Impact of PM 10 and meteorological factors on the incidence of hand, foot, and mouth disease in female children in Ningbo, China: a spatiotemporal and time-series study

Abstract

Hand, foot, and mouth disease (HFMD) is a viral illness that is considered a critical public health challenge worldwide. Previous studies have demonstrated that meteorological parameters are significantly related to the incidence of HFMD in children; however, few studies have focused only on female children. This study quantified the associations of HFMD incidence with meteorological parameters and PM₁₀ (particulate matter with an aerodynamic diameter of 10 μm) among female children. Data were collected on daily HFMD cases, meteorological variables, and PM₁₀ levels in Ningbo, China, from January 2012 to December 2016. Data were assessed using a distributed lag nonlinear model (DLNM) with Poisson distribution. A total of 59,809 female children aged 0−15 years with HFMD were enrolled. The results showed that highest relative risk (RR) of HFMD for temperature was 3 °C and the lag effect was 3 days. The highest RR for PM₁₀ was 80 mg/m³ and the lag effect was 5 days. Spatial analysis showed that female HFMD incidence was mainly concentrated in the suburban of Ningbo city indicating that female children in this area should be more paid attention on avoiding this disease outbreak. Our findings suggest that HFMD prevention strategies should focus more attention on local meteorological parameters.

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A Survey of Delphi Panelists after Core Outcome Set Development Revealed Positive Feedback and Methods to Facilitate Panel Member Participation

Publication date: Available online 30 June 2018
Source:Journal of Clinical Epidemiology
Author(s): Alison E. Turnbull, Victor D. Dinglas, Lisa Aronson Friedman, Caroline M. Chessare, Kristin A. Sepúlveda, Clifton O. Bingham, Dale M. Needham
Objective(s): To elicit feedback on consensus methodology used for core outcome set development.Study DesignOnline survey of international Delphi panelists participating in a recent Core Outcome Set for clinical research studies evaluating acute respiratory failure (ARF) survivors.SettingPanelists represented 14 countries (56% outside USA).ResultsSeventy (92%) panelists completed the survey, including 32 researchers, 19 professional association representatives, 4 research funding representatives, and 15 ARF survivors/caregiver members. Among respondents, 91% reported that the time required to participate was appropriate and 96% were not bothered by reminders for timely response. Attributes of measurement instruments and voting results from previous rounds were evaluated differently across stakeholder groups. When measurement properties were explained in the stem of the survey question, 59 (84%) panelists (including 73% of survivors/families) correctly interpreted information about an instrument's reliability. Without a reminder in the stem, only 20 (29%) panelists (including 38% of researchers), correctly identified properties of a core outcome set.ConclusionsThis international Delphi panel, including >20% patients/caregivers, favorably reported on feasibility of the methodology. Providing all panelists pertinent information/reminders about the project's objective at each voting round is important to informed decision-making across all stakeholder groups.



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Patients and investigators preferred measures of absolute risk in subgroups for pragmatic randomized trials

Publication date: Available online 30 June 2018
Source:Journal of Clinical Epidemiology
Author(s): Eleanor J. Murray, Ellen C. Caniglia, Sonja A. Swanson, Sonia Hernández-Díaz, Miguel A. Hernán
ObjectivesPragmatic randomized trials are important tools for shared decision-making, but no guidance exists on patients' preferences for types of causal information. We aimed to assess preferences of patients and investigators towards causal effects in pragmatic randomized trials.Study Design and SettingWe: (a) held 3 focus groups with patients (n=23) in Boston, MA; (b) surveyed (n=12) and interviewed (n=5) investigators with experience conducting pragmatic trials; and (c) conducted a systematic literature review of pragmatic trials (n=63).ResultsPatients were distrustful of new-to-market medications unless substantially more effective than existing choices, preferred stratified absolute risks, and valued adherence-adjusted analyses when they expected to adhere. Investigators wanted both intention-to-treat and per-protocol effects, but felt methods for estimating per-protocol effects were lacking. When estimating per-protocol effects, many pragmatic trials used inappropriate methods to adjust for adherence and loss to follow-up.ConclusionWe make 4 recommendations for pragmatic trials to improve patient centeredness: (1) focus on superiority in effectiveness or safety, rather than noninferiority; (2) involve patients in specifying a priori subgroups; (3) report absolute measures of risk, and (4) complement intention-to-treat effect estimates with valid per-protocol effect estimates.



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Mixed-methods research revealed the need for Dementia Services and Human Resource Master Plan in an Aging Philippines

Publication date: Available online 30 June 2018
Source:Journal of Clinical Epidemiology
Author(s): Shelley F. Dela Vega, Cynthia P. Cordero, Leah A. Palapar, Angely P. Garcia, Josephine D. Agapito
ObjectiveTo determine the status of dementia care services and workforce in selected public and private hospitals and geriatric-care facilities in the Philippines.Study design and settingFramework analysis of 54 key informant interviews, 4 focus group discussions and survey of 167 workers in 26 purposively selected facilities.ResultsThree dementia care models emerged: 1) separate unit, seen in 2 facilities 2) partial dementia services, 9 facilities and 3) integrated with the general services, 15 facilities. Only 1 of 26 facilities had specific outpatient services; only 1 provided care exclusive to dementia patients. Community daycare services were rare. Physicians, nurses and nursing assistants were available in all institutions. Nutrition and physical therapy services were generally available. There was a scarcity of physician specialists (ex. Geriatrics) and occupational therapists. Half of the workers surveyed rated the quality of their service at 80 or higher, 27% defined dementia correctly. Attitude towards dementia was very positive, in the form of willingness to care for and willingness to learn more.ConclusionMixed methods research helped identify service and healthworkforce needs, and elucidate understanding of healthworkers' attitude and perceptions towards a disease of which there is low knowedge and awareness.



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Specific-IgE to galactose-alpha-1,3-galactose (alpha-gal) has limited utility in diagnosing meat allergy in a tick-endemic population

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Dr Jamma Li, Mr Richard B. Fulton, RachelO'Connell, Dr Helena S. Jang, Prof. Suran L. Fernando




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Efficacy of C1Inhibitor concentrate in hereditary angioedema with C1Inhibitor deficiency: analysis in the French Cohort

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Aude Belbézier, Isabelle Boccon-Gibod, Aurélie Du Thanh, Olivier Fain, Laurence Bouillet




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Successful desensitization in a pediatric patient with acetazolamide allergy

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Annette Carlisle, Joshua L. Kennedy, Sheva Chervinskiy, Stacie M. Jones, Robert D Pesek




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Chronic Tearing Induced by Apremilast

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Matthew R. Norris, Leonard Bielory




https://ift.tt/2NcOzCV

Health Literacy and Asthma Among Hispanic and African American Urban Adolescents with Undiagnosed Asthma

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Melissa A. Valerio, Maureen George, Jianfang Liu, Zainab T. Osakwe, Jean-Marie Bruzzese




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Mechanisms of allergen-specific immunotherapy: diverse mechanisms of immune tolerance to allergens

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Anna Głobińska, Tadech Boonpiyathad, Pattraporn Satitsuksanoa, Mirelle Kleuskens, Willem van de Veen, Milena Sokołowska, Mübeccel Akdis




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An investigation of the process of change in psychopathology and exercise during inpatient treatment for adults with longstanding eating disorders

Abstract

Background

Excessive exercise is recognized as a predictor of poor outcome in eating disorders. However, little is known about how excessive exercise might affect the treatment process. The aim of this study was to describe process of weekly changes in eating disorder psychopathology, general psychopathology and exercise, and the possible interactive effects of excessive exercise on these changes during inpatient treatment of longstanding eating disorders.

Methods

Eighty-four patients meeting the DSM-IV criteria for Anorexia Nervosa, Bulimia Nervosa, or Eating Disorders Not Otherwise Specified received inpatient cognitive-behavioural therapy including, physical activity and nutritional counselling treatment over 12 weeks. Excessive exercise was defined as having ≥6 episodes of driven exercise during week 1 of treatment. Excessive exercisers received one additional session of individual counseling with the clinical exercise physiologist. The study used repeated measurements during treatment and collected measures of eating disorders: psychopathology (EDE-Q), general psychopathology (SCL-5), and frequencies of exercise and body mass index (BMI). Statistical analysis was performed using repeated measures ANOVA.

Results

Both eating disorders and general psychopathology were reduced from admission to discharge in excessive exercisers and non-exercisers. There was an overall interaction effect between time (week) and excessive exercise for the process of exercise and eating disorders psychopathology reduction. This interaction effect was also found in week 10 vs 11 regarding general psychopathology. The excessive exercisers showed steep reduction at first, followed by a smaller increase towards the end of treatment in both eating disorder and general psychopathology; this pattern was not found among the non-exercisers.

Conclusion

The process of change in exercise and psychopathology during inpatient treatment of longstanding eating disorders differs across excessive and non-excessive exercisers. Although excessive exercisers were given special attention for their exercise cognition and behavior during treatment, it is apparent that this part of treatment must be further developed.

https://ift.tt/2lNMdxU

Modelling local uncertainty in relations between birth weight and air quality within an urban area: combining geographically weighted regression with geostatistical simulation

Abstract

In this study, we combine known methods to present a new approach to assess local distributions of estimated parameters measuring associations between air quality and birth weight in the urban area of Sines (Portugal). To model exposure and capture short-distance variations in air quality, we use a Regression Kriging estimator combining air quality point data with land use auxiliary data. To assess uncertainty of exposure, the Kriging estimator is incorporated in a sequential Gaussian simulation algorithm (sGs) providing a set of simulated exposure maps with similar spatial structural dependence and statistical properties of observed data. Following the completion of the simulation runs, we fit a geographically weighted generalized linear model (GWGLM) for each mother's place of residence, using observed health data and simulated exposure data, and repeat this procedure for each simulated map. Once the fit of GWGLM with all exposure maps is finished, we take the distribution of local estimated parameters measuring associations between exposure and birth weight, thus providing a measure of uncertainty in the local estimates. Results reveal that the distribution of local parameters did not vary substantially. Combining both methods (GWGLM and sGs), however, we are able to incorporate local uncertainty on the estimated associations providing an additional tool for analysis of the impacts of place in health.

https://ift.tt/2KyYnZl

Phytoremediation of Mn-contaminated paddy soil by two hyperaccumulators ( Phytolacca americana and Polygonum hydropiper ) aided with citric acid

Abstract

The purpose of this study was to investigate the phytoremediation potential of two hyperaccumulator plants, Phytolacca americana L. and Polygonum hydropiper L., on manganese-contaminated paddy soils. The biomass growth, Mn concentrations in plant tissues, and potential Mn removal efficiency from soils of these two plants were studied with citric acid, and the mechanisms of citric acid on these two plants were analyzed by examining the root activity, the activities of superoxide dismutase (SOD), peroxidase (POD) and catalase (CAT) in leaves, as well as the concentrations of O₂·⁻ and H₂O₂ in leaves. The results showed that the biomass of these two plants were both promoted under low level of citric acid (3 mmol kg⁻¹). The concentration of Mn in the plants and the amount of Mn removed from the soil by the plants through harvesting were enhanced at low and intermediate (10 mmol kg⁻¹) citric acid application levels. The results also showed that root activity was enhanced at the low citric acid level and significantly inhibited under the intermediate and high levels (15 mmol kg⁻¹), which indicates the facilitative function of the low level of citric acid and the inhibitive function of the high level of citric acid application on plant biomass growth. Under the low and intermediate levels of citric acid application, O₂·⁻ in the plant leaves increased sharply, and the SOD, POD, and CAT activities also increased sharply, which made the level of H₂O₂ very similar to that of the control, ensuring the health of the plants. At the high level of citric acid application, however, the O₂·⁻ continued to rise sharply, while the activity of the three antioxidant enzymes declined sharply, causing the concentration of hydrogen peroxide to be much higher than that in the control, thus endangering the plants. The present study shows the potential of P. hydropiper for use in the phytoremediation of soil contaminated with a relatively low level of manganese.

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Prospective associations between sleep problems and subtypes of anxiety symptoms among disaster-exposed adolescents

Publication date: October 2018
Source:Sleep Medicine, Volume 50
Author(s): Fulei Geng, Xianchen Liu, Yingxin Liang, Xuliang Shi, Siyi Chen, Fang Fan
ObjectiveThis study aimed to investigate longitudinal relationships between sleep problems and subtypes of anxiety symptoms among adolescent earthquake survivors.MethodsParticipants were 1573 adolescents (male, 45.8%; mean age at baseline 15.01 years, standard deviation (SD) = 1.26) in the Wenchuan Earthquake Adolescent Health Cohort. The Pittsburgh Sleep Quality Index and the Screen for Child Anxiety Related Emotional Disorders were used to assess participants' sleep problems and anxiety symptoms four times during 2.5 years after the earthquake. Anxiety symptoms included subtypes of panic disorder (PD), generalized anxiety disorder (GAD), separation anxiety disorder (SeAD), social phobia (SP), school phobia (ScP). Longitudinal lagged generalized estimating equations (GEE) models were used to determine the prospective associations.ResultsOverall, there was a bidirectional relationship between sleep problems and anxiety symptoms. For the specific sleep problems and anxiety subtypes, short sleep duration predicted symptoms of PD, GAD, and ScP, and was predicted by GAD; difficulty falling asleep predicted GAD symptoms, whereas PD symptoms increased difficulty falling asleep; poor sleep quality predicted ScP symptoms and was predicted by symptoms of GAD and ScP; difficulty maintaining sleep was not associated with any subtype of anxiety symptoms in any direction; SeAD and SP were not associated with any specific sleep problems in any direction.ConclusionWhile sleep problems and anxiety symptoms are bidirectional, the associations vary by subtypes of sleep problems and anxiety symptoms. The potential biological mechanisms for the specific associations between dimensional sleep and anxiety symptoms and their clinical implications should be further investigated.



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Hypersomnia due to injury of the lower ventral ascending reticular activating system in a patient with intraventricular hemorrhage

Publication date: October 2018
Source:Sleep Medicine, Volume 50
Author(s): Sung Ho Jang, Young Hyeon Kwon




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Night sleep duration trajectories and associated factors among preschool children from the EDEN cohort

Publication date: August 2018
Source:Sleep Medicine, Volume 48
Author(s): Sabine Plancoulaine, Eve Reynaud, Anne Forhan, Sandrine Lioret, Barbara Heude, Marie-Aline Charles
ObjectiveSleep duration may vary both interindividually and intraindividually over time. We aimed to identify night-sleep duration (NSD) trajectories among preschoolers and to study associated factors.MethodsNSD was collected within the French birth-cohort study EDEN at ages 2, 3, and 5–6 years through parental questionnaires, and were used to model NSD trajectories among 1205 children. Familial socioeconomic factors, maternal sociodemographic, health and lifestyle characteristics, as well as child health, lifestyle, and sleep characteristics at birth and/or at age two years were investigated in association with NSD using multinomial logistic regressions.ResultsFive distinct NSD trajectories were identified: short (SS, <10 h, 4.9%), medium-low (MLS, <11 h, 47.8%), medium–high (MHS, ≈11.5 h, 37.2%), long (LS, ≥11.5 h, 4.5%) and changing (CS, ie, ≥11.5 h then <11 h, 5.6%) NSD trajectories. Multivariable analyses showed in particular that compared to the MHS trajectory factors associated with increased risk for the SS trajectory were male gender, first child, maternal age and working status, night-waking, parental presence when falling asleep, television-viewing duration, as well as both "Processed and fast foods" and the "Baby food" dietary patterns at age two years. Factors positively associated with the CS trajectory were maternal smoking, feeding at night, and the Processed and fast foods dietary pattern at age two years, whereas child's activity and emotionality scores at age one year were negatively associated.ConclusionWe identified distinct NSD trajectories among preschoolers and associated early life factors. Some of them may reflect less healthy lifestyles, providing cues for early multi-behavioral prevention interventions.



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Addition of targeted agents to chemotherapy for persistent or recurrent ovarian cancer: a meta-analysis of randomized controlled trials

Publication date: Available online 30 June 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): Xiao Li, Yuchan Mao, Qiwen Wu, Yuanyuan Liu, Qianqian Wu, Binghuan Wen
AimThe majority of epithelial ovarian cancer patients who achieve a full remission following first-line chemotherapy would finally develop recurrent disease. However, the optimal management of recurrent ovarian cancer (ROC) remains undefined. The preset meta-analysis aims to evaluate the role of novel targeted agents (TAs) in the treatment of ROC in terms of response, overall survival and toxicities.Materials and methodsEligible studies were identified using Medline, Pubmed, and meeting abstracts. Searches were last updated on April 30, 2018. Eligible randomized controlled studies reported survival, toxicities and/or response data for ROC patients receiving novel TAs were included. Primary outcomes of interest were objective response rate (ORR), overall survival (OS), progression free survival (PFS) and adverse events (AEs).ResultsA total of 6,606 patients from 16 studies were eligible for analysis. The pooled results showed that the addition of novel TAs to chemotherapy significantly improved ORR (RR 1.63, 95%CI: 1.33-2.00, p < 0.001), PFS (0.78, 95%CI: 0.68-0.89, p < 0.001) and OS (HR 0.92, 95%CI: 0.87-0.99, p = 0.016) in ROC patients when compared to controls. Similar results in terms of ORR (RR 2.23, p < 0.001), PFS (HR 0.65, p < 0.001), and OS (HR 0.89, p = 0.015) were observed in platinum-sensitive ROC who received TAs. While the addition of novel TAs to chemotherapy significantly improved ORR (RR 1.84, p = 0.002) in platinum-resistant or refractory ROC, it did not translate into PFS (HR 0.83, p = 0.067) and OS (HR 0.94, p = 0.19) benefits. Sub-group analysis according to specific targeted agents showed that combination angiogenesis inhibitors with chemotherapy significantly improved PFS (HR 0.67, p = 0.018), but not for OS (HR 0.93, p = 0.31). As for toxicities, the use of TAs in ROC significantly increased the risk of developing serious AEs (RR 1.27, 95%CI: 1.08-1.50, p = 0.005) and AEs leading to treatment discontinuation (RR 1.93, 95%CI: 1.31-2.84, p = 0.001), but not for fatal AEs (RR: 1.49, 95% CI: 0.89–2.48, p = 0.13). In addition, correlation analysis indicates that PFS (r=0.86, p < 0.001) and ORR (r=0.85, p < 0.001) was strongly correlated with OS for ROC patients received TAs.ConclusionCombination treatment with novel TAs and chemotherapy significantly improved ORR, PFS and OS in platinum-sensitive ROC with an increased risk of severe adverse events. Conversely, we detect no statistically significant survival benefit in platinum-resistant or refractory ROC received TAs. Further prospective randomized studies are needed to confirm our findings and investigate more efficient agents in platinum-resistant or refractory ROC.



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Corrigendum to ‘Ramucirumab as second-line treatment in patients with advanced hepatocellular carcinoma following first-line therapy with sorafenib: Patient-focused outcome results from the randomised phase III REACH study’ [Eur J Canc 81 (2017) 17–25]

Publication date: Available online 30 June 2018
Source:European Journal of Cancer
Author(s): Ian Chau, Markus Peck-Radosavljevic, Christophe Borg, Peter Malfertheiner, Jean Francois Seitz, Joon Oh Park, Baek-Yeol Ryoo, Chia-Jui Yen, Masatoshi Kudo, Ronnie Poon, Davide Pastorelli, Jean-Frederic Blanc, Hyun Cheol Chung, Ari D. Baron, Takuji Okusaka, L. Bowman, Zhanglin Lin Cui, Allicia C. Girvan, Paolo B. Abada, Ling Yang, Andrew X. Zhu




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Laypeople roles at road traffic accident scenes: a systematic review

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Juvenile ocular myasthenia gravis: presentation and outcome of a large cohort

Publication date: Available online 30 June 2018
Source:Pediatric Neurology
Author(s): Kavin Vanikieti, Kasamon Lowwongngam, Tanyatuth Padungkiatsagul, Anannit Visudtibhan, Anuchit Poonyathalang
BackgroundIsolated ocular myasthenia gravis (MG) is very common in children relative to adults, ranging from 71–93% of all children with MG.PurposeTo characterize the ocular manifestations and outcomes in children with isolated ocular MG.MethodsMedical records of consecutive 62 subjects, <15 years of age with ocular MG, were retrospectively reviewed. Demographic data, presenting ocular features, types and variabilities of duction limitation, MG confirmatory tests, types of and responses to treatment, and generalized MG conversion were reviewed.ResultsMean age at onset and follow-up time were 49 months (range, 1–173 months) and 95 months (range, 6–226 months), respectively. Female-to-male ratio was 1.5:1. Initially, ptosis was found in 60 subjects (96.8%), while duction limitation was observed in 28 subjects (45.2%). Total ophthalmoparesis was the most common type of duction limitation. Variability of duction limitation was found in 68% of subjects during the follow-up. Pyridostigmine alone was the most common medication used (48.4%); ptosis was more responsive than duction limitation. Generalized MG conversion was found in 19.4% of subjects, with a mean interval of 9 months after symptom onset. Most conversions (91.7%) occurred in the first two years.ConclusionsPtosis was more responsive than duction limitation significantly. Thus, other treatment modalities, as well as strabismic amblyopia screening, should be considered in children with prolonged duction limitation refractory to medication. In contrast with adults, a much lower proportion of children converted to generalized MG. This may explain the higher prevalence of isolated ocular MG among the juvenile population.



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Clinical Characteristics and Burden of Illness in Pediatric Patients with Narcolepsy

Publication date: Available online 30 June 2018
Source:Pediatric Neurology
Author(s): Giuseppe Plazzi, Heather M. Clawges, Judith A. Owens
Narcolepsy is a chronic and lifelong neurologic disorder with onset commonly occurring in childhood or adolescence, and affecting approximately 0.025% to 0.05% of the general population. The primary symptom is excessive daytime sleepiness (EDS), which is accompanied by cataplexy in 70% of patients. Other common symptoms include sleep paralysis, hallucinations upon falling asleep or waking, and disrupted nocturnal sleep. Narcolepsy is associated with a considerable burden of illness (BOI), which has been well characterized in adults, and is exacerbated by delays in symptom recognition, diagnosis, and intervention. This review describes the specific characteristics and BOI of pediatric narcolepsy.Pediatric narcolepsy presents distinct challenges in diagnosis and management. Narcolepsy symptoms often initially manifest differently in children and adolescents versus adults, which may pose diagnostic dilemmas. Children often respond to sleepiness with irritability, hyperactivity, and poor attention, which may be misinterpreted as misbehavior or neurocognitive sequelae of other conditions. Pediatric cataplexy symptoms may include subtle and unusual facial expressions or choreic-like movements, which are not observed in adults. Insufficient sleep and circadian rhythm disorders presenting with EDS are common in adolescents, potentially confounding narcolepsy diagnosis. Pediatric narcolepsy is also associated with comorbidities including rapid weight gain, precocious puberty, and attention deficit hyperactivity disorder (ADHD), and increased risk for deficits in social functioning, depression, and anxiety. School performance is also typically impaired, requiring special education services. Thus, the discrete BOI of pediatric narcolepsy underscores the need for prompt and accurate diagnosis, and appropriate treatment of this disorder.



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Analysis of blood supply in the hard palate and maxillary tuberosity—clinical implications for flap design and soft tissue graft harvesting (a human cadaver study)

Abstract

Objectives

The aim of the present study is to provide a detailed macroscopic mapping of the palatal and tuberal blood supply applying anatomical methods and studying specific anastomoses to bridge the gap between basic structural and empirical clinical knowledge.

Materials and methods

Ten cadavers (three dentate, seven edentulous) have been prepared for this study in the Department of Anatomy, Semmelweis University, Budapest, Hungary, and in the Department of Anatomy of the Medical University of Graz. All cadavers were fixed with Thiel's solution. For the macroscopic analysis of the blood vessels supplying the palatal mucosa, corrosion casting in four cadavers and latex milk injection in other six cadavers were performed.

Results

We recorded major- and secondary branches of the greater palatine artery (GPA) and its relation to the palatine spine, different anastomoses with the nasopalatine artery (NPA), and lesser palatal artery (LPA) as well as with contralateral branches of the GPA. Penetrating intraosseous branches at the premolar-canine area were also detected. In edentulous patients, the GPA developed a curvy pathway in the premolar area. The blood supply around the maxillary tuberosity was also presented.

Conclusion

The combination of different staining methods has shed light to findings with relevance to palatal blood supply, offering a powerful tool for the design and execution of surgical interventions involving the hard palate.

Clinical relevance

The present study provides clinicians with a good basis to understand the anatomical background of palatal and tuberal blood supply. This might enable clinicians to design optimized incision- and flap designs. As a result, the risk of intraoperative bleeding and postoperative wound healing complications related to impaired blood supply can be minimized.

https://ift.tt/2KBk7kn

Iodonium salt incorporation in dental adhesives and its relation with degree of conversion, ultimate tensile strength, cell viability, and oxidative stress

Abstract

Objective

The aim of this study was to evaluate the degree of conversion, ultimate tensile strength, cell viability, and oxidative stress of two different ternary initiation systems, using two photoinitiation polymerization times.

Methods

The groups investigated were camphorquinone (CQ); CQ and diphenyleneiodonium hexafluorophosphate (DPI); CQ and ethyl 4-dimethylamine benzoate (EDAB); and CQ, EDAB, and DPI, with EDAB in high and low concentration. To assess the degree of conversion (DC) and the ultimate tensile strength (UTS), a real-time Fourier transform infrared spectroscopy and a universal test machine Emic DL-500 were used, respectively. Cell viability and oxidative stress were evaluated by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide), superoxide dismutase (SOD), total sulfhydryl (SH) content, and thiobarbituric acid reactive species (TBARS) formation assays.

Results

Slight lower cell viability was shown when DPI was associated with high concentrations of EDAB; this reduction seemed to be attenuated when lower concentrations of EDAB were used. When EDAB and DPI were associated, no oxidative damage was shown. The degree of conversion was increased in the ternary systems (CQ + EDAB lower concentration + DPI) group, which did not affect the UTS, cytotoxicity, and oxidative stress parameters. The polymerization time did not affect cell viability, total SH, and TBARS; however, a slight increase was shown in SOD levels.

Clinical relevance

Our study emphasizes the relevance of incorporating the third element—iodonium salt—in a binary adhesive systems composed exclusively of CQ and EDAB.

https://ift.tt/2Kotfg3

Designing of membrane-active nano-antimicrobials based on cationic copolymer functionalized nanodiamond: Influence of hydrophilic segment on antimicrobial activity and selectivity

Publication date: Available online 30 June 2018
Source:Materials Science and Engineering: C
Author(s): Weiwei Cao, Xi Wang, Qiang Li, Xuefeng Peng, Lina Wang, Peili Li, Zhiwen Ye, Xiaodong Xing
Designing cationic nano-antimicrobial is a promising solution for combating drug resistant microbes. In this work, hydrophilic cationic copolymer was applied for the surface functionalization of nanodiamonds (NDs) aiming at developing a highly membrane-active nano-antibacterial agent with satisfactory selectivity. As a result, after functionalization, the increased repulsive forces within NDs and interaction with solvent molecular network made the heavily aggregated pristine NDs break down into tiny nanoparticles with particle size ranging from 10 to 100 nm. The improved hydrophilicity and enlarged surface area endowed QND-H5 and QND-H10 a powerful bactericidal capability toward both of Gram-negative Escherichia coli (E. coli) and Gram-positive Staphylococcus aureus (S. aureus). In the further bactericidal assessment, it was also demonstrated that the formation of hydrogen bonding between the 2-hydroxyethyl methacrylate (HEMA) side chains and lipid head groups of bacterial membrane also contributed to the enhanced bactericidal ability. Field emission scanning electron microscopy analysis confirmed that as-prepared nano-hybrid acted bactericidal ability via physical nature of outer membrane and cytoplasmic membrane-separating destruction mechanism toward E. coli, which may derive from the hydrogen bonding ability, making them more effective toward bacterial. More importantly, it was found that with just 10% of HEMA, QND-H10 displayed good selectivity toward bacteria over mammalian cells as shown by the high HC50 values with relatively low MIC values, suggesting the great potential application in medical fields. These results indicate that hydrogen bonding is an important element to achieve the desired high antibacterial activity and selectivity, particularly when cationic nano-antibacterial agents are required for medical application.

Graphical abstract

https://ift.tt/2KAH6zc

Application of compressed sensing to 3D magnetic resonance cholangiopancreatography for the evaluation of pancreatic cystic lesions

Publication date: October 2018
Source:Magnetic Resonance Imaging, Volume 52
Author(s): Alessandro Furlan, Ersin Bayram, Senthur Thangasamy, Dale Barley, Anil Dasyam
The aim of this study was to assess changes in acquisition time, image quality and evaluation of pancreatic cysts when applying CS to a 3D MRCP sequence. Thirty subjects (17F; 13M) undergoing MRCP for evaluation of pancreatic cyst(s) were prospectively recruited and underwent 3D MRCP and CS 3D MRCP (CS factor = 2) on a 3T scanner. The acquisition time was recorded. Two experienced radiologists independently recorded quality of the images, presence of artifacts, visualization of the main pancreatic duct, bile ducts and index pancreatic cyst using a five-point scale. Presence of mural nodules and septations in the cyst, size of the cyst and caliber of the main pancreatic duct were also recorded. A paired sample t-test was used to compare the acquisition time of 3D MRCP and CS 3D MRCP. Image quality metrics and visualization of cyst features were compared with Wilcoxon signed-rank test and McNemar test.The mean acquisition time of CS-3D-MRCP (150 ± 63 s) was significantly lower than that of 3D-MRCP (317 ± 104 s; P < 0.001). The median score of overall quality (reader 1, 3.7 ± 1.0 vs. 3.4 ± 1.1, P = 0.11; reader 2, 3.8 ± 1.0 vs. 3.7 ± 1.1, P = 0.36), artifacts and visualization of the bile ducts were not significantly different between 3D-MRCP and CS-3D-MRCP. There was no significant difference in the visualization score of the index pancreatic cyst (reader 1, 4.2 ± 0.9 vs. 4.1 ± 0.9, P = 0.42; reader 2, 4.2 ± 0.4 vs. 4.0 ± 0.7, P = 0.27) and no difference in the assessment of cyst features. Applying CS to 3D-MRCP yields a two-fold reduction in acquisition time with comparable image quality and visualization of key pancreatic cyst features.



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Oral lichenoid reactions may possibly be associated with abatacept: A case report and literature update

Publication date: Available online 30 June 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Bethany Zembiec-Wheeler, Abberly Lott-Limbach, Hans Malmström, Sharon Elad
Oral Lichenoid Reactions (OLRs) are a group of conditions, with a common clinical appearance and histopathologic pattern that may be induced by several conditions or medications. This report describes an OLR possibly induced by a biologic agent. A 69-year-old woman with rheumatoid arthritis (RA) presented with a chief complaint of oral pain. The patient retroactively reported of skin lesions as well. Clinically, she had mixed red-white mucosal lesions and ulcers suggestive of an OLR. This diagnosis was supported by the histopathologic findings. Withholding the putative etiologic agent, abatacept, resulted in an immediate improvement of both oral and skin lesions.Abatacept and other biologics are thought to help treat inflammation and are becoming more commonly prescribed to treat RA. However, the clinicians should explore these medications as a causative factor for OLR.



https://ift.tt/2NeeJ8q

Can Platelet-Rich Fibrin Improve Healing After Surgical Treatment of Medication-Related Osteonecrosis of the Jaw? A Pilot Study

Publication date: Available online 30 June 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Amerigo Giudice, Selene Barone, Carmen Giudice, Francesco Bennardo, Leonzio Fortunato
ObjectiveThe aim of this study was to evaluate the efficacy of platelet-rich fibrin (PRF) after bone surgery compared to surgery alone in the treatment of medication-related osteonecrosis of the jaw (MRONJ).Study designA total of 47 patients with diagnosis of stage II or III of MRONJ were recruited at the Academic Hospital of Magna Graecia University of Catanzaro and allocated to 2 groups: in the first, patients were treated with PRF in addition to surgery (PRF group), in the other, only bone surgery was performed (non-PRF group). Fisher's exact and Student t tests were used to evaluate differences between the 2 surgical protocols in terms of mucosal integrity, absence of infection, and pain evaluation at scheduled follow-ups of 1 month (T1), 6 months (T2), and 1 year (T3).ResultsAnalysis of mucosal integrity, absence of infection, and pain evaluation showed a significant difference between the 2 groups in favor of PRF only at T1 (p<0.05), while no differences were determined at T2 and T3 (p>0.05).ConclusionOur results suggested that local application of PRF after bone surgery may improve the quality of life limited to the short-term follow-up and reduce pain and post-operative infections.



https://ift.tt/2yVJLPp

Bifid variations of the mandibular canal: cone beam computed tomographic evaluation of 1000 Northern Chinese patients

Publication date: Available online 30 June 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ya-Qiong Zhang, Ya-Ning Zhao, Deng-Gao Liu, Yuan Meng, Xu-Chen Ma
ObjectivesTo evaluate and quantify variations of bifid mandibular canals (BMCs) in a population of Northern China by using cone beam computed tomography (CBCT).Study designCBCT images of 1000 consecutive patients were analyzed using the NewTom proprietary software. BMCs were identified and classified based on Naitoh's classification. Linear and angular measurements of BMCs were performed. Statistical analyses were conducted using chi-squared and Wilcoxon tests.ResultsBMCs were observed in 13.2% of 1000 patients and 8.4% of 2000 sides. The prevalence of BMCs was significantly lower in patients in the first two decades and in cases with a Class II molar relationship. The retromolar canal (68.4%) was the most common type of BMC observed. No buccolingual canals were identified; however, two special canals were detected. A classification system of three subtypes of retromolar canals was suggested. On average, the beginning site of the branches from the opening of the main canal was at a distance of 8.1 mm. The mean diameter and length of BMCs were 2.1 mm and 12.6 mm, respectively.ConclusionThis study underlined the prevalence and characteristics of BMCs in a population of Northern China. Preoperative identification of BMCs with CBCT may help prevent postoperative complications.



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Oral lichenoid reactions may possibly be associated with abatacept: A case report and literature update

Publication date: Available online 30 June 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Bethany Zembiec-Wheeler, Abberly Lott-Limbach, Hans Malmström, Sharon Elad
Oral Lichenoid Reactions (OLRs) are a group of conditions, with a common clinical appearance and histopathologic pattern that may be induced by several conditions or medications. This report describes an OLR possibly induced by a biologic agent. A 69-year-old woman with rheumatoid arthritis (RA) presented with a chief complaint of oral pain. The patient retroactively reported of skin lesions as well. Clinically, she had mixed red-white mucosal lesions and ulcers suggestive of an OLR. This diagnosis was supported by the histopathologic findings. Withholding the putative etiologic agent, abatacept, resulted in an immediate improvement of both oral and skin lesions.Abatacept and other biologics are thought to help treat inflammation and are becoming more commonly prescribed to treat RA. However, the clinicians should explore these medications as a causative factor for OLR.



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Can Platelet-Rich Fibrin Improve Healing After Surgical Treatment of Medication-Related Osteonecrosis of the Jaw? A Pilot Study

Publication date: Available online 30 June 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Amerigo Giudice, Selene Barone, Carmen Giudice, Francesco Bennardo, Leonzio Fortunato
ObjectiveThe aim of this study was to evaluate the efficacy of platelet-rich fibrin (PRF) after bone surgery compared to surgery alone in the treatment of medication-related osteonecrosis of the jaw (MRONJ).Study designA total of 47 patients with diagnosis of stage II or III of MRONJ were recruited at the Academic Hospital of Magna Graecia University of Catanzaro and allocated to 2 groups: in the first, patients were treated with PRF in addition to surgery (PRF group), in the other, only bone surgery was performed (non-PRF group). Fisher's exact and Student t tests were used to evaluate differences between the 2 surgical protocols in terms of mucosal integrity, absence of infection, and pain evaluation at scheduled follow-ups of 1 month (T1), 6 months (T2), and 1 year (T3).ResultsAnalysis of mucosal integrity, absence of infection, and pain evaluation showed a significant difference between the 2 groups in favor of PRF only at T1 (p<0.05), while no differences were determined at T2 and T3 (p>0.05).ConclusionOur results suggested that local application of PRF after bone surgery may improve the quality of life limited to the short-term follow-up and reduce pain and post-operative infections.



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Bifid variations of the mandibular canal: cone beam computed tomographic evaluation of 1000 Northern Chinese patients

Publication date: Available online 30 June 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ya-Qiong Zhang, Ya-Ning Zhao, Deng-Gao Liu, Yuan Meng, Xu-Chen Ma
ObjectivesTo evaluate and quantify variations of bifid mandibular canals (BMCs) in a population of Northern China by using cone beam computed tomography (CBCT).Study designCBCT images of 1000 consecutive patients were analyzed using the NewTom proprietary software. BMCs were identified and classified based on Naitoh's classification. Linear and angular measurements of BMCs were performed. Statistical analyses were conducted using chi-squared and Wilcoxon tests.ResultsBMCs were observed in 13.2% of 1000 patients and 8.4% of 2000 sides. The prevalence of BMCs was significantly lower in patients in the first two decades and in cases with a Class II molar relationship. The retromolar canal (68.4%) was the most common type of BMC observed. No buccolingual canals were identified; however, two special canals were detected. A classification system of three subtypes of retromolar canals was suggested. On average, the beginning site of the branches from the opening of the main canal was at a distance of 8.1 mm. The mean diameter and length of BMCs were 2.1 mm and 12.6 mm, respectively.ConclusionThis study underlined the prevalence and characteristics of BMCs in a population of Northern China. Preoperative identification of BMCs with CBCT may help prevent postoperative complications.



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Visual imagination and the narrative image. Parallelisms between art history and neuroscience

Publication date: Available online 30 June 2018
Source:Cortex
Author(s): Gyöngyvér Horváth
Understanding visually presented stories requires intense effort from our visual imagination. Artists and theoreticians from the Renaissance onwards suggested various ways to depict stories, either to enhance their understanding and enjoyment, or to help adjust the depictions to the aesthetic ideas of the era. Alberti's concept of istoria, Leonardo's practice of visual stimulation, Lessing's advice on how to choose the most fruitful moment of a story relied both on personal experience and the scientific knowledge of the era. Visual imagination is specially needed in non-figurative and sequential narratives in modern and contemporary art, which are supported by Arnheim's notion of stroboscopic motion. Recent developments in image-making technologies enable some clarification of the processes involved in human perception with regard to the understanding of painted scenes and visually presented stories. The objective of this paper is to find the counterparts of these art theoretical concepts in psychology and neuroscience. Through the phenomena of mirror neurons, scene perception, gist of scene, and face and object recognition, these findings establish parallelisms between art history and neuroscience.



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Mental imagery in dentistry: Phenomenology and role in dental anxiety

Publication date: Available online 30 June 2018
Source:Journal of Anxiety Disorders
Author(s): Annegret Schneider, Jackie Andrade, Karin Tanja-Dijkstra, David R. Moles
Dental anxiety is a prevalent problem with marked psychological, physical and public health implications. Based on cognitive theory and evidence, we hypothesized that vivid, sensory image-based cognitions play a role in dental anxiety. A quantitative online survey (N = 306) and qualitative semi-structured interviews (N = 18) found that vivid sensory images were common irrespective of dental anxiety levels, but that their content, associated distress and responses varied. Participants reporting higher anxiety experienced intense and intrusive fear-provoking dental imagery focusing on unpleasant sensations, which were associated with the intrusive recollection of negative past experiences and avoidance of dentistry. Participants with lower anxiety ratings, reported images that were less distressing and centered around reassuring aspects and positive appointment outcomes, potentially acting as protective factors against dental anxiety and facilitating appointment attendance. The inclusion of components aimed at reducing intrusive memories and dental imagery rescripting may help improve interventions for dental anxiety.



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New insights on the anti-inflammatory potential and safety profile of Thymus carnosus and Thymus camphoratus essential oils and their main compounds

Publication date: 28 October 2018
Source:Journal of Ethnopharmacology, Volume 225
Author(s): Mónica Zuzarte, Jorge M. Alves-Silva, Melissa Alves, Carlos Cavaleiro, Lígia Salgueiro, Maria Teresa Cruz
Ethnopharmacological relevanceThymus camphoratus and T. carnosus are widely used in Portugal for the treatment of inflammatory-related conditions, such as inflammation of the respiratory tract, being the later also used as an antitussive.Aim of the studyBearing in mind the lack of scientific studies focused on the pharmacological activity of Thymus camphoratus and T. carnosus, this work was designed to validate the anti-inflammatory properties ascribed to these traditional species and concomitantly to unveil both the putative molecular mechanisms behind their bioactivity as well as the safety profile of their essential oils and major compounds.Materials and methodsThe chemical composition of the essential oils was assessed by gas chromatography (GC) and gas chromatography – mass spectroscopy (GC/MS). The nitric oxide (NO) scavenging potential of the oils was tested using S-nitroso-N-acetyl-D,L-penicillamine (SNAP) as NO donor. The anti-inflammatory potential of the essential oils and their major compounds was evaluated by measuring the nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated macrophages as well as the expression of the pro-inflammatory enzymes, inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Importantly, and in an attempt to assess the safety profile of the oils and respective major compounds, their effect on macrophages and hepatocytes viability was also determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.ResultsT. carnosus essential oil was characterized by high amounts of borneol and camphene whereas T. camphoratus oil was rich in 1,8-cineole and borneol. The later presented higher pharmacological activity showing inhibitory effects towards NO production at lower concentrations (0.16 µL/mL) and concomitantly inhibiting the expression of two crucial pro-inflammatory proteins, iNOS and COX-2 (at 0.32 µL/mL). Since no NO scavenging activity was achieved, it is reasonable to conclude that the anti-inflammatory activity of the essential oils occurs upstream of iNOS expression, probably through inhibition of relevant pro-inflammatory signal transduction pathways. Importantly, at bioactive concentrations, the essential oils were devoid of toxicity towards macrophages and hepatocytes. The activity of the isolated compounds was far from that observed for the essential oils, thus suggesting that the anti-inflammatory activity is due to a synergic effect between several compounds in the mixture.ConclusionOverall, the results herein presented sustain and strengthen the anti-inflammatory properties traditionally ascribed to T. carnosus and T. camphoratus. Additionally, the molecular mechanisms associated to their pharmacological activity were highlighted, opening new avenues for the development of effective anti-inflammatory herbal medicinal products.

Graphical abstract

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A phylogenetic road map to antimalarial Artemisia species

Publication date: 28 October 2018
Source:Journal of Ethnopharmacology, Volume 225
Author(s): Jaume Pellicer, C. Haris Saslis-Lagoudakis, Esperança Carrió, Madeleine Ernst, Teresa Garnatje, Olwen M. Grace, Airy Gras, Màrius Mumbrú, Joan Vallès, Daniel Vitales, Nina Rønsted
Ethnopharmacological relevanceThe discovery of the antimalarial agent artemisinin is considered one of the most significant success stories of ethnopharmacological research in recent times. The isolation of artemisinin was inspired by the use of Artemisia annua in traditional Chinese medicine (TCM) and was awarded a Nobel Prize in 2015. Antimalarial activity has since been demonstrated for a range of other Artemisia species, suggesting that the genus could provide alternative sources of antimalarial treatments. Given the stunning diversity of the genus (c. 500 species), a prioritisation of taxa to be investigated for their likely antimalarial properties is required.Materials and methodsHere we use a phylogenetic approach to explore the potential for identifying species more likely to possess antimalarial properties. Ethnobotanical data from literature reports is recorded for 117 species. Subsequent phylogenetically informed analysis was used to identify lineages in which there is an overrepresentation of species used to treat malarial symptoms, and which could therefore be high priority for further investigation of antimalarial activity.ResultsWe show that these lineages indeed include several species with documented antimalarial activity. To further inform our approach, we use LC-MS/MS analysis to explore artemisinin content in fifteen species from both highlighted and not highlighted lineages. We detected artemisinin in nine species, in eight of them for the first time, doubling the number of Artemisia taxa known to content this molecule.ConclusionsOur findings indicate that artemisinin may be widespread across the genus, providing an accessible local resource outside the distribution area of Artemisia annua.

Graphical abstract

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Silicon improves salt tolerance of Glycyrrhiza uralensis Fisch. by ameliorating osmotic and oxidative stresses and improving phytohormonal balance

Abstract

Si has a beneficial effect on improving plant tolerance to salt stress. Nevertheless, the mechanisms of Si in mediating the stress responses are still poorly understood. Glycyrrhiza uralensis Fisch. (G. uralensis), a well-known medicinal plant, possesses vast therapeutic potentials. In the present study, a pot experiment was conducted to investigate the long-term effects of Si on growth and physiobiochemical characteristics in 2-year-old G. uralensis subjected to different levels of salinity. Si markedly affected G. uralensis growth in a salt concentration-dependent manner and had no effect on G. uralensis growth under 6 g/kg NaCl. However, it partly reversed the reduction effect induced by 9 g/kg NaCl. In addition, Si significantly increased the contents of soluble sugar and protein but deceased proline content and thus increased water relations; Si markedly increased the activities of SOD, peroxidase, and CAT and further resulted in decreased MDA content and membrane permeability. Moreover, Si altered the levels of phytohormones and their balances. With correlation analysis and principal component analysis (PCA), root biomass had a significant negative correlation with MDA and membrane permeability while a positive correlation with indole-3-acetic acid and GA₃. The PCA partitioned the total variance into three PCs contributing maximum (88.234%) to the total diversity among the salt stress with or without Si due to the study of various traits. In conclusion, Si exerts a beneficial property on salt-induced harmful effects in G. uralensis by relieving osmotic stress, improving water relations, and alleviating oxidative stress; thus, altering the levels and balance of phytohormones results in improved growth of salt-stressed G. uralensis.

https://ift.tt/2yUCajO

Fractal Dimension of EEG Signals and Heart Dynamics in Discrete Emotional States

Publication date: Available online 30 June 2018
Source:Biological Psychology
Author(s): Elisabeth Ruiz Padial, Antonio J. Ibáñez-Molina
In this study, we explored the fractal dimension (FD; a measure of signal complexity) of 28 EEG channels with positive and negative emotional states. The EEG of participants and their ECG were registered while watching short video clips that induced fear, disgust, humour, or neutral emotions. In order to better understand the nature of these emotions, the Higuchi FD of EEG segments and the heart rate variability (HRV) of the ECG associated with each emotion were obtained. Our results exhibited similar patterns of results with both measures. Humour elicited the highest FD scores in most EEG channels and the highest HRV, while fear, among all emotions, produced the lowest scores in both measures. These results may contribute to the understanding of the relationship between cortical and heart dynamics and their role on emotion perception.



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Oxytocin levels in the saliva of preterm infant twins during Kangaroo care

Publication date: Available online 30 June 2018
Source:Biological Psychology
Author(s): D. Kommers, M. Broeren, G. Oei, L. Feijs, P. Andriessen, S. Bambang Oetomo
Background and purposeTo investigate whether Kangaroo care (KC) influences the salivary oxytocin (OT) concentration in preterm infants, and which correlates affect the OT response.MethodsEleven twin pairs participated in a study in which we collected saliva using cotton swabs twice a day, once during KC and once during baseline conditions (lying in bed or incubator). The total study duration was five days. The saliva of twin siblings were pooled to obtain vials with sufficient volumes of either saliva collected during KC or at baseline. OT levels were measured using a radio-immuno assay. The infants' state of comfort and parent-infant interaction were examined using previously developed Likert-scales, amongst other correlates such as the KC duration, gestational age and birth weight.ResultsDuring KC, OT was lower compared to baseline (mean 1.39 pg/ml (SD 0.58 pg/ml) versus 2.40 pg/ml (SD 1.64 pg/ml), p =  0.03). Comfort at baseline and parent-infant interaction seemed to influence OT responses.ConclusionThe OT concentration in the pooled saliva of preterm infant twins decreased during KC. This response of the OT system might be explained by stress during baseline.



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No central adrenal insufficiency found in patients with Prader-Willi syndrome with an overnight metyrapone test

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


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The contemporary timing of trauma deaths

BACKGROUND The distribution of trauma deaths was classically described as trimodal. With advances in both technology and trauma systems, this was reevaluated and found to be bimodal in the early 2000s. Over the last decade there have been continued improvements in trauma and intensive care unit (ICU) care, related to damage control techniques and evidence based ICU pathways. A better understanding of the distribution of trauma deaths may be used to improve trauma systems. This study aimed to evaluate the contemporary distribution of trauma deaths after the widespread implementation of modern trauma and critical care principles. METHODS This study included patients entered in the NTDB from 2008 to 2014. For dead patients, hospital length of stay was equated to time until death. Additional data was collected to include demographics, mechanism of injury, Injury Severity Score, and Abbreviated Injury Scale score. Histograms were plotted to demonstrate peaks in deaths. Survival analysis was performed with Kaplan-Meier curves and Gehan-Breslow generalized Wilcoxon tests. RESULTS 4,185,009 patients were analyzed. Thirty-four percent of all deaths occurred within the first 24 hours of admission. The factors most associated with death in the first 24 hours were severe abdominal trauma (73%), penetrating trauma (55%), and severe extremity trauma (58%). Among patients with penetrating trauma and an abdominal Abbreviated Injury Scale score of 4 or higher, 83% of deaths occurred within 24 hours. When plotted, the distribution of deaths was seen to fall rapidly after the first 24 hours and continued to be flat for 30 days in all subgroups analyzed. CONCLUSION In this study, the distribution of trauma deaths no longer appears to be trimodal. This may reflect advances in trauma and ICU care, and the widespread adaption of damage control principles. Early deaths, however, remains a significant challenge, specifically from non-compressible abdominal hemorrhage and extremity trauma. Primary prevention and early hemorrhage control must continue to be a focus of research and trauma systems. LEVEL OF EVIDENCE Epidemiologic, level IV.

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No significant cancer mortality increase after the TMI accident

Publication date: September 2018
Source:Medical Hypotheses, Volume 118
Author(s): Alfred Körblein




https://ift.tt/2yXvul6

Risk of gastric cancer following percutaneous endoscopic gastrostomy: A nationwide population-based cohort study

Publication date: September 2018
Source:Medical Hypotheses, Volume 118
Author(s): Chih-Cheng Tsao, Shih-Yu Lee, Wei-Kuo Chang, Kuen-Tze Lin, Sheng-Der Hsu, Chen-Liang Tsai, Chun-Shu Lin
ObjectivesTo investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is associated with increased risk of gastric cancer.MethodsWe conducted a nationwide population-based retrospective study in Taiwan. Inpatient data from 1997 to 2010 were collected from Taiwan National Health Insurance Research Database. Patients with age less than 20 years; those with histories of PEG before 2000; those with histories of cancers; and those diagnosed with gastric cancer before or within 6 months of the first PEG procedure were excluded. Finally, 3505 patients who underwent PEG were included (PEG cohort), along with 7010 randomly-selected individuals, matched by age, sex, and year of index date, as the control cohort.ResultsAfter adjusting for age, sex, peptic ulcer, gastritis, hypertension, diabetes and coronary artery disease, risk of gastric cancer was significantly higher in the PEG cohort (adjusted hazard ratio, 5.31; 95% confidence interval, 4.12–6.00; p = 0.011). Patients with 2 or more PEG procedures were significantly associated with increasingly developing gastric cancer risk (adjusted hazard ratio, 2.73; 95% confidence interval, 1.91–3.85; p < 0.001). The possible hypothesis may be due to chronic inflammation caused by chemical and physical conditions of the tube.ConclusionsPatients with PEG might be associated with a greater risk of subsequent gastric cancer in Taiwan. Physicians should be aware of the link when assessing patients with PEG.



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Intracranial pressure and glaucoma: Is there a new therapeutic perspective on the horizon?

Publication date: September 2018
Source:Medical Hypotheses, Volume 118
Author(s): Peter Wostyn, Debby Van Dam, Peter Paul De Deyn
Primary open-angle glaucoma is one of the leading causes of irreversible blindness worldwide. Raised intraocular pressure is the most important modifiable risk factor and lowering it remains the mainstay therapeutic approach for slowing optic nerve damage and visual field progression in glaucoma patients. An intriguing finding of clinical retrospective and prospective studies is that intracranial pressure is lower in patients with glaucoma. Furthermore, in a recent study on monkeys subjected to an implantation of a lumboperitoneal cerebrospinal fluid shunt to lower intracranial pressure, chronic reduction in intracranial pressure was associated with the development of glaucoma-like pathology in half of the monkeys. In addition, a very recent study demonstrated that patients whose intracranial pressure has been lowered following ventriculoperitoneal shunt placement, as treatment for normal pressure hydrocephalus, have a significantly increased risk of developing normal-tension glaucoma. These findings suggest that a reduced intracranial pressure may play an important role in the pathogenesis of glaucoma. This may be due to an abnormally high pressure difference across the lamina cribrosa resulting in biomechanical changes of the optic nerve head and/or to a deficient clearance of toxic substances, particularly in the subarachnoid space of the optic nerve and/or in the 'ocular glymphatic system'. The search for drugs or medical devices useful to ameliorate glaucoma by lowering the trans-lamina cribrosa pressure difference and/or by facilitating cerebrospinal fluid circulation may therefore be an important area for future research. In this article, we propose that infusion of artificial cerebrospinal fluid through an implantable pump into the intrathecal space surrounding the spinal cord could be a new promising strategy for the treatment of glaucoma. Although the implantation of such a cerebrospinal fluid pump is a relatively invasive intervention, it seems worthwhile to make every effort to identify new therapies for patients who suffer from this devastating disease, especially given the significant number of patients for whom non-invasive treatment options are ineffective.



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Theoretical basis for a new approach of studying Emery-Dreifuss muscular dystrophy by means of thermography

Publication date: September 2018
Source:Medical Hypotheses, Volume 118
Author(s): A. Cabizosu, N. Carboni, A. Martinez-Almagro Andreo, J.M. Vegara-Meseguer, N. Marziliano, G. Gea Carrasco, G. Casu
IntroductionEmery-Dreifuss muscular dystrophy (EDMD) is a clinical condition characterized by neuro-skeletal and cardiac impairments. By means of thermography, an image acquisition technique that allows the recording of the heat emitted by objects or bodies, news insight can be obtained insights about the evaluation and follow-up of this disease. Actually, musculoskeletal disorders are a major cause of counseling and access to rehabilitation services and are some of the most important problems that affect the quality of life of many people. There are urgent both clinical and research needs for the assessment and follow-up of patients with Emery-Dreifuss muscular dystrophy and the thermography is a rapid, non-invasive, easy to use and objective technique that analyzes the temperature of the examined tissue.HypothesisThe main aim is to offer a new possible hypothesis of validating the thermography techniques that support the evaluation and clinical follow-up of the Emery-Dreifuss dystrophy. To carry out this work we rely on the evidence of the existing bibliography. To perform this work and to evaluate the current situation on this topic, a systematic review was carried and after the application of an automatic and manual filter, inclusion and exclusion criteria, a total of 0 articles was obtained. Unfortunately, there is a lack of articles that relate the use of thermography in the Emery-Dreifuss muscular dystrophy. Due to the absence of information, we have expanded the search to articles concerning the use of thermography in relation to alterations of the musculoskeletal system compatible with those of Emery-Dreifuss, genetic diseases related to the X chromosome and more generally muscular atrophy. Based on other studies and results carried out in diseases that show signs and symptoms similar to Emery-Dreifuss Muscular Dystrophy, we believe that a new line of translational research could be opened with novel findings and we think that thermography could be an optimal tool for the clinical monitoring of this pathology. We believe that it would be of a great importance to carry out an observational study, to lay the foundations for future works, that relate thermography to the Emery-Dreifuss muscular dystrophies.



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Unified neural structured model: A new diagnostic tool in primary care psychiatry

Publication date: September 2018
Source:Medical Hypotheses, Volume 118
Author(s): Tetsuya Akaishi
Overlap of multiple mental disorders in each psychiatric patient has been emphasized and the style of assessment and intervention in each patient has been gradually changed. A new practical structured model that can comprehensively explain and assess the major mental disorders integratedly has been desired.In this report, the relationships between each of the major mental disorders and each neuropsychiatric component like personality, reward system, or reinforcement learning have been comprehensively reviewed to construct a new integrated structured model for assessing the overlapped mental conditions in primary care psychiatry. This new structured model contains the following three loops: "input-output-feedback loop" (external/environmental loop), "reward-learning loop" (learning loop), and "mood-reward sensitivity loop" (mood loop), which are connected by the functions of prefrontal cortex and basal ganglia. With this new concept, overlapped mental conditions in each psychiatric patient could be theoretically much simply and logically explained.In conclusion, with the proposed psychiatric structured model, we can simply explain and understand the overlapped mental disorders in each patient. Inventing and developing such basic psychiatric structured model would offer us new diagnostic and therapeutic tools to realize personalized medicine, especially in the field of primary care psychiatry.



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Association between insomnia and type 2 diabetes mellitus in Han Chinese individuals in Shandong Province, China

Abstract

Purpose

Diabetes and sleep disorders are public health threats worldwide, but the potential association between them is still unclear.

Methods

We conducted a community-based cross-sectional study including 5078 participants (2665, 52.5% male) to determine the association between insomnia and diabetes mellitus prevalence.

Results

In patients with type 2 diabetes mellitus (T2DM) and nondiabetic controls, the prevalence of insomnia was 20.2% (68/377) and 12.2% (578/4741), respectively. The results showed that insomnia was associated with T2DM after adjusting for age, sex, BMI, smoking, alcohol consumption, presence of disease history (hypertension, dyslipidemia, stroke, cardiovascular diseases, cancers), and depression (odds ratio [OR] = 1.31, 95% confidence interval [CI] 1.03–1.66). After stratifying by age and sex, insomnia was significantly associated with diabetes mellitus only in the subgroup of middle-aged participants (40–59 years) (OR = 1.61, 95% CI 1.16–2.23) and males (OR = 1.48, 95% CI 1.08–2.03) after controlling for the above covariates.

Conclusions

This study suggests that insomnia is independently and significantly associated with diabetes mellitus in the northern Chinese population, especially in the 40–59-year-old age group and in males.

https://ift.tt/2yTXmqs

Evaluation of an UltraFast LabChip V280 assay for detection of toxigenic Clostridium difficile

Publication date: Available online 30 June 2018
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Xingxing Xu, Yun Luo, Xiaojun Song, Jianfei Ying, Julian Ye, Yong Lu, Jian Cai, Jian Ma, Xianjun Wang, Wanjun Yu, Yiping Wang, Dazhi Jin
In this study, we compared the performance of an UltraFast LabChip (UL) V280 system for Clostridium difficile detection in stool with that of Xpert C. difficile/Epi and VIDAS CDAB. Among 176 stool specimens, UL V280 detected toxigenic C. difficile in 22 (22/176, 12.5%) with a sensitivity, specificity, positive predictive value, negative predictive value (NPV) of 100.0%, 99.4%, 99.5% and 100.0%, respectively, which were higher than 95.2%, 97.4%, 83.3%, and 99.3% of Xpert C. difficile/Epi (P > 0.05). Notably, the sensitivity and NPV of ULV280 were significantly higher than those of VIDAS CDAB 52.4% (P < 0.001, odds ratio [OR] = 20.0, 95% confidence interval [CI] = 2.26-176.81) and 93.8% (P = 0.002, OR = 10.27, 95% CI = 1.30-81.17). UL V280 turnaround time (35 min) and cost (6.24 Dollars [$]) per specimen were less than those for Xpert C. difficile/Epi (47 min, 59.26 $) and VIDAS CDAB (65 min, 11.70 $). UL V280 possessed an analytical sensitivity limit of 2500 CFU/ml, 95% [CI] = (Ct: 30.76-34.90), and no cross-reactions with other pathogens were found. The study demonstrates that UL V280 based on a microfluidic chip is a rapid, accurate, easy, and cost-effective diagnostic test for toxigenic C. difficile in stool.



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Prospective evaluation of vancomycin pharmacokinetics in a heterogeneous critically-ill population

Publication date: Available online 30 June 2018
Source:Diagnostic Microbiology and Infectious Disease
Author(s): R. Brigg Turner, Kyle Kojiro, Regina Won, Eric Chang, Dominic Chan, Fawzy Elbarbry
Rich pharmacokinetic data on vancomycin in critically-ill patients are lacking. The purpose of this study was to evaluate the pharmacokinetics of vancomycin in this population using rich pharmacokinetic sampling.Nineteen critically-ill patients received individualized vancomycin doses by intermittent infusion to achieve target trough concentrations (15–20mg/L). Blood samples were collected following the 3rd or later dose of vancomycin. Serial blood samples were collected at 30minutes following initiation of the vancomycin infusion, at the end of the infusion, serially at 60, 120, 300, and 480minutes after the infusion finished, and immediately prior to the next dose. Vancomycin concentration-time profiles at steady state were fit to a noncompartmental model to determine the pharmacokinetic parameters.Vancomycin trough concentration was correlated to AUC0–24 (r=0.83, P<0.001). Total body weight was a predictor of volume of distribution (r=0.43, p=0.03). Age, serum creatinine, and creatinine clearance (CrCl) were found to be predictors for vancomycin clearance (r=−0.67, −0.52, and 0.72, respectively). CrCl was the best predictor of vancomycin CL and addition of other variables to a multivariate model failed to improve model fit.Vancomycin trough concentration may not be an adequate surrogate of AUC0–24. Additional research is needed to determine dosing strategies to optimize AUC0–24 while limiting toxicity.



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A mediated multigroup model examining marijuana use consequences by sexual orientation in us college students

Publication date: December 2018
Source:Addictive Behaviors, Volume 87
Author(s): Jamie E. Parnes, Mark A. Prince, Bradley T. Conner
Marijuana use holds a curvilinear relation to sexual orientation, whereby bisexual individuals reporter higher frequency of use than exclusively hetero- or homosexual individuals. This relation differs by gender, with more pronounced differences among women. Bisexual individuals are at greater risk for negative consequences of marijuana use, such as dependence. To mitigate potential risks, individuals employ protective behavioral strategies (PBS). While differences in use are known, research has yet to examine if consequences and PBS use vary by sexual orientation. This study seeks to address the relations between sexual orientation, consequences, gender, and PBS. It was hypothesized that orientation would be associated with consequences, mediated by PBS, and these relations would vary by gender. College students (N = 8141) from 11 different universities completed an online survey measuring marijuana consequences, PBS use, and sexual orientation. A final analytic sample (n = 2091) was composed of participants who indicated past 30-day marijuana use (60% women, 64% White, mean age 19.92). Path analysis was used to test all study hypothesis. Results indicated a curvilinear relation between sexual orientation and consequences among men, however not women. Moreover, PBS use mediated the relation between orientation and consequences among men, and negatively predicted consequences among women. Conclusions include that mixed sexual orientation men experience higher consequences through lower PBS use. For women, PBS use buffers against consequences. These findings reflect a general effectiveness of PBS use for mitigating negative marijuana-related consequences. The implications of these results are discussed.



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Sex differences in affect-triggered lapses during smoking cessation: A daily diary study

Publication date: December 2018
Source:Addictive Behaviors, Volume 87
Author(s): Sylvie Messer, Atara Siegel, Lauren Bertin, Joel Erblich
IntroductionSmoking lapses during a cessation attempt are common and are thought to be a key predictor of full relapse. Positive and negative affective states have been hypothesized as important precipitants of lapses during quit attempts, although findings have been mixed. Accumulating evidence suggests that women may smoke more when experiencing negative affective states, while men may smoke more when experiencing positive affective states. The possibility that these sex differences may play a role in predicting lapses during a smoking cessation attempt, however, has not been well-investigated. In this study, we hypothesized that, during a quit attempt, negative affect would be more strongly associated with lapses among women, and positive affect would be more strongly associated with lapses among men.MethodWe conducted a prospective study in which male and female nicotine-dependent smokers (n = 60) made an unaided, 'cold-turkey' quit attempt. For fourteen days following the initiation of the quit attempt, participants completed daily diaries in which they recorded the degree to which states of 'good mood' and 'bad mood' preceded smoking lapses.ResultsConsistent with the study hypothesis, findings indicated that men reported higher good-mood-induced smoking lapses than women across the 14-day study interval. Conversely, while levels of bad-mood-induced smoking subsided over the 14-day interval among men, levels persisted among women.DiscussionResults further underscore the need to address sex-specific affective triggers when developing smoking cessation strategies.



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Comparing cigarette and e-cigarette dependence and predicting frequency of smoking and e-cigarette use in dual-users of cigarettes and e-cigarettes

Publication date: December 2018
Source:Addictive Behaviors, Volume 87
Author(s): Meghan Morean, Suchitra Krishnan-Sarin, Stephanie S. O'Malley
IntroductionThe 4-item Patient-Reported Outcomes Measurement Information System Nicotine Dependence Item Bank is a psychometrically sound measure for assessing cigarette (PROMIS) and e-cigarette dependence (PROMIS-E). We evaluated whether dual-users of cigarettes and e-cigarettes self-report experiencing different levels of dependence on each product. We subsequently examined whether cigarette and e-cigarette dependence are associated with the frequency of using each product in dual-users.MethodsDual-users completed an online survey in Summer 2017 (n = 326; 49.7% male, 85.3% White, mean age 38.17 [13.08] years). Measurement invariance of the PROMIS and PROMIS-E was evaluated. Mean differences in cigarette and e-cigarette dependence then were examined. The correlation between cigarette and e-cigarette dependence also was examined. Finally, one-way MANOVA was used to evaluate how cigarette and e-cigarette dependence relate to past-month frequency of e-cigarette use and cigarette smoking.ResultsThe PROMIS and the PROMIS-E were scalar measurement invariant, and, on average, dual-users reported stronger dependence on cigarettes than on e-cigarettes. Cigarette and e-cigarette dependence were related, yet distinct constructs (r = 0.35), suggesting that dual-users can discriminate between dependence on each product. Stronger cigarette dependence predicted more frequent past-month smoking and less frequent past-month vaping. Stronger e-cigarette dependence predicted more frequent past-month vaping and less frequent smoking.ConclusionsOverall, dual-users reported stronger dependence on cigarettes than on e-cigarettes. However, dependence on each product was associated with increased use of each respective product and with less frequent use of the other product. Future research using the PROMIS can evaluate how potential FDA regulations could reduce nicotine dependence across products.



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Ecotoxicological evaluation of electrochemical oxidation for the treatment of sanitary landfill leachates

Abstract

In this study, the efficiency of electrochemical oxidation to treat a sanitary landfill leachate was evaluated by the reduction in physico-chemical parameters and in ecotoxicity. The acute toxicity of the sanitary landfill leachates, before and after treatment, was assessed with the model organism Daphnia magna. Electrochemical oxidation treatment was effective in the removal of organic load and ammonium nitrogen and in the reduction of metal ions concentrations. Furthermore, a reduction of 2.5-fold in the acute toxicity towards D. magna after 36 h of treatment was noticed. Nevertheless, the toxicity of the treated leachate is still very high, and further treatments are necessary in order to obtain a non-toxic effluent to this aquatic organism. Toxicity results were also compared with others described in the literature for different leachate treatments and test organisms.

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The spatial distribution of phosphorus and their correlations in surface sediments and pore water in Lake Chaohu, China

Abstract

The study presents the spatial distribution of different forms of phosphorus in the sediments in Lake Chaohu, a large eutrophic Chinese lake, and their correlation with phosphorus content in pore water. The sediment and pore water samples were taken from 19 sampling sites. A sequential extraction was used to determine the contents of different forms of phosphorus in the sediments. The compositions and spatial distribution of different forms of phosphorus in the sediments and their correlation with orthophosphate and total phosphorus content in the pore water were studied. The following results were obtained: (1) the mean content of total phosphorus was 474.7 ± 20.5 mg/kg, with 390.8 ± 82.4 mg/kg for the eastern lake (N = 5), 469.0 ± 53.9 mg/kg for the western lake (N = 5), and 524.5 ± 185.3 mg/kg for rivers (N = 9); (2) the order of the proportions of the different forms of phosphorus was occluded phosphorus (Oc-P, 52.4%) > debris phosphorus (De-P, 14.2%) > auto-calcium-bound phosphorus (ACa-P, 13.5%) > aluminum-bound phosphorus (Al-P, 9.8%) > organic phosphorus (Or-P, 6.8%) > exchangeable phosphorus (Ex-P, 2.1%) > iron-bound phosphorus (Fe-P, 1.3%); (3) Ex-P, Al-P, and Fe-P had significantly positive correlations with orthophosphate and total phosphorus content in pore water, which showed that these forms of phosphorus were released more easily and had an indirect impact on lake eutrophication.

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Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) for Improving Oromotor Function in Newborns

Publication date: Available online 30 June 2018
Source:Brain Stimulation
Author(s): Bashar W. Badran, Dorothea D. Jenkins, William H. Devries, Morgan Dancy, Philipp M. Summers, Georgia M. Mappin, Henry Bernstein, Marom Bikson, Patricia Cocker-Bolt, Mark S. George




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Within-subject test-retest reliability of the atlas-based cortical volume measurement in the rat brain: A voxel-based morphometry study

Publication date: 1 September 2018
Source:Journal of Neuroscience Methods, Volume 307
Author(s): Bin Jing, Bo Liu, Hui Li, Jianfeng Lei, Zhanjing Wang, Yutao Yang, Phillip Zhe Sun, Bing Xue, Hesheng Liu, Zhi-Qing David Xu
BackgroundVarious neurological and psychological disorders are related to cortical volume changes in specific brain regions, which can be measured in vivo using structural magnetic resonance imaging (sMRI). There is an increasing interest in MRI studies using rat models, especially in longitudinal studies of brain disorders and pharmacologic interventions. However, morphometric changes observed in sMRI are only meaningful if the measurements are reliable. To date, a systematic evaluation of the test-retest reliability of the morphometric measures in the rat brain is still lacking.New methodWe rigorously evaluated the test-retest reliability of morphometric measures derived from the voxel-based morphometry (VBM) analysis. 37 Sprague-Dawley rats were scanned twice at an interval of six hours and the gray matter volume was estimated using the VBM-DARTEL method. The intraclass coefficient, percent volume change and Pearson correlation coefficient were used to evaluate the reliability in 96 subregions of the rat brain.ResultsMost subregions showed excellent test-retest reliabilities within an interval of 6 h while a few regions demonstrated lower reliability, especially in the retrosplenial granular cortex. The results were consistent between different methods of reliability assessment.Comparison with existing methodTo the best of our knowledge, this is the first study to quantify the test-retest reliability of the VBM measurements of the rat brain.ConclusionAtlas-based cortical volume of the rat brain can be reliably estimated using the VBM-DARTEL method in most subregions. However, findings in subregions with lower reliability must be interpreted with caution.



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Common polymorphism in the glycine N-methyltransferase gene as a novel risk factor for cleft lip with or without cleft palate

Publication date: Available online 30 June 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): N. Karas Kuželički, A. Šmid, T. Kek, A. Eberlinc, K. Geršak, I. Mlinarič-Raščan
The objective of this study was to identify new environmental and genetic risk factors for orofacial clefts that arise during early foetal development. In this retrospective, case–control, mother–child pair study, 172 orofacial clefts cases and 199 healthy controls, and their respective mothers, were genotyped for common variants in relevant genes obtained by text and database mining using STRING 10.0. Exposure to environmental risk factors was evaluated using questionnaires. Variant glycine N-methyltransferase (odds ratio (OR) 2.1, 95% confidence interval (95% CI) 1.0–4.4) and dihydrofolate reductase (OR 2.4, 95% CI 1.3–4.5) genotypes were identified as risk factors for cleft lip with or without cleft palate formation. Furthermore, synergy was detected between variant glycine N-methyltransferase and dihydrofolate reductase genotypes in promoting cleft lip with or without cleft palate formation (OR 7, 95% CI 2–23). This study is novel in finding that common glycine N-methyltransferase variant genotypes increase the risk of cleft lip with or without cleft palate.



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Complete spontaneous regression of a metastatic melanoma of the mandible: a case report and follow-up recommendations

Publication date: Available online 30 June 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): J. Schlabe, K.A. Shah, F. Sheerin, M.J. Payne, A.A. Fasanmade
Regression of metastatic melanoma is very rare and occurs in only 0.23% of cases. Metastasis to the oral cavity is particularly uncommon and accounts for only 1–3% of all oral malignancies. This report presents a case of spontaneous and complete regression of a metastatic melanoma in the mandibular ramus. The patient remains asymptomatic more than 2 years after diagnosis. The patient was followed up regularly. It is recommended that further surveillance imaging be performed in asymptomatic patients following discussion with the surgical and oncological teams. This type of surveillance, together with new systemic treatments, is advocated due to its potential to increase long-term survival even after relapse.



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Common polymorphism in the glycine N-methyltransferase gene as a novel risk factor for cleft lip with or without cleft palate

Publication date: Available online 30 June 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): N. Karas Kuželički, A. Šmid, T. Kek, A. Eberlinc, K. Geršak, I. Mlinarič-Raščan
The objective of this study was to identify new environmental and genetic risk factors for orofacial clefts that arise during early foetal development. In this retrospective, case–control, mother–child pair study, 172 orofacial clefts cases and 199 healthy controls, and their respective mothers, were genotyped for common variants in relevant genes obtained by text and database mining using STRING 10.0. Exposure to environmental risk factors was evaluated using questionnaires. Variant glycine N-methyltransferase (odds ratio (OR) 2.1, 95% confidence interval (95% CI) 1.0–4.4) and dihydrofolate reductase (OR 2.4, 95% CI 1.3–4.5) genotypes were identified as risk factors for cleft lip with or without cleft palate formation. Furthermore, synergy was detected between variant glycine N-methyltransferase and dihydrofolate reductase genotypes in promoting cleft lip with or without cleft palate formation (OR 7, 95% CI 2–23). This study is novel in finding that common glycine N-methyltransferase variant genotypes increase the risk of cleft lip with or without cleft palate.



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Complete spontaneous regression of a metastatic melanoma of the mandible: a case report and follow-up recommendations

Publication date: Available online 30 June 2018
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): J. Schlabe, K.A. Shah, F. Sheerin, M.J. Payne, A.A. Fasanmade
Regression of metastatic melanoma is very rare and occurs in only 0.23% of cases. Metastasis to the oral cavity is particularly uncommon and accounts for only 1–3% of all oral malignancies. This report presents a case of spontaneous and complete regression of a metastatic melanoma in the mandibular ramus. The patient remains asymptomatic more than 2 years after diagnosis. The patient was followed up regularly. It is recommended that further surveillance imaging be performed in asymptomatic patients following discussion with the surgical and oncological teams. This type of surveillance, together with new systemic treatments, is advocated due to its potential to increase long-term survival even after relapse.



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HBV infection and extra-hepatic cancers in adolescents and 20s: A retrospective study in China

Publication date: August 2018
Source:Cancer Epidemiology, Volume 55
Author(s): Tingna Lu, Qing Yang, Mei Li, Jiqing Zhang, Jing Zou, Lu Huang, Jianhua Lin, Haosheng Jin, Jiman He
BackgroundThe mean age at cancer diagnosis is younger in hepatitis B virus (HBV) infected than non-infected patients. It remains unknown whether this association reflects an increase in the incidence rates of extra-hepatic cancers in adolescents and younger.MethodsWe examined 10 common extra-hepatic cancers (lung, breast, gastric, prostate, esophageal, rectal, cervical, nasopharyngeal, lymphatic, and urinary bladder) among patients diagnosed at three Chinese hospitals during 2007–2016. We compared the percentage distribution (frequencies at each age point are shown as a percentage of the total frequency) of HBsAg+ with HBsAgˉ patients, and calculated the standardized incidence ratio for each age group.ResultsA total of 60,323 patients were identified. The mean age at cancer diagnosis was 1.5–5.5 years younger in hepatitis B surface antigen (HBsAg) positive patients compared to HBsAgˉ patients (p ≤ 0.001). Lymphoma patients had the highest prevalence rate of HBV infection (20.7%). Among the pooled HBsAg+ cancer patients, 14.8% (1138/7666) were aged ≤39 years; by contrast, 9.7% (5122/52657) of HBsAgˉ cancer patients were in the same age range, giving an odds ratio of 1.6 [95%CI1.509–1.733)]. The observations were similar when each cancer was considered individually. The odds ratio was greater in pooled male patients aged ≤39 years [1.9(95%CI1.705–2.085)] compared with females [1.6(95%CI1.382–1.83)]. The ratio of the observed to the expected number of HBsAg+ patients aged 15–19, 20–24, and 25–29 years were 3.3, 4.8 and 2.0, respectively, higher than 1.2–1.7 observed for older age-groups.ConclusionHBV infection is a risk factor for diverse extra-hepatic cancers in adolescents and 20s.



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Sex differences in disordered eating and food addiction among college students

Publication date: 1 October 2018
Source:Appetite, Volume 129
Author(s): Zhiping Yu, Natalie Arce Indelicato, Paul Fuglestad, Michael Tan, Lindsay Bane, Caitlin Stice
This cross-sectional study aimed to assess sex differences and weight status differences in disordered eating behaviors (DEB) and food addiction (FA) along with their co-occurrence among college students. Self-reported demographic and weight information, the Eating Attitude Test (EAT-26), and Yale Food Addiction Scale (YFAS) were collected from 965 college students. Participants included 703 (72.8%) female, 720 (74.8%) white, and ranged in age from 18 to 25 years old. Female college students had a significantly higher prevalence of DEB (11.6% vs. 5.7%, p = 0.007, odds ratio (OR) = 2.19) and higher prevalence of FA (12.3% vs. 4.6%, p < 0.0001, OR = 3.04) than male students. The co-occurrence was also significantly higher in female students than in male students (5.4% vs. 1.9%, p = 0.022, OR = 3.03). Male and female obese participants versus healthy weight participants had higher prevalence of DEB (15.1% vs.8.6%, p = 0.047, OR = 1.91) and FA (19.4% vs. 8.9%, p = 0.002, OR = 2.51). Higher prevalence of DEB was positively associated with FA regardless of sex and weight status. The findings indicate higher prevalence of disordered eating in female college students than male students and add to the research on sex differences in food addiction. The co-occurrence of both and association between high prevalence of DEB and FA warrant additional research on the incidence as well as factors that contribute to sex differences. Understanding sex differences and comorbidity regarding DEB and FA is critical for the prevention and treatment of eating related disorders.



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A geo-ethnographic analysis of low-income rural and urban women's food shopping behaviors

Publication date: 1 September 2018
Source:Appetite, Volume 128
Author(s): Lillian MacNell
Many scholars have found evidence that low-income neighborhoods contain fewer supermarkets, but there is a lack of consensus regarding whether and how this matters to residents. A few qualitative studies have asked food desert residents about their experiences of their food environments, while a small number of other studies have utilized spatial analyses to examine actual shopping behaviors. To better understand barriers to food access, this study combines the two in a geo-ethnographic analysis. This study draws on data from a USDA-funded project about families and food to combine quantitative geographic data with qualitative interview data of 100 rural and urban low-income mothers of young children. For each participant, the nearest supermarket, as well most-frequented supermarket, was mapped, and distances to stores were calculated. On average, participants traveled more than twice as far as their nearest supermarket to reach a preferred store. Interviews with participants were conducted to assess the motivations and strategies of shoppers, in particular why they chose to bypass their nearest supermarkets. They shared a variety of reasons for doing so; foremost to find lower prices of food in order to stretch income and SNAP benefits. Access to transportation also played a major role in determining where people shopped for food. This research challenges scholars, policymakers, and health practitioners to look beyond proximate food environments to consider the lived experiences of food desert residents. Efforts to address poor food access should aim to increase household income, in addition to providing targeted food and nutrition assistance.

Graphical abstract

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An investigation of relationships between disordered eating behaviors, weight/shape overvaluation and mood in the general population

Publication date: 1 October 2018
Source:Appetite, Volume 129
Author(s): Felipe Q da Luz, Amanda Sainsbury, Haider Mannan, Stephen Touyz, Deborah Mitchison, Federico Girosi, Phillipa Hay
Disordered eating behaviors and cognitions have been extensively examined in samples of individuals with eating disorders, as well as in non-clinical samples. However, such examinations are lacking in the general population. We investigated disordered eating behaviors and cognitions in a community representative sample of 6052 participants in South Australia, aged 15–99 years. Participants were interviewed regarding weight/shape overvaluation, strict dieting, binge eating, purging, low mood and body mass index (BMI). Linear and logistic regression analyses were used to estimate the direct effects between these features. Steiger's Z test was used to compare the difference between the semi-partial associations of low mood and strict dieting with binge eating. Our findings suggest that similar relationships between strict dieting, low mood, purging and binge eating to those shown in the trans-diagnostic cognitive-behavioral model of eating disorders in clinical samples occur in the general community. However, in the general population, strict dieting was associated with elevated BMIs (and not with low BMIs as predicated by the model). Although this study does not ascertain any causal relationships in the observed associations, public health messages or services for weight reduction in people with higher body weights could potentially benefit from integration with messages addressing mood disorders and purging, in order to reduce potential adverse effects on disordered eating behaviors.



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Towards more sustainable food systems. Addressing food waste at school canteens

Publication date: 1 October 2018
Source:Appetite, Volume 129
Author(s): Belén Derqui, Vicenç Fernandez, Teresa Fayos
Food Waste is a global significant issue for ethical, environmental and economic reasons, while its management is difficult due to its frequent low visibility. Individual choices and preferences are closely related to the generation of food waste although likely to be modified through education and awareness campaigns. In particular, school canteens are big generators of food waste and, at the same time, provide a great opportunity to improve habits regarding nutrition and education on sustainability, thus impacting the future of the food system. The end purpose of this research is identifying the causes of food waste and unveiling best practices towards its reduction. To achieve this goal, we have designed and developed a mixed methods research approach including semi-structured interviews with managers and staff in schools and catering firms and waste audits at four school canteens - measuring waste from over 10,000 pupil's trays. In order to avoid potential bias due to meal preference, the audit lasted three to five consecutive weekdays per school, thus comprising different menus. We estimated overall food waste between 60 and 100 g per pupil per day. Plate waste represented the highest source of waste, although a big disparity was found among the schools based on their different educational perspectives. Key food waste determinants found were: first, top management standpoint towards food waste and sustainability in general. Secondly, we observed relevant differences among the three catering business models studied, regarding the stages where food waste is usually produced. Finally, food waste was also impacted by the diverse resource availability among the schools. Despite this, the human factor arose as the most relevant one when aiming to minimise food waste.



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