bluuebunny/crossref_metadata_2025 huggingface dataset:
Decision‐making and motor control in predatory insects: a review of the praying mantis
Authors: YAMAWAKI YOSHIFUMI
Published: August 2017

1. Predatory and defensive behaviours require multiple stages of decision‐making in predatory insects, such as the praying mantis.

2. During predation, a praying mantis must decide where to ambush prey and which prey to fixate on, catch, and eat. The mantis also needs to decide how to track, approach, and catch prey, all the while controlling these actions depending on the visual features and position of the prey. For defence, a mantis must decide when to be defensive and which defensive response to initiate.

3. This review summarises the current knowledge of decision‐making processes and the corresponding motor control in the mantis, remarking on the importance of considering the interaction between predatory and defensive systems. Current research suggests that the mantis is a good model for revealing the mechanisms behind an animal's selection of a certain behaviour from a broad repertoire.
Cost‐effectiveness of early intervention services for psychosis and fidelity to national policy implementation guidance
Authors: Radhakrishnan Muralikrishnan , McCrone Paul , Lafortune Louise , Everard Linda , Fowler David , Amos Tim , Freemantle Nick , Singh Swaran P. , Marshall Max , Sharma Vimal , Lavis Anna , Jones Peter B. , Birchwood Max
Published: August 2017

Aim

Early intervention services (EIS) for psychosis are being implemented, internationally. It is important to learn from established examples and define the components and intensity of services that provide good value for money. This study aims to assess the cost‐effectiveness of EIS according to how closely they adhered to the recommendations of the English Department of Health 2001 Policy Implementation Guide (PIG).

Methods

EIS from the National Eden Study were assessed using a measure of fidelity to the PIG that rated the presence or absence of 64 recommended items relating to team structure and practice. EIS were then classified into three groups: those with fidelity of 75–80%, 81–90% and 91–95%. Patient‐level resource use and outcomes were measured 1 year following inception into the service; costs were calculated and combined with quality‐adjusted life years (QALYs) gained.

Results

At a threshold of £20 000 per QALY, the 81–90% fidelity group had a 56.3% likelihood of being the most cost‐effective option followed by 75–80% fidelity at 35.8% and 91–95% fidelity group (7.9%).

Conclusions

The results from England suggest that striving to maximize fidelity may not be warranted, but that dropping below a certain level of fidelity may result in inefficient use of resources.
Effects of pair bonding on parental behavior and dopamine activity in the nucleus accumbens in male prairie voles
Authors: Lei K. , Liu Y. , Smith A. S. , Lonstein J. S. , Wang Z.
Published: August 2017

Male parental care is a vital behavior for the development as well as the physical and mental well‐being of the young. However, little is known about the neurochemical regulation of male parental behavior, mainly due to the lack of appropriate animal models. In this study, we used the socially monogamous male prairie vole (Microtus ochrogaster) to investigate the effect of pair‐bonding experience on paternal behavior and dopamine (DA) signaling in the nucleus accumbens (NAcc) in the brain. We compared sexually naïve males with males that were pair bonded with a female for two weeks. Our data showed that pair‐bonded males displayed enhanced paternal behavior, particularly in pup licking/grooming, associated with increased DA type‐1 receptor (D1R) protein expression in the NAcc, compared to sexually naïve males. Site‐specific brain microdialysis revealed a significant, but transient, increase in DA release in the NAcc associated with pup exposure in both groups of the males. Further, pharmacological blockade of D1R in the NAcc decreased pup licking/grooming in the pair‐bonded males. Together, our data demonstrate that pair‐bonding experience with a female facilitated male parental behavior via NAcc D1R mediation in male prairie voles.
Chemogenetic activation of the lateral hypothalamus reverses early life stress‐induced deficits in motivational drive
Authors: Campbell Erin J. , Mitchell Caitlin S. , Adams Cameron D. , Yeoh Jiann Wei , Hodgson Deborah M. , Graham Brett A. , Dayas Christopher V.
Published: August 2017

Altered motivated behaviour is a cardinal feature of several neuropsychiatric conditions including mood disorders. One well‐characterized antecedent to the development of mood disorders is exposure to early life stress (ELS). A key brain substrate controlling motivated behaviour is the lateral hypothalamus (LH). Here, we examined the effect of ELS on LH activation and the motivation to self‐administer sucrose. We tested whether chemogenetic activation of LH circuits could modify sucrose responding in ELS rats and examined the impact on LH cell populations. Male rat pups were maternally separated for 0 or 3 h on postnatal days 2–14. During adolescence, rats received bilateral injections of hM3D(Gq), the excitatory designer receptor exclusively activated by designer drugs, into LH. In adulthood, rats were trained to self‐administer sucrose and tested under a progressive ratio schedule to determine their motivation for reward following injection with either vehicle or 5 mg/kg clozapine‐N‐oxide. Brains were processed for Fos‐protein immunohistochemistry. ELS significantly suppressed lever responding for sucrose, indicating a long‐lasting impact of ELS on motivation circuits. hM3D(Gq) activation of LH increased responding, normalizing deficits in ELS rats, and increased Fos‐positive orexin and MCH cell numbers within LH. Our findings indicate that despite being susceptible to environmental stressors, LH circuits retain the capacity to overcome ELS‐induced deficits in motivated behaviour.
Comparative effectiveness of antiepileptic drugs in patients with mesial temporal lobe epilepsy with hippocampal sclerosis
Authors: Androsova Ganna , Krause Roland , Borghei Mojgansadat , Wassenaar Merel , Auce Pauls , Avbersek Andreja , Becker Felicitas , Berghuis Bianca , Campbell Ellen , Coppola Antonietta , Francis Ben , Wolking Stefan , Cavalleri Gianpiero L. , Craig John , Delanty Norman , Koeleman Bobby P. C. , Kunz Wolfram S. , Lerche Holger , Marson Anthony G. , Sander Josemir W. , Sills Graeme J. , Striano Pasquale , Zara Federico , Sisodiya Sanjay M. , Depondt Chantal ,   the EpiPGX Consortium
Published: August 2017

Objective

Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE‐HS) is a common epilepsy syndrome that is often poorly controlled by antiepileptic drug (AED) treatment. Comparative AED effectiveness studies in this condition are lacking. We report retention, efficacy, and tolerability in a cohort of patients with MTLE‐HS.

Methods

Clinical data were collected from a European database of patients with epilepsy. We estimated retention, 12‐month seizure freedom, and adverse drug reaction (ADR) rates for the 10 most commonly used AEDs in patients with MTLE‐HS.

Results

Seven hundred sixty‐seven patients with a total of 3,249 AED trials were included. The highest 12‐month retention rates were observed with carbamazepine (85.9%), valproate (85%), and clobazam (79%). Twelve‐month seizure freedom rates varied from 1.2% for gabapentin and vigabatrin to 11% for carbamazepine. Response rates were highest for AEDs that were prescribed as initial treatment and lowest for AEDs that were used in a third or higher instance. ADRs were reported in 47.6% of patients, with the highest rates observed with oxcarbazepine (35.7%), topiramate (30.9%), and pregabalin (27.4%), and the lowest rates with clobazam (6.5%), gabapentin (8.9%), and lamotrigine (16.6%). The most commonly reported ADRs were lethargy and drowsiness, dizziness, vertigo and ataxia, and blurred vision and diplopia.

Significance

Our results did not demonstrate any clear advantage of newer versus older AEDs. Our results provide useful insights into AED retention, efficacy, and ADR rates in patients with MTLE‐HS.
The use of multimodal analgesia in the management of suspected extremity compartment syndrome in the pelvic limb of a horse
Authors: Bruniges N. , Milner P. , Bardell D.
Published: August 2017

A 12‐year‐old Thoroughbred cross Dartmoor mare was referred to the clinic with marked lameness and swelling involving the left stifle region. There was poor initial response to medical management and arthroscopic examination of the stifle joint was performed under general anaesthesia. Following surgery, the lameness and swelling worsened and extremity compartment syndrome was suspected. A multimodal analgesia protocol was instigated to provide adequate analgesia and improved mobility, aiding the use of physical therapy in resolving the swelling. This report demonstrates the successful combination of nonsteroidal anti‐inflammatories, paracetamol, ketamine infusion and epidural opioid administration to manage the clinical signs. The mare was discharged from hospital after 15 days and at short‐term follow‐up (3 months), there was no reported residual swelling or lameness.
Nonalcoholic fatty liver disease promotes hepatocellular carcinoma through direct and indirect effects on hepatocytes
Authors: Ma Chi , Zhang Qianfei , Greten Tim F.
Published: August 2017

Hepatocellular carcinoma (HCC) is the sixth most frequent neoplasm and the second leading cause of cancer‐related deaths worldwide. Nonalcoholic fatty liver disease (NAFLD), a common disorder in obese people, has been identified as an important risk factor for HCC. Following the increasing prevalence of obesity, it is expected that the contribution of NAFLD to HCC's incidence worldwide will grow. Recently, a number of studies have been published, which help us better understand cellular and molecular mechanisms of how NAFLD promotes hepatocarcinogensis. Inflammatory cytokines, ER stress and circadian dysregulation, which mediate hepatocyte injury and NAFLD progression, have been identified to promote malignant transformation of hepatocytes. Besides these ‘intrinsic’ effects, lipid dysregulation dramatically affects the liver local microenvironment. The reshaped immune environment has also been found to contribute to the NAFLD‐mediated hepatocarcinogenesis. This review explores recent findings of both ‘intrinsic’ effects on hepatocytes and the role of the local environment in NAFLD‐promoted HCC development.
Crystal structure of a lipase from Streptomyces sp. strain W007 – implications for thermostability and regiospecificity
Authors: Zhao Zexin , Hou Shulin , Lan Dongming , Wang Xiumei , Liu Jinsong , Khan Faez Iqbal , Wang Yonghua
Published: August 2017

MAS1 from marine Streptomyces sp. strain W007 belongs to the bacterial lipase I.7 subfamily and is characterized as a thermostable and nonregiospecific lipase. To shed light on the catalytic mechanism of MAS1, we determined its crystal structure with closed conformation in two crystal forms at 2.3 Å resolution. MAS1 adopts the canonical α/β hydrolase core fold with its catalytic triad being formed by S109, D200 and H232. Structural analysis and biochemical assays revealed that disulfide bonds and salt bridges play a vital role in the thermostability of MAS1. In addition, we discovered that the replacement of H108 with a tryptophan converts MAS1 from a nonregiospecific to an sn‐1,3‐specific lipase, suggesting the functional importance of the second position from the conserved pentapeptide motif in defining the regiospecificity of MAS1. Our present study provides insights into the molecular basis for the thermostability and regiospecificity of MAS1, and it may aid in the rational design of thermostable or regiospecific lipases for potential industrial applications.

Database

Structural data are available in the Protein Data Bank database under the accession numbers 5H6B and 5H6G.
Subjective and objective halitosis among patients with Parkinson's disease
Authors: Barbe Anna Greta , Deutscher Deborah H. C. , Derman Sonja H. M. , Hellmich Martin , Noack Michael J.
Published: August 2017

Objectives

Parkinson's disease (PD) affects oral health, but prevalence of subjective and objective halitosis and the influence of hyposalivation remain unclear. We aimed to explore whether patients with PD suffer from halitosis and to define correlations between halitosis and hyposalivation. We hypothesised that patients with PD suffer more often from halitosis compared to healthy controls, influenced by dry mouth.

Materials and methods

Subjective (halitosis, xerostomia visual analogue scale [VAS], short German Oral Health Impact Profile [OHIPG]‐14) and objective scales (e.g., organoleptic score, volatile sulphur compounds [VSCs], stimulated whole saliva [SWS]) were assessed from 26 patients with PD and 26 healthy controls.

Results

The mean organoleptic score was 0.7 (SD: 0.7) in all patients, and VSCs were either comparable or significantly lower (dimethyl sulphide, P = .010) in PD patients compared with controls, yet more patients with PD perceived halitosis to be stronger (77% vs 54%, respectively; P = .059). Dry mouth was significantly more likely in patients with PD than controls: mean xerostomia VAS 4 (SD: 2) vs 1 (SD: 2), P = .010; SWS 0.4 (SD: 0.4) vs 0.7 (SD: 0.6) mL/min, P < .05); SWS did not correlate with subjective or objective halitosis. Oral health‐related quality of life (OHRQoL) was lower in patients with PD than controls (mean OHIPG‐14 score 12 (SD: 0.2) vs 5 (SD: 7.0), respectively; P < .05).

Conclusions

Patients with PD suffer from subjective and objective halitosis, dry mouth and impaired OHRQoL. Dry mouth problems do not correlate with prevalence or intensity of halitosis.
Trend of cardiovascular risk factors in the older Iranian population: 2002–2014
Authors: Eslami Ali , Lotfaliany Mojtaba , Akbarpour Samaneh , Azizi Fereidoun , Hadaegh Farzad
Published: August 2017

Aim

Current study aimed to investigate the sex‐stratified secular trend of cardiovascular disease risk factors among an older population in Iran during a median follow‐up period of 8.76 years.

Methods

A total of 1490 participants (733 women) aged ≥60 years were evaluated in four study phases of 2002–2005, 2005–2008, 2008–2011 and 2011–2014. The trends of cardiovascular disease risk factors for each sex were estimated using generalized estimating equations.

Results

The age‐adjusted prevalence of diabetes, hypertension, central obesity, and chronic kidney disease at the baseline was 24%, 43%, 55%, and 32% in men and 31%, 57%, 60% and 53% in women, respectively, and had noticeable upward trend during the study period to reach 35%, 56%, 61% and 51% in men, and 42%, 71%, 74% and 67% in women, respectively. However, lipid profile parameters showed favorable trends. Despite the increasing trend in drug consumption, approximately 27% of women with diabetes and 37% of men with diabetes did not use antidiabetic medication, respectively; the results were 23% and 35% for hypertensive women and men, respectively. Among men, there was a decreasing trend towards low physical activity, from 40% at baseline to 26% at the most recent follow up. The prevalence of smoking remained steady throughout follow up.

Conclusions

Despite the benefits of lipid lowering, the status of other risk factor profiles are often suboptimal in both sexes. There remains much room for improvement in risk factors management, particularly for hypertension, smoking and adiposity status, and a need for an intervention. Geriatr Gerontol Int 2018; 18: 130–137.
Genetic and environmental influences on cardiovascular risk factors and cognitive function: A Chinese twin aging study
Authors: Xu Chunsheng , Tian Xiaocao , Sun Jianping , Wu Yili , Zhang Dongfeng , Pang Zengchang , Li Shuxia , Petersen Inge , Mengel‐From Jonas , Christiansen Lene , Christensen Kaare , Tan Qihua
Published: August 2017

Aim

To explore the genetic and environmental influences on cardiovascular risk factors (CVRF) and cognitive function in the world's largest and rapidly aging Chinese population.

Methods

Cognitive function and CVRF, including body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure, glucose, total cholesterol, triglyceride, high‐density lipoprotein cholesterol (HDLC) and low‐density lipoprotein cholesterol were measured in 379 complete twin pairs. Univariate and bivariate twin models were fitted to estimate the genetic and environmental components in the variance and covariance of CVRF and cognition.

Results

Mild‐to‐high heritability was estimated for CVRF and cognition (0.27–0.74). Unique environmental factors showed low‐to‐moderate contributions (0.23–0.56). Only HDLC presented significant common environmental contribution (0.50). Bivariate analysis showed significantly negative genetic correlations (rG) between cognition and systolic blood pressure (rG = −0.56), diastolic blood pressure (rG = −0.42), pulse pressure (rG = −0.45), and positive genetic correlations between cognition and total cholesterol (rG = 0.33), triglyceride (rG = 0.23) and HDLC (rG = 0.41). HDLC and cognition presented a unique environmental correlation (rE = −0.13), but in the opposite direction.

Conclusions

Cognitive function was genetically related to systolic blood pressure, diastolic blood pressure, pulse pressure, total cholesterol, triglyceride and HDLC with a negative or positive direction. Cognition and HDLC might share part of a similar unique environmental factor. Geriatr Gerontol Int 2018; 18: 352–359.
‘Show us your frilly, pink underbelly’: Men administrative assistants doing masculinities and femininity
Authors: Seeley J. Lotus
Published: August 2017

Research on men tokens (or numerical minorities) at work has focused on the processes by which men try to claim hegemonic masculine identities for themselves and how workplace interactants support or reject these attempts. In contrast to masculinity studies, token theory has paid less attention to non‐hegemonic masculinities. Using interviews with men administrative assistants, I develop a more comprehensive understanding of men tokens' gender performances and their significance for gender inequality. I present a four‐part typology: hegemonic masculinity, alternative masculinity, critical masculinity and male femininity. The categories are differentiated along two axes: support for hegemonic masculinity and support for hierarchical, binary gender.
Psychometric Evaluation of a Novel Instrument Assessing the Impact of Migraine on Physical Functioning: The Migraine Physical Function Impact Diary
Authors: Kawata Ariane K. , Hsieh Ray , Bender Randall , Shaffer Shannon , Revicki Dennis A. , Bayliss Martha , Buse Dawn C. , Desai Pooja , Sapra Sandhya , Ortmeier Brian , Hareendran Asha
Published: August 2017

Objective

The objective of this study was to evaluate the measurement properties of the Migraine Physical Function Impact Diary (MPFID), a novel patient‐reported outcome (PRO) measure for assessing the impact of migraine on physical functioning.

Methods

In a prospective, observational study, adults with episodic migraine (EM) or chronic migraine (CM) used an eDiary to complete the MPFID (assessing daily impacts of migraine on physical function) and a headache diary (capturing migraine days, migraine pain intensity, and migraine interference) each day, and other PRO instruments related to migraine. Item‐level evaluation, item response theory (IRT), and exploratory factor analysis (EFA) methods were applied to identify domains, select final MPFID items, and develop scoring procedures. Psychometric properties of the final 13‐item MPFID were evaluated using confirmatory factor analysis and tests of reliability (Cronbach'sαfor internal consistency and intra‐class correlation [ICC] for test–retest) and validity (convergent and known‐groups).

Results

The study enrolled 569 adults with chronic or episodic migraine, mean (SD) age 39.9 (12.0) years and 87.2% female. Item‐level analyses based on interim data informed selection of a set of 13 items for the MPFID, through evaluation of floor/ceiling effects, item‐to‐item correlations, factor loadings, and IRT‐based fit/misfit statistics. Two domain scores (EA: Impact on Everyday Activities; PI: Physical Impairment) and a global item score for impact on everyday activities were identified. EA and PI domains exhibited high internal consistency (α = 0.97;α = 0.93) and good test–retest reliability among stable subjects (ICCs = 0.74 and 0.77). Convergent validity was demonstrated by moderate correlations (r = ±0.50‐0.68;P < .0001) between MPFID domain scores and number of migraine days, headache days, bed days, and other migraine‐related PRO instruments. EA and PI scores differentiated between groups who varied by number of migraine days, migraine interference levels, migraine pain intensity, and median split groups of scores based on other PROs instruments (P < .05).

Conclusions

The MPFID has robust psychometric properties (ie, reliability and validity). Findings supported two distinct domains about the impact of migraine on physical functioning: Impact on Everyday Activities and Physical Impairment. Both domain scores showed evidence of excellent reliability and construct validity in assessing the impacts of migraine on physical functioning.
‘Microcystic pattern’ should be recognised as part of the morphological spectrum of solid‐pseudopapillary neoplasm of the pancreas
Authors: Abe Atsushi , Ohishi Yoshihiro , Miyazaki Tetsuyuki , Ozono Keigo , Mochidome Naoki , Saeki Kiyoshi , Nakamura Masafumi , Oda Yoshinao
Published: August 2017

Aim

Solid pseudopapillary neoplasm (SPN) is an uncommon pancreatic tumour characterised by solid and pseudopapillary growth patterns. We have observed SPNs can show a microcystic pattern (microcystic SPN), which has been poorly described and may be confused with microcystic neoplasms. We conducted the present study to clarify the clinicopathological and immunohistochemical features of microcystic SPNs.

Methods and results

We examined a consecutive series of 44 SPNs and 10 serous cystadenomas (SCAs), and classified them into 13 microcystic SPNs (29.5%) and 31 conventional SPNs (70.5%). Clinicopathological analysis, immunohistochemical staining and mucin histochemistry were performed. Clear cell change, hyalinised stroma and haemorrhage were observed significantly more frequently in the microcystic SPNs compared to the conventional SPNs. Immunohistochemically, the microcystic SPNs showed significantly lower frequencies of CD10 (0%) and CD56 expression (62%) compared to the conventional SPNs (87%; P < 0.001, 90%; P < 0.0085, respectively). There were no significant differences in other clinicopathological and immunohistochemical features between the two groups (i.e. the nuclear expression of β‐catenin, E‐cadherin, progesterone receptor (PgR), lack of forkhead box (Fox)L2 and occasional oestrogen receptor (ER), AE1/AE3 expression). Microcystic SCAs lack such a characteristic immunophenotype. The myxoid stroma of microcystic SPNs contained hyaluronan revealed by Alcian blue stain with hyaluronidase digestion.

Conclusion

We thus conclude that the microcystic pattern should be recognised as a part of the morphological spectrum of SPNs. Our findings may contribute to the correct diagnosis of the pancreatic neoplasms with the microcystic pattern. In addition, we speculate that stromal change caused by an accumulation of hyaluronan may contribute to the microcystic pattern of SPN.
Histopathological and genetic review of phosphaturic mesenchymal tumours, mixed connective tissue variant
Authors: Yamada Yuichi , Kinoshita Izumi , Kenichi Kohashi , Yamamoto Hidetaka , Iwasaki Takeshi , Otsuka Hiroshi , Yoshimoto Masato , Ishihara Shin , Toda Yu , Kuma Yuki , Setsu Nokitaka , Koga Yuki , Honda Yumi , Inoue Takeshi , Yanai Hiroyuki , Yamashita Kyoko , Ito Ichiro , Takahashi Mitsuru , Ohga Shouichi , Furue Masutaka , Nakashima Yasuharu , Oda Yoshinao
Published: August 2017

Aims

Phosphaturic mesenchymal tumour, mixed connective tissue variant (PMT‐MCT), is a tumour of uncertain differentiation, characterised by ‘smudgy/grungy’ calcification and vitamin D‐resistant phosphaturic osteomalacia. Fibroblast growth factor (FGF)23 is recognised as a reliable marker of PMT‐MCT, but quantitative evaluation has never been performed. We reviewed cases of tumour‐associated osteomalacia or histologically definitive PMT‐MCT without osteomalacia using histological, immunohistochemical and genetic methods and evaluated the diagnostic significance of these findings.

Methods and results

A total of 19 tumours from 14 cases diagnosed previously as PMT‐MCT were retrieved, on which immunohistochemical staining, reverse transcription–polymerase chain reaction (RT–PCR) and fluorescence in‐situ hybridisation (FISH) analysis were performed. Histologically, fibrous capsule, calcification and giant cell reaction tended to be observed in soft‐tissue PMT‐MCT, while PMT‐MCT of bone and multiple PMT‐MCT showed an infiltrative growth pattern. The immunohistochemical results were as follows: the tumour cells were positive for FGF23 (nine of 12, 75%), FGFR1 (11 of 11, 100%), CD56 (12 of 14, 85.7%) and E26 oncogene homologue (ERG) (5 of 13, 38.4%). The sole malignant tumour was positive for p53. FGF23 mRNA was detected in seven of 14 formalin‐fixed paraffin‐embedded (FFPE) specimens and all five frozen specimens by RT–PCR. The level of FGF23 mRNA, which was determined by real‐time PCR, varied among the phosphaturic cases. Two of 17 tumours were positive for FGFR1 gene rearrangement.

Conclusions

It was considered that PMT‐MCT is a histopathological entity with or without phosphaturia, with varying levels of FGF23 mRNA, and with or without fibronectin 1 (FN1)–FGFR1 fusion gene. The authors propose that the histology of PMT‐MCT differs depending on its location, such as bone or soft tissue, which could complicate the differential diagnosis.
PTEN allelic loss is an important mechanism in the late stage of development of oral leucoplakia into oral squamous cell carcinoma
Authors: Miyahara Ligia A N , Pontes Flávia S C , Burbano Rommel M R , Conte Neto Nicolau , Guimarães Douglas M , Fonseca Felipe P , Pontes Hélder A R
Published: August 2017

Aim

The aim of this study was to analyse allelic loss of the phosphatase and tensin homologue deleted on chromosome 10 (PTEN) gene and its protein immuno‐expression in dysplastic oral lesions and oral squamous cell carcinomas (OSCCs).

Methods and results

Samples were collected from 153 patients [20 ranulas used as a control (C); 30 leucoplakias with mild dysplasia (MD); 30 leucoplakias with moderate to severe dysplasia (MSD); 73 oral squamous cell carcinoma (OSCC)]. PTEN protein expression was investigated using immunohistochemistry, and PTEN allelic loss was analysed by fluorescence in‐situ hybridisation (FISH). Differences among groups were evaluated using the χ2 test. PTEN expression was higher in MSD (P = 0.002) and OSCC (P = 0.0259) compared with the C group; additionally, a higher expression was observed in MSD (P = 0.0035) and OSCC (P = 0.049) than MD. Regarding FISH analysis, a higher hemizygous (single copy) loss was observed in OSCC than in C (P = 0.0467) and in OSCC than in MD (P = 0.0175), as well as a higher homozygous deletion in OSCC compared with C (P = 0.0159) and OSCC than MD (P = 0.0145).

Conclusion

The results of this work suggest that PTEN allelic loss is an important mechanism in the late stage of the development of oral potentially malignant lesions into oral cancer.
The extent of B‐cell activation and dysfunction preceding lymphoma development in HIV‐positive people
Authors: Shepherd L , Borges ÁH , Harvey R , Bower M , Grulich A , Silverberg M , Weber J , Ristola M , Viard J‐P , Bogner JR , Gargalianos‐Kakolyris P , Mussini C , Mansinho K , Yust I , Paduta D , Jilich D , Smiatacz T , Radoi R , Tomazic J , Plomgaard P , Frikke‐Schmidt R , Lundgren J , Mocroft A ,   EuroSIDA in EuroCOORD
Published: August 2017

Objectives

B‐cell dysfunction and activation are thought to contribute to lymphoma development in HIV‐positive people; however, the mechanisms are not well understood. We investigated levels of several markers of B‐cell dysfunction [free light chain (FLC)‐κ, FLC‐λ, immunoglobulin G (IgG), IgA, IgM and IgD] prior to lymphoma diagnosis in HIV‐positive people.

Methods

A nested matched case–control study was carried out within the EuroSIDA cohort, including 73 HIV‐positive people with lymphoma and 143 HIV‐positive lymphoma‐free controls. Markers of B‐cell dysfunction were measured in prospectively stored serial plasma samples collected before the diagnosis of lymphoma (or selection date in controls). Marker levels ≤ 2 and > 2 years prior to diagnosis were investigated.

Results

Two‐fold higher levels of FLC‐κ [odds ratio (OR) 1.84; 95% confidence interval (CI) 1.19, 2.84], FLC‐λ (OR 2.15; 95% CI 1.34, 3.46), IgG (OR 3.05; 95% CI 1.41, 6.59) and IgM (OR 1.46; 95% CI 1.01, 2.11) were associated with increased risk of lymphoma > 2 years prior to diagnosis, but not ≤ 2 years prior. Despite significant associations > 2 years prior to diagnosis, the predictive accuracy of each marker was poor, with FLC‐λ emerging as the strongest candidate with a c‐statistic of 0.67 (95% CI 0.58, 0.76).

Conclusions

FLC‐κ, FLC‐λ and IgG levels were higher > 2 years before lymphoma diagnosis, suggesting that B‐cell dysfunction occurs many years prior to lymphoma development. However, the predictive value of each marker was low and they are unlikely candidates for risk assessment for targeted intervention.
Cyclic fatigue resistance of R‐Pilot, HyFlex EDM and PathFile nickel‐titanium glide path files in artificial canals with double (S‐shaped) curvature
Authors: Uslu G. , Özyürek T. , Yılmaz K. , Gündoğar M.
Published: August 2017

Aim

To examine the cyclic fatigue resistances of R‐Pilot, HyFlex EDM and PathFile NiTi glide path files in S‐shaped artificial canals.

Methodology

Twenty R‐Pilot (12.5/.04), 20 HyFlex EDM (10/.05) and 20 PathFile (19/.02) single‐file glide path files were included. Sixty files (n: 20/each) were subjected to static cyclic fatigue testing using double‐curved canals until fracture occurred (TF). The number of cycles to fracture (NCF) was calculated by multiplying the rpm value by the TF. The length of the fractured fragment (FL) was determined by a digital microcaliper. Six samples of fractured files (n: 2/each) were examined by SEM to determine the fracture mode. The NCF and the FL data were analysed using one‐way anova, post hoc Tamhane and Kruskal–Wallis tests using SPPS 21 software. The significance level was set at 5%.

Results

In the double‐curved canal, all the files fractured first in the apical curvature and then in the coronal curvature. The NCF values revealed that the R‐Pilot had the greatest cyclic fatigue resistance, followed by the HyFlex EDM and PathFile in both the apical and coronal curvatures (P < 0.05).

Conclusions

R‐Pilot NiTi glide path files, used in a reciprocating motion, had the greatest cyclic fatigue resistance amongst the tested NiTi glide path files in an artificial S‐shaped canal.
Moisture content of root canal dentine affects detection of microcracks using micro‐computed tomography
Authors: Rödig T. , Müller C. , Hoch M. , Haupt F. , Schulz X. , Wiegand A. , Rizk M.
Published: August 2017

Aim

To evaluate the effect of moisture content in root canal dentine on detection of microcracks using micro‐computed tomography.

Methodology

Ten roots with and without craze lines or cracks (each n = 5) were selected and scanned six times with different moisture conditions of root dentine using a micro‐CT scanner at a high resolution of 10.5 μm. Scanning conditions were as follows: (i) after 30‐day wet storage, (ii) after 2‐h dry time, (iii) after 48‐h wet storage, (iv) after 24‐h dry time, (v) after 48‐h wet storage, (vi) after 2‐h dry time. From each scan, cross‐sectional images were obtained at intervals of 1 mm (total n = 708) and evaluated for the presence of dentinal microcracks twice by five calibrated blinded observers. Statistical analysis was performed by nonparametric analysis of variance for longitudinal data (P < 0.05).

Results

Intra‐rater percentage agreement ranged between 92% and 98%, whereas inter‐rater percentage agreement was 81% and 83%, respectively. No significant differences between all wet groups as well as between both groups with 2‐h dry time were detected (P > 0.05). Almost no cracks were observed after wet storage with a significant increase of cracks after 2‐h dry time (P < 0.001). Significantly more microcracks were identified after 24 h than after 2‐h dry time (P < 0.004).

Conclusions

Moisture content of dentine influenced detection of microcracks when evaluated using micro‐CT. Scanning should be performed on dried specimens to allow reliable identification of dentinal defects. Formation of new cracks during dry periods up to 24 h was disproved.
Histological, morphometric, protein and gene expression analyses of rat retinas with ischaemia–reperfusion injury model treated with sildenafil citrate
Authors: Zanoni Diogo S. , Da Silva Germana A. , Ezra‐Elia Raaya , Carvalho Márcio , Quitzan Juliany G. , Ofri Ron , Laus José L. , Laufer‐Amorim Renee
Published: August 2017

The aim of this study was to better understand the role of apoptosis in a retinal ischaemia–reperfusion injury model and to determine whether sildenafil citrate treatment can prevent retinal cell apoptosis. Thirty‐six rats were divided into a control group (n = 6) and two experimentally induced ischaemia–reperfusion groups (7 and 21 days; n = 15 per group). The induced ischaemia–reperfusion groups were treated with sildenafil for 7 and 21 days (n = 10 per group), and 10 animals were treated with a placebo for the same period (n = 5 per group). Paracentesis of the anterior chamber was performed with a 30‐G needle attached to a saline solution (0.9%) bag positioned at a height of 150 cm above the eye for 60 min. Intraocular pressure was measured by rebound tonometer (TonoVet®). The eyes were analysed by histology and morphometry, and by immunohistochemistry and qRT‐PCR for expression of Caspase‐7, Caspase‐6, Caspase‐9, Tnf‐r2, Fas‐l, Bcl‐2 and Bax. Sildenafil‐treated animals showed lower levels of histopathological changes (inflammatory, cellular and tissue) than their placebo‐treated counterparts at both 7 and 21 days. The retinal ganglion cell layer (RGC) was preserved in the sildenafil groups (SG), with a cell count closer to control than in the placebo groups (PG). Caspase‐7 expression was significantly higher in both treated groups at 7 days compared to controls. Gene expression levels in both treatment groups differed from the controls, but in SG Bax and Caspase‐6 expression levels were similar to control animals. These results suggest that the main mechanism of retinal cell death in this model is apoptosis, as there is an increase in pro‐apoptotic factors and decrease in the anti‐apoptotic ones. Also, sildenafil seems to protect the retinal ganglion cell layer from apoptosis. Cell survival was evident in the histological and morphometric analyses, and sildenafil treatment had a protective effect in the apoptosis pathways, with gene expression levels in SG similar to the controls.
EFFICIENT LEARNING AND JOB TURNOVER IN THE LABOR MARKET
Authors: Li Fei , Weng Xi
Published: August 2017

This article nests a continuous‐time learning model la Jovanovic (Journal of Political Economy 92 (1984), 108–22) into a directed on‐the‐job search framework. We prove that the socially efficient allocation is separable, that is, the workers' value functions and optimal controls are independent of both the distribution of workers across their current match qualities and the unemployment rate. We characterize the dynamics of job transitions in the efficient allocation. Furthermore, when the matching technology is linear, our numerical results show that increasing the vacancy creation cost and the speed of learning have ambiguous effects on the unemployment rate and aggregate job transition.
Direct oral anticoagulant medications in calciphylaxis
Authors: King Brian J. , el‐Azhary Rokea A. , McEvoy Marian T. , Shields Raymond C. , McBane Robert D. , McCarthy James T. , Davis Mark D. P.
Published: August 2017

Background

Recent studies suggest that calciphylaxis is a thrombotic condition in which arteriolar thrombosis leads to painful skin infarcts and consequent morbidity and mortality. Paradoxically, warfarin is implicated as a risk factor for calciphylaxis. Our objective is to report the use of oral direct thrombin and factor Xa inhibitors (termed direct oral anticoagulants [DOACs]) in patients with calciphylaxis.

Methods

We retrospectively reviewed records of 16 patients with calciphylaxis who received concomitant administration of novel anticoagulants. Patient data, including demographics, comorbidities, other treatments, and adverse events, were abstracted from the health records.

Results

Eleven patients (69%) had chronic kidney disease (stage ≥3A), and eight (50%) received dialysis. Apixaban was the most frequently used agent (n = 11 [69%]). Dabigatran (n = 4 [25%]) and rivaroxaban (n = 2 [13%]) were reserved for patients with mild renal impairment (stage ≤2). One clinically relevant but nonmajor bleeding event occurred. There were no major bleeding events. Nine patients (56%) were alive at last follow‐up, and five (31%) had complete resolution of their calciphylaxis (mean follow‐up, 523 days; range, 26–1884 days).

Conclusion

DOACs were safe and well tolerated in patients with calciphylaxis, in this initial experience. Several patients had improvement or resolution of calciphylaxis in response to therapy that included DOACs. The degree of renal impairment should guide DOAC choice. Randomized trials are required to determine treatment efficacy.
Trichoscopy – a useful tool in the preliminary differential diagnosis of autoimmune bullous diseases
Authors: Sar‐Pomian Marta , Rudnicka Lidia , Olszewska Malgorzata
Published: August 2017

Background

Scalp is a common location of autoimmune bullous diseases. Trichoscopy is a noninvasive method for diagnosing hair and scalp diseases. Data on trichoscopy in autoimmune bullous diseases are limited to the studies on pemphigus including a small number of patients. Trichoscopic characteristics of bullous pemphigoid and dermatitis herpetiformis were not reported to date. The aim of the study was to determine the value of trichoscopy in the differential diagnosis of pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, and dermatitis herpetiformis.

Methods

Trichoscopy was used to evaluate scalp lesions in 68 patients (26 with pemphigus vulgaris, 17 with pemphigus foliaceus, 17 with bullous pemphigoid, and 8 with dermatitis herpetiformis). The working magnification was 20‐fold and 70‐fold.

Results

The most frequent trichoscopic feature of autoimmune bullous diseases was extravasations. They occurred in 76.9% of patients with pemphigus vulgaris, 70.6% of patients with pemphigus foliaceus, 76.5% of patients with bullous pemphigoid, and 100% of patients with dermatitis herpetiformis. Yellow hemorrhagic crusts occurred in, respectively, 73.1%, 70.6%, 64.7%, and 35.5% of the cases. Yellow diffuse scaling and tubular scaling occurred more frequently in pemphigus foliaceus (52.9% and 41.2%, respectively). Clustered dotted vessels were characteristic for dermatitis herpetiformis (5/8, 62.5%). Dotted vessels with whitish halo were a hallmark of pemphigus vulgaris. A trichoscopic algorithm for the differential diagnosis of autoimmune bullous diseases was developed.

Conclusions

Autoimmune bullous diseases present characteristic trichoscopic patterns. Trichoscopy can be regarded as a rapid in‐office preliminary diagnostic method in the differential diagnosis of these diseases.
Failure of initial disease control in bullous pemphigoid: a retrospective study of hospitalized patients in a single tertiary center
Authors: Kremer Noa , Zeeli Tal , Sprecher Eli , Geller Shamir
Published: August 2017

Background

Bullous pemphigoid (BP) is the most prevalent autoimmune blistering skin disease in Western countries and in Israel. Initial disease control is achieved in 60–90% of BP patients within 1–4 weeks of corticosteroid therapy. In the remainder of patients, recalcitrant disease is controlled with additional immunosuppressive treatment.

Objectives

We aimed to evaluate the rate of BP patients who needed adjuvant therapy to achieve initial disease control and to identify potential predictors for recalcitrant disease.

Methods

We conducted a retrospective study of newly diagnosed BP patients who were hospitalized at the Tel Aviv Sourasky Medical Center between the years 2008–2014. We performed statistical analyses to assess the association between clinical factors and failure of initial disease control.

Results

Among 114 hospitalized patients with newly diagnosed BP, 1.8% presented with oral mucosa involvement. Seven patients (6.1%) required systemic agents in addition to corticosteroids to achieve disease control. Hypertension (P = 0.048), involvement of the head region (P = 0.042), and metformin treatment (P = 0.02) were significantly more prevalent among patients with recalcitrant disease.

Conclusions

The low frequency of recalcitrant BP (6.1%) and the rarity of involvement of the oral mucosa (1.8%) in this study suggest that Israeli BP patients present a milder phenotype compared to similar patients from other geographic areas. Hypertension, head involvement, and metformin therapy were found to be significantly associated with the need for adjuvant therapy to achieve initial control, suggesting that these parameters may serve as predictors of treatment response in BP.
Predictive value of symptoms, signs and biomarkers on computed tomography pulmonary angiogram results
Authors: Sethwala Anver , Wang Xiaojie , Sturm Emma E. , Collins Kate L. , O'Donnabhain Ronan , Friedman Nadia D.
Published: August 2017

Background

Pulmonary embolism (PE) is associated with significant morbidity and mortality. PE is a heterogeneous entity that causes a wide variety of clinical presentations, making it imperative to establish which clinical symptoms, signs and biomarkers can influence the pretest probability of PE to aid clinicians and reduce over testing.

Aim

To analyse the clinical parameters used by clinicians to order a computed tomography pulmonary angiogram (CTPA) and establish which were associated with the presence of PE.

Methods

Medical records of patients who underwent CTPA from December 2015 to March 2016 were extracted. Patient demographics, clinical symptoms, diagnostic and radiological results were analysed.

Results

The study included 150 CTPA studies. Of the studies, 25 were positive for PE and 125 were negative. There was no significant relationship between the presence or character of chest pain and a positive CTPA result (P = 0.216). Previous history of venous thromboembolism (VTE) (P < 0.0001), one or more risk factors for VTE and positive troponin (P < 0.002) were all predictive of PE. None of the patients with a negative D‐dimer had a positive CTPA.

Conclusion

This study supports the negative predictive value of the D‐dimer for excluding PE and demonstrates that the strongest pretest predictors of PE in our population are a prior history of VTE, risk factors for VTE and elevated troponin. None of the parameters that often generate requests for CTPA, including vital signs or the presence of chest pain, was associated with the presence of PE in our study population.
Physical activity, quality of life and successful ageing among community‐dwelling older adults
Authors: Choi M. , Lee M. , Lee M.‐J. , Jung D.
Published: August 2017

Aim

To identify the relationships between physical activity, quality of life and successful ageing among community‐dwelling older adults in South Korea.

Background

With increasing numbers of financially stable and active older adults, it has become imperative to understand successful ageing to promote well‐being in this population.

Methods

Questionnaire data were collected from senior welfare centres from August to November 2013. Participants were adults aged 65 years or older living in urban areas. Participants were asked to complete self‐report questionnaires assessing physical activity, quality of life and successful ageing. Data from 212 participants were analysed using descriptive statistics, independent t‐tests, ANOVAs with Scheffe tests and ordinary least square and quantile regression models using STATA 12.0.

Findings

In the ordinary least square model, the association between physical activity and successful ageing was not statistically significant, whereas quantile regression revealed significant associations within the 75th and 90th percentiles of successful ageing scores. Quality of life was significantly associated with successful ageing in the ordinary least square model and with the median and 75th percentiles of successful ageing in quantile regressions.

Conclusion

Results suggested that physical activity and quality of life were both in part significantly associated with successful ageing among Korean older adults.

Implications for nursing and health policies

Physical activity and quality of life play an important role in enhancing successful ageing. The development of an effective exercise programme advertised towards community‐dwelling older adults may be essential for maintaining their successful ageing.
The nursing profession in Sri Lanka: time for policy changes
Authors: Aluwihare‐Samaranayake D. , Ogilvie L. , Cummings G.G. , Gellatly Ian R.
Published: August 2017

Aim

We address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made.

Background

Increased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems.

Sources of evidence

We draw on first‐hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession.

Discussion

Policy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence‐based practice, research, leadership, and information systems.

Conclusion

There is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders.

Implications for nursing and health policy

Implementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers.