bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification, characterisation and inhibition of Geotrichum pseudocandidum spoilage microbe in Gastrodia elata tuber
Authors: Sun Haiyan , Liu Xiao , Pei Jinjin , Hao Danqing , Li Xinsheng , Chen Dejing , Shen Yixiao , Xu Zhimin
Published: September 2021

Gastrodia elata tuber is vulnerable to spoilage after harvested. A fungal strain Geotrichum pseudocandidum causing the spoilage was isolated from Gastrodia elata tuber and identified in this study. The log phase of the strain growth during incubation at 28 °C was from 24 to 48 h. The pH for highest spore production and largest colony formation were 5–6 and 7–9, respectively, while the temperature for them was 20–30 °C. Antifungal natamycin and tea polyphenols extract inhibited the stain at minimum inhibitory concentration of 0.25 and 0.5 mg mL−1, respectively. A short‐time heating treatment at temperature at 65 °C for 10 min also effectively prevented the strain growth. As tea extract is a GRAS (generally recognised as safe) food ingredient, the tea extract treatment could be a safe and non‐thermal treatment to prevent the spoilage of Gastrodia elata tuber with less loss of heat‐sensitive bioactives and other nutrients.
The effect of ultrasound‐vacuum‐assisted extraction on bioactive properties of pitaya (Hylocereus undatus)
Authors: Uslu Nurhan , Özcan Mehmet Musa
Published: September 2021

This study aimed to investigate the effect of ultrasound‐assisted extraction under vacuum on bioactive properties of peel and flesh of pitaya fruit, and also compare with sonication under atmosphere condition using the principal component analysis (PCA). Vacuum sonication exhibited better results for total phenolic (56.78–71.54 mg GAE per 100 g for peel; 11.03–17.92 mg GAE per 100 g for flesh) and total flavonoid (95.33–115.71 mg QE per 100 g for peel; 13.26–19.36 mg QE per 100 g for flesh) amounts. DPPH free radical scavenging activity values of peel and flesh increased from 1.97 to 2.53 mmol TE kg‐1; from 0.33 to 0.50 mmol TE kg‐1 after sonication process, respectively. The main phenolic compounds of pitaya were identified as catechin (1.15–20.31 mg per 100 g) and rutin (0.88–14.55 mg per 100 g) in peel; catechin (1.11–9.35 mg per 100 g) and 3,4‐dihydroxybenzoic acid (1.29–3.60 mg per 100 g) in flesh. The combination of vacuum and ultrasound process can be used as a green extraction technology in order to enhance the amounts of bioactive compounds of pitaya fruit.
Post‐burn scar malignancy: 5‐year management review and experience
Authors: Mousa Ahmed K. , Elshenawy Anwar A. , Maklad Salah M. , Bebars Shaimaa M. M. , Burezq Hisham A. , Sayed Sherif E.
Published: September 2021

The study spotlights a severe uncommon post‐burn complication, Marjolin's ulcer, in upper Egypt plastic and wound care centres. This problem is mainly related to inadequate medical care and awareness. No community or race is immune. The underlying malignant transformation mechanism remains unclear. The study aims, according to our experience, to review the prognostic factors through the management protocol of Marjolin's ulcers. This prospective study was conducted in the Aswan University Plastic & Burn surgery department in South Egypt between 2013 and 2020 and investigated 226 patients with chronic post‐burn ulceration. Nineteen cases were proved to have Marjolin's ulcer, and the other cases that had been excluded from being malignant went for reconstruction with split‐thickness skin graft with/without flap after adequate ulcer debridement. The surgical, oncologic, radiologic indications, and prognostic factors were reviewed according to our management outcome—the assessment with follow‐up period extended over 5 years. Histopathology of ulcers ranged among mild, moderate, and poorly differentiated squamous cell carcinoma. One scalp ulcer case showed basosquamous pathology. Most cases presented at age above 50, but no age was immune. The mean latent period was 29 years on average. The lesions' sites varied in their anatomic location where they involved the upper extremity, the scalp, and the lower extremity that had a predilection. Although surgical excision is the primary management line for tumour ablation, other factors may change the management course. During the follow‐up period, neoplasm recurrence in the form of lymph node enlargement and/or locoregional metastasis was detected in eight cases. Within 1 year after the intervention, six recurrent cases died, and two were saved. In addition to the case study, this paper reviewed the literature and provided our team a good experience in light of the NCCN protocol for non‐melanotic cutaneous carcinoma, although we suffered limited medical resources. It is concluded that early accurate diagnosis, low‐grade malignancy, and well‐planned individualised surgery with adjuvant radiotherapy were the best prognostic factors. The close follow‐up for an early sign of disease recurrence is paramount.
Low incidence of major complications after the first six hours post atrial fibrillation ablation: Is same‐day discharge safe and feasible in most patients?
Authors: Paul Nordin Astrid , Drca Nikola , Insulander Per , Bastani Hamid , Bourke Tara , Braunschweig Frieder , Kennebäck Göran , von Olshausen Gesa , Sadigh Bita , Saluveer Ott , Tapanainen Jari , Schwieler Jonas , Åkerström Finn , Jensen‐Urstad Mats
Published: September 2021

Aims

This study evaluates the incidence of procedural complications related to catheter ablation of atrial fibrillation (AF) to assess the potential feasibility and safety of same‐day discharge in a large cohort.

Methods

We performed an analysis of prospectively collected data of complications of all patients staying overnight after undergoing AF ablation between 2001 and 2020 at a tertiary center. Using medical records, we analyzed complications occurring intraprocedurally until 6 h postablation and between 6 h postablation and discharge the day after the ablation procedure.

Results

In 5414 AF ablations, we identified a total of 108 (2.0%) major complications occurring intraprocedural or before discharge. Most major complications occurred intraprocedurally or within 6 h after the procedure (n = 96, 1.8%). Twelve (0.2%) major complications occurred between 6 h Postablation and discharge. The most common of these major complications were congestive heart failure (n = 6) and transient ischemic attack (TIA, n = 4). During this time span, 61 (1.1%) minor complications occurred. Factors independently associated with major complications intraprocedurally and until discharge were body mass index (BMI) ≥ 30 kg/m2 (p = .009), significant valvular disease (p = .001), cardiomyopathy (p < .001), prior stroke or TIA (p = .014), first‐time procedure versus repeat procedure (p = .013), cryoablation versus radiofrequency (p < .001), and procedure duration (p < .001).

Conclusion

After AF ablation, very few complications occurred between 6 h postprocedure and discharge the next day. Therefore, same‐day discharge is a safe option for a majority of patients.
Cryoablation of atypical atrioventricular nodal reentry tachycardia
Authors: von Olshausen Gesa , Jemtrén Anette , Schwieler Jonas , Tapanainen Jari , Bourke Tara , Paul‐Nordin Astrid , Benson Lina , Saluveer Ott , Kennebäck Göran , Braunschweig Frieder , Drca Nikola
Published: September 2021

Aim

Data on ablation for atypical recurrent atrioventricular nodal reentry tachycardia (AVNRT) and long‐term follow‐up are generally sparse. Furthermore, the rate of recurrence and safety of cryoablation for atypical AVNRT has not been established. We compared patients cryoablated for atypical AVNRT and typical AVNRT during long‐term follow‐up.

Methods

All patients (n = 2612) who underwent catheter ablation for AVNRT at the Karolinska University Hospital between January 2009 and August 2019 were analyzed. A total of 91 patients undergoing first‐time cryoablation for atypical AVNRT were included. A control group with first‐time cryoablation for typical AVNRT was matched in a 1:1 ratio. Patients were followed‐up for recurrences for a median of 5.0 years (interquartile range: 3.1–7.5 years).

Results

After 5 years, AVNRT recurrence occurred in 10 patients (11.0%) in the atypical AVNRT group and in 8 patients (8.8%) in the typical AVNRT group (hazard ratio: 1.31 [95% confidence interval: 0.52–3.32]; p = 0.568). The duration of the index procedure was significantly longer for atypical compared to typical AVNRT ablation (132.1 ± 49.2 min vs. 110.1 ± 38.8 min; p = 0.001). Transient AV blocks occurred in a similar fashion in the atypical compared to typical group (11 [12.1%] vs. 4 [4.9%]; p = 0.103). However, no ablation induced persistent AV block developed in either group.

Conclusion

Cryoablation for atypical AVNRT showed similar rate of recurrences and safety compared to typical AVNRT during long‐term follow‐up.
Single‐sweep pulmonary vein isolation using the new third‐generation laser balloon—Evolution in ablation style using endoscopic ablation system
Authors: Tohoku Shota , Bordignon Stefano , Chen Shaojie , Zanchi Simone , Bianchini Lorenzo , Trolese Luca , Operhalski Felix , Urbanek Lukas , Chun K. R. Julian , Schmidt Boris
Published: September 2021

Background

The endoscopic ablation system (EAS) is an established ablation device for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). The novel X3 EAS is now equipped with a contiguous circumferential ablation mode (RAPID mode).

Aim

To determine the feasibility of single‐shot fashioned ablation using X3.

Methods

Consecutive patients who underwent AF ablation using X3 were enrolled. We assessed the acute procedural data focusing on “Single‐sweep PVI” defined as successful PVI with a single RAPID mode energy application, and on “first‐pass isolation” defined as successful PVI after initial circular lesion set.

Results

One hundred AF patients (56% male, age: 68 ± 10 years, 66% paroxysmal AF) were analyzed. A total of 379 of 383 PVs (99%) were isolated with X3. Single‐sweep PVI and first‐pass‐isolation were achieved in 214 PVs (56%) and in 362 PVs (95%), respectively. Single‐sweep PVI rates varied across PVs with higher rates at the superior PVs (61.2% vs. inferior PVs: 49.5%, p = .0239) and at PVs with maximal ostial diameter <24 mm (57.6% vs. >24 mm: 36.8%, p = .0151). The mean total procedure and fluoroscopy times were 43.0 ± 10 and 4.0 ± 2 min, respectively. In none of the patients an acute thromboembolic event (stroke or transient ischemic attack) or a pericardial effusion/tamponade occurred. A single transient phrenic nerve palsy was observed.

Conclusion

The new X3 EAS allows for single‐shot fashioned ablation in terms of single‐sweep PVI in half or more of PVs. The new RAPID ablation mode leads to an improved rate of first‐pass isolation associated with very short procedure times without compromising safety.
Earliest pulmonary vein potential‑guided cryoballoon ablation is associated with better clinical outcomes than conventional cryoballoon ablation: A result from two randomized clinical studies
Authors: Mizutani Yoshiaki , Yanagisawa Satoshi , Kanashiro Masaaki , Yamashita Daiki , Yonekawa Jun , Makino Yuichiro , Hiramatsu Takatsugu , Ichimiya Hitoshi , Uchida Yasuhiro , Watanabe Junji , Ichimiya Satoshi , Inden Yasuya , Murohara Toyoaki
Published: September 2021

Introduction

With regard to short‐term outcome in atrial fibrillation (AF), the benefit of cryoballoon ablation (CBA) by pressing a balloon against the earliest pulmonary vein (PV) potential site during PV isolation (earliest potential [EP]‐guided CBA) has been previously demonstrated. The present study aimed to evaluate the long‐term outcome of the EP‐guided CBA.

Methods and Results

This study included 136 patients from two randomized studies, who underwent CBA for paroxysmal AF for the first time. Patients were randomly assigned to the EP‐guided and conventional CBA groups in each study. In the EP‐guided CBA group, we pressed a balloon against the EP site when the time‐to‐isolation (TTI) after cryoapplication exceeded 60 and 45 s in the first and second studies, respectively. We compared the clinical outcomes for 1 year after the procedure between the EP‐guided CBA group (68 patients) and the conventional CBA group (68 patients). The primary endpoint was the recurrence of atrial arrhythmia after ablation. No significant differences in baseline characteristics were observed between the two groups. Compared with the conventional CBA group, the EP‐guided CBA group had a significantly higher success rate at TTI ≤ 90 s (98.5% vs. 90.0%, p < .001); lower touch‐up rate and total cryoapplication; and shorter procedure time, and fluoroscopy time. The recurrence at 1 year after ablation was significantly lower in the EP‐guided CBA group than in the conventional CBA group (6.0% vs. 19.4%; p = .019).

Conclusions

The EP‐guided CBA approach can facilitate the ablation procedure and achieve low recurrence at 1 year after ablation.
Outcomes and predictors of readmission after implantation of a percutaneous left atrial appendage occlusion device in the United States: A propensity score‐matched analysis from The National Readmission Database
Authors: Pasupula Deepak Kumar , Munir Muhammad B. , Bhat Anusha Ganapati , Siddappa Malleshappa Sudeep K. , Meera Srinidhi J. , Spooner Michael , Koranne Ketan , Olshansky Brian , Hirji Sameer , Hsu Jonathan C.
Published: September 2021

Background

Left atrial appendage occlusion (LAAO) devices have become a favorable alternative option among nonvalvular atrial fibrillation (AF) patients with long‐term contraindication to anticoagulation. Real‐world experience with postprocedural readmission rates and predictors of readmission in LAAO patients is limited.

Objective

To assess all‐cause 30‐day readmission rate and predictors of readmission after LAAO procedure in the United States.

Method

This retrospective observational study included all AF patients undergoing percutaneous LAAO procedures in the United States from January 1, 2016, and December 31, 2017, in the National Readmission Database. The primary outcome measure was all‐cause 30‐day readmission. A propensity score‐matched analysis compared outcomes with a non‐LAAO AF cohort.

Result

Among 14 024 LAAO procedures (age: 76 ± 8 years; 60.5% males), 9.4% were readmitted within 30‐days and, 0.2% died during their index hospitalization. The most frequent primary diagnosis during readmission among LAAO was gastrointestinal bleeding (12%). The incidence of LAAO procedures increased by 102%. In the multivariate model, gender and CHA2DS2‐VASc failed to predict readmission. Age 55–64 years had lower odds (adjusted odds ratios [aOR]: 0.41; 95% confidence interval [CI]: 0.18–0.94), while drug abuse (aOR: 4.1; 95% CI: 1.34–12.54), and deficiency anemia (aOR: 1.88; 95% CI: 1.12–3.18) had higher odds of readmission. In propensity‐matched cohort, compared to non‐LAAO AF, LAAO patients had lower 30‐day readmission (9.4% vs. 10.98%, p = .002) and all‐cause in‐hospital mortality (0.19% vs. 0.57%, p < .001).

Conclusion

The readmission rate following the LAAO procedure is substantial (approximately 10%), and largely attributable to gastrointestinal bleeding. Factors such as drug abuse and anemia must be explored further to minimize readmission risk.
Human Placental Mesenchymal Stem/Stromal cells (pMSCs) inhibit agonist‐induced platelet functions reducing atherosclerosis and thrombosis phenotypes
Authors: Al Subayyil Abdullah , Basmaeil Yasser S. , Alenzi Reem , Khatlani Tanvir
Published: September 2021

Mesenchymal stem/stromal cells isolated from human term placenta (pMSCs) have potential to treat clinically manifested inflammatory diseases. Atherosclerosis is a chronic inflammatory disease, and platelets play a contributory role towards its pathogenesis. During transplantation, MSCs interact with platelets and exert influence on their functional outcome. In this study, we investigated the consequences of interaction between pMSCs and platelets, and its impact on platelet‐mediated atherosclerosis in vitro. Human platelets were treated with various types of pMSCs either directly or with their secretome, and their effect on agonist‐mediated platelet activation and functional characteristics were evaluated. Human umbilical vein endothelial cells (HUVECs) were used as control. The impact of pMSCs treatment on platelets was evaluated by the expression of activation markers and by platelet functional analysis. A subset of pMSCs reduced agonist‐induced activation of platelets, both via direct contact and with secretome treatments. Decrease in platelet activation translated into diminished spreading, limited adhesion and minimized aggregation. In addition, pMSCs decreased oxidized LDL (ox‐LDL)‐inducedCD36‐mediated platelet activation, establishing their protective role in atherosclerosis. Gene expression and protein analysis show that pMSCs express pro‐ and anti‐thrombotic proteins, which might be responsible for the modulation of agonist‐induced platelet functions. These data suggest the therapeutic benefits of pMSCs in atherosclerosis.
Phylogenetic conservation of behavioural variation and behavioural syndromes
Authors: Dalos Jeremy , Royauté Raphaël , Hedrick Ann V. , Dochtermann Ned A.
Published: September 2021

Individuals frequently differ consistently from one another in their average behaviours (i.e. ‘animal personality’) and in correlated suites of consistent behavioural responses (i.e. ‘behavioural syndromes’). However, understanding the evolutionary basis of this (co)variation has lagged behind demonstrations of its presence. This lag partially stems from comparative methods rarely being used in the field. Consequently, much of the research on animal personality has relied on ‘adaptive stories’ focused on single species and populations. Here, we used a comparative approach to examine the role of phylogeny in shaping patterns of average behaviours, behavioural variation and behavioural correlations. In comparing the behaviours and behavioural variation for five species of Gryllid crickets, we found that phylogeny shaped average behaviours and behavioural (co)variation. Despite differences among species, behavioural responses and variation were most similar among more closely related species. These results suggest that phylogenetic constraints play an important role in the expression of animal personalities and behavioural syndromes and emphasize the importance of examining evolutionary explanations within a comparative framework.
The evolution of flower longevity in unpredictable pollination environments
Authors: Xu Kuangyi , Servedio Maria R.
Published: September 2021

Pollination requires a flower to remain open for long enough to allow for the arrival of pollinators. However, maintaining flowers costs energy and resources. Therefore, flower longevity, the length of time a flower remains viable, is critical for the outcome of plant reproduction. Although previous studies showed that the evolution of flower longevity depends on the rates of pollen deposition and removal, whether plants should increase or decrease flower life span when the pollination environment is unpredictable has not been explored. Moreover, the common hypothesis that an unpredictable pollination environment should select for increased flower longevity may be too simplistic since there is no distinction drawn between the effects of spatial and temporal variation. Adopting evolutionary game theory, we investigate the evolution of flower longevity under three types of variation: spatial heterogeneity, daily fluctuations within a flowering season and yearly fluctuations between flowering seasons. We find that spatial heterogeneity often selects for a shorter flower lifespan, while temporal fluctuations of fitness accrual rates at both daily and yearly time scales tends to favour greater longevity, although daily and yearly fluctuations have somewhat different effects. However, the presence of correlation between female and male fitness accrual rates seems to have no effect on flower longevity. Our work suggests that explicit measurements of spatial and temporal variation in both female and male functions may provide a better understanding of the evolution of flower longevity and reproduction.
Antiviral activity of esculin against white spot syndrome virus: A new starting point for prevention and control of white spot disease outbreaks in shrimp seedling culture
Authors: Shan Li‐Peng , Zhang Xu , Hu Yang , Liu Lei , Chen Jiong
Published: September 2021

White spot syndrome virus (WSSV) is a pathogenic and threatening virus in shrimp culture for which there is no effective control strategy. Finding antiviral lead compounds for the development of anti‐WSSV drugs is urgent and necessary; in this study, esculin from 12 monomeric compounds exhibited an excellent anti‐WSSV activity. The results showed that esculin increased the survival rate of WSSV‐infected shrimps by 59% and reduced the virus copy number in vivo over 90% at 100 μM. In the pre‐treatment and post‐treatment experiments, esculin could prevent and treat WSSV infection. Compared with the control group, the virus copy number decreased by 30% after 6 h of esculin pre‐incubation with WSSV particles and inhibited horizontal transmission of WSSV to a certain extent. Considering that the antiviral activity of esculin was stable in the aquacultural water for 2 days, we evaluated the dosing pattern of continuous medication changes. Obviously, the survival rate of WSSV‐infected shrimps was 0% at 108 h when no esculin exchange was made, while at 120 h the survival rate was over 40% at continuous medicine changes. In addition, esculin significantly increased the expression of antimicrobial peptides and thus improved the ability of shrimp to resist WSSV. Overall, our findings suggest that esculin has the potential to be developed into an anti‐WSSV medicine.
Development of extra virgin olive and olive pomace oil nanoemulsions (o/w and w/o) enriched with surface‐active phenolic compounds
Authors: Katsouli Maria , Papatheodorou Spyridon‐Andreas , Giannou Virginia , Tzia Constantina
Published: September 2021

The present study explored the potential use and the effectiveness of extra virgin olive oil (EVOO) and olive pomace oil (OPO) for water in oil (w/o) and oil in water (o/w) nanoemulsion preparations. Nonionic food grade emulsifiers were examined in the formulation of the nanoemulsions and the incorporation of polyphenols extracted from olive kernel on their physicochemical properties was also investigated. The effect of the dispersed phase and the incorporated bioactive compounds was evaluated based on the mean droplet diameter (MDD) and polydispersity index (PDI), turbidity and viscosity, MDD growth, surface tension, and total phenolic content of the nanoemulsions during storage. Results were statistically evaluated using analysis of variance and Duncan's test was performed where applicable. The most effective type and the optimum ratio of the emulsifier was determined in each system (o/w–w/o, EVOO–OPO). The nanoemulsions produced presented desirable properties, in terms of kinetic stability, MDD, PDI, and viscosity and they demonstrated satisfactory physical and chemical stability during storage. MDD and PDI values were minimum in the case of o/w nanoemulsion prepared with 4% Tween 40. The stability of the nanoemulsion was enhanced by polyphenols while their retention reached ~80% being higher in o/w nanoemulsions. It was concluded that it is possible to prepare fine o/w and w/o nanoemulsions using both EVOO and OPO. The incorporation of bioactive compounds can significantly affect the nanoemulsions' properties, improving their kinetic and chemical stability.

Practical Applications

Although olive oil has been thoroughly studied for nanoemulsion preparations, there is still limited study on olive pomace oil applications. Hence, this present study was designed to compare the effectiveness of extra virgin olive oil and olive pomace oil on the formation of o/w and w/o nanoemulsion enriched with phenolic compounds extracted from the olive kernel. The novelty of work is highlighted in the following: both extra virgin olive and olive pomace oil can be suitable for the preparation of o/w and w/o nanoemulsions with good physical stability and without excessive droplet growth upon storage. These nanoemulsions can be used as a suitable means for the incorporation and protection of bioactive ingredients, such as polyphenolic compounds, and serve as an excellent delivery system as they exhibit satisfactory retention during storage.
Collaborative care for depression yields similar improvement among older and younger rural adults
Authors: Renn Brenna N. , Johnson Morgan , Powers Diane M. , Vredevoogd Mindy , Unützer Jürgen
Published: September 2021

Background

Depressive disorders are among the most prevalent mental health conditions; however, significant barriers to treatment access persist. This study examined differences in depression outcomes between younger and older adults in a large‐scale implementation demonstration of the collaborative care model (CoCM).

Methods

Secondary data analysis of a longitudinal, observational implementation demonstration at eight primary care clinics across low‐resourced rural or frontier areas of the Western United States. Seven of these clinics were federally qualified health centers. The sample consisted of 3722 younger (18–64 years) and older (65+ years) adult primary care patients diagnosed with unipolar depression. All participants received depression treatment via CoCM, which enhances usual primary care and makes efficient use of specialists by using a behavioral healthcare manager and a psychiatric consultant to support primary care providers. Clinics were followed for up to 27 months. Patients were followed until they completed treatment or dropped out. The Patient Health Questionnaire (PHQ‐9) assessed depressive symptoms at baseline (enrollment) and at most follow‐up contacts. The primary treatment outcome was a change between a patient's first and last recorded PHQ‐9 scores.

Results

Across both age groups, there was an average overall reduction of 6.9 points on the PHQ‐9. Older adults demonstrated a greater decrease in depression scores of 2.06 points (95% CI −2.98 to −1.14, p < 0.001) on the PHQ‐9 compared with younger adults. Estimates were robust when adjusting for gender, race, and clinic.

Conclusions

CoCM resulted in meaningful improvement in depressive symptoms across age groups.
Changes in activity levels, physical functioning, and fall risk during the COVID‐19 pandemic
Authors: Hoffman Geoffrey J. , Malani Preeti N. , Solway Erica , Kirch Matthias , Singer Dianne C. , Kullgren Jeffrey T.
Published: September 2021

Background

Physical function worsens with older age, particularly for sedentary and socially isolated individuals, and this often leads to injuries. Through reductions in physical activity, the COVID‐19 pandemic may have worsened physical function and led to higher fall‐related risks.

Methods

A nationally representative online survey of 2006 U.S. adults aged 50–80 was conducted in January 2021 to assess changes in health behaviors (worsened physical activity and less daily time spent on feet), social isolation (lack of companionship and perceived isolation), physical function (mobility and physical conditioning), and falls (falls and fear of falling) since March 2020. Multivariable logistic regression was used to assess relationships among physical activity, social isolation, physical function, falls, and fear of falling.

Results

Among respondents, 740 (36.9%) reported reduced physical activity levels, 704 (35.1%) reported reduced daily time spent on their feet since March 2020, 712 (37.1%) reported lack of companionship, and 914 (45.9%) social isolation. In multivariable models, decreased physical activity (adjusted risk ratio, ARR: 2.92, 95% CI: 2.38, 3.61), less time spent on one's feet (ARR: 1.95, 95% CI: 1.62, 2.34), and social isolation (ARR: 1.51, 95% CI: 1.30, 1.74) were associated with greater risks of worsened physical conditioning. Decreased physical activity, time spent daily on one's feet, and social isolation were similarly associated with worsened mobility. Worsened mobility was associated with both greater risk of falling (ARR: 1.70, 95% CI: 1.35, 2.15) and worsened fear of falling (ARR: 2.02, 95% CI: 1.30, 3.13). Worsened physical conditioning and social isolation were also associated with greater risk of worsened fear of falling.

Conclusion

The COVID‐19 pandemic was associated with worsened physical functioning and fall outcomes, with the greatest effect on individuals with reduced physical activity and social isolation. Public health actions to address reduced physical activity and social isolation among older adults are needed.
Consumer acceptance of circular business models and potential effects on economic performance: The case of washing machines
Authors: Gülserliler Ece G. , Blackburn Joseph D. , Van Wassenhove Luk N.
Published: September 2021

A key principle of the circular economy is to fundamentally reconsider the nature of the transaction between producer and consumer. To facilitate circularity and enhance sustainability, producers retain ownership of a product throughout its lifetime, and consumers lease, rent, or share the product. This paper examines the feasibility of leasing instead of buying a product from both the consumer's and manufacturer's perspectives. We focus on repeated leasing with refurbishment in‐between for the specific case of washing machines. Through an online experiment, we assess the preferences of consumers among the alternatives of purchasing a new machine and leasing a new or a used machine. The results reveal that the market is segmented and consumers have distinct preferences driven by psychological antecedents such as disgust, pride of ownership, and convenience of leasing. While there is some demand for leasing new and used machines, there are also barriers to the transition from selling to leasing: a significant number of consumers prefer to buy instead of lease at any price that would sustain a manufacturer's profitability. Moreover, there appears to be an imbalance in the consumer demand for leasing new and leasing used—a mismatch that poses an obstacle to the economic feasibility of a circular economy.
Clinical application of traditional Chinese medicine moisture exposed burn ointment in the treatment of facial soft tissue defect
Authors: Wang Jun , Hao Lanqing , Zhou Xiaolong , He Wanggang , Hu Ming
Published: September 2021

Objective

To introduce a new method of treating facial soft tissue defect by observing the clinical curative effects of traditional Chinese medicine moisture exposed burn ointment in treating facial soft tissue defect.

Methods

A total of 85 patients with facial soft tissue defects were treated with traditional Chinese medicine moisture exposed burn ointment, and the clinical therapeutic effects were analyzed by observing the wound healing time, scar formation and changes of facial appearance and functions.

Results

Of the 85 patients, the shortest wound healing time was 12 days and the longest was 72 days; the facial appearance and functions restored to be normal in 74 patients, with good skin elasticity and mild scar formation in the wound area; 11 patients were lost to the follow‐up; two patients suffered from the longest wound healing time due to their skin defect of nasal tip and nasal columella and the cartilage defect of nasal wings, and V‐shaped defects were left at the edge of the left nostrils after the wound healing, which may be attributed to the ineffectiveness of MEBT/MEBO on cartilage.

Conclusion

Traditional Chinese medicine moisture exposed burn ointment can realize more satisfying healing effects when applied in the treatment of facial soft tissue defects, including user‐friendly operation, no special requirements for medical devices, obviously lower treatment cost, etc., and thus it is an easy‐to‐operate and effective way for such patients, especially for elderly patients, patients with poor body conditions and patients unbearable to undergo complicated operations.
Longevity and subject‐reported satisfaction after minimally invasive jawline contouring
Authors: Müller Daniel , Prinz Valentina , Sulovsky Monika , Cajkovsky Mia , Moellhoff Nicholas , Cotofana Sebastian , Frank Konstantin
Published: September 2021

Background

Minimally invasive treatments as soft tissue filler injections can enhance the appearance of the jawline. This prospective, single‐center study investigated aesthetic outcome, patient satisfaction, adverse events, and volume changes after jawline contouring using standardized reporting scales and objectifiable 3D surface analysis.

Methods

A total of 30 patients (1 male and 29 females, mean age: 57.2 (±8.7) years) were investigated. Patients underwent jawline augmentation using a highly cross‐linked hyaluronic acid–based soft tissue filler. Three‐dimensional surface imaging was performed after 2 weeks, and 3, 6, 9, and 12 months. Furthermore, the aesthetic results and the occurrence of complications were investigated after two weeks, and 3, 6, 9, and 12 months.

Results

The surface‐volume coefficient (SVC) had an average of 1.10 ± 0.2 after 14 days, 0.95 ± 0.1 after 3 months, 0.83 ± 0.1 after 6 months, 0.74 ± 0.1 after 9 months, and 0.63 ± 0.1 after 12 months. A significant correlation was revealed between time of measurement and measured SVC with rp = −0.761, p < 0.001. Multivariate analysis revealed a significant difference between the measured SVC and the different time points of measurement with p < 0.001. The data revealed strong aesthetic improvement with results most often reported as “very much improved” according to the 5‐point GAIS after 3, 6, and 9 months, both by the investigator and by the patients. A 12‐month follow‐up analysis showed “much improved” results in a majority of cases.

Conclusion

The result of this investigation showed that jawline enhancement using minimally invasive soft tissue filler injections produces durable, safe results that are generally rated as very satisfying from a patient's and investigator's perspective over a time period of 12 months.
Stem cell‐derived exosomes: A supernova in cosmetic dermatology
Authors: Shen Xu , Song Shenghua , Chen Nian , Liao Junlin , Zeng Li
Published: September 2021

Introduction

Stem cell‐derived exosomes are cell‐free vesicles secreted by stem cells. Exosomes play a pivotal role in cell‐to cell communication due to the functional proteins and genetic information which they carry. In addition, studies on cell migration, tumor invasion, tissue regeneration, myocardial repair after injury, and fracture healing have been widely reported.

Objectives

The purpose of this review is to sum up the current state of research on multiple stem cell‐derived exosomes in cosmetic dermatology and to discuss the current challenges and future directions.

Methods

We searched "skin" and "exosome" from PubMed to find the application of stem cell exosomes in cosmetic dermatology.

Results

We found that stem cell‐derived exosomes have an important place in skin cosmetology such as wound healing, skin aging, and scar formation.

Conclusion

Stem cell derived exosomes supply a potential tool to cosmetic dermatology. The performance of stem cell derived exosomes in regulating skin physiological and pathobiological functions suggests that stem cell derived exosomes have potential in cosmetic dermatology.
Cephalometric analysis following combined Sub‐SMAS hyaluronic acid injection and subdermal and supraperiosteal poly‐L‐lactic acid injections in Asian women
Authors: Chuang Andy Deng‐Chi , Yang Chuan‐Kai , Chang Chang‐Cheng , Lin Erh‐Ti , Tsai Li‐Cheng , Huang Yung‐Hsueh , Huang Peter , Chiang Hsiu‐Mei , Lin Bor‐Shyh
Published: September 2021

Background

The aging face is characterized by skin laxity and volume loss. Attenuation of facial retaining ligaments significantly contributes to skin sagginess and soft tissue volume loss.

Aims

We designed a prospective cohort study to quantitatively assess the efficacy of hyaluronic acid (HA) with adjunct poly‐L‐lactic acid (PLLA) injections in strengthening the retaining ligaments.

Patients/Methods

A total of 12 Asian women were treated with HA injections to the orbital, zygomatic, buccal‐maxillary, and mandibular retaining ligaments with adjunct supraperiosteal and subdermal PLLA injections to the temporal region, midface, and lower face. Cephalometric measurements were done before treatment and 2, 4, 12, and 24 weeks post‐procedurally.

Results

Eyebrow peak and tail angles increased 20.0° ± 3.8° to 21.0° ± 3.8° (p < 0.05) and −2.9° ± 4.2° to −1.3° ± 3.3° (p < 0.001) at week 12. Eyebrow‐to‐orbital‐rim distance increased 1.9 ± 2.0 mm to 3.9 ± 1.5 mm (p < 0.001) at week 12. Eyebrow‐to‐upper‐eyelid distance increased 11.6 ± 3.0 mm to 12.7 ± 3.2 mm (p < 0.001) at week 24. Eyebrow‐peak‐to‐lateral‐limbus distance decreased 6.1 ± 3.1 mm to 5.3 ± 2.4 mm (p < 0.05) at week 4. Tragus‐oral‐commissure length and lower‐facial‐contouring length decreased 281 ± 11 mm to 275 ± 10 mm (p < 0.01) and 297 ± 14 to 292 ± 11 mm (p < 0.05) at week 12, respectively.

Conclusion

Hyaluronic acid injection for strengthening of facial retaining ligaments with adjunct PLLA is viable, safe, and effective in facial rejuvenation as supported by quantitative data.
Outcomes of nurse‐led telecoaching intervention for patients with heart failure: A systematic review and meta‐analysis of randomised controlled trials
Authors: Imanuel Tonapa Santo , Inayati Aini , Sithichoksakulchai Siriluk , Daryanti Saragih Ita , Efendi Ferry , Chou Fan‐Hao
Published: September 2021

Background

Studies have identified that nurse‐led telephone health coaching benefited the continuity of care in patients with heart failure. However, the effect of nurse‐led telephone health coaching remains inconclusive among the previous studies.

Aim

This review aimed to determine the effects of nurse‐led telecoaching among patients with heart failure.

Design

This study was a systematic review and meta‐analysis of randomised controlled trials. This study was reported in accordance with the PRISMA guideline.

Methods

Seven databases (PubMed, Embase, CINAHL, Web of Science, MEDLINE, Cochrane library and Ovid) were electronically searched up to 20 October 2020. The eligibility criteria were a randomised controlled trial study on heart failure patients, with the intervention led by a nurse through telephone coaching. Two authors independently evaluated the methodological quality using the modified Jadad scale. The Comprehensive Meta‐Analysis software version 3.0 with a random effect model was used to conduct a meta‐analysis, and Begg's and Egger's tests were performed to assess publication bias. Furthermore, sensitivity analysis was carried out.

Results

A total of 12 randomised controlled trials were met eligibility criteria and representing 1938 heart failure patients. The results showed that the nurse‐led telecoaching significantly enhanced patients’ self‐care behaviour (SMD = .84, 95%CI [0.45–1.24], p < .001) and improved quality of life (SMD = .23, 95%CI [0.06–0.39], p = .007).

Conclusion

Nurse‐led telecoaching appears to enhance self‐care behaviour and improve quality of life in patients with heart failure. Further research needs to build the evidence for nurse‐led telecoaching intervention, including understanding its mechanisms of action (e.g. frequency, components) and identifying its moderating factors.

Relevance to clinical practice

Implementation of nurse‐led telecoaching is deemed helpful in promoting continuity of care because it was an accessible and sustainable intervention to improve patients’ self‐care and quality of life.
Prevalence of peripheral intravenous catheters and policy adherence: A point prevalence in a tertiary care university hospital
Authors: Berger Sarah , Winchester Kerry , Principe Rommel B. , Culverwell Elizabeth
Published: September 2021

Aims and objectives

To determine prevalence and policy adherence for peripheral intravenous catheters (PIVC) in adult inpatients at a tertiary care university hospital (with about 83,000 inpatient admissions annually).

Background

Up to 80% of hospitalised patients receive intravenous therapy, most commonly via PIVCs. However, these devices are not risk‐free. Studies indicate that PIVC management standards in clinical practice are inadequate despite established policies promoting best practice. This leads to premature failure resulting in treatment delays, extended length of stay and potential compromised venous access for subsequent IV therapy.

Design

Observational point prevalence study.

Methods

Study undertaken on all adult acute care medical, surgical and oncology wards. Data were collected by senior registered nurses working in pairs on a single day. Descriptive statistics used to analyse data. SQUIRE 2.0 checklist for quality improvement reporting used.

Results

There were 449 adult inpatients in 19 wards on survey day. One hundred and ninety‐seven had one or more PIVCs in situ. The total number of PIVCs in‐situ was 212. PIVC Prevalence was 47%. PIVCs were inserted in points of flexion such as antecubital fossa, back of hand or wrist in 52% of patients. Only 19% of cases had documented assessment of 8‐hourly visual infusion phlebitis (VIP) score. Patients had local signs of phlebitis in 14.4% of cases. Patients were not aware of the reason/need for their PIVC in 44% of cases.

Conclusions

Discrepancies between evidence‐based guidelines and local policy in clinical practice were identified including high rates of PIVC insertion in points of flexion and poor documentation. These quality problems increase likelihood of adverse patient outcomes especially when associated with limited patient awareness of the reason for their PIVC.

Relevance to clinical practice

Poor adherence to best practice standards is ‘accepted but unacceptable’. PIVC failure is costly to both patients and health systems. A strong focus on improvement in PIVC care and management is needed.
Is there a consensus on the health consequences of retirement? A literature review
Authors: Garrouste Clémentine , Perdrix Elsa
Published: September 2021

We investigate the causal effect of retirement on health through literature. We explore the potential mechanisms which explain three effects: the switch from employment to retirement, later retirement, and earlier retirement. The empirical strategies used to identify the causal effects are mainly based on the observation of changes in health status at the legal age for retirement entitlement or on reforms that have led to changes in retirement incentives. Literature renders possible to make several observations on the average effect estimation. Retirement leads to better self‐reported health, less depression, a decrease in healthcare consumption, a decline in cognition and an ambiguous effect on physical health. Later retirement has no effect on mortality, decreases healthcare consumption, and has a negative or non‐significant impact on self‐reported health. Studies on the impact of earlier retirement are scarce due to few natural experiments exploiting such a variation. Lastly, some studies find evidence of heterogeneous effects by gender and occupational status. As there are relatively few studies on this aspect, the question should be seriously explored in future research.
Utility of Smartphone‐based real‐time report (Ecological Momentary Assessment) in the assessment and monitoring of awake bruxism: A multiple‐week interval study in a Portuguese population of university students
Authors: Dias Ricardo , Vaz Rui , Rodrigues Maria João , Serra‐Negra Júnia Maria , Bracci Alessandro , Manfredini Daniele
Published: September 2021

Purpose

The Ecological Momentary Assessment (EMA) concept was the basis for developing a smartphone application for the on‐time report of awake bruxism (AB) activities. This study aims to monitor AB report over time in a population of healthy young adults.

Methods

A population of young adults recruited among dental students in good general health was recruited. All answered to a questionnaire, including the Oral Behavior Checklist (OBC‐1). They were then monitored with a smartphone application for AB report during seven consecutive days and completed three further observation periods (EMA‐1, 2 and 3) at one‐month intervals. After the third period (EMA‐3), participants answered again the OBC questionnaire (OBC‐2). Changes over time were described, and Pearson Correlation test was performed to assess the correlation between EMA and OBC items reports. A significance level of p = .01 was set.

Results

Thirty‐one University students completed the study protocol. Answers to the OBC showed an increase in the prevalence of self‐reported bracing and teeth clenching from the first to second report (38.7%–54.8% and 77.4%–90.3%, respectively). A slight increase in the ‘relaxed’ condition (62.5%–69.0%) was observed with EMA‐based smartphone application over time. No correlation between OBC items and EMA was detected between OBC‐1 and EMA‐1. A moderate positive correlation in bracing report (+0.509, p = .01) and weak positive correlation in teeth contact report (+0.380, p = .05) were found between OBC‐2 and EMA‐3.

Conclusion

Using a smartphone‐based approach to AB report may be helpful to monitor AB over time and increase an individual's awareness to recognise actions such as bracing and teeth contact concerning the single‐time report.
Direct immunofluorescence analysis of oral Tzanck smears for pemphigus vulgaris: A diagnostic test
Authors: He Wenxiu , Li Kaiyi , Hu Xiaosheng , Hua Hong , Wei Pan
Published: September 2021

Background

Pemphigus vulgaris (PV) is a rare and potentially fatal autoimmune blistering disease. Direct immunofluorescence (DIF) and histopathological analysis are crucial methods for PV diagnosis, but oral tissue biopsy is difficult to perform because of the fragile characteristics of the oral mucosa. However, no well‐designed diagnostic studies addressing the validity of DIF analysis of oral Tzanck smears for the diagnosis of PV exist. We aimed to design a diagnostic test based on DIF analysis combined with oral Tzanck smears and evaluate its diagnostic accuracy for PV.

Methods

We enrolled 81 patients with oral erosive lesions, of whom 41 patients had PV and 40 were non‐PV controls. Oral Tzanck smears were obtained from oral mucosal lesions and observed under a fluorescence microscope after fixing and fluorescence staining. The diagnostic efficacy indexes including sensitivity, specificity, predictive value, Youden index, diagnostic odds ratio, and likelihood ratio were calculated.

Results

Of the 41 PV patients, 36 showed DIF‐positive findings for oral Tzanck smears, and all 36 DIF‐positive PV patients showed IgG and/or C3 deposition, with seven also showing IgA and/or IgM positivity. None of the non‐PV controls showed DIF positivity. The sensitivity and specificity of DIF analysis with oral Tzanck smears were 87.80% and 100%, respectively. The area under the receiver operator characteristic curve (ROC) was 0.939, with the test demonstrating significantly high diagnostic efficacy.

Conclusion

DIF analysis of oral Tzanck smears is a minimally invasive and easy‐to‐operate technique that can assist the rapid and accurate diagnosis of PV in dental clinic.