bluuebunny/crossref_metadata_2025 huggingface dataset:
Sessile serrated adenoma/polyp showed rapid malignant transformation in the final 13 months
Authors: Amemori Sadahiro , Yamano Hiro‐o , Tanaka Yoshihito , Yoshikawa Kenjiro , Matsushita Hiro‐o , Takagi Ryo , Harada Eiji , Yoshida Yuko , Tsuda Kazunori , Kato Bunichiro , Tamura Eri , Eizuka Makoto , Sugai Tamotsu , Adachi Yasushi , Yamamoto Eiichiro , Suzuki Hiromu , Nakase Hiroshi
Published: November 2019

Based on the concept of the adenoma‐carcinoma sequence, most colorectal cancers are considered to arise from conventional adenomas. However, recent studies suggested that a subset of colorectal cancers develop through the serrated neoplastic pathway. It has also been documented that serrated polyps can rapidly transform into invasive cancers even when they are small in size. We now describe a case of a sessile serrated adenoma/polyp which had been followed up for 4 years but eventually showed rapid transformation into an advanced cancer accompanied by a remarkable morphological change within only 13 months. Retrospective genetic and epigenetic analyses showed microsatellite instability, CpG island methylator phenotype‐positive, and BRAF mutation in the lesion, suggesting the tumor had developed through the serrated neoplastic pathway. This case may provide valuable information about the natural history of sessile serrated adenoma/polyps which eventually progress to advanced cancers.
Socioeconomic status and executive function in early childhood: Exploring proximal mechanisms
Authors: Vrantsidis Daphne M. , Clark Caron A. C. , Chevalier Nicolas , Espy Kimberly Andrews , Wiebe Sandra A.
Published: November 2019

Although there is substantial evidence that socioeconomic status (SES) predicts children's executive function (EF), the mechanisms underlying this association are poorly understood. This study tested the utility of two theories proposed to link SES to children's EF: the family stress model and the family investment model. Data came from the Midwestern Infant Development Study (N = 151). To measure SES, parental education and income were assessed during pregnancy, and income was also assessed when children were 6 and 36 months old. Children's EF, operationalized as working memory/inhibitory control (WMIC) and self‐control, was assessed at 36 months of age, along with potential mediators including maternal psychological distress, harsh parenting, and cognitive stimulation. Using structural equation modeling, we tested simultaneous pathways from SES to EF: (a) via maternal psychological distress to harsh parenting (family stress model) and (b) via cognitive stimulation (family investment model). Of the SES measures, lower education predicted poorer WMIC directly and indirectly via greater maternal psychological distress. Lower education also predicted poorer self‐control via greater maternal psychological distress. This effect was partially suppressed by an indirect path from lower education to better self‐control via greater psychological distress and increased harsh parenting. Cognitive stimulation did not act as a mediator. Income was not directly or indirectly associated with EF. These findings provide partial support for the family stress model and suggest that family functioning is an important proximal mechanism for children's EF development. This study also highlights the importance of considering SES as a multidimensional construct.
CHD2‐related epilepsy: novel mutations and new phenotypes
Authors: Chen Jiaoyang , Zhang Jing , Liu Aijie , Zhang Liping , Li Hua , Zeng Qi , Yang Zhixian , Yang Xiaoling , Wu Xiru , Zhang Yuehua
Published: November 2019

The aim of this report was to refine the genotypes and phenotypes of chromodomain helicase DNA‐binding protein 2 (CHD2)‐related epilepsy. Seventeen patients with CHD2 mutations were enrolled. CHD2 mutations were identified by application of next‐generation sequencing of epilepsy or whole exome sequencing. Sixteen mutations were identified, among which 15 have not yet been reported. Thirteen mutations were de novo. Age at seizure onset ranged from 3 months to 10 years 5 months. Seizures observed were generalized tonic–clonic, myoclonic, atonic, atypical absence, focal, and myoclonic–atonic. Epileptic spasms occurred in two patients. Developmental disability was present in 14 patients. Autism features were observed in seven patients. Video electroencephalogram was abnormal in 15 patients. Five patients were diagnosed with non‐specific epileptic encephalopathy, two with epilepsy with myoclonic–atonic seizures, two with Lennox–Gastaut syndrome, two with febrile seizures plus, and one with West syndrome. Seizures were controlled in nine patients. Q1392TfsX17 may be a hot‐spot mutation of CHD2. West syndrome was observed as a new phenotype of CHD2 mutation. The severity of the phenotypes of CHD2 mutations ranged from mild febrile seizures to severe epileptic encephalopathy.

What this paper adds

Q1392TfsX17 maybe the hot‐spot mutation of CHD2.

West syndrome could be a new phenotype of CHD2 mutation.
Severe neonatal hypoxic‐ischaemic brain injury: still an important cause of infantile spasms
Authors: Vollmer Brigitte
Published: November 2019

This commentary is on the original article by Abu Dhais et al. on pages 62‐68 of this issue.
Expression profiling of winged‐ and wingless‐destined pea aphid embryos implicates insulin/insulin growth factor signaling in morph differences
Authors: Grantham Mary E. , Shingleton Alexander W. , Dudley Emma , Brisson Jennifer A.
Published: November 2019

Developmental plasticity allows the matching of adult phenotypes to different environments. Although considerable effort has gone into understanding the evolution and ecology of plasticity, less is known about its developmental genetic basis. We focused on the pea aphid wing polyphenism, in which high‐ or low‐density environments cause viviparous aphid mothers to produce winged or wingless offspring, respectively. Maternally provided ecdysone signals to embryos to be winged or wingless, but it is unknown how embryos respond to that signal. We used transcriptional profiling to investigate the gene expression state of winged‐destined (WD) and wingless‐destined (WLD) embryos at two developmental stages. We found that embryos differed in a small number of genes, and that gene sets were enriched for the insulin‐signaling portion of the FoxO pathway. To look for a global signature of insulin signaling, we examined the size and stage of WD and WLD embryos but found no differences. These data suggest the hypothesis that FoxO signaling is important for morph development in a tissue‐specific manner. We posit that maternally supplied ecdysone affects embryonic FoxO signaling, which ultimately plays a role in alternative morph development. Our study is one of an increasing number that implicate insulin signaling in the generation of alternative environmentally induced morphologies.
The uropygial gland of the monk parakeet Myiopsitta monachus: Histology, morphogenesis, and evolution within Psittaciformes (Aves)
Authors: Carril Julieta , Chiale María C. , Barbeito Claudio G.
Published: November 2019

We describe the morphology, histology, and histochemical characteristics of the uropygial gland (UG) of the monk parakeet Myiopsitta monachus. The UG has a heart‐shape external appearance and adenomers extensively branched with a convoluted path, covered by a stratified epithelium formed by different cellular strata and divided into three zones (based on the epithelial height and lumen width), a cylindrical papilla with an internal structure of delicate type and two excretory pores surrounded by a feather tuft. Histochemical and lectin‐histochemical techniques performed showed positivity against PAS, AB pH 2.5, AB‐PAS, and some lectines, likely related to the granivorous feeding habits. Also, we describe the morphogenesis of the UG of the monk parakeet, which appears at embryological stage 34 as a pair of ectodermal invaginations. Heterochronic events in the onset development of the UG when compared with other birds could be recognized. Finally, to examine the phylogenetic occurrence of the UG within the Psittaciformes and infer its evolutionary history, we mapped its presence/absence over a molecular phylogeny. The reconstruction of the characters states at ancestral nodes revealed that the presence of the UG was the plesiomorphic feature for Psittaciformes and its loss evolved independently more than once.
Phorid species from Acromyrmex’s hosts and effect on their survival of two fungi proposed for the control of leafcutter ants
Authors: Goffre Daniela , Folgarait Patricia J.
Published: November 2019

Phorid flies (Diptera: Phoridae, Metopinini) are natural enemies of leafcutter ants (Hymenoptera: Formicidae, Attini), which are among the most important pests in the Neotropical region. These parasitoids lay their eggs inside worker ants, causing the death of the parasitized ants, and the oviposition attacks on foraging workers interfere with the collection of vegetal material used in fungal gardens, thereby affecting the whole colony. However, because of the large number of ants per colony, more than one type of biological control agent is needed to have a significant impact. We collected parasitized leafcutter ants Acromyrmex lundii (Guérin‐Méneville), Acromyrmex heyeri (Forel), and Acromyrmex ambiguus (Emery) from various places in Argentina and reared their parasitoids. We recorded developmental times, host and phorid sizes, and other aspects of the biology of the phorids Apocephalus neivai Borgmeier, Apocephalus noetingerorum Brown & Disney, Myrmosicarius gracilipes Borgmeier, Myrmosicarius catharinensis Borgmeier, Myrmosicarius crudelis Borgmeier, and Myrmosicarius cristobalensis Disney et al. This is the first record of A. ambiguus, an important pest of pine plantations, being a host of phorids. We found the first cases of gregarious parasitoidism of a parasitoid with no‐free pupae: M. catharinensis on A. lundii ants. We also evaluated the effect on pupal survival of two cosmopolitan fungi, Beauveria bassiana (Balsamo) Vuill. and Trichoderma lentiforme (Rehm) Chaverri et al., which are also considered as potential biological control agents of leafcutter ants. Suspensions of conidia were tested on Myrmosicarius and Apocephalus parasitoid pupae of different ages. No negative effect on pupal survival was found under either fungal treatment. Therefore, the use of both natural enemies separately but simultaneously, or the introduction of fungi‐inoculated pupae in the pest habitats, seems to be a promising strategy for the multiple biological control of leafcutter ants.
Anatomy of the stridulation apparatus of the beech leaf‐mining weevil and characterization of, and behavioral responses to, stridulation sounds
Authors: Goodwin Joel T.L. , Hillier N. Kirk , Roscoe Lucas E. , Sweeney Jon D.
Published: November 2019

We investigated auditory signals and morphology of the stridulatory apparatus of the European beech leaf‐mining weevil, Orchestes fagi L. (Coleoptera: Curculionidae), an invasive herbivore now established in Nova Scotia, Canada, to determine their potential for enhancing survey tools to monitor the spread of the species in Canada. We recorded and described sounds produced by adult O. fagi, analyzed the morphology of the stridulatory mechanism for intersexual differences and asymmetry, and examined behavioral responses elicited in conspecifics by playback of stridulation recordings. Adult O. fagi produced sounds under three conditions: male in distress, female in distress, and male in the presence of female. Female distress chirps lasted significantly longer than male distress chirps and male chirps in the presence of females, but peak frequencies and mean number of chirps per s did not differ significantly among the three groups. Morphology of the stridulation structures in male and female O. fagi was compared using scanning electron microscopy. Orchestes fagi have an elytro‐tergal file‐ and scraper‐type sound production apparatus, through which sound is produced upon anterior motion of the abdomen. Female O. fagi have a ‘pars stridens’ that is longer and has more ridges than males. Width and number of ridges per length of pars stridens did not differ between the sexes. Evidence of asymmetry was found in male pars stridens, with the right side being longer than the left. Playback of recorded sounds to adult weevils suggests female O. fagi were repelled by sounds produced by distressed males.
Acute peripheral inflammation and post‐traumatic sleep differ between sexes after experimental diffuse brain injury
Authors: Saber Maha , Giordano Katherine R. , Hur Yerin , Ortiz John B. , Morrison Helena , Godbout Jonathan P. , Murphy Sean M. , Lifshitz Jonathan , Rowe Rachel K.
Published: November 2019

Identifying differential responses between sexes following traumatic brain injury (TBI) can elucidate the mechanisms behind disease pathology. Peripheral and central inflammation in the pathophysiology of TBI can increase sleep in male rodents, but this remains untested in females. We hypothesized that diffuse TBI would increase inflammation and sleep in males more so than in females. Diffuse TBI was induced in C57BL/6J mice and serial blood samples were collected (baseline, 1, 5, 7 days post‐injury [DPI]) to quantify peripheral immune cell populations and sleep regulatory cytokines. Brains and spleens were harvested at 7DPI to quantify central and peripheral immune cells, respectively. Mixed‐effects regression models were used for data analysis. Female TBI mice had 77%–124% higher IL‐6 levels than male TBI mice at 1 and 5DPI, whereas IL‐1β and TNF‐α levels were similar between sexes at all timepoints. Despite baseline sex differences in blood‐measured Ly6Chighmonocytes (females had 40% more than males), TBI reduced monocytes by 67% in TBI mice at 1DPI. Male TBI mice had 31%–33% more blood‐measured and 31% more spleen‐measured Ly6G+neutrophils than female TBI mice at 1 and 5DPI, and 7DPI, respectively. Compared with sham, TBI increased sleep in both sexes during the first light and dark cycles. Male TBI mice slept 11%–17% more than female TBI mice, depending on the cycle. Thus, sex and TBI interactions may alter the peripheral inflammation profile and sleep patterns, which might explain discrepancies in disease progression based on sex.
Hemispherectomy in adults and adolescents: Seizure and functional outcomes in 47 patients
Authors: McGovern Robert A. , N. V. Moosa Ahsan , Jehi Lara , Busch Robyn , Ferguson Lisa , Gupta Ajay , Gonzalez‐Martinez Jorge , Wyllie Elaine , Najm Imad , Bingaman William E.
Published: November 2019

Objective

To examine longitudinal seizure and functional outcomes after hemispherectomy in adults and adolescents.

Methods

We reviewed 47 consecutive patients older than 16 years who underwent hemispherectomy between 1996 and 2016 at our center. Clinical, electroencephalographic (EEG), imaging, neuropsychological, surgical, and functional status data were analyzed.

Results

Thirty‐six patients were 18 years or older at surgery; 11 were aged between 16 and 18 years. Brain injury leading to hemispheric epilepsy occurred before 10 years of age in 41 (87%) patients. At a mean follow‐up of 5.3 postoperative years (median = 2.9 years), 36 (77%) had Engel class I outcome. Longitudinal outcome analysis showed 84% seizure freedom (Engel IA) at 6 months, 76% at 2 years, and 76% at 5 years and beyond, with stable longitudinal outcomes up to 12 years from surgery. Multivariate analysis demonstrated that acute postoperative seizures and contralateral interictal spikes at 6‐month follow‐up EEG were associated with seizure recurrence. Patients who could walk unaided preoperatively and had no cerebral peduncle atrophy on brain magnetic resonance imaging were more likely to experience worsening of motor function postoperatively. Otherwise, postoperative ambulatory status and hand function were unchanged. Of the 19 patients who completed neuropsychological testing, 17 demonstrated stable or improved postoperative outcomes.

Significance

Hemispherectomy in adults is a safe and effective procedure, with seizure freedom rates and functional outcome similar to those observed in children.
Bilateral multiple oncocytic cysts of the parotid gland in type 2 diabetes patients
Authors: Soares Ciro D , Carlos Roman , Mota Marcelo V B , de Carvalho Maria G F , de Lima Morais Thayná M , de Almeida Oslei P , Altemani Albina
Published: November 2019

Aims

The hallmarks of type 2 diabetes (T2D) are hyperglycaemia and insulin resistance. These factors, at the cellular level, are associated with mitochondrial dysfunction and increased glucose uptake. Such events are poorly explored in the context of the salivary glands. In this study, we present a series of eight cases of a distinct salivary gland lesion characterised by multiple oncocytic cysts, and we provide new pathological insights regarding its pathogenesis.

Methods and results

Seven patients (87.5%) had confirmed T2D, and obesity was identified in five (62.5%) patients. Clinically, the patients showed bilateral parotid gland swelling with recurrent episodes of pain and enlargement. Imaging examination revealed multiple cystic lesions in both parotid glands. Microscopically, the parotid glands showed multiple cysts of different sizes, lined by oncocytic epithelial cells. Intraluminally, strongly eosinophilic glass‐like crystalloid material was observed. Immunohistochemical studies were performed, and the most notable finding was glucose transporter 1 (GLUT1) overexpression in the oncocytic cysts which is not observed in any other oncocytic lesion of patients without T2D. In addition, high expressions of mitochondrial antigen, fission 1 protein and mitofusin‐2 were observed in the oncocytic epithelium of the cysts. Furthermore, most of the oncocytic cysts showed a pattern of cytokeratin expression consistent with striated ducts.

Conclusions

These results strongly suggest that T2D is associated with alterations in GLUT1 expression in the cells of striated ducts with mitochondrial dysfunction, causing a hyperplastic process characterised by multiple oncocytic cysts. For this lesion, the designation of ‘diabetes‐associated–bilateral multiple oncocytic cysts of the parotid gland’ is proposed.
Prevalence of malocclusion in Chinese schoolchildren from 1991 to 2018: A systematic review and meta‐analysis
Authors: Lin Min , Xie Congman , Yang Hongmei , Wu Chuanxing , Ren Aishu
Published: November 2019

Background

Malocclusion is a common oral health problem in schoolchildren. Literature describing the prevalence of malocclusion varies substantially across China.

Aim

This study identified the epidemiological characteristics of malocclusion among Chinese schoolchildren from 1991 to 2018.

Design

Six English and Chinese electronic databases were searched through November 2018. The search was supplemented by hand searching to identify relevant surveys. The overall prevalence of malocclusion was estimated by a random‐effects meta‐analysis model, and variations in different groups were assessed by subgroup meta‐analysis.

Results

Thirty‐seven eligible articles describing 117 682 samples were investigated. The pooled national prevalence for malocclusion was 47.92% (95% CI: 58.6%‐71.9%). For the Angle classification, the overall prevalence rates were 30.07% (95% CI: 25.37%‐35.48%), 9.91% (95% CI: 7.41%‐13.79%), and 4.76% (95% CI: 3.85%‐6.54%) for Class I, Class II, and Class III malocclusion, respectively. A deep overbite (16.67%, 95% CI: 11.50%‐23.08%) was shown to be the most common trait of malocclusion. When stratified by sex, males had a slightly higher prevalence than females (RR = 1.04, 95% CI: 1.01‐1.06). More importantly, an ascending trend and substantial variations across the country were observed.

Conclusions

Our results confirmed that malocclusion has become a serious oral health problem in Chinese schoolchildren, highlighting the need for proactive interventions at an early age. Moreover, high‐quality epidemiological studies on malocclusion are still required.
Factors influencing the local cure rate of hidradenitis suppurativa following wide local excision
Authors: Ngaage Ledibabari M. , Wu Yinglun , Ge Shealinna , Gebran Selim , Liang Fan , Rada Erin M. , Nam Arthur J. , Silverman Ronald P. , Rasko Yvonne M.
Published: November 2019

Wide local excision is the gold standard and only potential curative therapy for recalcitrant hidradenitis suppurativa. However, high recurrence rates persist even post‐surgery with little known on the influencing factors for remission. We evaluated the effect of patient, disease, and operative factors on local cure rate of moderate to severe hidradenitis following wide local excision. We performed a retrospective chart review for all patients who had undergone surgical excision of hidradenitis at a university hospital from 2012 to 2018. We identified 79 patients with a total of 220 operative sites. The majority were obese (mean body mass index [BMI] 32.5), female (71%), African‐American (84%), and had a mean age of 31 years. A quarter of operative sites experienced a recurrence (n = 56). Patients who achieved remission had a significantly lower number of affected regions than those who experienced a recurrence (2.3 vs 3.6, P = .0023). Additionally, recurrence rate differed significantly between body locations (P = .0440). Smoking, BMI, Hurley grade, closure method, and excision size did not influence local cure rate. Surgical excision remains a worthy management option for hidradenitis patients with three quarters achieving remission after a single operation. Number of affected regions and location of hidradenitis may play a factor in recurrence.
Ti(C,N)‐based cermets with strengthened interfaces: Roles of secondary cubic carbides
Authors: Xiong Huiwen , Xie Dan , Chen Jinjuan , Chu Shenglin , Gan Xueping , Li Zhiyou , Zhou Kechao
Published: November 2019

Core‐rim structure, concerning its interface structure and internal stress, plays an important role in mechanical performance of Ti(C,N)‐based cermets. Four types of cermets containing equimolar TaC, VC, ZrC, and NbC were fabricated, in order to reveal the synergetic relationship between core‐rim structure and mechanical properties. VC and ZrC effectively inhibited the grain growth, while TaC and NbC favored for coarser core‐rim grains. A thin distortion layer at the rim‐binder interface was confirmed, formed during the solidifying stage. Compared to the TaC, ZrC and NbC, VC shrunk the lattice parameters of rims and effectively decreased the lattice misfit of the distortion zone from around 4.0%‐0.8%. Cermets containing VC showed satisfactory bending strength of 2099 MPa and toughness of 10. 3 MPa m1/2, owing to the strengthened rim‐binder interface. TaC and NbC exhibited the similar roles in cermets with comparable mechanical properties, while addition of ZrC increased the lattice misfit of core‐rim structure, resulting in poor mechanical performance. Decreased lattice misfit of rim‐binder interface changed the fracture mode of cermets from intergranular to transgranular fracture, with in‐situ formed dimples.
The “doing” or the “being”? Understanding the roles of involvement and social identity in peer‐led addiction support groups
Authors: Taylor Isabel , McNamara Niamh , Frings Daniel
Published: November 2019

While the efficacy of peer‐led support groups such as Alcoholics Anonymous (AA) are well established for people recovering from addiction, the “active ingredients” which underpin their efficacy are less understood. Drawing on social identity perspectives, in particular the Social Identity Model of Cessation Maintenance, the current study aimed to explore the relative effects of two possible processes: social identification and involvement with the group's activities. A sample (n = 44) of AA members completed measures pertaining to their social identification with AA, their involvement in the group's activities and their quit efficacy. The findings suggest that AA involvement was significantly related to identity. Mediation analysis revealed a relationship between involvement and efficacy meditated by identity. However, in contrast, the identity‐efficacy link was not mediated by involvement. The findings suggest that social identification with AA is as important as, or more important than, simple involvement in the group's activities. This suggests that group planners and facilitators should therefore encourage opportunities to generate a sense of belonging alongside the activities the group revolve around.
Effect of (R)‐salbutamol on the switch of phenotype and metabolic pattern in LPS‐induced macrophage cells
Authors: Wang Shanping , Liu Fei , Tan Keai Sinn , Ser Hooi‐Leng , Tan Loh Teng‐Hern , Lee Learn‐Han , Tan Wen
Published: November 2019

Evidence demonstrates that M1 macrophage polarization promotes inflammatory disease. Here, we discovered that (R)‐salbutamol, a β2 receptor agonist, inhibits and reprograms the cellular metabolism of RAW264.7 macrophages. (R)‐salbutamol significantly inhibited LPS‐induced M1 macrophage polarization and downregulated expressions of typical M1 macrophage cytokines, including monocyte chemotactic protein‐1 (MCP‐1), interleukin‐1β (IL‐1β) and tumour necrosis factor α (TNF‐α). Also, (R)‐salbutamol significantly decreased the production of inducible nitric oxide synthase (iNOS), nitric oxide (NO) and reactive oxygen species (ROS), while increasing the reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio. In contrast, (S)‐salbutamol increased the production of NO and ROS. Bioenergetic profiles showed that (R)‐salbutamol significantly reduced aerobic glycolysis and enhanced mitochondrial respiration. Untargeted metabolomics analysis demonstrated that (R)‐salbutamol modulated metabolic pathways, of which three metabolic pathways, namely, (a) phenylalanine metabolism, (b) the pentose phosphate pathway and (c) glycerophospholipid metabolism were the most noticeably impacted pathways. The effects of (R)‐salbutamol on M1 polarization were inhibited by a specific β2 receptor antagonist, ICI‐118551. These findings demonstrated that (R)‐salbutamol inhibits the M1 phenotype by downregulating aerobic glycolysis and glycerophospholipid metabolism, which may propose (R)‐salbutamol as the major pharmacologically active component of racemic salbutamol for the treatment of inflammatory diseases and highlight the medicinal value of (R)‐salbutamol.
Normative Power Europe or Capability–expectations Gap? The Performativity of Concepts in the Study of European Foreign Policy
Authors: Larsen Henrik
Published: November 2019

This article argues that the view that theories are constitutive of their object of study is useful for reflecting on the role of theories in the analysis of European foreign policy. A key concept used to study the constitutive role of theories is performativity. The article illustrates its relevance through a study of the use of the concept of a capability–expectations gap. On the basis of this study, the article also makes the point that research on European foreign policy does not unambiguously construct the EU as an ideal power Europe (of which normative power Europe is a part), as the use of the capability–expectations gap concept does not draw on the ideal power Europe discourse. The concept is mainly used as a critical label to describe EU foreign policy and applications of the concept end up by concluding that the EU is an international actor with quasi‐permanent shortcomings.
Association between periodontitis and the risk of inadequate disease control in patients with rheumatoid arthritis under biological treatment
Authors: Chen Hsin‐Hua , Chen Der‐Yuan , Huang Liang‐Gie , Chen Yi‐Ming , Hsieh Chia‐Wei , Hung Wei‐Ting , Tang Kuo‐Tung , Chen Gin
Published: November 2019

Aim

To assess the association between periodontitis (PD) and inadequate disease control (IDC) in patients with rheumatoid arthritis (RA) receiving biological therapy.

Materials and methods

In total, 111 RA patients receiving biological therapy for at least 3 months were assessed for periodontal disease at baseline. RA disease activity was assessed at baseline and at 3 months of follow‐up. A multivariable logistic regression analysis was used to estimate the association between PD and IDC, adjusting for age, sex, smoking, diabetes, and baseline RA disease activity. An additional exploratory model further controlled for disease characteristics and other medications.

Results

Among 111 patients, 84 (75.7%) had PD, of whom 37 (44.0%) received periodontal treatment. Thirty‐four (40.5%) of PD patients had IDC; 12 (32.4%) of treated PD patients and 22 (46.8%) of untreated patients had IDC, respectively. The ORs (95% CIs) for IDC were 1.45 (0.50–4.23) in PD patients and 1.84 (0.59–5.76) in untreated PD patients. In the exploratory model, the ORs (95% CIs) for IDC were 5.00 (1.19–21.03) in PD patients and 6.26 (1.34–29.34) in untreated PD patients.

Conclusion

This single‐centre, prospective study failed to demonstrate a consistently positive correlation between PD and IDC in RA patients receiving biological treatment.
Lumos for the long trail: Strategies for clinical diagnosis and severity staging for diabetic polyneuropathy and future directions
Authors: Himeno Tatsuhito , Kamiya Hideki , Nakamura Jiro
Published: November 2019

Diabetic polyneuropathy, which is a chronic symmetrical length‐dependent sensorimotor polyneuropathy, is the most common form of diabetic neuropathy. Although diabetic polyneuropathy is the most important risk factor in cases of diabetic foot, given its poor prognosis, the criteria for diagnosis and staging of diabetic polyneuropathy has not been established; consequently, no disease‐modifying treatment is available. Most criteria and scoring systems that were previously proposed consist of clinical signs, symptoms and quantitative examinations, including sensory function tests and nerve conduction study. However, in diabetic polyneuropathy, clinical symptoms, including numbness, pain and allodynia, show no significant correlation with the development of pathophysiological changes in the peripheral nervous system. Therefore, these proposed criteria and scoring systems have failed to become a universal clinical end‐point for large‐scale clinical trials evaluating the prognosis in diabetes patients. We should use quantitative examinations of which validity has been proven. Nerve conduction study, for example, has been proven effective to evaluate dysfunctions of large nerve fibers. Baba’s classification, which uses a nerve conduction study, is one of the most promising diagnostic methods. Loss of small nerve fibers can be determined using corneal confocal microscopy and intra‐epidermal nerve fiber density. However, no staging criteria have been proposed using these quantitative evaluations for small fiber neuropathy. To establish a novel diagnostic and staging criteria of diabetic polyneuropathy, we propose three principles to be considered: (i) include only generalizable objective quantitative tests; (ii) exclude clinical symptoms and signs; and (iii) do not restrictively exclude other causes of polyneuropathy.
Discordant patterns of introgression across a narrow hybrid zone between two cryptic lineages of an Iberian endemic newt
Authors: Sequeira Fernando , Bessa‐Silva Adam , Tarroso Pedro , Sousa‐Neves Tiago , Vallinoto Marcelo , Gonçalves Helena , Martínez‐Solano Iñigo
Published: November 2019

The study of natural hybrid zones can illuminate aspects of lineage divergence and speciation in morphologically cryptic taxa. We studied a hybrid zone between two highly divergent but morphologically similar lineages (south‐western and south‐eastern) of the Iberian endemic Bosca's newt (Lissotriton boscai) in SW Iberia with a multilocus dataset (microsatellites, nuclear and mitochondrial genes). STRUCTURE and NEWHYBRIDS analyses retrieved few admixed individuals, which classified as backcrosses involving parental individuals of the south‐western lineage. Our results show asymmetric introgression of mtDNA beyond the contact from this lineage into the south‐eastern lineage. Analysis of nongeographic introgression patterns revealed asymmetries in the direction of introgression, but except for mtDNA, we did not find evidence for nonconcordant introgression patterns across nuclear loci. Analysis of a 150‐km transect across the hybrid zone showed broadly coincident cline widths (ca.3.2–27.9 km), and concordant cline centres across all markers, except for mtDNA that is displacedca.60 km northward. Results from ecological niche modelling show that the hybrid zone is in a climatically homogenous area with suitable habitat for the species, suggesting that contact between the two lineages is unlikely to occur further south as their distributions are currently separated by an extensive area of unfavourable habitat. Taken together, our findings suggest the genetic structure of this hybrid zone results from the interplay of historical (biogeographic) and population‐level processes. The narrowness and coincidence of genetic clines can be explained by weak selection against hybrids and reflect a degree of reproductive isolation that is consistent with cryptic speciation.
Artificial selection for increased dispersal results in lower fitness
Authors: Zwoinska Martyna K. , Larva Tuuli , Sekajova Zuzana , Carlsson Hanne , Meurling Sara , Maklakov Alexei A.
Published: November 2019

Dispersal often covaries with other traits, and this covariation was shown to have a genetic basis. Here, we wanted to explore to what extent genetic constraints and correlational selection can explain patterns of covariation between dispersal and key life‐history traits—lifespan and reproduction. A prediction from the fitness‐associated dispersal hypothesis was that lower genetic quality is associated with higher dispersal propensity as driven by the benefits of genetic mixing. We wanted to contrast it with a prediction from a different model that individuals putting more emphasis on current rather than future reproduction disperse more, as they are expected to be more risk‐prone and exploratory. However, if dispersal has inherent costs, this will also result in a negative genetic correlation between higher rates of dispersal and some aspects of performance. To explore this issue, we used the dioecious nematode Caenorhabditis remanei and selected for increased and decreased dispersal propensity for 10 generations, followed by five generations of relaxed selection. Dispersal propensity responded to selection, and females from high‐dispersal lines dispersed more than females from low‐dispersal lines. Females selected for increased dispersal propensity produced fewer offspring and were more likely to die from matricide, which is associated with a low physiological condition in Caenorhabditis nematodes. There was no evidence for differences in age‐specific reproductive effort between high‐ and low‐dispersal females. Rather, reproductive output of high‐dispersal females was consistently reduced. We argue that our data provide support for the fitness‐associated dispersal hypothesis.
A rapid flood risk assessment method for response operations and nonsubject‐matter‐expert community planning
Authors: Longenecker Herbert E. , Graeden Ellie , Kluskiewicz Dan , Zuzak Casey , Rozelle Jesse , Aziz Ajmal L.
Published: November 2019

Flood risk planning and emergency response at community levels rely on fast access to accurate inundation models that identify geographic areas, assets, and populations that may be flooded. However, limited flood modelling resources are available to support these events and activities. We present a computationally‐efficient flood model for facilitating rapid risk analysis across a wide range of scenarios and decision support to operational, crisis action, local flood‐fight, and community planning efforts. Our flood depth regression method converts publicly‐available river stage heights to flood depths, then downscales the depths from gage locations onto high resolution National Hydrography Dataset flowlines and estimates areas and depths of flooding by subtraction of the National Elevation Dataset from modelled water surface elevations. We demonstrate proof‐of‐principle analyses for historic 2009 Red River of the North flooding in the United States, achieving comprehensive mainstem flood estimation for the length of the river and depth accuracy of 1.4 ft (0.4 m) compared to gage observations, remote sensing, and higher‐resolution hydrologic models. We also demonstrate the utility of the method to inform planning and response decisions in preparation for flooding in a companion scenario for Yerington, Nevada, and call for further research and operationalization of riverine inundation mapping techniques.
Effect of PNPLA3 polymorphism on diagnostic performance of various noninvasive markers for diagnosing and staging nonalcoholic fatty liver disease
Authors: Liu Wen‐Yue , Zheng Kenneth I. , Pan Xiao‐Yan , Ma Hong‐Lei , Zhu Pei‐Wu , Wu Xi‐Xi , Rios Rafael S. , Targher Giovanni , Byrne Christopher D , Wang Xiao‐Dong , Chen Yong‐Ping , Zheng Ming‐Hua
Published: November 2019

Background and Aim

Patatin‐like phospholipase domain‐containing protein 3 (PNPLA3) I148M (rs738409) genotype influences clinical/biochemical characteristics in patients with nonalcoholic fatty liver disease (NAFLD), but whether PNPLA3‐I148M (rs738409) genotype also influences the diagnostic performance of noninvasive diagnostic tests for NAFLD is uncertain. Our aim was to investigate the differences in diagnostic performance of noninvasive diagnostic tests for NAFLD according to PNPLA3‐I148M (rs738409) genotype.

Methods

Fifty‐eight healthy controls and 349 patients with biopsy‐proven NAFLD were included. Areas under the receiver operating characteristic curve (AUROCs) were calculated to predict hepatic steatosis (fatty liver index and hepatic steatosis index), nonalcoholic steatohepatitis (cytokeratin‐18 M30 and M65), and significant fibrosis (≥F2 fibrosis) (fibrosis‐4 and BARD), stratifying by rs738409 genotypes (CC and CG + GG groups).

Results

Fatty liver index and hepatic steatosis index showed good diagnostic performance for diagnosing steatosis only in the CG + GG group with AUROCs ranging from 0.819 to 0.832. Cytokeratin‐18 M30 (AUROC = 0.688) and M65 (AUROC = 0.678) had suboptimal performance for diagnosing nonalcoholic steatohepatitis in the CG + GG group, whereas both had good performance (AUROC = 0.814 and 0.813, respectively) in the CC group. BARD score showed good performance in the CG + GG group compared with the CC group (AUROC = 0.805 and 0.532, respectively). Fibrosis‐4 had suboptimal performance in the CG + GG group and good performance in the CC group (AUROC = 0.662 and 0.801, respectively).

Conclusions

Diagnostic performance of noninvasive tests for NAFLD varied markedly according to PNPLA3 genotypes. Clinicians should be aware that PNPLA3 genotype limits the clinical utility of noninvasive diagnostic tests for diagnosing NAFLD.
Long‐term outcome of endoscopic ultrasound‐guided pancreatic duct drainage using a fully covered self‐expandable metal stent for pancreaticojejunal anastomosis stricture
Authors: Oh Dongwook , Park Do Hyun , Song Tae Jun , Lee Sang Soo , Seo Dong‐Wan , Lee Sung Koo , Kim Myung‐Hwan
Published: November 2019

Background and Aim

Endoscopic ultrasound‐guided pancreatic duct drainage (EUS‐PD) has been proposed for pancreatic duct obstruction after failure of endoscopic retrograde pancreatography. We evaluate the long‐term outcomes of EUS‐PD using a fully covered self‐expandable metal stent (FCSEMS) for pancreaticojejunal anastomosis (PJA) strictures following Whipple procedures.

Methods

Twenty‐three patients with PJA strictures underwent EUS‐PD according to the findings of EUS‐guided pancreatogram and the passage of the guidewire through PJA stricture (complete vs partial stricture) after failure of endoscopic retrograde pancreatography. Technical and clinical success, adverse events (AEs), and long‐term outcomes were assessed.

Results

Technical and clinical success was achieved in all patients. The complete and partial strictures were 11 and 12, respectively. The direct transanastomotic and transmural plastic stenting in partial PJA stricture was successful in only three patients (13%). Therefore, 20 patients underwent EUS‐guided transmural FCSEMS placement during the initial attempt. Early AEs, including abdominal pain (n = 3) and peripancreatic fluid collection (n = 1), occurred in four patients (17.4%). During the follow‐up periods (median, 27.2 months; interquartile range [IQR], 18.7–40.6), five patients (21.7%) developed late AEs, including asymptomatic stent fracture at the gastric end (n = 3), asymptomatic stent migration (n = 1), and stent occlusion (n = 1). The total duration of stent placement was 27.2 months (IQR, 18.7–40.6), and the median number of stent revision was 2 (IQR, 1–2).

Conclusions

In terms of safety and efficacy, EUS‐PD with an FCSEMS showed favorable success and acceptable AEs rate and durable long‐term outcomes.
Planning mass eradication of Helicobacter pylori infection for indigenous Taiwanese peoples to reduce gastric cancer
Authors: Bair Ming‐Jong , Chuang Shu‐Lin , Lei Wei‐Yi , Chen Chien‐Lin , Tian Hui‐Wen , Chiang Tsung‐Hsien , Su William Wang‐Yu , Lin Chiu‐Chu , Chung Lo Yuan‐Ting , Jou Yann‐Yuh , Wu Chien‐Yuan , Chia Shu‐Li , Wu Ming‐Shiang , Chen Hsiu‐Hsi , Chu Chia‐Hsiang , Lee Yi‐Chia , Wang Ying‐Wei
Published: November 2019

Background and Aim

The aim of this study is to identify gastric cancer burden in Indigenous Taiwanese peoples and conduct a project to evaluate how to reduce the disparities most effectively in Indigenous communities.

Methods

First, we quantified the health disparities in gastric cancer in Indigenous peoples using data from the cancer registries during the period of 2006–2014. Second, we identified parameters that might be associated with Helicobacter pylori infection or help identify a good eradication strategy.

Results

Gastric cancer incidence (24.4 vs 12.3 per 100 000 person‐years) and mortality rates (15.8 vs 6.8 per 100 000 person‐years) were higher in Indigenous than in non‐Indigenous, with 2.19‐fold (95% confidence interval [CI]: 2.06–2.33) and 2.47‐fold (2.28–2.67) increased risk, respectively. In Indigenous communities, H. pylori infection was more prevalent in Indigenous than in non‐Indigenous (59.4% vs 31.5%, P < 0.01). Regression analyses consistently showed that either the mountain or plain Indigenous had 1.89‐fold (95% CI: 1.34–2.66) and 1.73‐fold (95% CI: 1.24–2.41) increased risk for H. pylori infection, respectively, as compared with non‐Indigenous, adjusting for other baseline characteristics. The high infection rates were similarly seen in young, middle‐aged, and older adults. Program eradication rates using clarithromycin‐based triple therapy were suboptimal (73.7%, 95% CI: 70.0–77.4%); the habits of smoking (1.70‐fold, 95% CI: 1.01–2.39) and betel nut chewing (1.54‐fold, 95% CI: 0.93–2.16) were associated with the higher risk of treatment failure.

Conclusion

Gastric cancer burden is higher in Indigenous Taiwanese peoples than in their non‐Indigenous counterparts. Eliminating the prevalent risk factor of H. pylori infection is a top priority to reduce this health disparity.
Effectiveness of risk scoring systems in predicting endoscopic treatment in colonic diverticular bleeding
Authors: Oguri Noriaki , Ikeya Takashi , Kobayashi Daiki , Yamamoto Kazuki , Yoshimoto Takaaki , Takasu Ayaka , Okamoto Takeshi , Shiratori Yasutoshi , Okuyama Shuhei , Takagi Koichi , Nakamura Kenji , Fukuda Katsuyuki
Published: November 2019

Background and Aims

The identification of stigmata of recent hemorrhage (SRH) in colonic diverticular bleeding (CDB) enables an endoscopic treatment and can improve the clinical outcome. However, SRH identification rate remains low. This study aims to investigate whether NOBLADS and Strate scoring systems are useful for predicting SRH identification rate of CDB pre‐procedurally via colonoscopy.

Methods

In this single‐center retrospective observational study, 302 patients who experienced their first episode of CDB from April 2008 to March 2018 were included. Patients were classified into SRH‐positive and SRH‐negative groups. The primary outcome was SRH identification rate. The secondary outcomes were active bleeding in SRH and early rebleeding rates. The usefulness of the NOBLADS and Strate scores as predicted values of SRH identification was evaluated using the area under the receiver operating characteristic curve.

Results

There were 126 and 176 patients in the SRH‐positive and SRH‐negative groups, respectively. The area under the receiver operating characteristic curve for SRH identification using the NOBLADS score was 0.74 (95% confidence interval, 0.69–0.80) and that using the Strate score was 0.74 (95% confidence interval, 0.68–0.79). Active bleeding and early rebleeding rates increased according to each score. By setting the cut‐off of the NOBLADS score to four points, treatment was possible in 70.2% (66/94) patients. Addition of extravasation at computed tomography to a NOBLADS score of ≧ 4 points allowed treatment of all patients (24/24).

Conclusions

Severity scoring in acute lower gastrointestinal bleeding was effective for predicting SRH identification in CDB. We suggest that combination of these scorings and CT findings could offer a new therapeutic strategy.
Feeding practices of pre‐school children and associated factors in Kathmandu, Nepal
Authors: Shrestha L. , Parmar A. , Kulig B. , Hensel O. , Sturm B.
Published: November 2019

Background

In developing countries such as Nepal, many children aged below 3 years do not grow at a sufficiently high rate and are vulnerable to micronutrient deficiencies (e.g. vitamin A). Challenges to child nutrition can result from poverty, unhealthy traditional practices, inadequate caring and feeding practices. The present study aimed to assess the feeding practices of pre‐school children and their associated factors.

Methods

A cross‐sectional study was carried out in pre‐schools located in Kathmandu district between February and March 2018. Three levels in terms of price range (lower, medium and higher level) of pre‐schools were selected to reach the mothers of children aged ≤3 years. A structured questionnaire was administered to 145 mothers. Descriptive analyses were conducted to observe the characteristics of the population. Multinomial logistic regression analyses were performed to identify the association for the factors of mothers’ perception of their current feeding practices.

Results

We found that dal‐bhat/jaulo was a common complementary food irrespective of socio‐economic background. Interestingly, mothers who had received a higher education were significantly less likely to change their feeding practices (odds ratio = 0.118, confidence interval = 0.01–0.94). The mothers that fed a higher quantity porridge to their children showed a high willingness to change the feeding practices.

Conclusions

Poor feeding practices are still an important public health problem in Nepal and were observed to be associated with low socio‐economic status, unawareness and a lack of knowledge towards dietary diversity combined with strong beliefs related to social forces and cultures.