bluuebunny/crossref_metadata_2025 huggingface dataset:
Low utility of ocular screening in sarcoidosis in Finland
Authors: Joukainen Elli , Antonen Jaakko , Leinonen Sanna
Published: September 2023

Purpose

Systematic ocular screening is recommended in sarcoidosis, because of a high rate of ocular involvement. The purpose of this study was to determine whether ocular screening is useful in sarcoidosis in a Finnish university hospital population with 0.5 M inhabitants.

Methods

Patient charts of patients with sarcoidosis, without a history of ocular sarcoidosis, without ocular inflammatory symptoms, and with a comprehensive eye exam from January 2014 to January 2021 at Tays Eye Centre, Tampere, Finland, were studied.

Results

Five of 262 patients (2%) were diagnosed with asymptomatic uveitis. No other types of ocular sarcoidosis were found. Anterior uveitis without complications was present in three patients, unilaterally in two and bilaterally in one patient. Posterior uveitis was present in two patients, a unilateral choroidal granuloma requiring treatment in one and bilateral punched‐out chorioretinal lesions in the other patient.

Conclusions

With this low rate of ocular involvement requiring treatment in sarcoidosis, systematic screening for asymptomatic ocular sarcoidosis does not seem useful in a Finnish population. In Tays Eye Centre, systematic screening of ocular sarcoidosis was discontinued in 2021.
Endothelial cell plasticity in kidney fibrosis and disease
Authors: Pohl Layla , Schiessl Ina Maria
Published: September 2023

Renal endothelial cells demonstrate an impressive remodeling potential during angiogenic sprouting, vessel repair or while transitioning into mesenchymal cells. These different processes may play important roles in both renal disease progression or regeneration while underlying signaling pathways of different endothelial cell plasticity routes partly overlap. Angiogenesis contributes to wound healing after kidney injury and pharmaceutical modulation of angiogenesis may home a great therapeutic potential. Yet, it is not clear whether any differentiated endothelial cell can proliferate or whether regenerative processes are largely controlled by resident or circulating endothelial progenitor cells. In the glomerular compartment for example, a distinct endothelial progenitor cell population may remodel the glomerular endothelium after injury. Endothelial‐to‐mesenchymal transition (EndoMT) in the kidney is vastly documented and often associated with endothelial dysfunction, fibrosis, and kidney disease progression. Especially the role of EndoMT in renal fibrosis is controversial. Studies on EndoMT in vivo determined possible conclusions on the pathophysiological role of EndoMT in the kidney, but whether endothelial cells really contribute to kidney fibrosis and if not what other cellular and functional outcomes derive from EndoMT in kidney disease is unclear. Sequencing data, however, suggest no participation of endothelial cells in extracellular matrix deposition. Thus, more in‐depth classification of cellular markers and the fate of EndoMT cells in the kidney is needed. In this review, we describe different signaling pathways of endothelial plasticity, outline methodological approaches and evidence for functional and structural implications of angiogenesis and EndoMT in the kidney, and eventually discuss controversial aspects in the literature.
Fibroscan liver stiffness after anti‐viral treatment for hepatitis C is independently associated with adverse outcomes
Authors: Vutien Philip , Kim Nicole J. , Moon Andrew M. , Pearson Meredith , Su Feng , Berry Kristin , Gelman Hannah , Ioannou George N.
Published: September 2023

Background

Fibroscan‐derived liver stiffness decreases after anti‐viral treatment for hepatitis C virus (HCV) infection, which may affect the associations and interpretation of liver stiffness.

Aims

To assess whether liver stiffness pre‐ or post‐anti‐viral therapy is associated with the development of decompensated cirrhosis, hepatocellular carcinoma (HCC) or death.

Methods

In this retrospective cohort study, we identified US veterans who initiated HCV treatment and had at least one liver stiffness before (n = 492) or after (n = 877) HCV therapy. We used Cox proportional hazards regression (adjusting for age, race/ethnicity, history of cirrhosis, body mass index, diabetes, FIB‐4 score, Charlson comorbidity index, alcohol use disorder, Model for end‐stage liver disease score and sustained virological response status) to determine the associations between pre‐ or post‐treatment liver stiffness values and the development of decompensated cirrhosis, HCC, death or liver transplant.

Results

In the post‐treatment liver stiffness cohort, during a mean follow‐up of 27.3 months, 21 (2.4%) developed decompensated cirrhosis, 26 (3.0%) developed HCC and 57 (6.5%) died or underwent liver transplant. Compared to patients with post‐treatment liver stiffness ≤12.5 kPa, those with post‐treatment liver stiffness >20 kPa, had higher rates of developing decompensated cirrhosis (adjusted HR 3.85, 95% CI 1.29‐11.50) and the composite outcome of death, liver transplant, decompensated cirrhosis or HCC (adjusted HR 1.95, 95% CI: 1.07‐3.56). There were no significant associations between pre‐treatment liver stiffness and any outcomes on multivariable analysis.

Conclusions

Post‐treatment liver stiffness >20 kPa, but not pre‐treatment liver stiffness, was independently associated with the development of decompensated cirrhosis and the composite outcome in multivariable analyses. Measuring liver stiffness should be considered after anti‐viral treatment because it predicts adverse outcomes even beyond routinely available clinical predictors.
Collagen proportionate area predicts clinical outcomes in patients with alcohol‐related liver disease
Authors: Israelsen Mads , Guerrero Misas Marta , Koutsoumourakis Anastasios , Huang Yi , Thiele Maja , Hall Andrew , Rasmussen Ditlev , Covelli Claudia , Buzzetti Elena , Prat Laura Iogna , Roccarina Davide , Detlefsen Sönke , Luong Tu Vinh , Quaglia Alberto , Krag Aleksander , Jeffrey Gary , Pinzani Massimo , Tsochatzis Emmanuel A.
Published: September 2023

Background

No prognostic tools are established for alcohol‐related liver disease (ALD). Collagen proportionate area (CPA) measurement is a technique that quantifies fibrous tissue in liver biopsies using digital image analysis.

Aim

To assess the predictive value of CPA on hepatic decompensation and liver‐related mortality in ALD

Methods

In a multicentre cohort study, we included 386 patients with biopsy‐verified ALD and with long‐term follow‐up. In the development cohort of 276 patients, we assessed the predictors of hepatic decompensation and liver‐related death in standard and competing risk multivariable Cox regression analyses. The results were validated in an independent prospective cohort of 110 patients, where CPA was also correlated with liver stiffness measurement (LSM).

Results

In the development cohort, 231 (84%) patients had early/compensated ALD (non‐cirrhotic or compensated cirrhosis) and 45 (16%) had decompensated cirrhosis. In the validation cohort, all patients had early/compensated ALD. Independent predictors of liver‐related mortality were higher CPA values (HR = 1.04, 95% CI 1.02‐1.04) and advanced fibrosis (HR = 2.80, 95% CI 1.29‐6.05) with similar results in standard and competing risk multivariable Cox regression analysis. In early/compensated ALD, CPA was the only independent predictor of hepatic decompensation and liver‐related death (HR = 1.08, 95% CI 1.06‐1.11). In the prospective cohort, we validated that CPA independently predicts hepatic decompensation in early/compensated ALD. The predictive power of CPA and LSM was equally strong.

Conclusions

CPA predicts liver‐related mortality in ALD and hepatic decompensation and/or liver‐related death in early/compensated ALD. Traditional histological assessment may benefit from the addition of CPA to the evaluation of ALD.
Child abuse and neglect: A comparative study between dental and medical students' competencies in Germany
Authors: Meyer Lisa‐Marie , Lehmann Thomas , Schüler Ina Manuela
Published: September 2023

Introduction

Despite children's right to a non‐violent upbringing, they become daily victims of violence. Physical violence concerns mostly the head—especially the orofacial area. Therefore, dentists and paediatricians should be able to suspect possible abuse and to initiate child protection. This study aimed to record and compare the training situation and competencies of dental and medical students at Jena University Hospital regarding child abuse and neglect (CAN).

Materials and Methods

Using a three‐part questionnaire about CAN, 123 medical and 77 dental students were surveyed anonymously after completing all courses on the topic. The question sets included as follows: (1) educational experiences, training content and satisfaction; (2) current knowledge regarding diagnostic, management and legal concerns; (3) self‐evaluation, needs of further education and wishes. Reliability of the questionnaire was tested with kappa‐statistics and assessed as good.

Results

Dental and medical students' overall satisfaction with CAN‐related training is low. Although medical students had more knowledge on CAN, all participants showed large deficits. Better diagnostic than management skills were reported in both groups. Only 1.3% dental and 16.3% medical students felt adequately prepared to deal with CAN. 7% of all study participants stated that they can report CAN without any help. 87.0% of medical and 79.2% of dental students expressed a desire for further education. To improve their knowledge, both courses prefer seminars, followed by expert talks, lectures and simulation‐based training (SkillsLab).

Conclusion

Dental and medical students are inadequately prepared to suspect possible abuse and to deal with possible signs of CAN. Mandatory interdisciplinary courses and lectures addressing CAN are recommendable for both medical and dental curricula.
Sunscreens can preserve human skin microbiome upon erythemal UV exposure
Authors: Schuetz Rolf , Claypool Joshua , Sfriso Riccardo , Vollhardt Juergen H.
Published: September 2023

Objective

Ultraviolet radiation (UVR) is a known environmental key factor for premature skin ageing. Only few scientific evidence is available to support the effects of UVR on the skin microbiome. This in vivo pilot study aimed to evaluate the impact on the skin microbiome upon erythemal UV exposure and the protection of UV‐exposed skin microbiome by UV filters.

Methods

Ten female volunteers were treated with an sun protection factor (SPF) 20 sunscreen and placebo formulation (without UV filters) on their upper middle backs and irradiated with an erythemal dose (2 MED) by a solar simulator. Skin swabbing samples from four zones (i.e., unexposed, exposed, sunscreen‐ and placebo‐treated on exposed skin) were collected for the microbiome analysis before and 2 h after UV exposure, respectively, and processed via shallow 16S rRNA Amplicon and Shotgun metagenomic sequencing. An in vitro UV method was developed to confirm the protection of isolated bacterial strains by single UV filters and combinations.

Results

Alpha diversity was impacted by significant inter‐individual differences and by treatment rather than by irradiation. Cutibacterium acnes was found to be the most abundant and a confounding factor for diversity. On a species level, Lactobacillus crispatus was negatively associated with UVR and placebo treatment, whereas there was a positive association with sunscreen treatment. The sunscreen treatment also favoured an interaction network with central Micrococcus genus. The in vitro results showed that both single UV filters and combinations had specific effects on the survival rates of L. crispatus, C. acnes, and Staphylococcus epidermidis.

Conclusion

We identified potential microorganisms and bacterial interactions that were associated with an SPF 20 sunscreen treatment. The specific protection of L. crispatus as a key player in the UV‐exposed skin microbiome and reduction of C. acnes population by UV filters might lead to new cosmetic concepts for photoprotection.
Description of a new laboratory evaluation method of interdental brush abrasion as a clinical hazard
Authors: Schmidlin Patrick R. , Schmidlin Tim M. , Gubler Andrea , Brändli Stephan , Attin Thomas
Published: September 2023

Objectives

To simulate the abrasive potential of an interdental brush when applied with toothpastes and prophylactic gels/solutions in a novel laboratory brushing simulation set‐up.

Methods

A brushing device was customized to treat dentin samples mimicking a simplified interdental space with an interdental brush (ISO 2). The brushing, that is, 7200 strokes for 1 h, was performed with artificial saliva (control), a povidone‐iodine solution, and slurries of chlorhexidine and fluoride gels as well as three toothpastes with different RDA values ranging from 29 to 100, respectively. The loss of dentin was profilometrically assessed and compared with ANOVA and Fishers LSD.

Results

While artificial saliva as control, the solution and the gel slurries showed no measurable dentin loss, toothpastes resulted in a measurable linear surface damage with respect to the actual intrinsic RDA values and ranged from 12.6 to 26.5 μm (p < 0.001).

Conclusions

Any interdental cleaning product should be tailored and carefully instructed. Any over‐ and misuse should be avoided, which applies especially to the use of interdental brushes in combination with abrasive toothpastes.
Enabling educator oral health literacy: An impetus for oral health promotion in early childhood development
Authors: Gordon Natalie Ann , Brijlal Priscilla , Rayner Chrisleen Ann , Abdullah Mubeena , Funa Mthunzi
Published: September 2023

Introduction

This study reports on the process evaluation of an oral health promotion intervention for educators (principals and teachers) at early childhood development (ECD) centres within a low‐socioeconomic community in South Africa. This approach was based on the premise that oral health literacy plays a significant role in shaping personal health and serves as an impetus to influence change in others.

Methods

Using a cross‐sectional, descriptive study design, 91 educators participated in the oral health intervention as part of their 1‐year ECD training programme. The pre‐test questionnaire measured perceived dental status, oral health‐related knowledge, attitudes and practices and impact of oral health problems on oral health‐related quality of life (OHRQoL). The post‐test questionnaire evaluated the usefulness of the oral health workshop to participants, intentions for personal change as well as for the inclusion of oral health in their ECD centre programme.

Results

Participants reported: having their natural teeth (80%), being happy with their mouth (56.2%), having oral problems (34%), inadequate oral hygiene practices (43%), dental visits when symptomatic (74%), a compromised OHRQoL and inadequate knowledge of oral problems experienced. Oral health promotion activities at ECD centres were limited, with only 34% reporting on toothbrushing programmes. Following the intervention, participants reported positively on aspects such as, the value of the workshop for themselves and their ECD centres, intentions for personal change to hygiene practices (56%), dietary practices (76%) and dental visits (63%). The incorporation of oral health education in their ECD centres was mentioned by most educators. Daily toothbrushing was noted by up to 40% while some highlighted their engagement with parents.

Conclusion

Building oral health literacy among educators has the potential for personal change and serves as an impetus to introduce oral health promotion programmes at ECD centres. The findings may be used to advocate for oral health partnerships with established community‐based structures to increase access to oral care in ECD centres in underserved communities.
Distribution of grammar learning through writing tasks: A potential role of proficiency
Authors: He Jiani , Suzuki Yuichi
Published: September 2023

The present study examines the optimal schedule of second language (L2) grammar practice. Fifty‐four English‐as‐a‐foreign language learners practiced using hypothetical conditionals through written production‐based dictogloss tasks, accompanied by an explicit grammatical explanation, in three learning sessions over several weeks. Learners in the longer spaced group engaged in dictogloss tasks at intervals of 7 days (Day 1, 8, and 15), while those in the shorter spaced group did so at intervals of 3.5 days (Day 1, 4, and 8). Results showed that shorter spaced and longer spaced learning led to equally accurate use of the hypothetical conditionals on both 3‐week and 6‐week delayed posttests. The effects of practice condition on 6‐week delayed posttest performance were moderated by L2 proficiency. Specifically, the retention rate after 6 weeks was greater for more proficient learners than for less proficient learners, but only in the shorter spaced group. Due to the exploratory nature of this study with small sample size, we call for more empirical research that explores the interaction between practice distribution and individual differences, including but not limited to L2 proficiency.
Nurses' and patient' descriptions about forms of power in pro re nata medication participation in forensic psychiatric care: A qualitative secondary analysis
Authors: Hipp Kirsi , Kangasniemi Mari , Varpula Jaakko , Lantta Tella
Published: September 2023

Despite there being an emphasis on patient participation in their own care, it has been a challenge in pro re nata (PRN, as the circumstance arises) medication in forensic psychiatric care. The power imbalance in treatment relationships can be a barrier to patient participation and should therefore be further explored. This qualitative descriptive study aimed to explore the aspect of power in the descriptions of patients and nurses interviewed in a Finnish forensic psychiatric hospital about patient participation in PRN. A qualitative secondary analysis was conducted through the semi‐structured interviews of the patients (n = 34) and nurses (n = 19). The data were analysed with deductive content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used to ensure comprehensive reporting. The findings revealed that patients and health professionals may have conflicting goals in PRN and that they both use power to try to achieve them. Power in PRN was described in different forms, including authority, force, manipulation and persuasion. Based on our results, the power that health professionals have in PRN medication is particularly based on their legitimate authority and the hierarchical structures of the hospital environment. Patients also hold power in the dynamics of PRN medication care, but their position as a power holder can vary individually and situationally. Recognizing different forms of power and supporting patients with a decreased capacity for decision‐making is essential for promoting high‐quality and patient‐centred forensic psychiatric nursing.
Challenges and success in periodontal plastic surgery
Authors: Pini Prato GiovanPaolo , Di Gianfilippo Riccardo
Published: September 2023

To truly understand a field of study, one must delve into its past and examine the challenges and successes that have shaped its current practices. In the case of periodontal plastic surgery, recognizing how challenges induced changes over the last 70 years—from the 1950s to today—is essential to fully comprehend its evolution. This editorial provides a perspective on the field, highlighting the interrelationships between influential surgical techniques and advancements in research methodology. With each event building upon the last, the evolution of periodontal plastic surgery is a story of scientific progress and ongoing research, fostering a sense of community and shared knowledge.
Persistence and recovery of SARS‐CoV‐2 from abiotic and biotic surfaces found in meat processing plants
Authors: Russell Tristan , Macori Guerrino , Russell Lauren , Mulcahy Grace , Sammin Dónal , Fanning Séamus , Barry Gerald
Published: September 2023

The meat processing industry was negatively affected by the COVID‐19 pandemic. The unique conditions in meat processing plants (MPPs) were recognized to have the potential to increase SARS‐CoV‐2 transmission. Should SARS‐CoV‐2 persist for extended periods in these built environments, this may contribute to increased risk of virus transmission. To test this hypothesis, SARS‐CoV‐2 persistence was assessed in conditions reflective of a MPP. Different biotic/abiotic materials were inoculated with SARS‐CoV‐2 and recovery of viable virus measured over time. Findings showed it was possible to recover SARS‐CoV‐2 from beef, pork, and salmon for at least 22 days at −20°C and for at least 12 days at +4°C. SARS‐CoV‐2 recovery from salmon scales and salmon flesh was similar, but viable virus recovered from pork fat was significantly reduced compared to pork meat. In parallel, foods purchased from Irish supermarkets during a COVID‐19 wave were contemporaneously tested for the presence of SARS‐CoV‐2 RNA but none of the samples tested positive by RT‐qPCR. Viable SARS‐CoV‐2 can be inactivated on food or abiotic surfaces by incubation at 56°C or 75°C but fomite transmission during MPP outbreaks cannot be ruled out due to the recovery of SARS‐CoV‐2 from stainless steel and work clothing fabric for up to 10 h under representative conditions. These data support a multilayered approach to reducing the risk of airborne infections such as SARS‐CoV‐2 that should include mitigations such as increased ventilation, mask wearing, and the disinfection of work surfaces to reduce the amount of SARS‐CoV‐2 in the meat processing plant environment.
Increased alpha‐synuclein and neuroinflammation in the substantia nigra triggered by systemic inflammation are reversed by targeted inhibition of the receptor for advanced glycation end products (RAGE)
Authors: Peixoto Daniel Oppermann , Bittencourt Reykla Ramon , Gasparotto Juciano , Kessler Flávio Gabriel Carazza , Brum Pedro Ozorio , Somensi Nauana , Girardi Carolina Saibro , dos Santos da Silva Lucas , Outeiro Tiago Fleming , Moreira José Cláudio Fonseca , Gelain Daniel Pens
Published: September 2023

The receptor for advanced glycation end products (RAGE) is a protein of the immunoglobulin superfamily capable of regulating inflammation. Considering the role of this receptor in the initiation and establishment of neuroinflammation, and the limited understanding of the function of RAGE in the maintenance of this condition, this study describes the effects of RAGE inhibition in the brain, through an intranasal treatment with the antagonist FPS‐ZM1, in an animal model of chronic neuroinflammation induced by acute intraperitoneal injection of lipopolysaccharide (LPS). Seventy days after LPS administration (2 mg/kg, i.p.), Wistar rats received, intranasally, 1.2 mg of FPS‐ZM1 over 14 days. On days 88 and 89, the animals were submitted to the open‐field test and were killed on day 90 after the intraperitoneal injection of LPS. Our results indicate that blockade of encephalic RAGE attenuates LPS‐induced chronic neuroinflammation in different brain regions. Furthermore, we found that intranasal FPS‐ZM1 administration reduced levels of gliosis markers, RAGE ligands, and α‐synuclein in the substantia nigra pars compacta. Additionally, the treatment also reversed the increase in S100 calcium‐binding protein B (RAGE ligand) in the cerebrospinal fluid and the cognitive‐behavioral deficits promoted by LPS—less time spent in the central zone of the open‐field arena (more time in the lateral zones), decreased total distance traveled, and increased number of freezing episodes. In summary, our study demonstrates the prominent role of RAGE in the maintenance of a chronic neuroinflammatory state triggered by a single episode of systemic inflammation and also points to possible future RAGE‐based therapeutic approaches to treat conditions in which chronic neuroinflammation and increased α‐synuclein levels could play a relevant role, such as in Parkinson's disease.

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Live vaccines following intravenous immunoglobulin for Kawasaki disease: Are we vaccinating appropriately?
Authors: Cardenas‐Brown Cassandra , Lucas Ryan D , Buttery Jim , Britton Philip N , Wood Nicholas , Singh‐Grewal Davinder , Burgner David
Published: September 2023

Aim

Australian and New Zealand guidelines recommend that live vaccines be postponed for 11 months after treatment of Kawasaki disease (KD) with intravenous immunoglobulin (IVIG). We aimed to describe patterns of live‐vaccine administration after KD treatment, focusing on the measles–mumps–rubella/measles–mumps–rubella–varicella (MMR/MMRV) vaccines, and to compare real‐world practice with current recommendations.

Methods

We combined data from inpatient Electronic Health Records and the Australian Immunisation Register for all children who received IVIG for the treatment of KD under the age of 5 years at two Australian tertiary children's hospitals over a 12‐year period. Children who received IVIG <11 months before a scheduled MMR/MMRV were deemed ‘at risk’ of breaching the guidelines, and those whose subsequent vaccination occurred <11 months after the IVIG were deemed to have ‘breached’ the guidelines.

Results

Of those at risk, three‐quarters (76%) breached the guidelines for their first MMR/MMRV. Findings were similar (50%–80%) for the second MMR/MMRV dose.

Conclusions

The majority of Australian children treated for KD with IVIG may not be optimally protected by MMRV vaccination. Immunisation systems should address this avoidable risk.
Elucidation of common molecular diagnostic biomarkers between chronic periodontitis and Parkinson's disease via bioinformatics analyses
Authors: Zehui Wen , Mengting Zhao , Pengfei Liu , Yuanyin Wang , Jianguang Xu , Tao Wu
Published: September 2023

Background and Objectives

Parkinson's disease (PD) and chronic periodontitis (CP) are both inflammatory diseases; a correlation between the two diseases has been reported, but the underlying mechanisms of this association have not been investigated. We investigated the common molecular mechanisms between PD and CP and the role of immune cells in the pathogenesis of them using bioinformatics analyses to elucidate the association between the two diseases.

Methods

We obtained gene expression data from the Gene Expression Omnibus (GEO) database: GSE10334, GSE16134, and GSE23586 for CP gingival samples and GSE20146 for PD brain samples. Subsequently, we conducted an enrichment analysis of the differentially expressed genes (DEGs) using the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses. Moreover, all DEGs were analysed for protein–transcription factor interactions and protein–immune cell co‐expression. We constructed protein–transcription factor, protein–protein interaction (PPI), and protein–immune cell co‐expression networks using the Cytoscape software. Moreover, we identified the hub genes and investigated them for potential diagnostic value.

Results and Conclusion

We identified 99 DEGs in the three CP datasets, 520 DEGs in the PD dataset and found five common DEGs in the CP and PD datasets, namely CXCR4, CXCL8, CD19, RPTN, and SLC16A9. These common DEGs identified in our study may have a potential impact on disease pathogenesis through the involvement of CXCR4‐CXCL8‐CD19 protein‐complexes in dendritic cells. Therefore, CD19, LCP2, CXCR4, and LYN could be used as target molecules for the clinical diagnosis of both diseases.
Comparative effectiveness of hypoglossal nerve stimulation and alternative treatments for obstructive sleep apnea: a systematic review and meta‐analysis
Authors: Kim Do Hyun , Kim Sung Won , Han Jae Sang , Kim Geun‐Jeon , Park Jeong Hae , Basurrah Mohammed Abdullah , Kim Sun Hong , Hwang Se Hwan
Published: September 2023

Continuous positive airway pressure (CPAP) is the primary therapeutic modality for obstructive sleep apnea (OSA) management. However, despite efforts to encourage patients to comply with CPAP usage, long‐term adherence remains low. Consequently, surgical intervention for OSA is considered a secondary option for patients who exhibit non‐compliance with CPAP. Therefore, we conducted systematic review and meta‐analysis assessed the relative effectiveness of hypoglossal nerve stimulation (HNS) treatment and alternative surgical interventions for managing OSA. Five databases were searched. Studies were included if they measured polysomnography parameters and assessed sleep apnea‐related quality of life (Epworth Sleepiness Scale [ESS]) both before and after HNS, and compared these outcomes with control, CPAP, or airway surgery (uvulopalatopharyngoplasty, expansion sphincter pharyngoplasty, or tongue base surgery) groups. A total of 10 studies (2209 patients) met the inclusion criteria. Compared to other airway surgeries, the rates of post‐treatment apnea–hypopnea index (AHI) < 10 and < 15 events/h were significantly lower in the HNS group (odds ratio [OR] 5.33, 95% confidence interval [CI] 1.21–23.42; and 2.73, 95% CI 1.30–5.71, respectively). Additionally, postoperative AHI was significantly lower in the HNS group than in all other airway surgery groups (AHI: mean difference [MD] −8.00, 95% CI −12.03 to−3.97 events/h). However, there were no significant differences in the rate of post‐treatment AHI < 5 events/h (OR 1.93, 95% CI 0.74–5.06) or postoperative ESS score (MD 0.40, 95% CI−1.52 to 2.32) between the two groups. HNS is an effective option for selected patients with moderate‐to‐severe OSA and CPAP intolerance.
Does the unemployment rate moderate the well‐being disadvantage of the unemployed? Within‐region estimates from the European Social Survey
Authors: Hajdu Gábor , Hajdu Tamás
Published: September 2023

Using pooled cross‐sectional data (eight waves of the European Social Survey), this work analysed how the regional unemployment rate influences the well‐being disadvantages of the unemployed. We estimate region fixed effects and slopes models that, unlike the standard region fixed effects approach, provide an unbiased estimate of the cross‐level interaction term (between being unemployed and the unemployment rate) in the absence of unobserved time‐variant confounders. The results show that the satisfaction disadvantage of the unemployed (relative to the employed) is larger when the regional unemployment rate is higher. Smaller and insignificant differences were found regarding happiness. These results are in line with the argument that worse re‐employment perspectives in high‐unemployment regions may be particularly harmful to unemployed people. These results do not contradict the claim that, in regions with a weaker social norm to work, unemployed people may be more satisfied. Instead, they suggest that the unemployment rate does not reflect the social norm to work.
Linking meteorites to their asteroid parent bodies: The capabilities of dust analyzer instruments during asteroid flybys
Authors: Eckart Lisa Maria , Hillier Jon K. , Postberg Frank , Marchi Simone , Sternovsky Zoltan
Published: September 2023

Linking meteorites to their asteroid parent bodies remains an outstanding issue. Space‐based dust characterization using impact ionization mass spectrometry is a proven technique for the compositional analysis of individual cosmic dust grains. Here we investigate the feasibility of determining asteroid compositions via cation mass spectrometric analyses of their dust ejecta clouds during low (7–9 km s−1) velocity spacecraft flybys. At these speeds, the dust grain mass spectra are dominated by easily ionized elements and molecular species. Using known bulk mineral volume abundances, we show that it is feasible to discriminate the common meteorite classes of carbonaceous chondrites, ordinary chondrites, and howardite–eucrite–diogenite achondrites, as well as their subtypes, relying solely on the detection of elements with ionization efficiencies of ≤700 or ≤800 kJ mol−1, applicable to low (~7 km s−1) and intermediate (~9 km s−1) flyby speed scenarios, respectively. Including the detection of water ion groups enables greater discrimination between certain meteorite types, and flyby speeds ≥10 km s−1 enhance the diagnostic capabilities of this technique still further. Although additional terrestrial calibration is required, this technique may allow more unequivocal asteroid‐meteorite connections to be determined by spacecraft flybys, emphasizing the utility of dust instruments on future asteroid missions.
A possible 5 km wide impact structure with associated 22 km wide exterior collapse terrain in the Alhabia–Tabernas Basin, southeastern Spain
Authors: Sánchez Gómez Sebastián Tomás , Ormö Jens , Alwmark Carl , Holm‐Alwmark Sanna , Zachén Gabriel , Lilljequist Robert , Sánchez Garrido Juan Antonio
Published: September 2023

The Tabernas–Alhabia Basin is a structural depression situated in the province of Almería, southeastern Spain. The basin is filled with Neogene, Pliocene, and Pleistocene sediments resting discordantly on a Paleozoic metamorphic basement. During the marine Tortonian sedimentation, a bed of breccia (Gordo megabed) was formed. It consists of rotated sedimentary megablocks commonly capped and/or surrounded by a polymict breccia composed mainly of up to dm‐sized clasts of the crystalline (schist) basement. Previous work has suggested the bed to be a seismite corresponding to events induced by earthquakes. Here, we link the formation of the Gordo megabed with an ∼5 km wide, rimmed depression with exposed breccias on the northern flank of the Sierra de Gádor mountain. This semicircular structure, developed in mainly schists and dolostone of the basement, is delimited to the W, S, and E by an up to 350 m high escarpment with overturned stratigraphy. Toward the north, this crater‐like structure opens toward the Gordo megabed of the Tabernas Basin. In the southern sector, the overturned strata transform outward for into a blocky allochthonous breccia with decreasing thickness and clast size. In the interior of the structure, there are occurrences of graded breccia and arenite superposed on a blocky, autochthonous breccia. Based on the presence of mineralogical shock metamorphic evidence, potential shatter cones, and a high Ir anomaly (∼500 ppb) as well as the position of the structure near the town of Alhama de Almería, we propose to call it the Alhama de Almería impact structure.
Rapid orthodontics via surgery: Multiple auto‐transplantations
Authors: Rowlands Catherine E. P. , Kwok Jerry
Published: September 2023

Aim

To use auto‐transplantation of a central incisor and canine and repositioning of a lateral incisor with corticotomy as an alternative to complex lengthy orthodontics and possible tooth loss.

Method

Following initial consultation in a joint orthodontic/oral surgery clinic in Guy's Hospital, the decision was made to carry out auto‐transplantation of the ectopic teeth under general anaesthesia. The procedure included extraction of retained primary teeth, auto‐transplantation of upper right permanent central incisor and canine, segmental osteotomy/corticotomy to reposition the lateral incisor, followed by splinting of the upper 3–3 for 6 weeks. The patient was reviewed multiple times over a 2.5‐year period and no signs of inflammation, ankylosis, sensitivity, root resorption, mobility or loss of vitality was noted.

Discussion

Auto‐transplantation is an underutilised technique despite being used for over 70 years. It does, however, have its limitations and there are several factors that can affect its success and predictability. This case highlights that it can be an excellent alternative to lengthy and difficult orthodontic treatment and resulted in avoidance of loss of teeth. This treatment method reduced time and cost to the NHS as well as improved the patient journey. It is important to work closely with colleagues and adopt a multidisciplinary approach to treatment planning and have an awareness for alternative treatment options that are available for joint orthodontic/oral surgery cases.

Conclusion

Auto‐transplantation, in certain cases and conditions, can be very successful and save both patient and the NHS time and money. Greater awareness of this technique is required so that it can be offered more regularly as a treatment option.
Rise and fall of the phacopids: the morphological history of a successful trilobite family
Authors: Bault Valentin , Crônier Catherine , Monnet Claude , Balseiro Diego , Serra Fernanda , Waisfeld Beatriz , Bignon Arnaud , Rustán Juan José
Published: September 2023

Phacopidae were a successful family of the Silurian–Devonian period. Although their diversity trends are well identified, their shape evolution is unknown; their morphology often considered to be conservative. We have quantified these morphologies using geometric morphometrics (landmarks) and investigated their evolution using morphological disparity indices. Results identified morphological variations between the genera, and through time. Phacopids differ from each other by the position of the facial suture linked to the size of the visual complex, the shape of the genal angle and the elongation of both cephalon and pygidium. The morphological disparity of cephala was high from the Silurian, contrary to that of pygidia. Subsequently, the morphological disparity increased in the Early Devonian with the development of narrow cephala and triangular pygidia. Morphological disparity was greater in the Emsian for both cephala and pygidia, more than 50 myr after the origination of phacopids. It constituted a perfect example illustrating that a peak of biodiversity does not necessarily happen in the early history of a clade. Subsequently, a strong decrease of morphological disparity occurred in the Middle Devonian, in conjunction with sea‐level changes and anoxic events. Taxonomic richness and morphological disparity declined strongly in the Givetian, in a non‐random extinction affecting particularly blind genera. The morphological disparity remained low in the Frasnian despite progressive eye reduction influenced by environmental changes. An extensive recovery occurred in the Famennian with an important increase of both taxonomic and morphological diversity. The Hangenberg event caused the final extinction of phacopids.
Heart rate variability in adults with chronic musculoskeletal pain: A systematic review
Authors: Rampazo Érika P. , Rehder‐Santos Patrícia , Catai Aparecida M. , Liebano Richard E.
Published: September 2023

Purpose

The aim of this review was to compare the heart rate variability (HRV) responses at rest of adults with chronic musculoskeletal pain against healthy controls.

Methods

The PubMed, Scopus, Web of Science (Science and Social Science Citation Index), and CINAHL databases were searched, with no date restrictions. Two independent reviewers selected observational studies that characterized the HRV responses at rest in adults with chronic musculoskeletal pain compared with those of healthy controls. Methodological quality was assessed using the Downs and Black checklist.

Results

This study followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. HRV in adults with chronic musculoskeletal pain was evaluated systematically. Of the 4893 studies screened, 20 of poor‐to‐moderate quality met the inclusion criteria. Most studies used electrocardiography and at least one time and/or frequency domain index. Studies were found that investigated HRV in adults with temporomandibular disorders, neck pain, whiplash, low back pain, and fibromyalgia. The heterogeneity of the studies in relation to painful conditions, parameters or position for HRV analysis precluded a meta‐analysis. In general, these studies seem to show increased sympathetic and decreased parasympathetic modulation in adults with musculoskeletal pain when compared to controls.

Conclusions

Adults with musculoskeletal pain exhibited a decline in HRV compared to controls. However, definitive conclusions cannot be drawn since the evidence is heterogeneous and of moderate quality. Further high‐quality research with standardized measurements is needed.
A dyadic session‐by‐session assessment of therapeutic alliance and short‐term outcome among clients with schizophrenia in comparison with clients with emotional disorders
Authors: Lavi‐Rotenberg Adi , Kivity Yogev , Igra Libby , Atzil‐Slonim Dana , Hasson‐Ohayon Ilanit
Published: September 2023

Objective

Although the clinical significance of the therapeutic alliance (TA) is well documented, the literature regarding the establishment of TA and the relation between client–therapist agreement on it to short‐term outcome among various diagnostic groups—and specifically among clients diagnosed with serious mental illness (SMI)—is sparse. The aim of the present study was to examine the effect of client diagnosis on the abovementioned TA characteristics.

Method

Dyadic analyses of session‐by‐session (SBS) data were used to compare clients diagnosed with schizophrenia and clients diagnosed with emotional disorders (based on a clinical interview) in their TA characteristics.

Results

TA as initially rated by clients was stronger in the emotional disorders group than in the schizophrenia group. Higher TA ratings, regardless of whether these were provided by the therapist or the client, predicted better subsequent functioning in the emotional disorders group, whereas in the schizophrenia group, this association was observed only among good‐outcome cases.

Conclusions

Establishing TA, having client–therapist agreement on it, and having clients derive therapeutic benefit from it might be more challenging with clients with schizophrenia than with clients with emotional disorders. Special attention should be given to specific challenges and needs regarding clients' diagnosis in order to enhance favourable therapy outcomes.
Understanding the impact of pediatric kidney transplantation on cognition: A review of the literature
Authors: Lullmann Olivia , van der Plas Ellen , Harshman Lyndsay A.
Published: September 2023

Background

Chronic kidney disease (CKD) is a relatively rare childhood disease that is associated with a wide array of medical comorbidities. Roughly half of all pediatric patients acquire CKD due to congenital anomalies of the kidneys and urinary tract, and of those with congenital disease, 50% will progress to end‐stage kidney disease (ESKD) necessitating a kidney transplantation. The medical sequelae of advanced CKD/ESKD improve dramatically following successful kidney transplantation; however, the impact of kidney transplantation on neurocognition in children is less clear. It is generally thought that cognition improves following kidney transplantation; however, our knowledge on this topic is limited by the sparsity of high‐quality data in the context of the relative rarity of pediatric CKD/ESKD.

Method

We conducted a narrative review to gauge the scope of the literature, using the PubMed database and the following keywords: cognition, kidney, brain, pediatric, neurocognition, intelligence, executive function, transplant, immunosuppression, and neuroimaging.

Results

There are few published longitudinal studies, and existing work often includes wide heterogeneity in age at transplant, variable dialysis exposure/duration prior to transplant, and unaccounted cofounders which persist following transplantation, including socio‐economic status. Furthermore, the impact of long‐term maintenance immunosuppression on the brain and cognitive function of pediatric kidney transplant (KT) recipients remains unknown.

Conclusion

In this educational review, we highlight what is known on the topic of neurocognition and neuroimaging in the pediatric KT population.
Role of TRDMT1/DNMT2 in stress adaptation and its influence on transcriptome and proteome dynamics under osmotic stress in Physcomitrium patens
Authors: Wadhwa Nikita , Singh Darshika , Yadav Radha , Kapoor Sanjay , Kapoor Meenu
Published: September 2023

Early land plants such as the moss Physcomitrium patens lack several morphological traits that offer protection to tracheophytes from environmental stresses. These plants instead have evolved several physiological and biochemical mechanisms that facilitate them to adapt to terrestrial stresses such as drought. We have previously shown that loss‐of‐function mutants of tRNA (cytosine(38)‐C(5))‐methyltransferase TRDMT1/DNMT2 in P. patens are highly sensitive to oxidative and osmotic stress. To gain insight into the role of PpTRDMT1/PpDNMT2 in modulating genetic networks under osmotic stress, genome‐wide transcriptome and proteome studies were undertaken in wild‐type and ppdnmt2 plants. Transcriptome analysis revealed 375 genes to be differentially expressed in the ppdnmt2 under stress compared to the WT. Most of these genes are affiliated with carbohydrate metabolic pathways, photosynthesis, cell wall biogenesis, pathways related to isotropic and polarised cell growth and transcription factors among others. Histochemical staining showed elevated levels of reactive oxygen species in ppdnmt2 while transmission electron microscopy revealed no distinct defects in the ultrastructure of chloroplasts. Immunoprecipitation using PpDNMT2‐specific antibody coupled with mass spectrometry revealed core proteins of the glycolytic pathway, antioxidant enzymes, proteins of amino acid biosynthetic pathways and photosynthesis‐related proteins among others to co‐purify with PpTRDMT1/PpDNMT2 under osmotic stress. Yeast two‐hybrid assays, protein deletion and α‐galactosidase assays showed the cytosol glycolytic protein glyceraldehyde 3‐phosphate dehydrogenase to bind to the catalytic motifs in PpTRDMT1/PpDNMT2. Results presented in this study allow us to better understand genetic networks linking enzymes of energy metabolism, epigenetic processes and RNA pol II‐mediated transcription during osmotic stress tolerance in P. patens.
How reducing documentation burdens impacts equity in access to small business COVID‐19 relief funding
Authors: Bell Elizabeth , Kappes Heather Barry , Williams Miles
Published: September 2023

Scholars have unveiled how and why administrative burdens perpetuate inequity in access to government benefits. However, less is known about the tools public managers can use to reduce burdens and disparities in program access. We partner with a local government in the U.S. to investigate whether a reduction in documentation requirements increased equity by promoting access for “underserved” small business owners (i.e., racial/ethnic minorities, women, people with disabilities, and veterans). Specifically, we analyze outcomes for more than 8500 businesses in a COVID‐19 small business relief fund before and after a reduction in documentation requirements. Utilizing an interrupted time series design, we find increased application success for underserved small businesses, but other applicants benefitted more from the program change, calling into question whether the policy change advanced equity. Our findings suggest that even well‐intentioned interventions can perpetuate disparity if targeted supports for marginalized communities are not implemented.
Enforcing transboundary water obligations through investment treaty arbitration: China, Laos and the Mekong River
Authors: Daza‐Clark Ana Maria
Published: September 2023

The study of the intersection between international investment law and international water law is not new. However, this intersection may be better understood through the analysis of specific case studies, regions and/or economic sectors. This article observes the relationship between China and Laos in connection to the construction of dams in the Lancang/Mekong River. In so doing, it addresses China’s attitudes towards the negotiation and conclusion of economic integration and transboundary water agreements, observing a sharp contrast between the two. Against this background, the article examines some of the most important agreements between China and Laos regarding both the protection of foreign investment and the management of shared waters. The article argues that investor‐State dispute settlement may lend some ‘teeth’ to the enforcement of transboundary obligations with regard to the Mekong River.