bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient preferences for gene therapy in haemophilia: Results from the PAVING threshold technique survey
Authors: van Overbeeke Eline , Hauber Brett , Michelsen Sissel , Peerlinck Kathelijne , Lambert Catherine , Hermans Cedric , Lê Phu Quoc , Goldman Michel , Simoens Steven , Huys Isabelle
Published: September 2021

Objectives

The aim of the Patient preferences to Assess Value IN Gene therapies (PAVING) study was to investigate trade‐offs that adult Belgian people with haemophilia (PWH) A and B are willing to make when choosing between prophylactic factor replacement therapy (PFRT) and gene therapy.

Methods

The threshold technique was used to quantify the minimum acceptable benefit (MAB) of a switch from PFRT to gene therapy in terms of ‘Annual bleeding rate’ (ABR), ‘Chance to stop prophylaxis’ (STOP), and ‘Quality of life’ (QOL). The design was supported by stakeholder involvement and included an educational tool on gene therapy. Threshold intervals were analysed using interval regression models in Stata 16.

Results

A total of 117 PWH completed the survey. Mean thresholds were identified for all benefits, but substantial preference heterogeneity was observed; especially for the STOP thresholds, where the distribution of preferences was bimodal. Time spent on the educational tool and residence were found to impact MAB thresholds. The most accepted (88% of PWH) gene therapy profile investigated in this study comprised of zero bleeds per year (vs. six for PFRT), 90% chance to stop prophylaxis, no impact on QoL, and 10 years of follow‐up on side effects (vs. 30 for PFRT).

Conclusions

Results from this study proved the value of educating patients on novel treatments. Moreover, preference heterogeneity for novel treatments was confirmed in this study. In gene therapy decision‐making, preference heterogeneity and the impact of patient education on acceptance should be considered.
MAFLD: Renovation of clinical practice and disease awareness of fatty liver
Authors: Kawaguchi Takumi , Tsutsumi Tsubasa , Nakano Dan , Torimura Takuji
Published: September 2021

Recently, international expert panels have proposed a new definition of fatty liver: metabolic dysfunction‐associated fatty liver disease (MAFLD). MAFLD is not just a simple renaming of non‐alcoholic fatty liver disease (NAFLD). The unique feature of MAFLD is the inclusion of metabolic dysfunctions, which are high‐risk factors for events. In addition, MAFLD is independent of alcohol intake and the co‐existing causes of liver disease. This new concept of MAFLD may have a widespread impact on patients, medical doctors, medical staff, and various stakeholders regarding fatty liver. Thus, MAFLD may renovate clinical practice and disease awareness of fatty liver. In this review, we introduce the definition of and rationale for MAFLD. We further describe representative cases showing how the diagnostic processes differ between MAFLD and NAFLD. We also summarize recent studies comparing MAFLD with NAFLD and discuss the impact of MAFLD on clinical trials, Japanese populations, and disease awareness.
Concordance between core needle biopsy and surgical excision specimens for Ki‐67 in breast cancer – a systematic review of the literature
Authors: Kalvala Jahnavi , Parks Ruth M , Green Andrew R , Cheung Kwok‐Leung
Published: September 2021

Aims

The biomarkers oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) are routinely measured in patients with breast cancer with international consensus on how they should be interpreted. There is evidence to support use of other biomarkers to give more detailed predictive and prognostic information. Ki‐67 is one example, and measures the proliferative activity of cancer cells. It is important that this can be performed at diagnosis of breast cancer for patients who do not have initial surgical treatment (mainly older women) and those receiving neoadjuvant therapies.

Methods and results

A systematic review was performed to assess concordance of measurement of Ki‐67 between core needle biopsy (CNB) samples and surgical excision (SE) samples in patients with invasive breast cancer. MEDLINE and Embase databases were searched. Studies were eligible if performed within the last 10 years; included quantitative measurement of Ki‐67 in both CNB and SE samples with no prior breast cancer treatment; measured concordance between two samples; and had full text available. A total of 22 studies, including 5982 paired CNB and SE samples on which Ki‐67 was measured, were appraised. Overall, there appeared to be concordance; however, reliability was unclear. Where given, the Cohen’s kappa coefficient (κ) of correlation between samples ranged from 0.261 to 0.712. The concordance rate between CNB and SE where measured as a percentage had a range from 70.3 to 92.7%

Conclusions

Assessment of level of concordance of Ki‐67 between CNB and SE samples is hampered by different methodologies. International consensus on Ki‐67 measurement is urgently needed.
Effectiveness of D,L‐2‐hydroxyisocaproic acid (HICA) and alpha‐mangostin against endodontopathogenic microorganisms in a multispecies bacterial–fungal biofilm in anex vivotooth model
Authors: Leelapornpisid Warat , Novak‐Frazer Lilyann , Qualtrough Alison , Rautemaa‐Richardson Riina
Published: September 2021

Aim

To develop a defined multispecies root canal biofilm modelex vivo, and to perform viable compositional analysis following D,L‐2‐hydroxyisocaproic acid (HICA), alpha‐mangostin, Calcicur®, and Odontopaste®exposure.

Methodology

Time‐kill assays were conductedin vitrousing HICA, alpha‐mangostin, Calcicur®, Odontopaste®, and saline solution on the planktonic cultures ofC. albicans,E. faecalis,L. rhamnosus, andS. gordonii. Human root dentine blocks were prepared (n = 100)ex vivo, and multispecies suspensions containing each of 1.5 × 108 CFU/mLC. albicans,E. faecalis,L. rhamnosus, andS. gordoniiin brain heart infusion (BHI) were incubated within the root canals for 21 days. Canals (n = 20/group) were then exposed to medicaments for 7 days. Samples taken from the inner (first 0.1 mm) and deeper (second 0.1 mm) dentine by drilling with Ash Steel Burs No. 5 and No. 6, and residual roots were cultured in broth for 24 h. Cell growth was detected by spectrophotometry and confirmed by culture on agar. The other set of inner dentine, deeper dentine, and residual root samples were sonicated, and then exposed with 50 μM PMA before DNA was extracted using the QIAamp DNA mini kit. Real‐time quantitative PCR was performed to determine the biofilm composition as well as the number of live and total cells remaining in the biofilm following each treatment. The OD data were analysed with Kruskal–Wallis and Friedman with Wilcoxon signed‐rank test between and within groups, respectively, agar culture and qPCR data with Pearson chi‐square with Mann–Whitney and Cochran with McNemar tests, respectively (p < .0001).

Results

Time‐kill assays revealed that HICA and Calcicur®killed all planktonic organisms within 24 h, whilst alpha‐mangostin killed the organisms within 72 h. However, Odontopaste®was a slow‐killing agent: 10 cells of planktonic organisms survived after exposure to the agent for 7 days. Theex vivotooth model demonstrated that HICA and alpha‐mangostin significantly inhibited the cell growth in all sampling depths (p < .0001). All species‐specific data revealed the effectiveness of each medicament on the biofilm composition.

Conclusions

D,L‐2‐hydroxyisocaproic acid and alpha‐mangostin had antimicrobial activity against multispecies bacterial–fungal biofilms.
Effect of water‐soluble magnesium lactate on the volume stability of refractory castables containing calcium aluminate cement
Authors: Guo Liu , Fu Yunhe , Zhao Zongqiang , Cui Junyan , Mu Yuandong , Jia Quanli , Chen Liugang
Published: September 2021

A kind of organic magnesium salt, water‐soluble magnesium lactate, was used as the MgO‐precursor in new forms to identify the particular impact of additive dispersity on properties of calcium aluminate cement (CAC)‐bonded castables, especially the volume stability. Magnesium lactate could dissolve in water in the mixing process, distribute uniformly, and decompose during heating, providing space for counterbalancing the expansion from in‐situ calcium aluminates and MgAl2O4 spinel generation. Hence, in this study, CAC‐bonded castables containing 0–1.2 wt% magnesium lactate were prepared. The volume stability and thermo‐mechanical strength of castables were tested. Results show that the dissolution of magnesium lactate in water distinctly enhances the volume stability of castables. To understand the underlying mechanism of water‐soluble magnesium lactate on the samples, phase compositions and microstructure development of castable matrices were examined.
Compassion fatigue among haemodialysis nurses in public and private hospitals in China
Authors: Wang Yun‐Yan , Xiong Ying , Zhang Ying , Li Chun‐Yin , Fu Li‐Li , Luo Hua‐Li , Sun Yan
Published: September 2021

Aim

This study was conducted to identify and compare the levels of compassion fatigue and job satisfaction among haemodialysis nurses in public and private hospitals in China and explore explanatory factors based on sociodemographic and occupational characteristics.

Methods

A descriptive study was conducted using a self‐designed demographic questionnaire, the Professional Quality of Life Scale and the Minnesota Satisfaction Questionnaire, with responses from 283 haemodialysis nurses working at six public and private hospitals in China between June and November 2018.

Results

The compassion fatigue score of public hospital nurses was significantly higher than that of private hospital nurses. Univariate analysis showed that there were significant differences in compassion fatigue among nurses based on the number of years worked, nature of employment, and education level. Correlational analysis showed a negative correlation between overall job satisfaction and compassion fatigue in both public and private hospitals. Multiple regression analysis showed that compassion fatigue among haemodialysis nurses in public hospitals was associated with years worked, type of employment, and intrinsic and extrinsic satisfaction, whereas in private hospitals, education level, years worked, and intrinsic and extrinsic satisfaction were significant.

Conclusion

Haemodialysis nurses in public hospitals are more likely to develop compassion fatigue than those in private hospitals.
Contraceptive literacy among school‐going adolescents in Botswana
Authors: Barchi Francis , Ntshebe Oleosi , Apps Helen , Ramaphane Peggie
Published: September 2021

Aim

To examine adolescent contraceptive literacy and condom knowledge in Botswana.

Background

In Botswana, adolescent HIV infection rates remain high and unintended pregnancies are the predominant reason girls drop out of school. Despite a national mandate for comprehensive sexuality education and youth‐friendly health services, access to accurate sexual and reproductive health information for adolescents remains limited.

Methods

Two hundred forty adolescents attending secondary schools in Maun, Botswana, completed cross‐sectional surveys in 2020. Bivariate and logistic regression examined factors associated with contraceptive literacy and self‐reported condom knowledge.

Findings

Although 90% of students were aware of one or more forms of contraception, only 67% could name a method for which they knew a source and only half of sexually active respondents had used birth control during their last sexual experience. Respondents reported that teachers and family members were the most important sources of information; only 8.2% of respondents identified health professionals in that role. Adolescents who consulted nurses had eight times greater odds of reporting correct condom‐use knowledge than those who consulted teachers.

Implications for Nursing Policy

The positive association between adolescents’ condom‐use knowledge and nurses as information resources supports a call to expand nurses’ role in health education in secondary schools and clinics in Botswana. Education and training programs for health professionals that build communication skills for working with adolescents should be promoted as an essential step in youth‐friendly service provision.

Conclusion

Contraceptive literacy among adolescents in Botswana is low and may contribute to risk behaviors that drive rates of HIV and pregnancies in this population. Interventions to reduce adolescent HIV risk behaviors and unintended pregnancy may prove more effective if they involve nurses as communicators and educators.
Kinetic Monte Carlo simulation of ZrO2 coating deposited by EB‐PVD
Authors: Gao Jin , Jing Yuhang , He Xiaodong , Jiang Chunzhu , Song Guangping , Zheng Yongting , Bai Yuelei
Published: September 2021

Kinetic Monte Carlo (KMC) simulations have been used for electron beam physical vapor deposition (EB‐PVD) of ZrO2 coatings, with the critical potential function fitted by full first‐principles calculations in the framework of density functional theory, emphasizing the effect of critical processing parameters, for example, the substrate temperature (600–1150 K), deposition rate (0.03–7.5 μm/min), and initial kinetic energy (0–0.5 eV). Here, the interaction between ZrO2 particles is described by coarse grain (CG) model with a numerical non‐bonded potential developed by multi‐iterative boltzmann inversion (multi‐IBI). Overall, the calculated energy barrier by the nudged elastic band (NEB) shows the internal diffusion (3.29–4.80 eV) requires more energy than the surface diffusion (2.90–3.42 eV), because of fewer surrounding particles in the latter. Moreover, the energy barrier of Line Jump is smaller than that of Schwoebel Jump, contributing to the columnar grains rather than a dense coating. Of importance, the simulated morphologies of ZrO2 coatings are well consistent to experiments, with a weaker effect from the substrate temperature, initial kinetic energy to deposition rate. Furthermore, the porosity can be effectively reduced by increasing the temperature and initial kinetic energy, however, with a slight increase when increasing the deposition rate.
Periodontal furcation lesions: A survey of diagnosis and management by general dental practitioners
Authors: Nibali Luigi , Shemie Melissa , Li Guanhong , Ting Rachel , Asimakopoulou Koula , Barbagallo Giovanni , Lee Ryan , Eickholz Peter , Kocher Thomas , Walter Clemens , Aimetti Mario , Rüdiger Stefan
Published: September 2021

Aim

The aim of this study was to explore general dental practitioners' (GDPs) attitude to periodontal furcation involvement (FI).

Materials and methods

An online survey focused on diagnosis and management of periodontal FI was circulated to GDPs in seven different countries.

Results

A total of 400 responses were collected. Nearly a fifth of participants reported rarely or never taking 6‐point pocket charts; 65.8% of participants had access to a Nabers probe in their practice. When shown clinical pictures and radiographs of FI‐involved molars, the majority of participants correctly diagnosed it. Although 47.1% of participants were very/extremely confident in detecting FI, only 8.9% felt very/extremely confident at treating it. Differences in responses were detected according to country and year of qualification, with a trend towards less interest in periodontal diagnosis and treatment in younger generations. Lack of knowledge of management/referral pathways (reported by 22.8%) and lack of correct equipment were considered the biggest barriers to FI management. Most participants (80.9%) were interested in learning more about FI, ideally face to face followed by online tutorials.

Conclusions

Plans should be put in place to improve general dentists' knowledge and ability to manage FI, as this can have a significant impact on public health.
Recent progress in research on the gut microbiota and highland adaptation on the Qinghai‐Tibet Plateau
Authors: Liu Kui , Yang Jinshui , Yuan Hongli
Published: September 2021

Microbial communities that inhabit the host's intestine influence many aspects of the host's health and bear the adaptive potential to alterations in harsh environments and diets. The Qinghai‐Tibet Plateau represents one of the harshest environments in the world. Preliminary progress has been made in identifying the communities of gut microbes in Indigenous Tibetans and non‐human animals. However, due to the complexity of microbial communities, the effects of gut microbes on the host's health and high‐plateau adaptation remain unexplained. Herein, we review the latest progress in identifying factors affecting the gut microbiota of native Tibetans and non‐human animals and highlight the complex interactions between the gut microbiota, health and highland adaptation, which provides a basis for exploring the correlations between the gut microbiota and clinical indexes in native highland residents and travellers, as well as developing microbiota‐based strategies to mitigate health risks for tourists and treatments for mountain sickness during high‐altitude travel in the future.
A multi‐epitope chimeric protein elicited a strong antibody response and partial protection against Edwardsiella ictaluri in Nile tilapia
Authors: Machimbirike Vimbai Irene , Pornputtapong Natapol , Senapin Saengchan , Wangkahart Eakapol , Srisapoome Prapansak , Khunrae Pongsak , Rattanarojpong Triwit
Published: September 2021

Edwardsiella ictaluri infects several fish species and protection of the all the susceptible fish hosts from the pathogen using a monovalent vaccine is impossible because the species is composed of host‐based genotypes that are genetic, serological and antigenic heterogenous. Here, immunoinformatic approach was employed to design a cross‐immunogenic chimeric EiCh protein containing multi‐epitopes. The chimeric EiCh protein is composed of 11 B‐cell epitopes and 7 major histocompatibility complex class II epitopes identified from E. ictaluri immunogenic proteins previously reported. The 49.32 kDa recombinant EiCh protein was expressed in vitro in Escherichia coli BL‐21 (DE3) after which inclusion bodies were successfully solubilized and refolded. Ab initio protein modelling revealed secondary and tertiary structures. Secondary structure was confirmed by circular dichroism spectroscopy. Antigenicity of the chimeric EiCh protein was exhibited by strong reactivity with serum from striped catfish and Nile tilapia experimentally infected with E. ictaluri. Furthermore, immunogenicity of the chimeric EiCh protein was investigated in vivo in Nile tilapia juveniles and it was found that the protein could strongly induce production of specific antibodies conferring agglutination activity and partially protected Nile tilapia juveniles with a relative survival percentage (RPS) of 42%. This study explored immunoinformatics as reverse vaccinology approach in vaccine design for aquaculture to manage E. ictaluri infections.
Industrial metabolism analysis of a Chinese wine industry chain based on material flow and input–output analyses
Authors: Liu Lu , Li Jinhua , Jia Zhibin , Liu Jing
Published: September 2021

Recently, Chinese wine industry has developed rapidly and its sustainability has attracted increasing attention. However, the existing wine industry chain is short and its metabolic pathway and metabolic efficiency remain unknown. Therefore, we selected a representative wine company in China to conduct industrial metabolism analysis (IMA) research based on material flow analysis (MFA) and input–output analysis. MFA model and input–output matrix for the traditional industry chain (TIC) and ecological industry chain (EIC) of the investigated company were established to explore the material flow relationship between the industrial structure and the nodes. A new IMA evaluation index system was developed to evaluate the industrial metabolic efficiency and development trends of two scenarios considered in the study. The results showed that the addition of nodes in EIC promoted the reuse of byproducts and wastes, and reduced the waste of resources. The industrial metabolic efficiency of EIC was also higher than that of TIC. For example, the node material cycle coefficient (Ri) during the preliminary treatment and pressing and fermentation of EIC was increased by 0.041 and 0.127, respectively, compared with TIC. A correlation analysis showed that EIC nodes had stronger pull and push effects on upstream and downstream than those of TIC, and the influence coefficient (Uj) of viticulture and pressing and fermentation increased by 0.168 and 0.112, respectively. This study provides a scientific basis for optimizing the wine industrial layout, improving the overall environmental performance of the industry chain, and promoting sustainable development.
Does Rosacea, a localized skin disease, affect the choroidal thickness?
Authors: Şahin Tayfun , Öztekin Aynure , Cevher Selim
Published: September 2021

Introduction

This study aims to compare the choroidal thickness (CT) of patients with rosacea with healthy individuals.

Methods

This study was conducted with 42 patients with Papulopustular Rosacea (PPR), 38 patients with Erythematotelangiectatic Rosacea (ETR), and gender and age‐matched 37 healthy individuals in the control group. CT measurements were done using the spectral‐domain optical coherence tomography.

Results

Choroidal thickness means were measured as 352 ± 78 μm, 331 ± 67 μm, and 346 ± 83 μm at the subfoveal region; 323 ± 72.3 μm, 303.5 ± 68.4 μm, and 314 ± 80.3 μm at 1000 μm nasal; and 325.2 ± 71 μm, 304.4 ± 52.2 μm, and 309 ± 67 μm at 1000 μm temporal in the PPR, ETR, and control groups, respectively (p > 0.05).

Conclusion

Although rosacea is a common chronic skin disease that could have systemic findings, CT is not affected by this disease.
Neurite orientation dispersion and density imaging in a rodent model of acute mild traumatic brain injury
Authors: McCunn Patrick , Xu Xiaoyun , Moszczynski Alexander , Li Alex , Brown Arthur , Bartha Robert
Published: September 2021

Background and Purpose

Identification of changesin brain microstructure following mild traumatic brain injury (mTBI) could be instrumental in understanding the underlying pathophysiology. The purpose of this study was to apply neurite orientation dispersion and density imaging (NODDI) to a rodent model of mTBI to determine whether microstructural changes could be detected immediately following injury.

Methods

Fifteen adult male Wistar rats were scanned on a Bruker 9.4 Tesla small animal MRI using a multi‐shell acquisition (30 b = 1000 s/mm2 and 60 b = 2000 s/mm2). Nine animals experienced a single closed head controlled cortical impact followed by NODDI from 1 to 4 h post injury. Region of interest analysis focused on the corpus callosum and hippocampus. A mixed analysis of variance (ANOVA) was used to determine statistically significant interactions in neurite density index (NDI), orientation dispersion index (ODI), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity. Follow up repeated‐measures ANOVAs were used to determine individual changes over time.

Results

NDI showed a significant increase in the hippocampus and corpus callosum following injury, while ODI showed increases in the corpus callosum. No significant changes were observed in the sham control animals. No changes were found in FA, MD, AD, or RD. Histological analysis revealed increased glial fibrillary acidic protein staining relative to controls in both the hippocampus and corpus callosum, with evidence of activated astrocytes in these regions.

Conclusions

Changes in NODDI metrics were detected as early as 1 h following mTBI. No changes were detected with conventional diffusion tensor imaging (DTI) metrics, suggesting that NODDI provides greater sensitivity to microstructural changes than conventional DTI.
Framing and insurance choices
Authors: Burkovskaya Anastasia , Teperski Adam , Atalay Kadir
Published: September 2021

The presentation of objective information should not affect a rational decision‐maker; however, in practice, it often does. This paper studies the effect of the framing of contingencies on insurance choices. In several experiments, we presented participants with differently framed insurance tasks, where they had to choose deductibles against two different types of losses. The treatment group received a broad description of the risky situation and was asked to decide on the deductibles jointly, whereas the control group received a narrow description of the same task and was asked to decide on the deductibles separately. We discovered that the distribution of the insurance premium paid was identical in all groups, but the actual choices of the insurance plans were significantly diverse: On average, the treatment group preferred more similar deductibles than did the control group. These results indicate the importance of framing in insurance decision‐making.
How consistently does sleep quality improve at retirement? Prospective analyses with group‐based trajectory models
Authors: Peristera Paraskevi , Nyberg Anna , Magnusson Hanson Linda L. , Westerlund Hugo , Platts Loretta G.
Published: September 2021

Growing evidence indicates that retiring from paid work is associated, at least in the short‐term, with dramatic reductions in sleep difficulties and more restorative sleep. However, much is still not known, in particular how universal these improvements are, how long they last, and whether they relate to the work environment. A methodological challenge concerns how to model time when studying abrupt changes such as retirement. Using data from Swedish Longitudinal Occupational Survey of Health (n = 2,148), we studied difficulties falling asleep, difficulties maintaining sleep, premature awakening, restless sleep, a composite scale of these items, and non‐restorative sleep. We compared polynomial and B‐spline functions to model time in group‐based trajectory modelling. We estimated variations in the individual development of sleep difficulties around retirement, relating these to the pre‐retirement work environment. Reductions in sleep difficulties at retirement were sudden for all outcomes and were sustained for up to 11 years for non‐restorative sleep, premature awakening, and restless sleep. Average patterns masked distinct patterns of change: groups of retirees experiencing greatest pre‐retirement sleep difficulties benefitted most from retiring. Higher job demands, lower work time control, lower job control, and working full‐time were work factors that accounted membership in these groups. Compared to polynomials, B‐spline models more appropriately estimated time around retirement, providing trajectories that were closer to the observed shapes. The study highlights the need to exercise care in modelling time over a sudden transition because using polynomials can generate artefactual uplifts or omit abrupt changes entirely, findings that would have fallacious implications.
Implantable vagus nerve stimulator settings and short‐term adverse effects in epileptic dogs
Authors: Harcourt‐Brown Thomas R. , Carter Michael
Published: September 2021

Background

Implantable vagus nerve stimulation (VNS) devices can be used to treat epilepsy in dogs. Adverse effects and short‐term complications associated with delivering suggested therapeutic electrical stimulation (>1.5 mA) are not well‐described.

Objectives

To compare complications and adverse effects observed with standard and rapid protocols of current increase.

Animals

Sixteen client‐owned dogs with idiopathic epilepsy.

Methods

Nonrandomized, nonblinded prospective cohort study. Surgical complications, stimulation‐related adverse effects, modifications to stimulator settings, number of hospital visits, and time to reach 1.5 mA stimulation current without intolerable adverse effects were described in dogs receiving current increases every 1 to 3 weeks (slow ramping) and dogs receiving current increases every 8 to 12 hours (fast ramping).

Results

Self‐resolving surgery site seromas formed in 6 dogs. No other surgical complications were observed. Fourteen dogs reached 1.5 mA. Coughing (11/14 dogs; 5 slow, 6 fast ramping) was the most common adverse effect. Intolerable coughing that limited current increases despite changing other stimulus parameters occurred in 6/7 of the fast‐ramping group and in none of the slow‐ramping group. Median time to 1.5 mA was 72 days (range, 28‐98) in the slow‐ramping group and 77 days (range, 3‐152) in the fast‐ramping group. Median number of clinic visits was 6 for the slow‐ramping group (range, 5‐6) and 3 for the fast‐ramping group (range, 1‐7).

Conclusions and Clinical Importance

Coughing is a common adverse effect of VNS in dogs and generally is well tolerated, particularly if current is increased slowly and other stimulation parameters are adapted for effect.
Protecting expressions of Naga folklore through sui generis model
Authors: Varah Franky , Pamreishang Chodang , Khamrang Sophayo
Published: September 2021

Recently, the protection of expressions of folklore has been a concern in developing countries. In India, efforts have been made to protect expressions of folklore which usually involve Intellectual Property (IP) laws. However, the protection provided by IP laws may be inadequate for Naga communities. The paper attempts to analyse the limitations of IP laws of patents, copyrights, trademarks and GeographicalIndications (GI) for the protection of expression of Naga folklore. The finding shows that current IP laws in India do not fully protect the Naga folklore. This paper suggests that expressions of folklore need to look at alternative regimes. The paper further discusses the need for a sui generis legislation of an IP nature by presenting the example of sui generis legislation. As an overall outcome, it is concluded that a sui generis legislation of an IP nature would be able to protect the expression of Naga folklore.
A wake‐up call: Time to raise physicians' awareness of the consequences of fatigue
Authors: Choshen‐Hillel Shoham , Gileles‐Hillel Alex
Published: September 2021

Expanding on worry about medical teams being aware but unconcerned about the harm fatigue causes residents' cognitive impairment, the authors explore emotional consequences and the mental and physical costs to physicians' well‐being.
The Challenges of Identifying Juvenile Soldiers in the Spanish Civil War
Authors: Benito Sánchez María , Mezquida Fenández Miguel , Iglesias‐Bexiga Javier , Calpe Vicente Alejandro , Martínez Vallejo Azahara , Fortuna Murillo María
Published: September 2021

Every conflict referred to as a war results in the horror of loss and death. This is true of any war, and the Spanish Civil War is a good example. Many people disappeared and were never found again, mainly because nobody ever looked for them. There were several counteroffensives on the eastern war front in Spain's Levante region during 1938, which, although ending in Pyrrhic victories for the Republican Army, were forgotten for years, as were the bodies of the soldiers abandoned to the elements on the battlefields. In 2014, this research project was developed to locate, exhume, and identify four graves containing the bodies of Republican soldiers found at the site of Peña Salada, Spain. The graves were found to contain five individuals, including some considered to be juvenile soldiers, aged between 14 and 20. They displayed many signs of violence, and it was possible to infer differences in injuries from bladed weapons and firearms. There was also evidence of the pillaging and desecration of the burial site. The genetic profiles of the five individuals were obtained in order to create a DNA database, which would make it possible to compare their profiles with those of potential family members who still live with the uncertainty of not knowing the whereabouts of their loved ones. This study offers the first scientific evidence of the participation of juvenile soldiers on the Levante Front, within the context of the Spanish Civil War.
Facilitators and barriers of children's participation in nutrition, physical activity, and obesity interventions: A systematic review
Authors: Clayton Priscilla , Connelly Jeneene , Ellington Malik , Rojas Vicky , Lorenzo Yaisli , Trak‐Fellermeier María Angélica , Palacios Cristina
Published: September 2021

Recruitment of children into clinical trials is challenging. Most systematic reviews exploring facilitators and barriers of child recruitment in clinical trials are related to drugs or experimental treatments for various health conditions. This may differ in nutrition, physical activity, and obesity interventions. The objective was to conduct a systematic review of facilitators and barriers for children's participation in nutrition, physical activity, and obesity interventions from the perspective of parents, children, and researchers. Studies were identified from five databases and restricted to children 2–18 years and the English language. Studies without results on facilitators and barriers of recruitment were excluded. Four hundred twenty‐three records were identified; 94 duplicates and 269 unrelated records were initially excluded; 60 records were reviewed for full‐text, and subsequently 34 were excluded, for a total of 26 included studies. The top barriers for recruiting children into clinical trials were time constraints, understanding of clinical trial information or complexity of consent/trial info, and transportation/lack of childcare. The most common facilitators were benefits to others and self, compensation/incentives, physician recommendations/referrals, and support. These barriers and facilitators should be addressed in future studies to assist in the successful recruitment of children into nutrition, physical activity, and obesity interventions.
Movement disorders in patients with Rett syndrome: A systematic review of evidence and associated clinical considerations
Authors: Singh Jatinder , Lanzarini Evamaria , Nardocci Nardo , Santosh Paramala
Published: September 2021

Aim

This systematic review identified and thematically appraised clinical evidence of movement disorders in patients with Rett syndrome (RTT).

Method

Using PRISMA criteria, six electronic databases were searched from inception to April 2021. A thematic analysis was then undertaken on the extracted data to identify potential themes.

Results

Following the thematic analysis, six themes emerged: (i) clinical features of abnormal movement behaviors; (ii) mutational profile and its impact on movement disorders; (iii) symptoms and stressors that impact on movement disorders; (iv) possible underlying neurobiological mechanisms; (v) quality of life and movement disorders; and (vi) treatment of movement disorders. Current guidelines for managing movement disorders in general were then reviewed to provide possible treatment recommendations for RTT.

Conclusion

Our study offers an enriched data set for clinical investigations and treatment of fine and gross motor issues in RTT. A detailed understanding of genotype–phenotype relationships of movement disorders allows for more robust genetic counseling for families but can also assist healthcare professionals in terms of monitoring disease progression in RTT. The synthesis also showed that environmental enrichment would be beneficial for improving some aspects of movement disorders. The cerebellum, basal ganglia, alongside dysregulation of the cortico‐basal ganglia‐thalamo‐cortical loop, are likely anatomical targets. A review of treatments for movement disorders also helped to provide recommendations for treating and managing movement disorders in patients with RTT.
Asking how to fish vs. asking for fish: Antecedents and outcomes of different types of help‐seeking at work
Authors: Liu Yihao , Chen Fan Xuan , Chiang Jack Ting‐Ju , Wang Zheng , Liu Haiyang
Published: September 2021

In the modern workplace, it is virtually impossible to succeed without seeking any help from others. Despite its widely recognized importance, several areas surrounding help‐seeking have not yet been clearly understood in the organization literature. Specifically, it is unclear whether seeking help always benefits employees in need, and how various work demands drive help‐seeking behavior in different ways. In this research, we drew from the dual‐type view of help‐seeking (i.e., autonomous and dependent help‐seeking) and the challenge‐hindrance stressors framework to elaborate how seeking help of different types influences employees’ work competence‐related outcomes in various directions, what work demands drive employees to seek different types of help, and when encountering work demands is particularly influential on their help‐seeking tendencies. Evidence from a field study (Study 1) showed that while challenge stressors increased employees’ autonomous help‐seeking, hindrance stressors increased dependent help‐seeking especially for employees with greater workflow centrality. Moreover, autonomous help‐seeking benefited help‐seekers’ job performance ratings through increased self‐perceived competence, whereas dependent help‐seeking hurt their job performance via decreased perceived competence by coworkers. To cross‐validate our findings, we then examined and replicated our core findings with three experimental vignette studies (Studies 2, 3a, and 3b). Theoretical and practical implications are discussed.
Combining photogrammetric and bathymetric data to build a 3D model of a canal tunnel
Authors: Moisan Emmanuel , Heinkelé Christophe , Foucher Philippe , Charbonnier Pierre , Grussenmeyer Pierre , Guillemin Samuel , Koehl Mathieu
Published: September 2021

This paper introduces an original method for modelling in 3D the full tube (both vault and canal) of navigable tunnels using data acquired dynamically from a boat. The recording system is composed of cameras that provide images of the vault and a multibeam echo sounder that acquires 3D profiles underwater. Reconstructing partially submerged structures, in a confined environment where no global positioning system signal is available, is challenging. The method exploits the capabilities of photogrammetry, not only to reconstruct the tunnel vault, but also to estimate the trajectory of the vessel, which is necessary to rearrange sonar profiles and form the 3D model of the canal. The comparison of a model reconstructed from in situ dynamic acquisitions with a reference one, obtained from static laser and sonar acquisitions, shows that the accuracy is of the order of a centimetre for the vault, while it is decimetric for underwater features.
Time trends, geographic variation and risk factors for gastroschisis in Canada: A population‐based cohort study 2006–2017
Authors: Liu Shiliang , Evans Jane , Boutin Amélie , Luo Wei , Gheorghe Mihaela , Auger Nathalie , Arbour Laura , Moore Aideen , Joseph K. S. , Little Julian
Published: September 2021

Background

Previous studies showed increases in rates of gastroschisis in Canada in the first decade of the 21st century.

Objective

We sought to examine the epidemiologic characteristics of gastroschisis in Canada in recent years.

Methods

We conducted a retrospective population‐based cohort study of all livebirths and stillbirths delivered in Canada (excluding Quebec) from 2006 to 2017, with information obtained from the Canadian Institute for Health Information. Gastroschisis rates by maternal age, region of residence, and maternal and infant characteristics were quantified using prevalence rate ratios (RR) and 95% confidence intervals (CI). Log‐binomial regression was used to quantify the associations between risk factors and gastroschisis.

Results

There were 1314 gastroschisis cases among 3 364 116 births. The prevalence rate was 3.7 per 10 000 total births in 2006 and 3.4 per 10 000 total births in 2017, with substantial annual variation in rates. The proportion of mothers aged 20–24 years decreased from 16.5% in 2006 to 11.3% in 2017, while the proportion of mothers aged <20 years halved from 4.8% to 2.3%. The prevalence of gastroschisis at birth remained unchanged among mothers aged <20, 20–24 and 30–49 years but increased among mothers aged 25–29 years. The age‐adjusted prevalence rate of gastroschisis increased across the period (for 2016–2017 versus 2006–2007 rate ratio [RR] 1.28, 95% CI 1.05, 1.56), and there was substantial regional variation. Risk factors included problematic use of substances (RR 2.61, 95% CI 2.01, 3.39) and hypothyroidism (RR 2.76, 95% CI 1.56, 4.88). There was a North‐to‐South difference in gastroschisis prevalence (adjusted RR Far North compared with South 1.54, 95% CI 1.11, 2.15).

Conclusion

Gastroschisis birth prevalence rates in Canada have stabilised in recent years compared with the increase documented previously. The substantial geographic variation and North‐to‐South difference in gastroschisis prevalence may indicate variation in socio‐economic status, lifestyle and nutritional patterns.
Integrating evolutionary potential and ecological function into agricultural seed production to meet demands for the decade of restoration
Authors: Leger Elizabeth A. , Agneray Alison C. , Baughman Owen W. , Brummer E. Charles , Erickson Todd E. , Hufford Kristina M. , Kettenring Karin M.
Published: September 2021

The UN Decade on Ecosystem Restoration will result in an unprecedented need for seeds. Agricultural production, or the growing of plants under controlled conditions to produce desired resources, can be a helpful tool for providing the quantities of seeds needed for large‐scale restoration. In some ecosystems, agricultural production of native plant seeds is part of the restoration process. This is particularly true for native plants that are similar to major food crops, such as native grasses. However, conventional crops have contrasting characteristics (e.g. fast growing, high yield for a focused use) from those desired in restored vegetation (plants capable of surviving and providing ecosystem services in variable environments). This contrast leads to significant, often opposing differences in desirable characteristics in crop versus natural systems. Examples include rapid germination in domesticated crops versus seed dormancy in wild plants, uniform germination, growth and flowering versus bet‐hedging strategies, or high seed retention versus seed dispersal. While it may be useful to maximize productivity of native plants in agricultural environments with similar trait modifications, for restoration, the demands of the natural environment should be primary, and agricultural production should aim to maximize the diversity, function, and evolutionary potential of native species. Any perceived benefits that come from the production of large quantities of inexpensive seeds that cannot meet the needs of wild communities are short‐sighted. We suggest research directions that will be needed to meld agricultural production needs with those of restoration practitioners, as a challenge for those invested in the procurement and use of wild seeds.
Partially Pooled Propensity Score Models for Average Treatment Effect Estimation with Multilevel Data
Authors: Lee Youjin , Nguyen Trang Q. , Stuart Elizabeth A.
Published: September 2021

Causal inference analyses often use existing observational data, which in many cases has some clustering of individuals. In this paper, we discuss propensity score weighting methods in a multilevel setting where within clusters individuals share unmeasured confounders that are related to treatment assignment and the potential outcomes. We focus in particular on settings where models with fixed cluster effects are either not feasible or not useful due to the presence of a large number of small clusters. We found, both through numerical experiments and theoretical derivations, that a strategy of grouping clusters with similar treatment prevalence and estimating propensity scores within such cluster groups is effective in reducing bias from unmeasured cluster-level covariates under mild conditions on the outcome model. We apply our proposed method in evaluating the effectiveness of centre-based pre-school programme participation on children’s achievement at kindergarten, using the Early Childhood Longitudinal Study Kindergarten data.
Measuring Family Planning Provider Bias: A Discrete Choice Experiment among Burkinabé, Pakistani, and Tanzanian Providers
Authors: Dieci Maria , Wagner Zachary , Friedman Willa , Burgess Sarah , Vandermark Jessica , McCoy Sandra I. , Shah Manisha , Dow William H.
Published: September 2021

The unmet need for modern contraception remains high around the world, particularly for youth. While some of this unmet need is driven by limited health infrastructure and method mix availability, many adolescents who visit family planning providers still do not receive methods that fit their needs. This suggests that providers may be biased against youth and that interventions to change provider behavior could help close this gap. However, it is unclear if this bias is a result of age or other characteristics common among young women such as not being married and not having children. We use a discrete choice experiment in Burkina Faso, Pakistan, and Tanzania to disentangle the effects of age on providers’ decisions to provide contraception from the effects of other potential confounding factors. We find that, although young women may experience the most bias, age is not the main driver. Rather, marital status and parity seem to influence provider decisions to offer services or counsel on modern methods. These findings suggest that interventions to reduce provider bias should focus on changing behavior towards unmarried and nulliparous women, regardless of their age.
Young voters and political participation in Indonesia: Revisiting a marriage gap
Authors: Halimatusa'diyah Iim , Prihatini Ella
Published: September 2021

Objectives

This article responds to an understudied question on how does marital status make a difference in terms of voter turnout among young people in the Muslim world.

Methods

The article draws on the 2010 Muslim Youth Survey and focus on 1127 respondents aged between 15 and 25 in Indonesia. Using binominal logistic regression analysis, it seeks to examine how marital status affects Indonesian young people’s voting behaviour in three types of elections held in 2009: legislative, presidential, and regional.

Results

The finding confirms that married young individuals are more likely to vote than those who are not married. However, the marriage gap only exists in the legislative and presidential elections as the impact of marital status diminishes in regional elections.

Conclusion

This paper contributes to the literature by examining how the marriage gap in politics does not only occur in post‐industrialized and developed countries. Also, regional election systematically prevents young voters to participate as the ballot sheets are only available in respective jurisdiction.