bluuebunny/crossref_metadata_2025 huggingface dataset:
Defining early vs late fetal growth restriction by placental pathology
Authors: Aviram Amir , Sherman Christopher , Kingdom John , Zaltz Arthur , Barrett Jon , Melamed Nir
Published: October 2018

Introduction

Although early and late fetal growth restriction have been suggested to be distinct entities, the optimal gestational age cut‐off that differentiates the two conditions is currently unclear and has been arbitrarily set in previous studies between 32 and 37 weeks. We aimed to use placental pathology findings to determine that optimal gestational age cut‐off between early and late fetal growth restriction.

Material and methods

A retrospective cohort study of all women with singleton gestation who gave birth to a neonate diagnosed as small‐for‐gestational age (small‐for‐gestational age, defined as birthweight <10th percentile for gestational age) at a tertiary referral center between January 2001 and December 2015, and for whom placental pathology was available. Placental abnormalities were classified into lesions associated with maternal vascular malperfusion (MVM), fetal vascular malperfusion, placental hemorrhage and chronic villitis. Placental findings were analyzed as a function of gestational age at birth. The analysis was repeated in the subgroups of women without hypertensive complications of pregnancy (to reflect changes associated with isolated small‐for‐gestational age) and of neonates with severe small‐for‐gestational age (defined as birthweight <5th percentile), which are more likely to represent true fetal growth restriction.

Results

A total of 895 women met the inclusion criteria. The only histological finding that changed with gestational age was MVM pathology, which decreased in frequency with increasing gestational age. We identified a considerable drop in the rate of MVM lesions at 33 weeks of gestation. The rate of MVM pathology in placentas of infants born before 330/7 weeks was significantly higher than that observed in placentas of infants born at 330/7 weeks or longer: 71.6% vs 27.4%, P < 0.001 for ≥2 MVM lesions, and 35.5% vs 3.5%, P < 0.001 for ≥3 MVM lesions. These findings persisted in the subgroups of women without hypertensive complications of pregnancy (n = 662) and of neonates with severe small‐for‐gestational age (n = 464).

Conclusions

Using placental pathology as a direct measure of the mechanisms underlying fetal growth restriction, the optimal gestational age at birth cut‐off which differentiates early from late fetal growth restriction appears to be 330/7 weeks.
Effects of Pulsatile Control Algorithms for Diagonal Pump on Hemodynamic Performance and Hemolysis
Authors: Wang Shigang , Force Madison , Moroi Morgan K. , Patel Sunil , Kunselman Allen R. , Ündar Akif
Published: October 2018

The objective of this study is to compare hemodynamic performances under different pulsatile control algorithms between Medos DeltaStream DP3 and i‐cor diagonal pumps in simulated pediatric and adult ECLS systems. An additional pilot study was designed to test hemolysis using two pumps during 12h‐ECLS. The experimental circuit consisted of parallel combined pediatric and adult ECLS circuits using an i‐cor pump head and either an i‐cor console or Medos DeltaStream MDC console, a Medos Hilite 2400 LT oxygenator for the pediatric ECLS circuit, and a Medos Hilite 7000 LT oxygenator for the adult ECLS circuit. The circuit was primed with lactated Ringer's solution and human packed red blood cells (hematocrit 40%). Trials were conducted at various flow rates (pediatric circuit: 0.5 and 1L/min; adult circuit: 2 and 4L/min) under nonpulsatile and pulsatile modes (pulsatile amplitude: 1000–5000rpm [1000 rpm increments] for i‐cor pump, 500–2500rpm [500 rpm increments] for Medos pump) at 36°C. In an additional protocol, fresh whole blood was used to test hemolysis under nonpulsatile and pulsatile modes using the two pump systems in adult ECLS circuits. Under pulsatile mode, energy equivalent pressures (EEP) were always greater than mean pressures for the two systems. Total hemodynamic energy (THE) and surplus hemodynamic energy (SHE) levels delivered to the patient increased with increasing pulsatile amplitude and decreased with increasing flow rate. The i‐cor pump outperformed at low flow rates, but the Medos pump performed superiorly at high flow rates. There was no significant difference between two pumps in percentage of THE loss. The plasma free hemoglobin level was always higher in the Medos DP3 pulsatile group at 4 L/min compared to others. Pulsatile control algorithms of Medos and i‐cor consoles had great effects on pulsatility. Although high pulsatile amplitudes delivered higher levels of hemodynamic energy to the patient, the high rotational speeds increased the risk of hemolysis. Use of proper pulsatile amplitude settings and intermittent pulsatile mode are suggested to achieve better pulsatility and decrease the risk of hemolysis. Further optimized pulsatile control algorithms are needed.
Sizable Scaffold‐Free Tissue‐Engineered Articular Cartilage Construct for Cartilage Defect Repair
Authors: Park In‐Su , Jin Ri Long , Oh Hyun Ju , Truong Minh‐Dung , Choi Byung Hyune , Park Sang‐Hyug , Park Do Young , Min Byoung‐Hyun
Published: October 2018

This study introduces an implantable scaffold‐free cartilage tissue construct (SF) that is composed of chondrocytes and their self‐produced extracellular matrix (ECM). Chondrocytes were grown in vitro for up to 5 weeks and subjected to various assays at different time points (1, 7, 21, and 35 days). For in vivo implantation, full‐thickness defects (n = 5) were manually created on the trochlear groove of the both knees of rabbits (16‐week old) and 3 week‐cultured SF construct was implanted as an allograft for a month. The left knee defects were implanted with 1, 7, and 21 days in vitro cultured scaffold‐free engineered cartilages. (group 2, 3, and 4, respectively). The maturity of the engineered cartilages was evaluated by histological, chemical and mechanical assays. The repair of damaged cartilages was also evaluated by gross images and histological observations at 4, 8, and 12 weeks postsurgery. Although defect of groups 1, 2, and 3 were repaired with fibrocartilage tissues, group 4 (21 days) showed hyaline cartilage in the histological observation. In particular, mature matrix and columnar organization of chondrocytes and highly expressed type II collagen were observed only in 21 days in vitro cultured SF cartilage (group 4) at 12 weeks. As a conclusion, cartilage repair with maturation was recapitulated when implanted the 21 day in vitro cultured scaffold‐free engineered cartilage. When implanting tissue‐engineered cartilage, the maturity of the cartilage tissue along with the cultivation period can affect the cartilage repair.
Beat‐to‐beat detection of aortic valve opening in HeartWare left ventricular assist device patients
Authors: Clifford Rachel , Robson Desiree , Gross Christoph , Moscato Francesco , Schima Heinrich , Jansz Paul , Macdonald Peter S. , Hayward Christopher S.
Published: October 2018

Continuous flow left ventricular assist devices (cfLVADS) result in a significant reduction in aortic valve (AV) opening, which has been associated with several complications. Reliable monitoring of AV opening is needed to determine whether pump speed adjustment may be able to minimize adverse outcomes. We assessed AV status continuously by echocardiography for 4 minutes in 3 states in 18 HeartWare HVAD patients: 2 minutes at rest, and 1 minute each following Valsalva maneuver and supine leg‐raising. Using a previously described algorithm, beat‐to‐beat AV status was compared with the area under the curve of the normalized power spectral density analysis (PSD‐AUC) for the corresponding beats of the pump speed waveform. Five thousand five hundred twenty‐seven beats were analyzed. AV opening varied between 0% and 100% for the cohort with the median AV opening frequency 21.5%, and median duration of opening of 124 msec (range 0–279). The receiver operating characteristic (ROC) curve area for AV opening by the PSD‐AUC algorithm was 0.95 (P < 0.0001). A PSD‐AUC cut‐off of 0.82 distinguished between an open and closed AV with 86% sensitivity and 93% specificity. Accuracy was similar in regular cardiac rhythm, atrial fibrillation or with frequent ventricular ectopic beats. Valsalva maneuver and leg‐raising had no impact on accuracy. The PSD‐AUC was strongly predictive of AV opening duration (P < 0.0001). We found that AV status and opening duration can be determined with high accuracy on a beat‐to‐beat basis irrespective of cardiac rhythm and with low level exercise and changes in filling.
A randomised controlled trial of protocolised music therapy demonstrates developmental milestone acquisition in hospitalised infants
Authors: Emery Lelia , Hamm Ellyn L. , Hague Kaleigh , Chorna Olena D. , Moore‐Clingenpeel Melissa , Maitre Nathalie L.
Published: October 2018

Aim

To compare the effectiveness of an intensive‐intermittent vs. standard spaced protocolised music therapy intervention on supporting developmental milestone acquisition of infants >44 weeks postmenstrual age (PMA) hospitalised in a Neonatal Intensive Care Unit (NICU).

Method

This was a comparative effectiveness study of infants 44–66 weeks PMA with a projected NICU stay of at least one month from recruitment. Infants were randomised to one of two treatment groups: traditional therapy (2x/week) and intermittent‐intensive (4x/week, off, 4x/week, off). Both groups received the same number of sessions over a 4‐week period. Sessions at the start and end of the treatment period were video recorded. Two masked researchers reviewed and coded videos. Milestones used for video recording were adapted from the Developmental Assessment of Young Children.

Results

Twenty‐four infants participated, with groups matched for birth age, PMA at start of study, race, IVH severity, and respiratory support. Total and motor composite scores were higher post‐intervention (Cohen's d = 0.71 and 0.97, both p < 0.01), with the same degree of skill acquisition found for both intervention groups.

Conclusion

A developmental music therapy protocol supports developmental skills acquisition of post‐term infants in a NICU. Similar outcomes for both groups provide therapists with varying treatment dosing options to best support their patients.
Mitochondrial complex IV mutation increases reactive oxygen species production and reduces lifespan in aged mice
Authors: Reichart Gesine , Mayer Johannes , Zehm Cindy , Kirschstein Timo , Tokay Tursonjan , Lange Falko , Baltrusch Simone , Tiedge Markus , Fuellen Georg , Ibrahim Saleh , Köhling Rüdiger
Published: October 2018

Aim

Mitochondrial DNA (mtDNA) mutations can negatively influence lifespan and organ function. More than 250 pathogenic mtDNA mutations are known, often involving neurological symptoms. Major neurodegenerative diseases share key etiopathogenetic components ie mtDNA mutations, mitochondrial dysfunction and oxidative stress.

Methods

Here, we characterized a conplastic mouse strain (C57BL/6 J‐mtNOD) carrying an electron transport chain complex IV mutation that leads to an altered cytochrome c oxidase subunit III. Since this mouse also harbours adenine insertions in the mitochondrial tRNA for arginine, we chose the C57BL/6 J‐mtMRL as control strain which also carries a heteroplasmic stretch of adenine repetitions in this tRNA isoform.

Results

Using MitoSOX fluorescence, we observed an elevated mitochondrial superoxide production and a reduced gene expression of superoxide dismutase 2 in the 24‐month‐old mtNOD mouse as compared to control. Together with the decreased expression of the fission‐relevant gene Fis1, these data confirmed that the ageing mtNOD mouse had a mitochondrial dysfunctional phenotype. On the functional level, we could not detect significant differences in synaptic long‐term potentiation, but found a markedly poor physical constitution to perform the Morris water maze task at the age of 24 months. Moreover, the median lifespan of mtNOD mice was significantly shorter than of control animals.

Conclusion

Our findings demonstrate that a complex IV mutation leads to mitochondrial dysfunction that translates into survival.
Clinical relevance of serum non‐organ‐specific antibodies in patients with HCV infection receiving direct‐acting antiviral therapy
Authors: Shahini Endrit , Iannone Andrea , Romagno Domenico , Armandi Angelo , Carparelli Sonia , Principi Mariabeatrice , Viggiani Maria Teresa , Ierardi Enzo , Di Leo Alfredo , Barone Michele
Published: October 2018

Background

Hepatitis C virus (HCV) infection is associated with production of different serum non‐organ‐specific antibodies (NOSA) and risk for developing autoimmune disorders. The clinical significance of these phenomena is not fully understood.

Aim

To assess non‐organ‐specific antibodies before and 24 weeks after the end of therapy with direct‐acting antivirals in patients with HCV‐related infection, to better clarify the clinical relevance of these antibodies in terms of treatment response and prognostic value.

Methods

Patients enrolled (191) were considered non‐organ‐specific antibody‐positive for titres ≥1:40 on at least two determinations before treatment.

Results

At baseline, 46 patients were positive and 145 were negative for autoantibodies. The prevalence of autoimmune thyroiditis was significantly higher in non‐organ‐specific antibody‐positive group than non‐organ‐specific antibody‐negative group (P = 0.02). HCV‐RNA 24 weeks after the end of antiviral therapy was 100% negative in patients with antibodies positivity and 98.6% in antibody‐negative patients (P = 1.0). In the former group, autoantibodies disappeared in 30 of 46 patients (65.2%). On multivariate analysis, non‐organ‐specific antibody‐negativity was significantly reduced in patients with hepatic hilar lymphadenopathy (OR = 0.17; 95% CI 0.02‐0.94, P = 0.04). None of the adverse events occurring during antiviral therapy was related to autoimmune disorders.

Conclusions

Hepatitis C virus clearance frequently reduces non‐organ‐specific antibody positivity suggesting that they represent an epiphenomenon of the viral infection. However, in patients who did not become negative, long‐term monitoring would establish whether they could hide an underlying process that may progress into a clear autoimmune or rheumatologic disease. (Trial registration number: NCT03566966).
Adults with eosinophilic oesophagitis identify symptoms and quality of life as the most important outcomes
Authors: Safroneeva Ekaterina , Balsiger Lukas , Hafner David , Kuehni Claudia E. , Zwahlen Marcel , Trelle Sven , Godat Sébastien , Biedermann Luc , Greuter Thomas , Vavricka Stephan , Straumann Alex , Schoepfer Alain M.
Published: October 2018

Background

Well informed patients who are in cohesive partnership with physicians and who have realistic expectations towards therapy are more likely to be adherent, which results in better disease control.

Aim

To assess which therapy goals adults with eosinophilic oesophagitis consider relevant.

Methods

Following refinement during three focus groups, a study brochure and questionnaire were sent to 148 patients. Patients ranked the importance (five levels) of short‐term (in the next 3 months) and long‐term (≥1 year) treatment effect on symptoms, quality of life (QoL), histologically‐detected inflammation and fibrosis, endoscopically‐detected inflammation, and stricture formation as well as achieving histological remission while asymptomatic. Patients’ characteristics associated with treatment goals were identified using logistic regression.

Results

Of 109 respondents (mean age 43 years), 85 were men. Over 90% chose symptoms and QoL improvement as important short‐ and long‐term therapy goals. A greater proportion attributed more importance to long‐term reduction in endoscopic (90% vs 73%, P < 0.001) and histological (81% vs 62%, P = 0.002) inflammation, and histologically‐detected fibrosis (79% vs 64%, P = 0.018) when compared to short‐term reduction in these features. Patients (88%) ranked achieving histological remission while being asymptomatic as important. Gender, therapy use, education level, QoL, symptom severity, and history of dilation were associated with patients’ choice of treatment goals.

Conclusions

Patients attributed most importance to improvement in symptoms and QoL. Reduction in biological activity was judged less important, but more relevant in the long‐ compared to the short‐term.
Household empowerment as the key to eradicate poverty incidence
Authors: Abrar ul haq Muhammad , Jali Mohd Razani Mohd , Islam Gazi Md Nural
Published: October 2018

The current study aimed to investigate how the household empowerment can potentially reduce the rural poverty incidence. The data were collected through multistage random sampling from the rural households of 24 villages in Southern Punjab, Pakistan. A total of 600 households were selected as sample pool. Face‐to‐face interviews with the household heads were conducted. The household empowerment was measured through an index that was adopted from Abrar‐ul‐haq (“An assessment of the role of household empowerment in alleviating poverty in Southern Punjab, Pakistan” (Ph.D. Dissertation), School of Economics, Finance and Banking, Universiti Utara Malaysia, 2017). The binary logit model was used to analyze the impact of household empowerment with other control variables on poverty incidence. The results of the current study confirm the negative nexus between household empowerment and poverty incidence of rural households as the study reported that the probabilities (odds ratio: 0.877) of being poor are reduced by increasing the empowerment (in every aspect, economically, politically, and socially) of the households, and the results are statistically significant at the 1% level of significance. Based on empirical results, this study suggests that household empowerment has significant potential to reduce poverty incidence in the rural areas of Southern Punjab, Pakistan.
The Influence of Institutional Mission on Students’ Values: A Comparison Among Three Universities
Authors: Weber James , McManus Warnell Jessica
Published: October 2018

Many business schools profess a commitment to ethics in their mission statements and focus a spotlight on the intersection between the university’s mission and attention to business ethics. To explore this trend, we analyze a sample of students’ values from two universities with an explicit religious foundation and recognized commitment to ethics against students from another university where this attention is not as explicit. This study identifies the personal values orientations (PVOs) for these students, born between 1980 and 2000, thus millennials, and considers if differences can be attributed to the university’s culture and mission or business school curriculum. We utilize Social Identity Theory as a promising framework for illuminating these considerations. Our results confirm that a religious‐orientation characterizing a university’s mission may influence the business students’ (or millennials’) PVOs. Students at the two religious institutions manifested a stronger social, rather than personal, and moral, rather than competence, value orientation. Only marginal differences were discovered when assessing within group differences in the value orientations among our sample of business students.
Cultural Analysis of Corporate Social Action
Authors: Mattingly James E. , Hall Harry T. , VanSandt Craig
Published: October 2018

Previous studies of corporate environmental and social action identify exactly three similar patterns of activity. They provide divergent structural explanations for these patterns, as networks of institutional constraint, and networks of local inter‐dependence, respectively. A theory of sociocultural viability, known in anthropology and policy science as Cultural Theory, explains that social systems consist of four patterns of social interaction, shaped by two distinct structural factors. Our own analysis of 45 items of environmental, social, and governance factors reconcile extant studies’ findings with Cultural Theory’s expectations. Although earlier studies of corporate social action observed only three patterns of activity, our analysis uncovered the fourth, and that diverging structural explanations of earlier studies are partial and complementary, clarified by Cultural Theory. Our call for further study leverages the normative dimension of Cultural Theory, which specifies policy processes that privilege human decency over parochial preference functions.
Serum uric acid as a predictor of bipolarity in individuals with a major depressive episode
Authors: dos Santos Oliveira Pedro Miguel , Santos Vítor , Coroa Manuel , Ribeiro Joana , Madeira Nuno
Published: October 2018

Objectives

There are no well‐established biomarkers to predict the risk of conversion to bipolar disorder (BD) in patients with depression. Given the putative role of purinergic neurotransmission dysfunction in BD, the purpose of our study was to evaluate if higher serum uric acid (UA) levels could predict BD conversion in depressed inpatients.

Methods

We reviewed retrospectively the records of subjects hospitalized between June 2007 and June 2010 with a diagnosis of major depressive disorder (MDD) who had undergone routine UA levels testing at admission. At an approximate 10‐year follow‐up we identified subjects with a subsequent diagnosis of BD. We compared UA levels between the BD‐converter and non‐BD converter groups, performed Receiver operating characteristic curve analysis to evaluate the prognostic accuracy of serum UA levels and calculated the clinical utility index (CUI) as a risk biomarker for conversion to BD.

Results

The study included 250 subjects (55 “BD‐converters” and 195 “No BD‐converters”). “BD‐converters” had significantly higher plasma UA levels compared to “No BD‐converters” in their index hospitalization irrespective of gender (males: 403.84 ± 91.76 vs 270.81 ± 53.58 µmol/L; U = 94.5, P < 0.001 and females 302.19 ± 52.64 vs 202.69 ± 48.93 µmol/L; t = 10.75, P < 0.001). Serum UA levels showed a very good to excellent accuracy for predicting conversion to BD in inpatients with MDD (area under the curve [AUC]: 0.90; 95% CI: 0.86, 0.94) and had a good to excellent CUI− and a moderate to good CUI+ grading for discriminating BD‐converter cases from non‐BD converters.

Conclusions

Our study suggests that depressed patients with higher levels of serum UA are at greater risk of a subsequent manic or hypomanic episode. The purinergic system could prove a promising path for the search of biomarkers in BD.
Voice and power: Feminist governance as transnational justice in the globalized value chain
Authors: Ahmed Fauzia Erfan
Published: October 2018

Women constitute the majority of workers in global value chains (GVCs), yet few GVC scholars focus on the governance of gender. Based on an investigation (2013–2017) started after the Rana Plaza disaster in Bangladesh, this article presents “voice to the subordinate strata” as the first principle of feminist governance in the GVC. Findings reveal the matrix of power, which includes the International Labour Organization and the state that underpins the political economy of the Southern factory. This study provides a transformative model of feminist governance as transnational justice. As the relational ethic that links justice in the workplace to the quality of a woman's life, feminist governance is also the moral economy of the GVC wherein the woman worker is valued as a citizen in the global economy.
Involvement of dual‐strand of the miR‐144 duplex and their targets in the pathogenesis of lung squamous cell carcinoma
Authors: Uchida Akifumi , Seki Naohiko , Mizuno Keiko , Misono Shunsuke , Yamada Yasutaka , Kikkawa Naoko , Sanada Hiroki , Kumamoto Tomohiro , Suetsugu Takayuki , Inoue Hiromasa
Published: October 2018

The prognosis of patients with advanced‐stage lung squamous cell carcinoma (LUSQ) is poor, and effective treatment protocols are limited. Our continuous analyses of antitumor microRNAs (miRNAs) and their oncogenic targets have revealed novel oncogenic pathways in LUSQ. Analyses of our original miRNA expression signatures indicated that both strands of miR‐144 (miR‐144‐5p, the passenger strand; miR‐144‐3p, the guide strand) showed decreased expression in cancer tissues. Additionally, low expression of miR‐144‐5p significantly predicted a poor prognosis in patients with LUSQ by The Cancer Genome Atlas database analyses (overall survival, P = 0.026; disease‐free survival, P = 0.023). Functional assays revealed that ectopic expression of miR‐144‐5p and miR‐144‐3p significantly blocked the malignant abilities of LUSQ cells, eg, cancer cell proliferation, migration, and invasion. In LUSQ cells, 13 and 15 genes were identified as possible oncogenic targets that might be regulated by miR‐144‐5p and miR‐144‐3p, respectively. Among these targets, we identified 3 genes (SLC44A5, MARCKS, and NCS1) that might be regulated by both strands of miR‐144. Interestingly, high expression of NCS1 predicted a significantly poorer prognosis in patients with LUSQ (overall survival, P = 0.013; disease‐free survival, P = 0.048). By multivariate analysis, NCS1 expression was found to be an independent prognostic factor for patients with LUSQ patients. Overexpression of NCS1 was detected in LUSQ clinical specimens, and its aberrant expression enhanced malignant transformation of LUSQ cells. Our approach, involving identification of antitumor miRNAs and their targets, will contribute to improving our understanding of the molecular pathogenesis of LUSQ.
“It is like a jungle gym, and everything is under construction”: The parent's perspective of caring for a child with a rare disease
Authors: Currie Genevieve , Szabo Joanna
Published: October 2018

Descriptive title

Parents of children with rare diseases face pervasive challenges in meeting medical and social care needs. Existing research on the parents' experience of caring for a child with a rare disease is limited. This paper offers suggestions for better supporting families living with rare disease as well as possible avenues of future research.

Background

Parents of children with rare diseases face pervasive challenges in meeting medical and social care needs. Existing research on the parent's experience of caring for a child with a rare disease is limited.

Methods

An interpretive phenomenological approach was applied in this inquiry. Fifteen parents of children with rare diseases participated in semistructured interviews.

Results

Interpretive thematic analysis revealed that due to the rarity of the disease and an overall lack of knowledge of the disease, there is an increase in the burden on the family in relation to “rarity” in addition to “disability.” Four insights were also revealed: (a) Parents often know more about the disease then Health Care providers, and this leads to entanglements in communication and collaboration as experts and parents; (b) there is lack of coordination of care between providers and services caring for children with rare diseases; (c) there is a gap in accessibility to government supports; and (d) due to fragmented care, parents must fill the aforementioned gaps by juggling multiple roles including that of advocate, case manager, and medical navigator.

Conclusion

This paper offers suggestions for better supporting families living with rare disease as well as possible avenues of future research.
Adult Finns’ perceptions about communication with the dentist during their latest visit
Authors: Raittio Eero , Lahti Satu , Suominen Anna Liisa
Published: October 2018

Objectives

The aim of this study was to investigate adult Finns’ perceptions about communication with the dentist during their latest visit in three aspects: receiving adequate information about health status and care, being listened to and shown interest by the dentist, and being able to influence the treatment decisions.

Methods

Data were taken from the Health 2011 Survey (BRIH8901). A representative sample (n = 5806) of adult Finns aged over 29 years old was interviewed or alternatively filled in a questionnaire. Basic descriptive tabulations, Rao‐Scott chi‐square tests and logistic regression analyses were used to study how socioeconomic status, perceived oral health and oral Health care variables are associated with the three aspects of communication with the dentist.

Results

Most (85%‐90%) adult Finns felt that, during their latest visit to a dentist, they had received adequate information, were listened to and shown interest by their dentist, and that they had been able to influence the treatment decisions. Those who perceived poor oral health, felt visiting dentist somewhat frightening, were in a difficult economic situation, visited a public dentist, or tended to visit oral Health care services irregularly, felt more often that there was a deficit in communication with the dentist.

Conclusions

In 2011, most adult Finns did not report any deficit in communication with the dentist during their latest visit. Oral Health care professionals should focus more on communicating with patients who have economic problems, poor oral health, dental fear or a problem‐oriented visiting pattern.
Increased mortality and morbidity in patients with chronic hypoparathyroidism: A population‐based study
Authors: Vadiveloo Thenmalar , Donnan Peter T. , Leese Callum J. , Abraham Kirstin J. , Leese Graham P.
Published: October 2018

Objectives

A population‐based study was undertaken to determine the mortality and morbidity for people with hypoparathyroidism compared to the general population.

Methods

In this study, patients identified with chronic hypoparathyroidism using data linkage from regional datasets were compared with five age‐ and gender‐matched controls from the general population. Data from biochemistry, hospital admissions, prescribing and the demographic dataset were linked. Outcomes for mortality and specified conditions were examined for all patients and subdivided into post‐surgical and non‐surgical cases of hypoparathyroidism.

Results

All patients had an increased risk of epilepsy (HR 1.65 [95% CI 1.12‐2.44]) and cataracts (HR 2.10 [1.30‐3.39]) but no increased fracture risk. Only non‐surgical hypoparathyroid patients also had increased mortality (HR 2.11 [1.49‐2.98]), cardiovascular disease (HR 2.18 [1.41‐3.39]), cerebrovascular disease (HR 2.95 [1.46‐5.97]), infection (HR 1.87 [1.2‐2.92]) and mental illness (HR 1.59 [1.21‐2.11]). There was an increased risk of renal failure (HR 10.05 [95% CI 4.71‐21.43]) during the first 2000 days (5.5 years) of follow‐up. Renal failure and death were associated with increasing serum calcium concentrations.

Conclusion

Patients with hypoparathyroidism have an increased risk of cataract and epilepsy. Non‐surgical hypoparathyroidism is associated with increased mortality and additional morbidities.
Patient satisfaction versus retention of implant overdentures with two attachment systems: A randomized trial
Authors: de Albuquerque Rubens Ferreira , Fromentin Olivier , Lassauzay Claire , Conceição Pereira Saraiva Maria da
Published: October 2018

Background

Clinical success with mandibular implant overdentures is highly dependent on a reliable attachment system connecting prosthesis and implants.

Purpose

To compare the levels of retention and patient‐based outcomes on implant overdentures retained/supported by cylindrical (LA) and ball (RA) attachment systems overtime and investigate their relationship.

Materials and Methods

Attachment retention (Newtons), and patient satisfaction with the treatment, prosthesis stability, and ability to chew (VAS, 100 mm) were assessed in a crossover trial for both attachment systems at baseline, 1 week, 3, 6, and 12 months and compared to preintervention values. Patients' preference was also recorded.

Results

Mean retention of worn attachments and patient satisfaction with denture retention assessed in the preintervention phase were 3.2 N (SD 4.9) and 23.5 mm (IQR 6.5‐65.5), respectively. Overall mean retention along the study was higher for RA than LA (difference of 5.0 N, 95%CI: 2.5‐7.6;P = 0.0005), declining significantly overtime (P < 0.0001), more steeply for the cylindrical attachment. Differences in VAS ratings between attachments were nonsignificant in the crossover phase (P > 0.05), but general satisfaction, satisfaction with retention, and comfort were significantly higher when compared with preintervention scores (P < 0.05). Ratings of retention decreased significantly overtime for both systems and earlier for LA than RA. Satisfaction was lower when retention was either too low or too high, although there was large variation in this association. At the end of the study, all participants chose to remain with the attachment system that they had received last.

Conclusions

Attachment selection should be based on patients' individual characteristics and expectations as satisfaction with the attachment retention and denture stability vary largely among patients.
Getting Lost in Gatlinburg: How Low‐Income Residents “Make Do” in an Appalachian Tourist Town
Authors: Hope Amason J.
Published: October 2018

Perched at the edge of the most‐visited national park in the US—the Great Smoky Mountains—Gatlinburg, Tennessee, is a bustling tourist resort, filled with hotels, restaurants, and amusements. Every summer hundreds of people come to Gatlinburg looking for work, a place to stay, and a “fresh start.” Gatlinburg has become a place for those who want to relocate after experiencing life‐altering crises: job loss, domestic violence, addiction, bankruptcy, or the death of a loved one. Whatever circumstances propel them there, new arrivals inevitably face a critical housing shortage and a labor market dominated by low‐wage, contingent jobs. They confront these challenges by developing tactics for getting by in Gatlinburg. Borrowing a phrase from a long‐time Gatlinburg resident, I identify some of these tactics as “getting lost in Gatlinburg.” This paper presents two case studies of low‐income white women who make ends meet by using their obscurity in the face of neoliberal social institutions, including making use of their “white privilege” and detailed local knowledge. Understanding “getting lost” as a deliberate tactic reveals subtle and complex forms of agency in their efforts to move beyond the stigma of their current circumstances toward more personally fulfilling lives for themselves and their families.
Prevalence of contact allergy in the general population: A systematic review and meta‐analysis
Authors: Alinaghi Farzad , Bennike Niels H. , Egeberg Alexander , Thyssen Jacob P. , Johansen Jeanne D.
Published: October 2018

Background

Contact allergy and allergic contact dermatitis are frequent conditions in the general population.

Objectives

To provide an updated estimate of the prevalence of contact allergy in the general population based on data from our previous review combined with new data from an updated search for relevant studies published between 2007 and 2017.

Methods

Two authors independently searched PubMed for studies reporting on the prevalence of contact allergy in samples of the general population. Proportion meta‐analyses were performed to calculate the pooled prevalence estimates of contact allergy.

Results

A total of 28 studies were included in the analysis, covering 20 107 patch tested individuals from the general population. Overall, the pooled prevalence of contact allergy was 20.1% (95% confidence interval [CI]: 16.8%‐23.7%). In children and adolescents (<18 years), the prevalence was 16.5% (95%CI: 13.6%‐19.7%). The prevalence was significantly higher in women (27.9% [95%CI: 21.7%‐34.5%]) than in men (13.2% [95%CI: 9.3%‐17.6%]). The most common allergen was nickel (11.4% [95%CI: 9.4%‐13.5%]), followed by fragrance mix I (3.5% [95%CI: 2.1%‐5.4%]), cobalt (2.7% [95%CI: 2.1%‐3.4%]), Myroxylon pereirae (1.8% [95%CI: 1.0%‐2.7%]), chromium (1.8% [95%CI: 1.3%‐2.6%]), p‐phenylenediamine (1.5% [95%CI: 1.0%‐2.1%]), methylchloroisothiazolinone/methylisothiazolinone (1.5% [95%CI: 0.8%‐2.5%]), and colophonium (1.3% [95%CI: 1.0%‐1.6%]).

Conclusions

This meta‐analysis confirmed that at least 20% of the general population are contact‐allergic to common environmental allergens. It highlights the need for more effective preventive strategies for common allergens in consumer goods, cosmetics, and the workplace.
Urinary microbiome associated with chronic allograft dysfunction in kidney transplant recipients
Authors: Wu Jennifer F. , Muthusamy Amutha , Al‐Ghalith Gabriel A. , Knights Dan , Guo Bin , Wu Baolin , Remmel Rory P. , Schladt David P. , Alegre Maria‐Luisa , Oetting William S. , Jacobson Pamala A. , Israni Ajay K.
Published: October 2018

Background

We performed a study to identify differences in the urinary microbiome associated with chronic allograft dysfunction (CAD) and compared the urinary microbiome of male and female transplant recipients with CAD.

Methods

This case‐control study enrolled 67 patients within the Deterioration of Kidney Allograft Function (DeKAF) Genomics cohort at two transplant centers. CAD was defined as a greater than 25% rise in serum creatinine relative to a 3 month post‐transplant baseline. Urine samples from patients with and without CAD were analyzed using 16S V4 bacterial ribosomal DNA sequences.

Results

Corynebacterium was more prevalent in female and male patients with CAD compared to non‐CAD female patients (P = 0.0005). A total 21 distinct Operational Taxonomic Unit (OTUs) were identified as significantly different when comparing CAD and non‐CAD patients using Kruskal‐Wallis (P < 0.01). A subset analysis of female patients with CAD compared to non‐CAD females identified similar differentially abundant OTUs, including the genera Corynebacterium and Staphylococcus (Kruskal‐Wallis; P = 0.01; P = 0.004, respectively). Male CAD vs female CAD analysis showed greater abundance of phylum Proteobacteria in males.

Conclusion

There were differences in the urinary microbiome when comparing female and male CAD patients with their female non‐CAD counterparts and these differences persisted in the subset analysis limited to female patients only.
A Graph Mining Approach to Identify Financial Reporting Patterns: An Empirical Examination of Industry Classifications
Authors: Yang Steve Y. , Liu Fang‐Chun , Zhu Xiaodi , Yen David C.
Published: October 2018

This study proposes a quantitative method using the eXtensible Business Reporting Language financial accounting taxonomies to identify firms' common business characteristics and demonstrates that this graph mining approach can effectively identify industry boundaries. The premise of this method is based on the previous findings that financial accounts and the structural semantic information represented in financial statements reveal firms' general business operations and common characteristics if they have similar business models. Specifically, we introduce a graph similarity metric combined with spectral clustering algorithm to quantify the similarity of financial disclosures. Through industry classification comparison with the traditional classification schemes, the Standard Industrial Classification and the North American Industry Classification System, we show that the proposed method consistently clusters firms into their respective industries based on financial disclosures with significantly lower variance in a time‐varying fashion. This novel graph mining method provides an automated way for decision makers to identify common business operations as well as detecting potential financial fraud and uncovering accounting information misrepresentation.
Comparative effects of proximal and distal small intestinal administration of metformin on plasma glucose and glucagon‐like peptide‐1, and gastric emptying after oral glucose, in type 2 diabetes
Authors: Borg Malcolm J. , Bound Michelle , Grivell Jacqueline , Sun Zilin , Jones Karen L. , Horowitz Michael , Rayner Christopher K. , Wu Tongzhi
Published: October 2018

Aims

The gastrointestinal tract, particularly the lower gut, may be key to the anti‐diabetic action of metformin. We evaluated whether administration of metformin into the distal, vs the proximal, small intestine would be more effective in lowering plasma glucose by stimulating glucagon‐like pepetide‐1 (GLP‐1) and/or slowing gastric emptying (GE) in type 2 diabetes (T2DM).

Materials and methods

Ten diet‐controlled T2DM patients were studied on three occasions. A transnasal catheter was positioned with proximal and distal infusion ports located 13 and 190 cm beyond the pylorus, respectively. Participants received infusions of (a) proximal + distal saline (control), (b) proximal metformin (1000 mg) + distal saline or (c) proximal saline + distal metformin (1000 mg) over 5 minutes, followed 60 minutes later by a glucose drink containing 50 g glucose and 150 mg 13C‐acetate. “Arterialized” venous blood and breath samples were collected over 3 hours for measurements of plasma glucose, GLP‐1, insulin and glucagon, and GE, respectively.

Results

Compared with control, both proximal and distal metformin reduced plasma glucose and augmented GLP‐1 responses to oral glucose comparably (P < 0.05 each), without affecting plasma insulin or glucagon. GE was slower after proximal metformin than after control (P < 0.05) and tended to be slower after distal metformin, without any difference between proximal and distal metformin.

Conclusions

In diet‐controlled T2DM patients, glucose‐lowering via a single dose of metformin administered to the upper and lower gut was comparable and was associated with stimulation of GLP‐1 and slowing of GE. These observations suggest that the site of gastrointestinal administration is not critical to the glucose‐lowering capacity of metformin.
Impact of contrast echocardiography on accurate discrimination of specific degree of left ventricular systolic dysfunction and comparison with cardiac magnetic resonance imaging
Authors: Alherbish Aws , Becher Harald , Alemayehu Wendimagegn , Paterson D. Ian , Butler Craig R. , Anderson Todd J. , Ezekowitz Justin A. , Shanks Miriam ,   Alberta HEART investigators
Published: October 2018

Aim

Limited data exist on the impact of contrast‐enhanced echocardiography on treatment decisions in heart failure patients that require specific left ventricular ejection fraction (LVEF) criteria. This study assessed accuracy of contrast‐enhanced echocardiography in identifying patients with LVEF >35% vs ≤35% with cardiac magnetic resonance (CMR) used as reference method.

Methods and results

Fifty‐five patients from prospective Alberta HEART cohort with LVEF ≤50% on CMR were included. All patients had echocardiography performed within 2 weeks of CMR. Contrast agent was used when ≥2 contiguous LV endocardial segments were poorly visualized on echocardiography. LVEF was computed by Simpson's biplane method using non‐contrast echocardiography and contrast‐enhanced echocardiography and by outlining the endocardial contours in short‐axis cine CMR images. Strong agreement in LV volumes and LVEF was seen between CMR and echocardiography with and without contrast (intra‐class correlation coefficients >0.8) with less underestimation of LV volumes by contrast‐enhanced echocardiography. Good agreement in LVEF ≤35% vs >35% was seen between CMR and non‐contrast echocardiography with optimal images (κ 0.862) and contrast echocardiography (κ 0.769) while it was moderate for non‐contrast echocardiography with suboptimal images (κ 0.491). The use of LV contrast in patients with suboptimal images (n = 39) resulted in correctly upgrading LVEF from ≤35% to >35% in 5 (13%) patients and downgrading LVEF from >35% to ≤35% in 2 (5%) patients using CMR as reference.

Conclusions

Contrast‐enhanced echocardiography in heart failure patients with suboptimal images helps to more accurately assess eligibility for specific therapies and avoid need for further testing, therefore should be considered routine part of echocardiographic assessment.
Left atrial appendage mass
Authors: Chan Po F. , Kofidis Theodoros , Tan Kong B. , Yip James W.‐L. , Ling Lieng H.
Published: October 2018

Left atrial (LA) masses are known to be associated with peripheral embolization. Accurate identification of etiology is crucial because treatment strategies may differ. We present the case of a young woman, who was initially diagnosed with a LA thrombus and anticoagulated. The diagnosis was revised to a primary cardiac tumor after review of the echocardiographic findings. Surgical excision revealed an atrial myxoma in an unusual location.
In‐depth echocardiographic analysis of left atrial function in healthy adults using speckle tracking echocardiography and volumetric analysis
Authors: van Grootel Roderick W. J. , Strachinaru Mihai , Menting Myrthe E. , McGhie Jackie , Roos‐Hesselink Jolien W. , van den Bosch Annemien E.
Published: October 2018

Purpose

Left atrial (LA) dilatation is predictive for complications in a multitude of cardiac diseases; therefore, adequate assessment is essential. Technological advances have made it possible to quantify LA function with Speckle Tracking Echocardiography (STE); however, there are currently no recommendations for normal values with regard to LA function. We aimed to assess LA myocardial and volumetric function in a healthy cohort and investigate correlations with baseline characteristics.

Methods

This prospective cohort study included 147 (aged 20–72) healthy individuals and assessed LA volumetric function using maximum, minimum and pre‐a‐wave volumes and myocardial function using reservoir function using peak strain in LA relaxation (LA‐strain), conduit function using peak strain rate in early LA contraction (LA‐SRe) and pump function using peak strain rate in late LA contraction (LA‐SRa).

Results

Mean LA‐strain was 39.7 ± 6.2%, LA‐SRe −2.78 ± 0.62 s−1 and LA‐SRa −2.56 ± 0.62 s−1. Subjects were divided into 5 age decades (each 50% female). LA‐strain and LA‐SRe were lower in the oldest groups, whereas LA‐SRa was higher. LA‐SRa was higher in males(−2.69 ± 0.68 s−1 vs −2.42 ± 0.52 s−1). Age‐specific values are provided. Age proved to be an independent predictor for LA‐SRa after correction for blood pressure and heart rate. LA expansion index and passive emptying fraction decreased with age, while active emptying fraction increased with age. LA maximum volume did not increase with age.

Conclusion

This study provides normal values for the three phasic functions of the LA, assessed with STE and volumetric function. Our results suggest the need for age‐specific reference ranges, and normal values for this cohort have been calculated.
Risk factors for infections in newly diagnosed Multiple Myeloma patients: A Danish retrospective nationwide cohort study
Authors: Sørrig Rasmus , Klausen Tobias W. , Salomo Morten , Vangsted Annette , Gimsing Peter
Published: October 2018

Objectives

Infections pose the greatest risk of early death in patients with Multiple Myeloma. However, few studies have analyzed the risk factors for infections in Multiple Myeloma patients. The aim of this study was to analyze the risk factors infections within a population‐based MM cohort.

Methods

Using Danish registries (from 2005 to 2013), we analyzed all ICD‐10 codes for infections within the first 6 months of Multiple Myeloma diagnosis in 2557 patients.

Results

Pneumonia and sepsis represented 46% of infections. Multivariable regression analysis showed that risk factors for pneumonia were male gender (HR 1.4; P = 0.001), ISS II (HR 1.6; P = 0.0004) and ISSIII (HR 1.8; P = 0.0004) and elevated LDH (HR 2.6; P = 0.0008). Risk factors for sepsis were high bone marrow plasma cell % (HR 1.1; P = 0.038), ISS II (HR 1.7; P = 0.007) ISS III (HR 2.0; P = 0.002) and creatinine (HR 2.1; P = 0.002). Neither immunoparesis (hypogammaglobulinemia) nor comorbidity was significant risk factors.

Conclusions

Our study suggests that tumor burden and renal impairment are risk factors for pneumonia and sepsis in the early phase of Multiple Myeloma.