bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of cholinergic pathway disruption on cortical and subcortical volumes in subcortical vascular cognitive impairment
Authors: Lim J.‐S. , Kwon H.‐M. , Lee Y.‐S.
Published: August 2019

Background and purpose

The brain's cholinergic network has various interconnections with the cortical and subcortical structures. Disruption of cholinergic pathways by white matter hyperintensities (WMH) may cause pathologic changes within brain regions. Thus, WMH may represent an important pathological contributor to subcortical vascular cognitive impairment (scVCI). We aimed to investigate associations between the magnitude of WMH and volumetric changes in cortical and subcortical regions innervated by cholinergic neurons in patients with scVCI.

Methods

We enrolled patients with scVCI, defined as moderate to severe WMH or multiple (>2) lacunar infarcts outside the brainstem. Cholinergic Pathway HyperIntensities Scale (CHIPS) scores were used to quantify the magnitude of cholinergic pathway disruptions by WMH. We measured cortical thickness and subcortical volumes of 11 brain regions innervated by cholinergic neurons. Partial correlation of brain region volumes with total CHIPS scores was obtained using multiple linear regression.

Results

In total, 80 patients were enrolled. The mean age was 78.4 ± 6.5 years, median Mini‐Mental State Examination score was 17 (interquartile range, 13–20) and median CHIPS score was 11 (interquartile range, 7–17). CHIPS scores were positively correlated with subcortical volumes of the putamen (rʹ = 0.46, P = 0.002) and pallidum (rʹ = 0.45, P = 0.002), and were negatively associated with inferior temporal (rʹ = −0.35, P = 0.002) and medial orbitofrontal (rʹ = −0.32, P = 0.002) cortical thickness.

Conclusion

Our study suggested that WMH in cholinergic pathways may contribute to volumetric structural changes in cortical and subcortical structures innervated by cholinergic neurons.
Contribution of Otoacoustic Emissions for Diagnosis of Atypical or Recurrent Intracranial Hypotension. A Cases Series
Authors: Redon Sylvain , Elzière Maya , Kaphan Elsa , Donnet Anne
Published: August 2019

Background

The diagnosis of spontaneous or post‐traumatic intracranial hypotension mainly rely on clinical features and neuroimaging. In atypical presentations, other non‐invasive tests are missing to support the diagnosis of intracranial hypotension. The assessment of otoacoustic emissions (OAE) shown interest to monitor intracranial pressure mainly in cases of intracranial hypertension. This non‐invasive method was also assessed in response to pressure change after lumbar puncture. A few reports showed abnormal results of distortion product otoacoustic emissions (DPOAE) in cases of spontaneous or post‐traumatic intracranial hypotension. We describe additional results in a series of intracranial hypotension cases. We discuss the interest of DPOAE assessment in atypical presentations of intracranial hypotension. We review the other non‐invasive tests reported in literature.

Methods

We studied 4 atypical or recurrent cases of spontaneous or post‐traumatic intracranial hypotension by recording OAE in sitting then supine position.

Results

Unilateral or bilateral abnormal changes of DPOAE were recorded in all cases, in response to postural test. These changes were present even in the absence of vestibular symptoms.

Conclusion

The study of OAE may be a non‐invasive tool for the diagnosis of spontaneous intracranial hypotension.
SOX17 expression and its down‐regulation by promoter methylation in cervical adenocarcinoma in situ and adenocarcinoma
Authors: Hopman Anton N H , Moshi Jobran M , Hoogduin Klaas J , Ummelen Monique , Henfling Mieke E R , van Engeland Manon , Wouters Kim A D , Stoop Hans , Looijenga Leendert H J , Ramaekers Frans C S
Published: August 2019

Aims

SOX17 expression has not been studied in glandular lesions of the uterine cervix like adenocarcinoma in situ (AIS) and invasive adenocarcinomas (AdC), whereas SOX17 promoter CpG island methylation has been reported. Therefore, the aim of this study was to relate the topographical distribution of SOX17 expression and SOX17 methylation status to each other, and to SOX2 expression, human papillomavirus (HPV) type, and physical status of the virus.

Methods and results

Immunohistochemistry was used in 45 cases to assess expression of SOX17 and SOX2. SOX17 promoter methylation was determined in 25 cases by means of bisulphite conversion and methylation‐specific polymerase chain reaction. SOX17 and SOX2 showed a mutually exclusive expression pattern in normal epithelium, with a sharp delineation in the squamocolumnar junction. SOX17 was found in endocervical columnar and reserve cells, whereas SOX2 was exclusively found in squamous epithelium. In both glandular lesions and cases with coexisting glandular and squamous intraepithelial components, a complex combination of SOX17 and SOX2 expression patterns was seen and mutually exclusive expression was lost. Frequently, gain of expression of SOX2 was found and expression of SOX17 was lost. Methylation of the CpG island in the SOX17 promoter was shown to be strongly associated with loss of expression of SOX17 (P = 0.0016).

Conclusions

In this study, we show for the first time a direct correlation between the topographical distribution of SOX17 expression and the methylation status of its gene promoter. This explains the heterogeneity of SOX17 expression in the glandular lesions of the cervix. No correlation was found between HPV type and physical status of the virus on the one hand and methylation status on the other.
Innovations in skin camouflaging techniques: Where are we scientifically?
Authors: Derbyshire E.
Published: August 2019

Objective

Cutaneous disorders can impact on the psycho‐social well‐being of children and adults alike, which has been reviewed elsewhere (Body Image 27, 2018 and 98). The present review sets out to evaluate progressions in skin masking and camouflaging techniques together with evaluating the efficacy of these. There does not appear to have been any recent reviews about innovations in skin camouflaging techniques.

Methods

Using the National Centre for Biotechnology Information PubMed database, a search was made for all studies published between 2000 and 2019 that met defined inclusion criteria. A total of seven relevant publications were identified.

Results

Of the seven studies identified, skin camouflaging improved quality of life in three studies and reduced anxiety, depression and social isolation in others. Of the camouflaging methods used, liquidized simulated second skin technology (Microskin™) appears to look particularly promising. This method of colour matching and a spray/stippling application uses a technology that binds to the epidermis of the skin helping to overcome previous concerns about the colour, coverage and application of camouflage and masking bases. Two studies showed that this innovative mode of camouflaging raised confidence, feelings of happiness and social experiences in children and adolescents with burn scarring. Very few studies reported drawbacks of camouflaging techniques, with limited colour matches and ‘itching’ appearing to be the main shortcomings. New technologies now appear to be addressing these.

Conclusion

Results show that there is wide variation in the quality and modes of skin camouflaging. Of the methods used, simulated second skin technology appears to be an important and effective therapy for individuals with cutaneous skin disorders. Training schemes along with increased awareness of this technique must now be communicated to medical professionals who come into contact with children and adults who could benefit physically, psychologically and socially from this therapy.
A novel low‐permittivity LiAl0.98(Zn0.5Si0.5)0.02O2‐based microwave dielectric ceramics for LTCC application
Authors: Lan Xue‐Kai , Li Jie , Wang Fei , Wang Xiaohong , Lu Wen‐Zhong , Hu Ming-Zhe , Lei Wen
Published: August 2019

Phase composition, morphology, and microwave dielectric properties of (1−x) LiAl0.98(Zn0.5Si0.5)0.02O2 + x CaTiO3 (0.05 ≤ x ≤ 0.20) materials synthesized via the solid state reaction method were investigated. All these densified materials were obtained at a sintering temperature of 1150°C. All compositions showed a major LiAlO2 phase that was accompanied by a minor CaTiO3 phase. The εr value increased gradually from 10.88 to 11.60, whereas the Q × f value remarkably decreased from 33 251 GHz to 13 511 GHz. The τf value changes from −85 ppm/°C to 212 ppm/°C, thereby indicating that CaTiO3 could effectively adjust this value. HBO3‐doping was used to further decrease the sintering temperature to 900°C. The optimum value was obtained at 7 wt.% HBO3 doped with microwave dielectric properties of εr = 9.39, Q × f = 10 224 GHz, and τf = −7.8 ppm/°C. This material also exhibited chemical compatibility with silver, making it a candidate for low temperature co‐fired ceramics applications.
Leveraging the Global Influenza Surveillance and Response System for global respiratory syncytial virus surveillance—opportunities and challenges
Authors: Broor Shobha , Campbell Harry , Hirve Siddhivinayak , Hague Siri , Jackson Sandra , Moen Ann , Nair Harish , Palekar Rakhee , Rajatonirina Soatiana , Smith Peter G , Venter Marietjie , Wairagkar Niteen , Zambon Maria , Ziegler Thedi , Zhang Wenqing
Published: August 2019

Background

Respiratory syncytial virus (RSV)‐associated acute lower respiratory infection is a common cause for hospitalization and hospital deaths in young children globally. There is urgent need to generate evidence to inform immunization policies when RSV vaccines become available. The WHO piloted a RSV surveillance strategy that leverages the existing capacities of the Global Influenza Surveillance and Response System (GISRS) to better understand RSV seasonality, high‐risk groups, validate case definitions, and develop laboratory and surveillance standards for RSV.

Methods

The RSV sentinel surveillance strategy was piloted in 14 countries. Patients across all age groups presenting to sentinel hospitals and clinics were screened all year‐round using extended severe acute respiratory infection (SARI) and acute respiratory infection (ARI) case definitions for hospital and primary care settings, respectively. Respiratory specimens were tested for RSV at the National Influenza Centre (NIC) using standardized molecular diagnostics that had been validated by an External Quality Assurance program. The WHO FluMart data platform was adapted to receive case‐based RSV data and visualize interactive visualization outputs.

Results

Laboratory standards for detecting RSV by RT‐PCR were developed. A review assessed the feasibility and the low incremental costs for RSV surveillance. Several challenges were addressed related to case definitions, sampling strategies, the need to focus surveillance on young children, and the data required for burden estimation.

Conclusions

There was no evidence of any significant adverse impact on the functioning of GISRS which is primarily intended for virologic and epidemiological surveillance of influenza.
Accuracy of single molecular biomarkers in gingival crevicular fluid for the diagnosis of periodontitis: A systematic review and meta‐analysis
Authors: Arias‐Bujanda Nora , Regueira‐Iglesias Alba , Balsa‐Castro Carlos , Nibali Luigi , Donos Nikos , Tomás Inmaculada
Published: August 2019

Aim

To analyse, by means of a meta‐analytical approach, the diagnostic accuracy of molecular biomarkers in gingival crevicular fluid (GCF) for the detection of periodontitis in systemically healthy subjects.

Material and Methods

Studies on GCF molecular biomarkers providing a binary classification table (or sensitivity and specificity values and group sample sizes) in individuals with clinically diagnosed periodontitis were considered eligible. The search was performed using six electronic databases. The methodological quality of studies was assessed through the tool Quality Assessment of Diagnostic Studies. Meta‐analyses were performed using the Hierarchical Summary Receiver Operating Characteristic, which adjusts classification data using random effects logistic regression.

Results

The included papers identified 36 potential biomarkers for the detection of periodontitis and for four of them meta‐analyses were performed. The median sensitivity and specificity were for MMP8, 76.7% and 92.0%; for elastase, 74.6% and 81.1%; for cathepsin, 72.8% and 67.3%, respectively. The worst estimates of sensitivity and specificity were for trypsin (71.3% and 66.1%, respectively).

Conclusions

MMP8 showed good sensitivity and excellent specificity, which resulted in this biomarker being clinically the most useful or effective for the diagnosis of periodontitis in systemically healthy subjects, regardless of smoking condition.
An experimental test for body size‐dependent effects of male harassment and an elevated copulation rate on female lifetime fecundity and offspring performance
Authors: Iglesias‐Carrasco Maider , Fox Rebecca J. , Vega‐Trejo Regina , Jennions Michael D. , Head Megan L.
Published: August 2019

Many studies investigate the benefits of polyandry, but repeated interactions with males can lower female reproductive success. Interacting with males might even decrease offspring performance if it reduces a female's ability to transfer maternal resources. Male presence can be detrimental for females in two ways: by forcing females to mate at a higher rate and through costs associated with resisting male mating attempts. Teasing apart the relative costs of elevated mating rates from those of greater male harassment is critical to understand the evolution of mating strategies. Furthermore, it is important to test whether a male's phenotype, notably body size, has differential effects on female reproductive success versus the performance of offspring, and whether this is due to male body size affecting the costs of harassment or the actual mating rate. In the eastern mosquitofish Gambusia holbrooki, males vary greatly in body size and continually attempt to inseminate females. We experimentally manipulated male presence (i.e., harassment), male body size and whether males could copulate. Exposure to males had strong detrimental effects on female reproductive output, growth and immune response, independent of male size or whether males could copulate. In contrast, there was a little evidence of a cross‐generational effect of male harassment or mating rate on offspring performance. Our results suggest that females housed with males pay direct costs due to reduced condition and offspring production and that these costs are not a consequence of increased mating rates. Furthermore, exposure to males does not affect offspring reproductive traits.
Real‐world effectiveness and safety of ledipasvir/sofosbuvir for genotype 6 chronic hepatitis C patients in Taiwan
Authors: Chen Jyh‐Jou , Lee Pei‐Lun , Chiu Hung‐Chih , Tung Hung‐Da , Chiu Yen‐Cheng , Cheng Pin‐Nan
Published: August 2019

Background and Aim

Infection with hepatitis C virus (HCV) genotype (GT) 6 is uncommon in Taiwan, and reports of ledipasvir/sofosbuvir (LDV/SOF) treatment for GT6 are few. This study evaluates the effectiveness and safety of LDV/SOF in treating chronic hepatitis C (CHC) patients with GT6 infection.

Methods

CHC patients that were infected with GT6 and treated for 12 weeks with LDV/SOF at two hospitals were enrolled. All patients were followed for an additional 12 weeks after the completion of LDV/SOF treatment. Demographics, HCV viral load, lipid and sugar profiles, and adverse events were recorded and reviewed.

Results

A total of 127 patients were enrolled. Cirrhosis was found in 68.2% of them. Sustained virological response (SVR), determined by per‐protocol analysis, was 97.6%. The SVR rates for cirrhosis versus non‐cirrhosis (96.5% vs 100%, P = 0.229) and low versus high viral load (cutoff value: 106 IU/mL; 100% vs 95.6%, P = 0.108) were similar. Following HCV clearance, significantly lower glycosylated hemoglobin was present both in patients with or without diabetes mellitus. Twenty‐three (18.1%) patients exhibited adverse events, and each adverse event presented with an incidence of 0.8% to 3.1%. Neuropsychiatric symptoms were the most common. During treatment, 18 patients (14.2%) had alanine aminotransferase elevations consistent with more than grade 1 abnormalities, and none had signs of decompensation. Renal function remained unchanged.

Conclusion

The high SVR and excellent safety of LDV/SOF treatment for GT6 CHC patients suggest that LDV/SOF is a favorable option for treating GT6 CHC patients in Taiwan and Asia.
Determining the current indications for endoscopic submucosal dissection in patients with Lauren mixed‐type early gastric cancer
Authors: Choi Jinju , Chung Hyunsoo , Kim Jung , Kim Jue Lie , Kim Sang Gyun , Jung Hyun Chae
Published: August 2019

Background and Aim

Recent study showed that early gastric cancer (EGC) with Lauren mixed‐type (MT) histology is associated with worse prognosis. We aimed to evaluate the clinicopathologic features and prognostic significance of Lauren MT‐EGCs that meets the criteria for endoscopic submucosal dissection (ESD).

Methods

We reviewed 2665 patients with EGC who underwent surgery between 2010 and 2015. The clinicopathologic features and invasiveness including lymph node metastasis (LNM) and lymphovascular invasion (LVI) of MT‐EGC were compared with those of intestinal type and diffuse type by Lauren histology.

Results

Among 2665 patients, EGCs in 241 (9%) patients were classified as MT. Tumor size was larger and depth of invasion was greater than other histology. Among patients with MT‐EGC, 16.6% (40/241) showed LNM and 22.8% (55/241) showed lymphatic invasion, which were significantly higher than that of patients with other Lauren types (8.2% and 15.3% in intestinal type and 9.1% and 8.7% in diffuse type, P < 0.001). This finding remained significant even after adjusting for depth of invasion. However, when we analyzed the patient groups who met the absolute or expanded criteria of ESD, no significant difference was observed in the rates of LNM or LVI or cancer mortality by Lauren classification.

Conclusion

Mixed‐type early gastric cancer (MT‐EGC) exhibited larger tumor size, greater depth of invasion, and higher risk of LNM and LVI. However, among the patients who met the absolute or expanded criteria of ESD, no significant difference was observed in LNM, LVI, and gastric cancer mortality risk.
Patient perception of beauty on social media: Professional and bioethical obligations in esthetics
Authors: Wang Jordan V. , Rieder Evan A. , Schoenberg Elizabeth , Zachary Christopher B. , Saedi Nazanin
Published: August 2019

Recently, social media use has skyrocketed, especially with millennials. The use of filtered images and photo editing has led to a new trend of social media‐induced dissatisfaction with appearance, termed “snapchat dysmorphia” and “selfie dysmorphia”. It is important for practitioners to recognize and understand this trend in addition to knowing how to manage these patients. As clinicians, we have bioethical and professional obligations to educate ourselves on new and relevant trends, ensure adequate patient safety, and advocate for continued consumer education.
Self‐reported dry mouth in 50‐ to 80‐year‐old Swedes: Longitudinal and cross‐sectional population studies
Authors: Johansson Ann‐Katrin , Johansson Anders , Unell Lennart , Ekbäck Gunnar , Ordell Sven , Carlsson Gunnar E.
Published: August 2019

Xerostomia is a common condition among elderly. The objectives were to examine prevalence, persistence, progression, yearly incidence of xerostomia, associated background factors and its influence on oral impacts on daily performances (OIDP) in 50‐ to 80‐year‐old people. In 1992, a questionnaire was sent to all 50‐year‐old (n = 8888) and in 2007 to all 75‐year‐old persons (n = 5195) living in two Swedish counties. In 2012, the same questionnaire was sent to both age cohorts, now 70‐ and 80‐year‐old. Response rate was for the 50‐, 70‐ 75‐ and 80‐year‐old groups 71.4%, 72.2%, 71.9% and 66.4%, respectively. In the 50‐ to 70‐year‐old sample, 40.3% of the participants answered all five examinations and in the 75‐80 group 49.5% (intact samples). In all age groups, xerostomia was significantly more prevalent in women than in men. At age 80, “often mouth dryness at night” was reported by 24.3% and 16.2% of women and men, respectively. Prevalence increased with age and was more frequent at night‐time. Persistence of xerostomia was reported by 61.4%‐77.5%, progression by 11.5%‐33.0% and remission by 5.7%‐11.3%. Average yearly incidence was 0.99%‐3.28%. Xerostomia was more prevalent in those who reported a negative impact on OIDP. Highest odd ratios for xerostomia were burning mouth (OR 12.0), not feeling healthy (OR 5.1) and medicine usage (OR 3.9). Xerostomia is common in older age, persistence is high and progression common. The comorbidity between xerostomia, oral health problems and impaired general health needs to be taken into consideration when providing dental care to elderly patients.
Manipulation of vegetation with activated carbon reveals the role of root exudates in shaping native grassland communities
Authors: Nettan Siim , Thetloff Marge , Lepik Anu , Semchenko Marina , Zobel Kristjan
Published: August 2019

Question

Plant community assembly has traditionally been viewed from the perspective of plant resource niches and competition and, more recently, facilitation in stressful environments. However, plants also engage in biotic interactions with neighbours and soil microbiome by producing chemically diverse root exudates. Root exudates have the potential to affect plant community productivity and composition by mediating plant interactions, fostering beneficial microbial interactions and affecting nutrient cycling. However, empirical evidence for the role of root exudates in plant community dynamics is still lacking, particularly under field conditions.

Location

Two calcareous grasslands in Western Estonia, Europe.

Methods

We tested the role of root exudates in shaping plant community productivity and composition by applying activated carbon powder, known to adsorb root exudates from soil solution, to two intact species‐rich grasslands. The experiment continued for four years and was combined with fertiliser application.

Results

We found that the application of activated carbon triggered significant changes in root morphology, plant productivity and growth form composition that were distinct from the effects of fertilisation. Community responses were site‐specific and varied with the duration of activated carbon application. Activated carbon addition increased the production of finer roots in a community with shallow soil in the first year of the experiment and significantly reduced above‐ground productivity at both sites by the end of the fourth growth season. The application of activated carbon promoted legume abundance at both sites and suppressed forb dominance at the site with shallow soil.

Conclusion

Our findings suggest that chemical interactions in the plant rhizosphere may play an important role in shaping grassland productivity and plant community composition. We also show that activated carbon can be used as an effective tool for manipulating plant interactions in intact grasslands occupied by long‐lived individuals.
A novel spleen‐dedicated stiffness measurement by FibroScan® improves the screening of high‐risk oesophageal varices
Authors: Stefanescu Horia , Marasco Giovanni , Calès Paul , Fraquelli Mirella , Rosselli Matteo , Ganne‐Carriè Nathalie , de Ledinghen Victor , Ravaioli Federico , Colecchia Antonio , Rusu Corina , Andreone Pietro , Mazzella Giuseppe , Festi Davide
Published: August 2019

Background & Aims

Several non‐invasive tests (NITs) have been developed to diagnose oesophageal varices (EV), including the recent Baveno VI criteria to rule out high‐risk varices (HRV). Spleen stiffness measurement (SSM) with the standard FibroScan® (SSM@50Hz) has been evaluated. However, the EV grading could be underestimated because of a ceiling threshold (75 kPa) of the SSM@50Hz. The aims were to evaluate SSM by a novel spleen‐dedicated FibroScan® (SSM@100Hz) for EV diagnosis compared with SSM@50Hz, other validated NITs and Baveno VI criteria.

Methods

This prospective multicentre study consecutively enrolled patients with chronic liver disease; blood data, endoscopy, liver stiffness measurement (LSM), SSM@50Hz and SSM@100Hz were collected.

Results

Two hundred and sixty patients met inclusion criteria. SSM@100Hz success rate was significantly higher than that of SSM@50Hz (92.5% vs 76.0%, P < .001). SSM@100Hz accuracy for the presence of EV (AUC = 0.728) and HRV (AUC = 0.756) was higher than in other NITs. SSM@100Hz AUC for large EV (0.782) was higher than SSM@50Hz (0.720, P = .027). AUC for HRV with SSM@100Hz (0.780) was higher than with LSM (0.615, P < .001). The spared endoscopy rate of Baveno VI criteria (8.1%) was significantly increased by the combination to SSM@50Hz (26.5%) or SSM@100Hz (38.9%, P < .001 vs others). The missed HRV rate was, respectively, 0% and 4.7% for combinations.

Conclusions

SSM@100Hz is a new performant non‐invasive marker for EV and HRV providing a higher accuracy than SSM@50Hz and other NITs. The combination of Baveno VI criteria and SSM@100Hz significantly increased the spared endoscopy rate compared to Baveno VI criteria alone or combined with SSM@50Hz. Clinical trial number: NCT02180113.
Clinical predictors of malignancy in palatal salivary gland tumors
Authors: Mariz Bruno Augusto Linhares Almeida , do Socorro Queiroz Feio Patricia , Roza Ana Luiza Oliveira Corrêa , de Andrade Bruno Augusto Benevenuto , Agostini Michelle , Romañach Mário José , Fonseca Felipe Paiva , Pontes Helder Antonio Rebelo , Ribeiro Ana Carolina Prado , Brandão Thaís Bianca , Rocha Andre Caroli , Vargas Pablo Agustin , Lopes Marcio Ajudarte , Santos‐Silva Alan Roger
Published: August 2019

Objectives

To establish a predictive clinical index of malignancy risk in palatal salivary gland tumors (PSGT).

Materials and methods

One hundred cases of PSGT were evaluated. Clinical data were retrieved from the patient's files. Representative clinical photographs of each tumor were evaluated to identify clinical features suggestive of a malignant tumor. Features significantly associated with malignancy were included in a binary logistic regression model.

Results

Malignant tumors were more common in the hard palate, in women and in older patients. Features associated with a malignant diagnosis included pain (p = .017), irregular surface (p = .004), bluish/purple coloration (p < .001), ulceration (p = .005), and telangiectasia (p = .015). After multivariate logistic regression, pain (OR: 4.017; 95% CI: 1.198–13.471; p = .024) and color alteration (OR: 7.243; 95% CI: 2.068–25.363; p = .002) were independently associated with malignancy. Including these factors in a predictive index, the proportion of malignant tumors in patients presenting none, one and two factors were 25% (95% CI: 0.13–0.40), 67% (95% CI: 0.48–0.83), and 85% (95% CI: 0.42–0.99), respectively.

Conclusion

Pain and color alteration might be independent predictors of malignancy in PSGT, which could support the decision to perform an incisional or excisional biopsy.
Online Knowledge Communities: Breaking or Sustaining Knowledge Silos?
Authors: Hwang Elina H. , Krackhardt David
Published: August 2019

Effective operations require the coordination of distributed knowledge. Division and distance across teams and specialties form barriers to communication, creating insulated pockets of knowledge along geographic and specialty borders. Such fragmentation can hamper a company's ability to fully utilize existing knowledge, potentially hurting its productivity in the long run. As such, many companies have created internal online knowledge communities, in which employees can exchange solutions in various knowledge domains anywhere in the world. Although online knowledge communities offer an exciting potential to mobilize knowledge across locations and specialties virtually, little is known about whether such mobilization of knowledge happens in reality. The objective of this study is to advance our understanding of the effectiveness of an online knowledge community in promoting distance‐ and specialty‐crossing knowledge sharing. To this end, we analyze knowledge sharing patterns in an online knowledge community of a global Fortune 500 consulting company that provides knowledge‐intensive services. We find that, despite the global connectivity enabled by the Internet, knowledge is still circulated mostly within a smaller group of employees who are nearby or who have the same specialties in the online knowledge community. This finding indicates that existing knowledge is not efficiently utilized across locations and specialties; thus, companies are missing learning opportunities.
The novel HLA‐C*04:387 allele is likely generated by intra‐locus recombination event
Authors: Kwon Won K. , Hwang Sejun , Choi So‐Jung , Kang Eun‐Suk
Published: August 2019

The new HLA‐C*04:387 allele was found and characterized in a Korean hematopoietic stem cell donor.
Two B‐box proteins, PpBBX18 and PpBBX21, antagonistically regulate anthocyanin biosynthesis via competitive association with Pyrus pyrifolia ELONGATED HYPOCOTYL 5 in the peel of pear fruit
Authors: Bai Songling , Tao Ruiyan , Yin Lei , Ni Junbei , Yang Qinsong , Yan Xinhui , Yang Feng , Guo Xianping , Li Hongxu , Teng Yuanwen
Published: August 2019

Light is indispensable for the accumulation of anthocyanin in the peel of red pear fruit (Pyrus pyrifolia Nakai). ELONGATED HYPOCOTYL 5 (HY5) is considered to be a critical regulator for induction of anthocyanin biosynthesis, but detailed characterization of its regulatory mechanism is needed. In this study, multiple genetic and biochemical approaches were applied to identify the roles of P. pyrifolia HY5 (PpHY5) and two B‐box (BBX) proteins, PpBBX18 and PpBBX21, in the transcriptional regulation of PpMYB10. The functions of the two BBX proteins were analyzed in overexpression lines using pear calli‐based approaches. On its own PpHY5 was unable to activate downstream genes. The two BBX proteins, PpBBX18 and PpBBX21, physically interacted with PpHY5 and antagonistically regulated anthocyanin biosynthesis in Arabidopsis and pear. PpBBX18 formed a heterodimer with PpHY5 via two B‐box domains, in which PpHY5 bound to the G‐box motif of PpMYB10 and PpBBX18 provided the trans‐acting activity, thus inducing transcription of PpMYB10. PpBBX21 interacted with PpHY5 and PpBBX18 and hampered formation of the PpHY5–PpBBX18 active transcription activator complex, and subsequently repressed anthocyanin biosynthesis. The present results demonstrate the fine‐tuned regulation of anthocyanin biosynthesis via transcriptional regulation of PpMYB10 by PpHY5‐associated proteins and provide insights into light‐induced anthocyanin biosynthesis.
Clinical findings and management of six horses with subtendinous bursitis of the long digital extensor tendon in the hind limb fetlock
Authors: Iglesias‐García Manuel , Roquet Imma , Jiménez Joaquin , Martín‐Cuervo Maria , Fuentes‐Romero Beatriz , Ezquerra‐Calvo Luis J.
Published: August 2019

Objective

To describe the history, clinical signs, and management of six horses in which subtendinous bursitis of the long digital extensor tendon (LDET) in the hind limb fetlock had been diagnosed.

Study design

Retrospective case series.

Sample population

Six privately owned horses.

Methods

The medical records of horses presented at the hospital with similar sypmtoms were evaluated and collected. Finally 6 horses met the inclusion criteria and the relevant data were compiled and analysed. In three of the six cases a surgical treatment was carried out.

Results

All horses had similar clinical signs, mainly distention beneath the long digital extensor tendon (LDET) at the level of the hind limb fetlock without associated lameness; the major issues were the presence of cosmetic defects and concern about their functional use in the future. Three of the six horses were treated surgically with bursoscopic debridement. The cosmetic results were excellent in two of these three horses. One horse that underwent an operation experienced a recurrence. None of the horses with bursitis treated medically experienced resolution of the problem.

Conclusion

Bursoscopy is a technique to consider for the management of bursitis of the LDET at the level of the fetlock combined with prolonged bandage application when medical treatment has failed to manage the condition.

Clinical significance

To the best of our knowledge, subtendinous bursitis of the LDET in the hind limb is not a commonly diagnosed condition. This small case series provides some insight into methods for the clinical management of this issue.
Activation of mTORC1 in fibroblasts accelerates wound healing and induces fibrosis in mice
Authors: Hu Xiao , Zhang Hanbin , Li Xiaojian , Li Yeyang , Chen Zhenguo
Published: August 2019

Wound healing is a multicellular process that involves the coordinated efforts of several cell types, including keratinocytes, fibroblasts, and endothelial cells. This process is also regulated by an equally complex signaling network involving numerous growth factors, cytokines, and chemokines. The mechanistic target of rapamycin complex 1 (mTORC1) is a central regulator of cell growth, proliferation, and differentiation. A recent study showed that mTORC1 activation in epithelial cells dramatically enhanced epithelial cell proliferation, migration, and cutaneous wound healing; however, the roles of mTORC1 in fibroblasts during wound healing remain unknown. Here, we generated genetically mutated mice with activated mTORC1 in fibroblasts by conditionally deleting the mTORC1 inhibitor, TSC1. Activation of mTORC1 in fibroblasts significantly increased fibroblastic cell proliferation and contractile α‐smooth muscle actin expression, thus promoting wound closure. Elevated mTORC1 activity also adversely induced excessive collagen production, leading to excessive scaring and fibrosis. Importantly, both accelerated wound healing and fibrotic phenotypes were largely reversed by the mTORC1 inhibitor, rapamycin. These observations were also replicated in primary human dermal fibroblasts. These results collectively demonstrated that mTORC1 activity in skin fibroblasts was a critical orchestrator in cutaneous wound healing and scarring.
Sodium‐activated potassium channels moderate excitability in vascular smooth muscle
Authors: Li Ping , Halabi Carmen M. , Stewart Richard , Butler Alice , Brown Bobbie , Xia Xiaoming , Santi Celia , England Sarah , Ferreira Juan , Mecham Robert P. , Salkoff Lawrence
Published: August 2019

Key points

We report that a sodium‐activated potassium current, IKNa, has been inadvertently overlooked in both conduit and resistance arterial smooth muscle cells.

IKNa is a major K+ resting conductance and is absent in cells of IKNa knockout (KO) mice.

The phenotype of the IKNa KO is mild hypertension, although KO mice react more strongly than wild‐type with raised blood pressure when challenged with vasoconstrictive agents.

IKNa is negatively regulated by angiotensin II acting through Gαq protein‐coupled receptors.

In current clamp, KO arterial smooth muscle cells have easily evoked Ca2+‐dependent action potentials.

Although several potassium currents have been reported to play a role in arterial smooth muscle (ASM), we find that one of the largest contributors to membrane conductance in both conduit and resistance ASMs has been inadvertently overlooked. In the present study, we show that IKNa, a sodium‐activated potassium current, contributes a major portion of macroscopic outward current in a critical physiological voltage range that determines intrinsic cell excitability; IKNa is the largest contributor to ASM cell resting conductance. A genetic knockout (KO) mouse strain lacking KNa channels (KCNT1 and KCNT2) shows only a modest hypertensive phenotype. However, acute administration of vasoconstrictive agents such as angiotensin II (Ang II) and phenylephrine results in an abnormally large increase in blood pressure in the KO animals. In wild‐type animals Ang II acting through Gαq protein‐coupled receptors down‐regulates IKNa, which increases the excitability of the ASMs. The complete genetic removal of IKNa in KO mice makes the mutant animal more vulnerable to vasoconstrictive agents, thus producing a paroxysmal‐hypertensive phenotype. This may result from the lowering of cell resting K+ conductance allowing the cells to depolarize more readily to a variety of excitable stimuli. Thus, the sodium‐activated potassium current may serve to moderate blood pressure in instances of heightened stress. IKNa may represent a new therapeutic target for hypertension and stroke.
Risk factors for colorectal cancer significantly vary by anatomic site
Authors: Demb Joshua , Earles Ashley , Martínez María Elena , Bustamante Ranier , Bryant Alex K , Murphy James D , Liu Lin , Gupta Samir
Published: August 2019

Objective

To conduct an anatomic site-specific case–control study of candidate colorectal cancer (CRC) risk factors.

Design

Case–control study of US veterans with >1 colonoscopy during 1999–2011. Cases had cancer registry-identified CRC at colonoscopy, while controls were CRC free at colonoscopy and within 3 years of colonoscopy. Primary outcome was CRC, stratified by anatomic site: proximal, distal, or rectal. Candidate risk factors included age, sex, race/ethnicity, body mass index, height, diabetes, smoking status, and aspirin exposure summarised by adjusted ORs and 95% CIs.

Results

21 744 CRC cases (n=7017 rectal; n=7039 distal; n=7688 proximal) and 612 646 controls were included. Males had significantly higher odds relative to females for rectal cancer (OR=2.84, 95% CI 2.25 to 3.58) than distal cancer (OR=1.84, 95% CI 1.50 to 2.24). Relative to whites, blacks had significantly lower rectal cancer odds (OR=0.88, 95% CI 0.82 to 0.95), but increased distal (OR=1.27, 95% CI 1.19 to 1.37) and proximal odds (OR=1.62, 95% CI 1.52 to 1.72). Diabetes prevalence was more strongly associated with proximal (OR=1.29, 95% CI 1.22 to 1.36) than distal (OR=1.15, 95% CI 1.08 to 1.22) or rectal cancer (OR=1.12, 95% CI 1.06 to 1.19). Current smoking was more strongly associated with rectal cancer (OR=1.81, 95% CI 1.68 to 1.95) than proximal cancer (OR=1.53, 95% CI 1.43 to 1.65) or distal cancer (OR=1.46, 95% CI 1.35 to 1.57) compared with never smoking. Aspirin use was significantly more strongly associated with reduced rectal cancer odds (OR=0.71, 95% CI 0.67 to 0.76) than distal (OR=0.85, 95% CI 0.81 to 0.90) or proximal (OR=0.91, 95% CI 0.86 to 0.95).

Conclusion

Candidate CRC risk factor associations vary significantly by anatomic site. Accounting for site may enable better insights into CRC pathogenesis and cancer control strategies.
Impact of Ramadan fasting on kidney function and related outcomes in patients with chronic kidney disease: a systematic review protocol
Authors: Bello Aminu K , Kurzawa Julia , Osman Mohamed A , Olah Michelle E , Lloyd Anita , Wiebe Natasha , Habib Syed , Qarni Uwais , Shojai Soroush , Pauly Robert P
Published: August 2019

Introduction

Fasting during the month of Ramadan is a significant Islamic religious practice that involves abstinence from food, drink and medication from dawn to dusk. As just under a quarter of the world’s population identifies as Muslim, the effect of fasting on chronic conditions, such as chronic kidney disease (CKD) is a topic of broad relevance. To date, the information in this area has been mixed, with many limitations of previous studies. This study aims to synthesise the evidence of the effect of Ramadan fasting on changes on kidney function, risk factors, episodes of acute kidney injury and impact on the quality of life in patients with CKD or kidney transplant.

Methods and analysis

A systematic review of the literature will be conducted, using electronic databases such as MEDLINE, Embase, Global Health, CINAHL and Scopus. Original research and grey literature on the effect of Ramadan fasting in adult patients with CKD or renal transplantation will be included. Two reviewers will independently screen articles for inclusion in the review and independently assess the methodology of included studies using a customised checklist. Mean difference or risk ratio will be reported for continuous or dichotomous outcomes and results will be pooled using a random-effects model where heterogeneity is reasonable. If possible, subgroups (CKD status, setting, season and risk of bias) will be analysed for effect modification with fasting and the outcomes of interest. Risk of bias will be assessed using the Downs and Black checklist.

Ethics and dissemination

The results will be disseminated using a multifaceted approach to engage all stakeholders (patients, practitioners and community leaders). Research ethics board approval is not required as this is a systematic review of previously published research.

PROSPERO registration number

CRD42018088973.
Association between adverse childhood experiences and adult diseases in older adults: a comparative cross-sectional study in Japan and Finland
Authors: Amemiya Airi , Fujiwara Takeo , Shirai Kokoro , Kondo Katsunori , Oksanen Tuula , Pentti Jaana , Vahtera Jussi
Published: August 2019

Objective

We aimed to examine the association between adverse childhood experiences (ACEs) and diseases in older adults in Japan and Finland.

Design

Cross-sectional comparative study.

Setting

Data from a gerontological study in Japan and two public health studies in Finland were evaluated.

Participants

A total of 13 123 adults (mean age, 69.5 years) from Japan and 10 353 adults (mean age, 64.4 years) from Finland were included in this study. Logistic regression was used to examine the association of each of, any of and the cumulative number of ACEs (parental divorce, fear of a family member and poverty in childhood; treated as ordered categorical variables) with poor self-rated health (SRH), cancer, heart disease or stroke, diabetes mellitus, smoking and body mass index. Models were adjusted for sex, age, education, marital status and working status.

Results

Of the respondents, 50% of those in Japan and 37% of those in Finland reported having experienced at least one of the measured ACEs. Number of ACEs was associated with poor SRH in both countries, and the point estimates were similar (OR: 1.35, 95% CI: 1.25 to 1.46 in Japan; OR: 1.34, 95% CI: 1.27 to 1.41 in Finland). Number of ACEs was associated with the prevalence of cancer, heart disease or stroke, diabetes mellitus, current smoking and an increase in body mass index in both countries.

Conclusions

The association between ACEs and poor SRH, adult diseases and health behaviours was similar among older adults in both Japan and Finland. This international comparative study suggests that the impact of ACEs on health is noteworthy and consistent across cultural and social environments.
Prevalence and factors associated with fatigue in the Lausanne middle-aged population: a population-based, cross-sectional survey
Authors: Galland-Decker Coralie , Marques-Vidal Pedro , Vollenweider Peter
Published: August 2019

Objective

To assess the prevalence and factors associated with fatigue in the general population.

Design

Population-based, cross-sectional survey performed between May 2014 and April 2017.

Setting

General population of the city of Lausanne, Switzerland.

Participants

2848 participants (53.2% women, age range 45–86 years).

Primary outcome measure

Prevalence of fatigue the previous week, defined as a score of ≥4 using the Fatigue Severity Scale.

Results

The prevalence of fatigue was 21.9% (95% CI 20.4% to 23.4%) in the total sample. On bivariate analysis, participants with fatigue were younger, had a higher body mass index, a lower handgrip strength and lower ferritin levels. Participants with fatigue were more frequently women, had a lower educational level, presented more frequently with clinical insomnia, diabetes, anaemia, depression and low thyroid stimulating hormone (TSH) values, had a higher consumption of antihistamines, antidepressants and hypnotics, and rated more frequently their health as bad or very bad. Multivariable analysis showed that obesity (OR 1.40 (95% CI 1.03 to 1.91)), insomnia categories (p value for trend <0.001), depression (OR 3.26 (95% CI 2.38 to 4.46)), anaemia (OR 1.70 (95% CI 1.00 to 2.89)) and low self-rated health status (p value for trend <0.001) were positively associated with fatigue, while older age (p value for trend 0.002) was negatively associated with fatigue. Conversely, no association was found for diabetes, TSH levels, antihistamines or hypnotics.

Conclusion

In a population-based sample aged 45–86, fatigue was present in one out of five subjects. Regarding clinical factors, sleep disturbances such as insomnia and sleep apnoea should be assessed first, followed by depression. Regarding biological factors, anaemia should be ruled out, while screening for hypothyroidism is not recommended as a first step. Sleep complaints and fatigue in older subjects are not due to ageing and should prompt identification of the underlying cause.
Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design
Authors: Macefield Rhiannon , Brookes Sara , Blazeby Jane , Avery Kerry
Published: August 2019

Objectives

To describe the novel concept of, and methods for developing, a ‘universal-reporter’ outcome measure (UROM); a single questionnaire for completion by patients and/or healthcare professionals (HCPs) when views on the same subject are required.

Design

A mixed methods study with three phases—phase I: identification of relevant content domains from existing clinical tools, patient questionnaires and in-depth interviews with multistakeholders; phase II: item development using a novel approach that considered plain language in conjunction with medical terminology; and phase III: pretesting with multistakeholders using cognitive interviews.

Setting

A case study in surgical wound assessment undertaken in two UK hospital trusts and one university setting.

Participants

Patients who had recently undergone general abdominal surgery and healthcare professionals involved in post-surgical wound care.

Results

Phase I: In the example case study, 19 relevant content domains were identified from two clinical tools, two patient questionnaires and 19 multistakeholder interviews (nine patients, 10 HCPs). Phase II: Domains were operationalised into items and subitems (secondary components to collect further information, if relevant). The version after pretesting had 16 items, five of which included further subitems. Plain language in conjunction with medical terminology was applicable in nine (27%) items/subitems. Phase III: Pretesting with 28 patients and 14 HCPs found that the UROM was acceptable to both respondent groups. An unanticipated secondary finding of the study was that the combined use of plain language and medical terminology during questionnaire development may be a useful, novel technique for evaluating item interpretation and thereby identifying items with inadequate content validity.

Conclusion

UROMs are a novel approach to outcome assessment that are acceptable to both patients and HCPs. Combining plain language and medical terminology during item development is a recommended technique to improve accuracy of item interpretation and content validity during questionnaire design. More work is needed to further validate this novel approach and explore the application of UROMs to other settings.