) has emerged as a promising candidate adjuvant due to its safety profile and immunostimulatory properties. The presence of endotoxin contamination in biomaterials is generally underappreciated and can generate misleading results. It is important to establish a convenient methodology to obtain large amounts of high quality chitosan nanoparticles for biomedical applications.

Methods

We developed an easy method to generate endotoxin-free chitosan and assessed its purity using the Limulus amebocyte lysate assay and by measuring dendritic cell activation.

Key findings

Purified chitosan-based formulations alone failed to induce production of the proinflammatory cytokines tumour necrosis factor alpha (TNF-α) and interleukin (IL)-6 in bone marrow-derived dendritic cells (BMDCs) generated from C57BL/6 mice, while maintaining its ability to promote IL-1β secretion in combination with the Toll-like receptor (TLR)-9 agonist, CpG. Moreover, BMDCs from C3H/HeN and TLR4-deficient mice, C3H/HeJ were stimulated with endotoxin-free chitosan-based formulations and no differences were observed in IL-6 and IL-1β secretion, excluding the involvement of TLR-4 in the immunomodulatory effects of chitosan.

Conclusions

The developed method provides simple guidelines for the production of endotoxin-free chitosan, ideal for biomedical applications.
An efficient method for DNA extraction from cyanobacteria isolated from hypersaline and marine environments
Authors: Bhardwaj Bhavna , Agrawal Akhil , Ledwani Lalita , Vaiphei S. Thangminlal , Jain Shikha
Published: February 2019

Cyanobacteria are ancient organisms surviving on the earth due to their simple nutritional requirements and ability to produce distinct secondary metabolites that can combat detrimental environmental impacts. In order to understand these abilities of cyanobacteria at the molecular level, it is necessary to extract high‐quality genomic DNA. However, the presence of secondary metabolites and exopolysaccharides hinders the DNA extraction from these organisms, especially from hypersaline environments. Here we have developed and compared a new method with two known methods of DNA extraction from environmental isolates. The results clearly indicate that the new optimized method yielded large amount of DNA with high purity. Additionally, the extracted DNA showed reduced degradation and excellent overall quality, which can be used directly for downstream purposes such as PCR and sequencing.
Red And far‐red regulation of filament movement correlates with the expression of phytochrome and FHY1 genes in Spirogyra varians (Zygnematales, Streptophyta)1
Authors: Lee Ji Woong , Kim Gwang Hoon
Published: February 2019

Spirogyra filaments show unique photomovement that differs in response to blue, red, and far‐red light. Phototropins involved in the blue‐light movement have been characterized together with downstream signaling components, but the photoreceptors and mechanical effectors of red‐ and far‐red light movement are not yet characterized. The filaments of Spirogyra varians slowly bent and aggregated to form a tangled mass in red light. In far‐red light, the filaments unbent, stretched rapidly, and separated from each other. Mannitol and/or sorbitol treatment significantly inhibited this far‐red light movement suggesting that turgor pressure is the driving force of this movement. The bending and aggregating movements of filaments in red light were not affected by osmotic change. Three phytochrome homologues isolated from S. varians showed unique phylogenetic characteristics. Two canonical phytochromes, named SvPHY1 and SvPHY2, and a noncanonical phytochrome named SvPHYX2. SvPHY1 is the first PHY1 family phytochrome reported in zygnematalean algae. The gene involved in the transport of phytochromes into the nucleus was characterized, and its expression in response to red and far‐red light was measured using quantitative PCR. Our results suggest that the phytochromes and the genes involved in the transport system into the nucleus are well conserved in S. varians.