bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of cognitive function on the poor's economic performance: Evidence from Cambodian smallholder farmers
Authors: Bruns Selina , Dalheimer Bernhard , Musshoff Oliver
Published: November 2021

Despite manifold policy interventions, poverty still exists. Those most harshly affected are people living in rural areas of low‐income countries. A seminal strand in the literature presents a promising avenue for analyzing the lives of the poor by suggesting that poverty impedes cognitive function. However, the real‐world consequences of impeded cognitive function are yet to be discovered. We ask whether the level of cognitive function can help to explain the differences in economic performance of the poor. We conducted a field study in rural Cambodia using the well‐established Raven's Progressive Matrix to elicit cognitive function. Employing stochastic frontier analysis, we find that the level of cognitive function of poor smallholder farmers helps in explaining differences in economic performance. Our findings suggest that impeded cognitive function results in a negative economic performance feedback loop, which can be a reason why some farmers appear to be stuck in poverty while others manage to escape it.
Aged care nurses’ perception of unwanted sexual behaviour in Australian residential aged care services
Authors: Smith Daisy E. , Wright Meghan T. , Ibrahim Joseph E.
Published: November 2021

Objectives

To explore aged care nurses’ awareness and experience of unwanted sexual behaviour (USB) in residential aged care services (RACS).

Methods

An anonymous online questionnaire was administered to an opportunistic sample of RACS nurses enrolled to complete an e‐learning course in Australia. From the 167 participants who expressed interest to enrol, 129 were eligible and 53 returned completed consent forms.

Results

46/53 responded of which most were females (41/45, 91.1%). Few respondents reported resident‐resident USB (<35%) or staff‐resident USB (<22%) happened once a year. Most respondents had not been informed by a resident of USB (>75%) or had personally reported USB within their internal reporting system (>77%). Respondents were also unaware if their facility had lodged an incident report to the regulator or law enforcement authorities within the past 12 months (34/46, 73.9%). Finally, most considered there to be no barriers to reporting USB (35/46, 77.8%).

Conclusions

Respondents’ awareness and estimates of USB directed at residents were much lower than known national prevalence rates. This lack of awareness could be a substantive barrier to recognition and optimal management of this form of abuse.
Incisional hernia following ileostomy closure: who's at risk? The Gold Coast experience
Authors: Bloomfield Ian , Dobson Benjamin , Von Papen Michael , Clark David
Published: November 2021

Background

Diverting ileostomy is utilized to protect high‐risk anastomoses, though it is not shown to reduce the leak rate it may reduce the severe consequences of an anastamotic leak. In recent years mesh development has advanced to allow placement of meshes into potentially contaminated fields, such as an ostomy closure site.

Method

A retrospective review of all ileostomy closure procedures in Gold Coast from 1st January 2011 until 31st December 2018 were included. Patient demographics and surgical outcomes and follow up reviewed to identify any cases of incisional hernia relating to ostomy closure.

Results

A total of 193 patients were identified, after exclusions 171 were suitable for analysis within the study, a total of 25 incisional hernia detected radiologically or clinically. Two independent risk factors were identified BMI >30 and ASA 3–4. Both had significant association with development of incisional hernia with a 3‐ and 2‐fold RR increase, respectively. This was also reflected in a subset analysis of BMI ranges demonstrating increased risk in the obese and severely obese group.

Discussion

The high‐risk group in our population was elevated BMI and ASA, these are the patients we would expect to benefit the most from targeted therapy to reduce the incidence of incisional hernia. Future studies to look at whether reducing BMI or prophylactic mesh placement are effective.
Effects of paeoniflorin‐6′‐O‐benzene sulfonate on the pharmacokinetics, excretion and tissue distribution of leflunomide in rats
Authors: Xiao Ning , Xiao Feng , Gao Jinzhang , Xu Zhengkun , Wang Qianlei , Kuai Jiajie , Wei Wei , Wang Chun
Published: November 2021

Paeoniflorin‐6′‐O‐benzene sulfonate (CP‐25) is a novel ester derivative of paeoniflorin, which has been shown to have synergistic pharmacodynamic effects with leflunomide (LEF). To determine the effects of CP‐25 on the pharmacokinetics of LEF in rats, we developed a ultra‐high performance liquid chromatography‐tandem mass spectrometry (UPLC‐MS/MS)‐based method for the determination of levels of teriflunomide (TER, an active metabolite of LEF). This method was used to determine TER concentrations in the plasma, urine, faeces and bile; heart, liver, spleen, lung, kidney, intestinal, brain and synovial tissues; and peripheral blood mononuclear cells (PBMCs) of rats in the control (LEF [10 mg/kg]) and combined (CP‐25 [50 mg/kg × 7d] plus LEF [10 mg/kg]) groups. TER area under the curve [AUC], Tmax, mean residence time (MRT), t1/2α and t1/2β were significantly lower, and clearance (CL) was significantly higher in the combined group than in the control group. Oral CP‐25 administration in combination with LEF was found to promote TER excretion in urine, faeces and bile and to reduce its contents in most tissues and organs, especially in the liver, which may reduce LEF‐induced liver injury. CP‐25 also increased TER exposure in the synovium and its absorption by PBMCs, and this could explain the synergistic effects of CP‐25 and LEF.
Correlates of higher‐risk drug‐related behaviours at music festivals in New South Wales, Australia
Authors: Healey Amy , Siefried Krista J. , Harrod Mary Ellen , Franklin Erica , Peacock Amy , Barratt Monica J. , Brett Jonathan
Published: November 2021

Introduction

There are few contemporary data on illicit drug use at music festivals. We describe drug use patterns and prevalence of specific higher‐risk drug‐related behaviours, and their associations with festivalgoer characteristics.

Methods

We approached attendees at six major music festivals in New South Wales, Australia, from November 2019 to March 2020. Participants self‐completed an anonymous survey on prior and intended drug use and associated higher‐risk behaviours; double dropping; higher‐volume ethanol alongside drug use; higher quantity 3,4‐methylenedioxymethamphetamine (MDMA); mixing stimulants; and preloading. Logistic regression and UpSet analyses were performed to identify festivalgoer characteristics and the intersection of high‐risk behaviours, respectively.

Results

Of 1229 participants, 372 (30.3%) used or planned to use drugs at the festival. In multivariable analyses, men and those purchasing drugs both inside and outside the venue had greater odds of engaging in higher‐risk behaviours. Of those using MDMA, 47.9% reported double dropping. People using drugs for the first time had 3.3 (95% confidence interval 1.2–8.7) greater odds of higher‐volume ethanol alongside drug use. People reporting that police/police dog presence influenced their decision to take drugs had 2.2 (95% confidence interval 1.4–3.6) greater odds of preloading. In UpSet analysis, preloading was the most common intersection (17% of those using drugs).

Discussions and Conclusions

Engagement in the five higher‐risk drug behaviours was common, particularly amongst males and those using drugs for the first time, while police/police dog presence appeared to influence higher‐risk behaviours amongst festival attendees. This information can be used to inform harm reduction advice, public health and law enforcement strategies.
The elevational ascent and spread of exotic annual grass dominance in the Great Basin, USA
Authors: Smith Joseph T. , Allred Brady W. , Boyd Chad S. , Davies Kirk W. , Jones Matthew O. , Kleinhesselink Andrew R. , Maestas Jeremy D. , Morford Scott L. , Naugle David E.
Published: November 2021

Aim

In the western United States, sagebrush (Artemisia spp.) and salt desert shrublands are rapidly transitioning to communities dominated by exotic annual grasses, a novel and self‐reinforcing state that threatens the economic sustainability and conservation value of rangelands. Climate change is predicted to favour annual grasses, potentially pushing transitions to annual grass dominance into higher elevations and north‐facing aspects. We sought to quantify expansion of annual grass‐dominated vegetation communities along topographic gradients over the past several decades.

Location

Our analysis focused on rangelands among three ecoregions in the Great Basin of the western United States, where several species of exotic annual grasses are widespread among shrub and perennial grass‐dominated vegetation communities.

Methods

We used recently developed remote sensing‐based rangeland vegetation data to produce yearly maps of annual grass‐dominated vegetation communities spanning 1990–2020. With these maps, we quantified the rate of spread and characterized changes in the topographic distribution (i.e. elevation and aspect) of areas transitioning to annual grass dominance.

Results

We documented more than an eightfold increase in annual grass‐dominated area since 1990, occurring at an average rate of >2,300 km2 year−1 (0.6% of the area of Great Basin rangelands). In 2020, annual grasses dominated approximately one‐fifth (>77,000 km2) of Great Basin rangelands. This rapid expansion was associated with a broadening topographic niche, with widespread movement into higher elevations and north‐facing aspects consistent with predicted effects of a warming climate.

Main conclusions

More than a century after first appearing in the region, exotic annual grasses continue to proliferate and establish dominance in new environments across the Great Basin. Accelerated, strategic intervention is critically needed to conserve vulnerable sagebrush and salt desert shrub communities not yet heavily invaded. In this era of warming, future climate provides important context for selecting from among alternative management actions and judging long‐term prospects of success.
Field studies need to report essential information on social organisation – independent of the study focus
Authors: Makuya Lindelani , Olivier Charlotte‐Anaïs , Schradin Carsten
Published: November 2021

Comparative studies on social evolution are ideally based on large datasets to ensure high statistical power, but their scientific validity also relies on the quality of the data. However, even though social organisation, that is the composition of social units, is measured in many field studies testing specific hypotheses, these data are often not adequately reported. Here, we summarise which data on social organisation should always be reported regardless of the study focus to make them available for comparative studies. As an example, we report data from a literature survey on one of the four superorders of placental mammals, the Xenarthra from South America (armadillos, anteaters and sloths), of which all 30 species are generally assumed to be solitary living. In total, we found 4510 articles. The titles and abstracts of 61 publications indicated that data on social organisation were collected, but only 12 publications contained sufficient information for us to determine the social organisation. We found reliable information on nine species, of which seven were strictly solitary. Two species showed a combination of solitary‐living and pair‐living with one including female groups. This review therefore indicates that Xenarthra may not be exclusively solitary. Our literature survey further shows that valuable data are often not reported even though it can be assumed that these data had been collected. We report examples from 23 additional studies on monotremes, marsupials and two other placental superorders showing similar issues in reporting data. It is important to make authors aware that this information would be valuable for comparative studies. In sum, we recommend including data on the composition of social units, sex of individuals, occupancy of sleeping sites, frequency of observations and trapping events, home range overlap and the proportion of the individuals in the study area, independent of the study question in all publications.
Eutrophication‐driven eco‐evolutionary dynamics indicated by differences in stoichiometric traits among populations of Daphnia pulicaria
Authors: Moody Eric K. , Butts Tyler J. , Fleck Rachel , Jeyasingh Punidan D. , Wilkinson Grace M.
Published: November 2021

Microevolution can have consequences at higher levels of ecological organization. Although divergence among populations can be rapid and driven by anthropogenic changes to the environment, the ecological relevance of evolution induced by human activities remains poorly understood.

A frequent way in which human activities drive microevolution is the increase in supply of nutrients such as phosphorus (P) that are required for fitness‐relevant traits such as growth and reproduction. Because higher P concentrations decrease P‐use efficiency and feeding rate in heterotrophic consumers such as Daphnia, we hypothesized that such adjustments should alter consumer–resource dynamics.

We examined how cultural eutrophication in temperate lakes causes trait variation in the grazer Daphnia pulicaria. We tested for variation in Daphnia traits and genetic variation in the metabolic enzyme phosphoglucose isomerase (Pgi) which are each known to respond to eutrophication. We then examined the impact of this variation on consumer–resource dynamics using a combination of experiments and a multi‐lake survey.

We found that Daphnia from hypereutrophic lakes responded to experimental hypereutrophic conditions with increased growth rates and fecundity when raised on P‐fertilized seston, but had reduced performance on P‐poor seston relative to eutrophic source Daphnia. These results suggest that Daphnia may face a trade‐off in performance at low versus excess P that may be mediated in part by genetic variation at the Pgi locus.

The variation observed in laboratory growth experiments scaled up to Daphnia populations in both mesocosm experiments and among lakes. In both the mesocosm experiment and in the lake survey, Daphnia from hypereutrophic source lakes reached high biomass while phytoplankton biomass also remained high.

Given the prevalence and rapid eutrophication of freshwater ecosystems worldwide, these results indicate that considering the potential effects of evolutionary change in ecosystem models could be useful in forecasting the effects of anthropogenic environmental change on pivotal ecosystem services.
Impacts of the COVID pandemic on international faculty's academic activities and life in Japan
Authors: Huang Futao
Published: November 2021

The purpose of this study is to explore impacts of the pandemic on the academic activities and life of full‐time international faculty at Japanese universities, drawing on findings from semi‐structured interviews with them. Main findings include three points. First, although the vast majority of the interviewees believed that the pandemic has had more negative impacts on their academic activities and life, the case study of Japan suggests that there are both negative and positive impacts from the pandemic that are unique on international faculty's academic activities and life. Second, the study reveals that the impacts on international faculty vary according to the backgrounds of the interviewees such as their academic disciplines, countries of origin, and work roles and duties. Finally, participants may have experienced discrimination etc., but not felt comfortable talking about it. It seems that no interviewees, particularly those from China and other parts of Asia, experienced social exclusion and xenophobic attitudes and, at times, became victims of discrimination and verbal assaults.
Chemical vapor infiltration of additively manufactured preforms: Pore‐resolved simulations and experimental validation
Authors: Ramanuj Vimal , Sankaran Ramanan , Jolly Brian , Schumacher Austin , Mitchell David
Published: November 2021

The densification of additively manufactured porous preforms by chemical vapor infiltration (CVI) is studied using pore‐resolved simulations and experiments. Experimentally, 3D printed silicon carbide (SiC) preforms are subject to CVI synthesis using methyltrichlorosilane (MTS) precursor to obtain high purity SiC/SiC composites. Optical images of the cross sections of the processed preforms are analyzed to obtain the spatial porosity distribution. The numerical method is based on a level set formulation to capture the spatial distribution and time evolution of the pore scale microstructural characteristics. The coupled transport and kinetic effects are represented using a dimensionless Thiele modulus. Simulations are initialized using representative synthetic preform geometries comprising of packed particles based on the size distribution of the powder used for 3D printing. The simulation results are validated against the experimental observations in terms of total density and the distribution of residual porosity. The densification characteristics, porosity classification, concentration profiles, and structure functions are analyzed as functions of processing temperature and Thiele modulus.
Spatial variation in bioclimatic relationships for a snow‐adapted species along a discontinuous southern range boundary
Authors: Sultaire Sean M. , Humphreys John M. , Zuckerberg Benjamin , Pauli Jonathan N. , Roloff Gary J.
Published: November 2021

Aim

Variation in the relationship between variables across space, known as spatial non‐stationarity, is a common phenomenon in ecology. Species distribution models (SDMs), however, typically assume stationarity in species–environment relationships across space. Spatial non‐stationarity may be particularly apparent in populations along range boundaries where species are actively adapting to changes in climate, and geographically isolated areas where isolation can facilitate adaptation. We used data collected from the southern range boundary of a winter‐adapted mammal to evaluate spatially varying environmental relationships in a region with a geographically isolated population.

Taxon

Lepus americanus.

Location

Laurentian Great Lakes region, USA.

Methods

We surveyed 320 sites for snowshoe hares near their regional southern range boundary. We related snowshoe hare occurrence to short‐term climate variables (snow cover duration, maximum temperature and their interaction) with a spatially explicit model that allowed the effect of climate variables on snowshoe hare occurrence to vary spatially.

Results

We found highest support for an SDM that incorporated geographic barriers when estimating spatial effects, in addition to spatially varying effects of maximum temperate, snow cover duration and their interaction. Hares were more likely to occupy sites with longer snow cover duration but the influence of temperature was more variable. Increasing temperature in northern portions of our study area had a positive influence on hare occurrence, but exhibited a negative relationship along the southern range boundary.

Main Conclusions

We provide a robust evaluation of stationarity assumptions in bioclimatic relationships and highlight spatially variable relationships between a cold‐adapted species and short‐term climate variables across a range boundary. However, spatial non‐stationarity was not most apparent across dispersal barriers but coincided with differences in the relationship between climate variables across space. Our study provides evidence that the distribution of a winter‐adapted species is strongly constrained by snow cover, but prevailing temperature modulates the strength of this relationship across space.
Phylogeography of Artemisia frigida (Anthemideae, Asteraceae) based on genotyping‐by‐sequencing and plastid DNA data: Migration through Beringia
Authors: Oyundelger Khurelpurev , Harpke Dörte , Herklotz Veit , Troeva Elena , Zheng Zhenzhen , Li Zheng , Oyuntsetseg Batlai , Wagner Viktoria , Wesche Karsten , Ritz Christiane M.
Published: November 2021

Artemisia frigida is a temperate grassland species that has the largest natural range among its genus, with occurrences across the temperate grassland biomes of Eurasia and North America. Despite its wide geographic range, we know little about the species’ distribution history. Hence, we conducted a phylogeographical study to test the hypothesis that the species’ distribution pattern is related to a potential historical migration over the ‘Bering land bridge’. We applied two molecular approaches: genotyping‐by‐sequencing (GBS) and Sanger sequencing of the plastid intergenic spacer region (rpl32 – trnL) to investigate genetic differentiation and relatedness among 21 populations from North America, Middle Asia, Central Asia and the Russian Far East. Furthermore, we identified the ploidy level of individuals based on GBS data. Our results indicate that A. frigida originated in Asia, spread northwards to the Far East and then to North America across the Bering Strait. We found a pronounced genetic structuring between Middle and Central Asian populations with mixed ploidy levels, tetraploids in the Far East, and nearly exclusively diploids in North America except for one individual. According to phylogenetic analysis, two populations of Kazakhstan (KZ2 and KZ3) represent the most likely ancestral diploids that constitute the basally branching lineages, and subsequent polyploidization has occurred on several occasions independently. Mantel tests revealed weak correlations between genetic distance and geographical distance and climatic conditions, which indicates that paleoclimatic fluctuations may have more profoundly influenced A. frigida's spatial genetic structure and distribution than the current environment.
Understanding professionals’ perspectives and experiences of elder self‐neglect: A systematic review and meta‐synthesis of qualitative studies
Authors: Yu Mingming , Ramachandran Hadassah Joann , Qian Min , Shi Yuexian , Gu Libin , Wang Wenru
Published: November 2021

Purpose

To systematically review and synthesize the findings on various professionals’ perspectives of elder self‐neglect (ESN) and/or their experiences with ESN.

Design

A systematic qualitative review was used.

Methods

Primary qualitative studies published either in English or Chinese until August 2020 were systematically searched in the following databases: PubMed, Web of Science, Embase, CINAHL Plus, PsycINFO, Wanfang Data, and China National Knowledge Infrastructure (CNKI).

Findings

Eleven studies were included. Five subthemes including retaining a sense of normalcy/identity, service refusal, isolation, contributing factors in ESN, and manifestations and consequences of ESN were included in the overarching theme of ESN features. Another two subthemes, emotional and ethical dilemmas in caring for self‐neglecters and management strategies, were included under the second overarching theme of complicated experiences managing cases of ESN.

Conclusions

This qualitative synthesis provides a deep and comprehensive insight into professionals’ perspectives and experiences of self‐neglect in older adults. Understanding professionals’ perspectives of ESN can help with the knowledge and theory development pertinent to this particular phenomenon.

Clinical relevance

Findings are valuable in informing the provision of funds and structural, informational, and emotional support systems development for professionals managing ESN cases. Establishing a strong link between ESN case management and improved outcomes in older self‐neglecters is essential to establish a definite need for the provision of support, resource, and stardardized guidelines for these professionals.
Adherence to systemic therapy in patients with psoriasis during the COVID‐19 pandemic: A multicenter study
Authors: Oguz Topal Ilteris , Kara Polat Asude , Zindancı İlkin , Kıvanç Altunay İlknur , Akbulut Tuğba Özkök , Arıkan Eylem Emel , Topaloğlu Demir Filiz , Sivaz Onur , Karadağ Ayşe Serap
Published: November 2021

Background

Adherence to treatment is important in chronic dermatological diseases. There are limited data regarding the adherence to treatment in patients with psoriasis during the COVID‐19 pandemic.

Aims

We aimed to determine the rates of adherence to systemic treatments in patients with psoriasis and to identify the causes of non‐adherence during the COVID‐19 pandemic.

Methods

We conducted a cross‐sectional multicenter study from May 2021 to August 2021. A questionnaire including items regarding sociodemographic characteristics of the patients, disease‐related characteristics, and treatment‐related characteristics were filled out by the physicians. The Psoriasis Area Severity Index (PASI), Hospital Anxiety, and Depression Scale, and the Dermatology Life Quality Index were calculated. The rate of adherence and non‐adherence to treatment and reasons for non‐adherence to treatment were examined.

Results

A total of 342 patients with psoriasis were included (182 male/160 female) in the study. The mean age of the patients was 45.9 ± 14.2 years. The average duration of psoriasis was 192 ± 134.7 months. While the rate of adherence to treatment was 57.6%, the rate of non‐adherence to treatment was 42.4%. There were no significant differences with respect to adherence to treatment in comparison with oral and injection‐therapy groups. The most frequent reasons for non‐adherence to treatment were inability to go to the hospital (19.2%), concern about the COVID‐19 infection (16.3%), discontinuation of the treatment by the doctor (13.7%), inability to reach the doctor (7.3%), and inability to have access to the medication (7.3%).

Conclusion

Adherence to oral and injection therapies was fairly high among our patients with psoriasis during the COVID‐19 pandemic. Psoriasis severity and duration of medication use had a negative impact on adherence to treatment.
Evaluation of a new‐formula shampoo containing 6% glycyrrhetinic acid complex for scalp seborrheic dermatitis: A pilot study
Authors: Wang Hsiao‐Chi , Wang Chii‐Shyan , Hsieh Shu‐Chen , Hung Yu‐Ting , Chen Hsuan‐Hsiang
Published: November 2021

Background

Scalp seborrheic dermatitis (SD) is a chronic inflammatory dermatosis associated with sebum imbalance and proliferation of Malassezia species. Various antifungal shampoos are commonly used for scalp SD.

Aims

Glycyrrhetinic acid is known to have antioxidative, anti‐inflammatory, and anti‐allergic effects. This study was designed to evaluate the effectiveness of a new‐formula shampoo that contains glycyrrhetinic acid for the treatment of scalp SD.

Patients/Methods

Thirty‐four patients were enrolled and treated with the 6% glycyrrhetinic acid complex shampoo. Efficacy was assessed clinically with Dermatology Life Quality Index (DLQI) and Adherent Scalp Flaking Score (ASFS) by the same dermatologist at baseline, week 2, and week 5. Among the 24 subjects with the most significant clinical improvement, four common microorganisms from scalp samples were analyzed by quantitative polymerase chain reaction (qPCR) at baseline, and week 5.

Results

The DLQI and ASFS at week 2 and week 5 improved significantly relative to baseline. The bacteria profiles showed a significant increase of Cutibacterium acnes and a decrease of Staphylococcus epidermidis at week 5. The fungi profiles showed significant decreases of both Malassezia restricta and Malassezia globosa. The ratio of C. acne to S. epidermidis increased significantly from 0.93 at baseline to 1.55 at week 5. The ratio of M. restricta to M. globosa decreased from 5.02 at baseline to 1.00 at week 5.

Conclusions

The effectiveness of this new regimen was objectively demonstrated at the clinical and microbiological levels. This new formula may alleviate the bacterial and fungal dysbiosis in scalp SD.
Dorsogluteal intramuscular injection depth needed to reach muscle tissue according to body mass index and gender: A systematic review
Authors: Strohfus Pamela , Palma Sara , Wallace Chelsea Tindell
Published: November 2021

Aims and objective(s)

The objective of this systematic review was to determine the needle length required to reach the dorsogluteal muscle based on body mass index and sex. Our aim was to provide evidence‐based recommendations to current intramuscular injection guidelines from the result(s) of this review.

Background

Studies worldwide are documenting reduced medication effectiveness due to improperly placed dorsogluteal intramuscular injections because of incorrect needle length, wrong site selection and/or obesity. Current intramuscular injection guidelines lack specific instructions according to weight or sex. While there are similar concerns with other injectable sites, this review focuses solely on adult dorsogluteal intramuscular injections.

Design

A systematic review of relevant literature of dorsogluteal intramuscular injections based on body mass index and sex.

Methods

This systematic review was reported using the PRISMA checklist 2020. The review protocol was registered with Center for Open Science (OSF). We analysed 1,412 articles from nine databases. We compared twelve studies that utilised computerised tomography or ultrasonography using The Johns Hopkins Evidence‐Based Practice Model and Guidelines.

Results

A significant number of dorsogluteal intramuscular injections are administered into subcutaneous tissue rather than muscle because needles are too short for populations with body mass indexes over 25, especially women. Poor landmarking often results in improperly placed injections.

Conclusions

To prevent administering a dorsogluteal intramuscular injection into subcutaneous tissue, women with a BMI of 25 and over require needles longer than 38 mm (1.5 inches). Men have less subcutaneous tissue in the dorsogluteal area and only require longer needles if BMI is 35 and over. If skin‐to‐muscle depth is questionable in either sex, an ultrasound‐guided intramuscular injection is warranted for accurate dorsogluteal placement. Landmarking and needle length are key to appropriately placed IM injections.

Relevance to clinical practice

Dorsogluteal injections are often injected into subcutaneous tissue rather than muscle because needles are not long enough to reach muscle, especially in women. Critical elements that determine placement of intramuscular injections into muscle versus subcutaneous tissue are sex, BMI, needle length and landmarking.

Medications delivered into subcutaneous tissue may have reduced bioavailability.
Accuracy of Additively Manufactured and Milled Interim 3‐Unit Fixed Dental Prostheses
Authors: Karasan Duygu , Legaz Juan , Boitelle Philippe , Mojon Philippe , Fehmer Vincent , Sailer Irena
Published: November 2021

Purpose

To investigate the accuracy of additive manufacturing (AM) by means of internal fit of fixed dental prostheses (FDPs) fabricated with two AM technologies using different resins and printing modes (validated vs nonvalidated) compared to milling and direct manual methods.

Material and methods

Sixty 3‐unit interim FDPs replacing the first mandibular molar were divided into 6 groups (n = 10): manual (Protemp 4), milled (Telio‐CAD), and AM groups were subdivided based on AM technology (direct light processing (Rapidshape P30 [RS]) and stereolithography (FormLabs 2 [FL])) and the polymer type (P‐Pro‐C&B [St] and SHERAprint‐cb [Sh]) (RS‐St, RS‐Sh, FL‐St, FL‐Sh). Validated (RS‐Sh and RS‐St) or nonvalidated (FL‐St and FL‐Sh) modes were adopted for AM. The specimens were scanned to 3D align (GOM inspect) according to the triple scan method. The internal space between the FDPs and preparation surfaces in four sites (marginal, axial, occlusal, and total) was measured using equidistant surface points (GOM Inspect). Statistical analysis was done using Kruskal Wallis and Dunn post‐hoc tests. (α = 0.05).

Results

One AM group (FL‐Sh) and milling exhibited better adaptation compared to manual and RS‐St at molar site (p < 0.05). FDPs with St resin (FL‐St and RS‐St) displayed bigger marginal space than milled, FL‐Sh, and RS‐Sh. The nonvalidated printing mode showed better mean space results (p < 0.05) with higher predictability and repeatability (p < 0.001).

Conclusions

The AM interim FDPs tested provided valid alternatives to the milled ones in regard to their accuracy results. The printing mode, resin, and the AM technology used significantly influenced the manufacturing accuracy of interim FDPs, particularly at the marginal area. The nonvalidated printing mode with lower‐cost 3D printers is a promising solution for clinical applications.
Climate impacts on air quality and child health and wellbeing: Implications for Oceania
Authors: Sly Peter D , Vilcins Dwan
Published: November 2021

Despite the enormous gains in reducing child mortality resulting from the United Nations Millennium Development Goals, in some ways children's future wellbeing has never been under greater threat. Climate and environmental change, primarily driven by poor air quality, represents a major threat to child health and wellbeing, through both direct and indirect effects. Climate change has multiple environmental consequences impacting negatively on child health and wellbeing, including increases in ambient temperature, rising atmospheric carbon dioxide (CO2), altered distribution of rainfall, ocean warming, rising sea level and more frequent and severe adverse weather events. Multiple pathways link these exposures to a wide variety of adverse health outcomes. Countries in Oceania are especially likely to be subjected to the effects of increases in ambient temperature, altered distribution of rainfall, ocean warming and sea level rise. These changes pose a significant risk to children and provide a moral imperative for us to act to protect child health.
Delivering environmental sustainability in healthcare for future generations: Time to clean up our own cubby house
Authors: Kiang Karen Minnie , Behne Carol
Published: November 2021

Children and future generations will be those most affected by climate change, and paediatricians have a moral responsibility to preserve a secure and habitable world for them. Despite our pledge to ‘first do no harm’, the health‐care sector itself is a major contributor to global warming and environmental degradation. These contributions are projected to rise unless urgent measures are undertaken to decarbonise. Fortunately, an increasing number of individuals, health institutions, organisations and government agencies are taking action to shift this trajectory. Opportunities to reduce emissions and improve environmental sustainability in the health‐care sector are vast. If done well, sustainable climate‐smart health care offers opportunities for financial, environmental, and social gains – a ‘triple win’. By getting our own house in order, the health sector can influence action throughout our economy and society, realise the health co‐benefits of climate action and fulfil our obligation to help minimise the growing health impacts of climate change.
Geographic, racial/ethnic, and socioeconomic inequities in broadband access
Authors: Zahnd Whitney E. , Bell Nathaniel , Larson Annie E.
Published: November 2021

Introduction

Broadband access is a “super determinant of health.” Understanding the spatial distribution and predictors of access may help target government programs and telehealth applications. Our aim was to examine broadband access across geography and sociodemographic characteristics using American Community Survey (ACS) data.

Methods

We used 5‐year ACS estimates from 2014 to 2018 to evaluate broadband access across contiguous US census tracts. Rural‐Urban Commuting Area (RUCA) codes were categorized as metropolitan, micropolitan, small town, and isolated rural. We performed bivariate analyses to determine differences by RUCA categories and meeting the Healthy People 2020 (HP2020) objective (83.2% broadband access) or not. We conducted spatial statistics and spatial regression analyses to identify clusters of broadband access and sociodemographic factors associated with broadband access.

Results

No RUCA grouping met the HP2020 objective; 80.6% of households had broadband access, including 82.0% of metropolitan, 73.9% of micropolitan, 70.7% of small town, and 70.0% of isolated rural households. Areas with high percentages of Black residents had lower broadband access, particularly in isolated rural tracts (54.9%). Low access was spatially clustered in the Southeast, Southwest, and northern plains. In spatial regression models, poverty and education were most strongly associated with broadband access, while the proportion of American Indian/Alaska Native population was the strongest racial/ethnic factor.

Conclusions

Rural areas had less broadband access with the greatest disparities experienced among geographically isolated areas with larger Black and American Indian/Alaska Native populations, more poverty, and lower educational attainment, following well‐known social gradients in health. Resources and initiatives should target these areas of greatest need.
Competition and the negative expected social value of cost‐reducing innovation
Authors: Zhang Anzhou
Published: November 2021

I study an R&D race among outside entities to a cost‐reducing innovation of a certain magnitude and the subsequent patent licensing by the winner. The target is to study whether the expected social value of the innovation is positive or not. Sufficient conditions under which it is negative or positive are provided. I also find non‐monotonic effects of the innovation's magnitude and the number of incumbent firms on the expected social value.
Pure 100% fruit juices – more than just a source of free sugars? A review of the evidence of their effect on risk of cardiovascular disease, type 2 diabetes and obesity
Authors: Ruxton Carrie H. S. , Derbyshire Emma , Sievenpiper John L.
Published: November 2021

Pure 100% fruit juice (100%FJ) provides a source of nutrients and bioactive substances, such as flavonoids, carotenoids and pectin, and counts as a serving of fruit in several countries. Nevertheless, 100%FJ has been the subject of debate since it also contains free sugars and provides less fibre than whole fruits. Sugar recommendations, when translated into policy, are designed to limit population consumption of free sugars. The World Health Organization (WHO) free sugars classification does not differentiate between added sugars and free sugars naturally occurring in 100%FJ and other foods. Hence, there is an implication that all sources of free sugars are equally detrimental and should be reduced. But is this the case? Since WHO’s original 2003 classification, a considerable amount of evidence has been published on 100%FJ and its impact on health. This paper provides an update, focussing on meta‐analyses where available. These show protective associations for cardiovascular health at intakes of up to 200 ml/day, and significant improvements in vascular function, blood pressure and inflammation at higher intakes. Evidence on obesity, metabolic markers and type 2 diabetes risk – where studies have clearly differentiated consumption data for 100%FJ – suggests no clinically significant negative impact of 100%FJ at a wide range of intakes, unless diets are in positive energy balance. Data on nutrient adequacy from observational studies indicate positive associations between 100%FJ and intakes of whole fruits, vitamin C, vitamin A, folate and potassium. Since the evidence does not appear to show that drinking moderate amounts of 100%FJ is harmful to metabolic health or weight management, free sugars reduction policies should focus on sources that represent a genuine health risk and make a negligible contribution to nutrient adequacy. 100%FJ at intakes of up to 150 ml/day and consumed at mealtimes to protect dental health should remain part of 5 A DAY advice.
Examining the effect of infection prevention and control awareness among nurses on patient and family education: A cross‐sectional study
Authors: Hammoud Sahar , Amer Faten , Kocsis Béla
Published: November 2021

The significance of patient engagement in infection prevention and control remains to be stressed as a means of improving patient safety. This study aimed to determine nurses’ awareness of infection prevention and control, assess patient and family education on infection prevention and control, and examine the effect of nurses’ infection prevention and control awareness on patient and family education. A multi‐site, cross‐sectional study was conducted among 566 nurses in Hungary. Nurses responded to a questionnaire of three parts: demographics, infection prevention, and control awareness; healthcare‐associated infections, hand hygiene, and standard precautions; and patient and family education. High scores were reached in overall awareness and standard precautions. Nurses educated patients and family members the most on hand hygiene and respiratory hygiene. Nurses with higher awareness educated patients more than those with lower awareness, but the differences were only significant for respiratory hygiene and the reason for isolation. Nursing leaders are encouraged to enhance the culture that is based on nurse/patient partnership and to develop reminders to emphasize the importance of engaging patients and family members in infection prevention and control.
Surgical Outcomes for C2 Tear Drop Fractures: Clinical Relevance to Hangman's Fracture and C2‐3 Discoligamentous Injury
Authors: Kim Sung‐Kyu , Rhee John M. , Park Eric T. , Seo Hyoung‐Yeon
Published: November 2021

Objective

To analyze characteristics of surgically managed tear drop (TD) fractures of the C2 axis associated with other injuries such as hangman's fracture and C2‐3 discoligamentous injury as well as treatment outcomes.

Methods

A total of 14 patients (eight men and six women) with TD fractures of the C2, who were surgically treated at four national trauma centers of tertiary university hospitals from January 2000 to December 2017, were included in this retrospective study. The mean age of the patients was 45.5 years (ranging from 19 to 74 years). The characteristics, surgical treatment methods (anterior fusion vs posterior fusion), and results of 14 TD fractures of the C2 were analyzed retrospectively. And the clinical relevance between C2 TD fracture and hangman's fracture and C2‐3 discoligamentous injury was investigated through the co‐occurrence between injuries. The mean follow‐up time after surgery was 22.6 months (ranging from 12 to 60 months).

Results

Among 14 patients with TD fracture of the C2, four patients (28.6%) had anterior TD fracture and 10 patients (71.4%) had posterior TD fracture. All 10 posterior TD fracture patients had anterior C2‐3 displacement. While two of four anterior TD fracture patients had posterior C2‐3 displacement, the remaining two did not. All 14 patients of TD fracture had at least two or more other associated C2 injuries as well as C2‐3 discoligamentous injuries. About 92.9% (13/14) of the patients had typical or atypical hangman's fracture; 100% (10/10) of the posterior TD fracture patients had hangman's fracture, but 75% (3/4) of the anterior TD fracture had hangman's fracture. At admission, 13 patients were neurologically intact. However, the remaining patient had spinal cord injury with American Spinal Injury Association (ASIA) impairment scale B with C2‐3 bilateral facet dislocation. All four anterior TD fracture patients underwent posterior C2‐3 fusion. While four of 10 posterior TD fracture patients underwent C2‐3 anterior fusion, the remaining six underwent posterior fusion. At last follow‐up, 100% (14/14) of the patients achieved solid fusion, and visual analog scale for neck pain was significantly improved (5.9 vs 2.2, P < 0.001). One patient with ASIA impairment scale B had significantly improved to scale D. No major complications occurred.

Conclusion

Our study showed that surgically managed TD fractures of the C2 showed a high incidence of other associated spine injuries including hangman's fracture and C2‐3 discoligamentous injury. Therefore, special attention and careful radiologic evaluation are needed to investigate the presence of other associated spine injuries including hangman's fracture and C2‐3 discoligamentous injury, which are likely to require surgery.
Large discrepancy in optimal atrioventricular delay between sensed and paced atrial events in a pacemaker patient
Authors: Yamagishi Yasunobu , Oginosawa Yasushi , Miki Hajime , Yagyu Keishiro , Miyamoto Taro , Tsukahara Keita , Iwataki Mai , Ohe Hisaharu , Kohno Ritsuko , Kataoka Masaharu
Published: November 2021

A 74‐year‐old man experienced complete atrioventricular (AV) block 2 days after catheter ablation for right atrial (RA) macroreentrant tachycardia. We performed DDD pacemaker implantation with atrial septal pacing because other sites of pacing threshold were not acceptable. The maximum left ventricular outflow tract velocity time integral was 15.8 cm with sensed AV delay (40 ms) and 15.0 cm with paced AV delay (220 ms); however, this exceeded the pacemaker's maximum difference of 100 ms. We herein report the case of a large discrepancy in optimal AV delay intervals between sensed and paced atrial events, requiring consideration of proper pacemaker settings.
Gaming country rankings: Consultancies as knowledge brokers for global benchmarks
Authors: Broome André
Published: November 2021

This article explores how for‐profit consultancies mediate knowledge about global benchmarks in developing countries. Drawing on the case of the Ease of Doing Business rankings, published annually by the World Bank and the International Finance Corporation between 2005 and 2019, it examines the role consultancies play as knowledge brokers connecting global benchmarks produced by intergovernmental organizations to regulatory reform programs undertaken by national public administrations. The article shows how consultancies contracted to implement business enabling environment projects by the United States Agency for International Development advised national policymakers on how to design reforms to improve their country's ranking status. Lending weight to criticisms that shifts in country rankings are misleading as an indicator of changes in regulatory quality, the findings suggest that consultancies have leveraged benchmarks to perpetuate demand for their own expertise rather than to improve the evidence base for aid allocation and the evaluation of development projects.
Oral manifestations of multisystemic inflammatory syndrome in children (MIS‐C) and Kawasaki disease associated to COVID‐19: A systematic review
Authors: Nascimento Rebeca Barros , Araujo Nara Santos , Silva Jamerson Carvalho , Xavier Flávia Caló Aquino
Published: November 2021

Aims

Multisystemic inflammatory syndrome in children (MIS‐C) is a condition noted in some children asymptomatic but positive to Sars‐cov‐2 antibody and it presents clinical and laboratory changes similar to Kawasaki disease (KD). Oral changes have also been observed. This systematic review evaluated oral manifestations detected in children with MIS‐C and KD associated to COVID‐19.

Methods and Results

This work was registered at PROSPERO (#CRD42020225909), following PRISMA guidelines. A comprehensive research was conducted in MEDLINE, Web of Science, EMBASE, LILACS, Scopus, and Grey Literature through August 2021, based on original research evaluating children diagnosed with MIS‐C or KD related to COVID‐19. Two authors independently screened all retrieved references. Twenty five selected studies evaluated 624 children, mean age 8.78 years. The assessment of the risk of bias (ROB) showed that most of them presented low ROB. Oral manifestations were erythematous mucous membrane, oral ulcers lesions, dry, swollen and cracked lips, and strawberry tongue.

Conclusion

MIS‐C and KD share the same oral manifestations and their identification may lead to an early diagnosis.