bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of hypomineralised second primary molar on preschoolers' oral health–related quality of life—A hierarchical approach
Authors: Cerqueira Silva Renara Natália , Lima Cacilda Castelo Branco , Bendo Cristiane Baccin , Lima Luciano Rodrigues Silva , de Moura Marcoeli Silva , Moura Lúcia de Fátima Almeida de Deus , Lima Marina de Deus Moura de
Published: June 2021

Background

Hypomineralised second primary molar (HSPM) is a developmental enamel defect associated with dental caries.

Aim

To evaluate the impact of HSPM on oral health–related quality of life (OHRQoL) in preschoolers through hierarchical analysis.

Design

This population‐based cross‐sectional study assessed 834 5‐year‐old preschoolers, in Teresina, Piauí, Brazil, using sociodemographic questionnaires and Early Childhood Oral Health Impact Scale (ECOHIS). Dental examination was performed by two calibrated examiners (κ ≥ 0.80) for the diagnosis of HSPM (EAPD), dental caries (dmft and pufa indices), and malocclusion (Foster and Hamilton criteria). Analysis of the determinants of OHRQoL was stratified at three levels (P < .05).

Results

Severe HSPM was associated with OHRQoL in bivariate analysis (P < .05). In adjusted final multivariate analysis (model 1), the presence of dental caries with or without clinical consequences was associated with worse OHRQoL (P < .05). In model 2, after the removal of dental caries, preschoolers with severe HSPM had greater probability of having a negative impact on OHRQoL in the child impact section (RR = 2.14; 95% CI = 1.26‐3.65), family impact section (RR = 1.99; 95% CI = 1.16‐3.42), and total score (RR = 2.09; 95% CI = 1.25‐3.49) of the ECOHIS.

Conclusion

Severe HSPM had a negative impact on the OHRQoL of preschoolers and their families, but the presence of dental caries neutralised this impact.
Systematic profiling of invasion‐related gene signature predicts prognostic features of lung adenocarcinoma
Authors: Yu Ping , Tong Linlin , Song Yujia , Qu Hui , Chen Ying
Published: June 2021

Due to the high heterogeneity of lung adenocarcinoma (LUAD), molecular subtype based on gene expression profiles is of great significance for diagnosis and prognosis prediction in patients with LUAD. Invasion‐related genes were obtained from the CancerSEA database, and LUAD expression profiles were downloaded from The Cancer Genome Atlas. The ConsensusClusterPlus was used to obtain molecular subtypes based on invasion‐related genes. The limma software package was used to identify differentially expressed genes (DEGs). A multi‐gene risk model was constructed by Lasso‐Cox analysis. A nomogram was also constructed based on risk scores and meaningful clinical features. 3 subtypes (C1, C2 and C3) based on the expression of 97 invasion‐related genes were obtained. C3 had the worst prognosis. A total of 669 DEGs were identified among the subtypes. Pathway enrichment analysis results showed that the DEGs were mainly enriched in the cell cycle, DNA replication, the p53 signalling pathway and other tumour‐related pathways. A 5‐gene signature (KRT6A, MELTF, IRX5, MS4A1 and CRTAC1) was identified by using Lasso‐Cox analysis. The training, validation and external independent cohorts proved that the model was robust and had better prediction ability than other lung cancer models. The gene expression results showed that the expression levels of MS4A1 and KRT6A in tumour tissues were higher than in normal tissues, while CRTAC1 expression in tumour tissues was lower than in normal tissues. The 5‐gene signature prognostic stratification system based on invasion‐related genes could be used to assess prognostic risk in patients with LUAD.
Periodontitis is associated with incidental valvular heart disease: A nationwide population‐based cohort study
Authors: Sia Sung‐Kien , Jan Ming‐Shiou , Wang Yu‐Hsun , Huang Yu‐Feng , Wei James Cheng‐Chung
Published: June 2021

Aim

Periodontitis and valvular heart disease (VHD) are common diseases. Both diseases are related to chronic inflammation and share many common risk factors. Previous periodontal studies had focused mainly on atherosclerotic cardiovascular disease. This study aimed to determine whether periodontitis is associated with the development of VHD.

Materials and methods

This was a retrospective nationwide cohort study using Taiwan's Longitudinal Health Insurance Database. Using ICD‐9‐CM coding, both the periodontitis and non‐periodontitis groups were matched.

Results

There were 8483 cases and 4919 cases of VHD diagnosed in the periodontitis group and non‐periodontitis group, respectively. The cumulative incidence of VHD was significantly higher in the periodontitis group (log‐rank test, p < .001), with the incidence density of 6.44 (95% CI, 6.31–6.58) per 1000 person‐years in the periodontitis group compared to 4.65 (95% CI, 4.52–4.78) in the non‐periodontitis group. The relative risk for VHD was 1.39 (95% CI, 1.34–1.44). After multivariate analysis, periodontitis was independently associated with a risk for VHD (HR, 1.38; 95% CI, 1.33–1.42, p < .001). Intensive treatment of periodontitis significantly lowered the risk for VHD (HR, 0.68; 95% CI, 0.60–0.77, p < .001).

Conclusions

Periodontitis was significantly associated with the development of VHD. Treatment of periodontitis reduced the risk for VHD.
Masking ability of bleach‐shade resin composites using the multilayering technique
Authors: Dalmolin Andressa , Perez Bibiana Gabardo , Gaidarji Bruna , Ruiz‐López Javier , Lehr Roberta Maronesi , Pérez María M. , Durand Letícia Brandão
Published: June 2021

Objective

Evaluate the masking ability of bleach‐shade resin composites applied by multilayering techniques over colored substrates.

Materials and methods

Disc‐shaped specimens were fabricated from bleach‐shade resin composites using different multilayering techniques. Substrates were produced in opaque ceramic discs simulating colored substrates (A2, A3, A3.5, C2, C3, C4) and a bleached tooth (0M1). Color coordinates were obtained using a reflectance spectrophotometer. Color difference was calculated by CIEDE2000 using coordinates of 0 M1 ceramic as standard reference. Data were analyzed by one‐way ANOVA and Tukey's post‐hoc test (p ≤ 0.05). Masking ability interpretation was based on perceptibility and acceptability thresholds.

Results

All combinations presented ΔE00 above the acceptable threshold (ΔE00>1.8), ranging from 2.49 to 7.42, regardless of the restorative system, multilayering strategy or substrate color. Multilayering combinations placed over A2, A3 and A3.5 were moderately (1.8<ΔE00≤3.6) and clearly unacceptable (3.6<ΔE00≤5.4), combinations associated with C2, C3 and C4 were clearly unacceptable and, extremely unacceptable (ΔE00>5.4). Lower ΔE00 was observed for combinations with 0.5 mm extra white enamel layer (2.49), or 1.0 mm white dentin layer (2.69), over A2 and A3.5 substrates. Lightness difference showed the greatest contribution to ΔE00.

Conclusions

Bleach‐shade resin composite systems applied by the multilayering technique were not able to ensure effective masking ability.

Clinical significance

Bleach‐shade resin composites applied with different combinations of the multilayering technique were not effective in masking colored substrates. Alternative strategies, techniques and dental materials should be explored to obtain acceptable masking.
Charcoal‐based dentifrices: Effect on color stability and surface wear of resin composites
Authors: Torso Victor Hugo , Fraga May Anny Alves , Lopes Raquel Marianna , Aranha Ana Cecília Corrêa , Correr‐Sobrinho Lourenço , Correr Américo Bortolazzo
Published: June 2021

Objective

To evaluate the effect of charcoal‐based dentifrices on the color change (CC) and surface wear (SW) of resin composites.

Materials and Methods

Five dentifrices, including three toothpastes: Colgate total‐12 (C12), Black is the new White (CPX), and Natural (NAT); and two powders: Carvvo (CVV) and Whitemax (WMX), were evaluated. Composite blocks (5x5x2mm‐ Z350 3 M/ESPE, shade A2) were subjected to 417 and 5004 brushing cycles. The CC (n = 7, CIEDE2000; ΔE00) was evaluated using a spectrophotometer. SW (n = 5) was assessed using profilometry. The dentifrice particles were characterized by scanning electron microscopy (SEM).

Results

In 417 brushing cycles, resin composite exhibited higher color change upon being exposed to NAT, CVV and WMC than to C12 (p ≤ 0.05). In 5004 brushing cycles, resin composite showed higher color change values when exposed to all dentifrices, except C12 (p ≤ 0.05). The powders promoted higher SW on resin composite than C12 in both evaluation times (p ≤ 0.05). In 417 cycles, WMX caused higher SW on composite than C12, CPX, and NAT (p ≤ 0.05). No significant different SW was found between powders and charcoal‐based toothpastes after 5004 brushing cycles (p > 0.05). SEM showed larger particles for powder than for toothpaste dentifrices.

Conclusion

Within the limitations of this study, both null hypotheses have been rejected. Resin composites exposed to charcoal‐based dentifrices exhibited significantly (p ≤ 0.05) higher color change and surface wear than conventional toothpastes.

Clinical Significance

Color change and surface wear shown by charcoal dentifrices may compromise the longevity of restorations.
Whole grain claims: Do they matter?
Authors: Zank Gail M. , Smith Karen H.
Published: June 2021

Consumers are offered many food choices when grocery shopping and often use product package claims and labels to help in decision making. Although many studies have evaluated health‐related product claims, few have examined whole grain claims or the use of the whole grain stamp. Two experiments show that whole grain claims and stamp do influence consumer health perceptions about a fictitious brand of crackers. Also, consumer knowledge about whole grains is not always accurate. Based on the results, more consumer education is needed for consumers to make informed decisions. Public policy suggestions are provided.
Effects of the straw inclusion in the diet of dairy calves on growth performance, rumen fermentation, and blood metabolites during pre‐ and post‐weaning periods
Authors: Gąsiorek Michał , Stefańska Barbara , Pruszyńska‐Oszmałek Ewa , Komisarek Jolanta , Nowak Włodzimierz
Published: June 2021

The aim of this study was to investigate the effects of the inclusion of chopped straw into a diet with pelleted starter feed on starter intake, growth performance, fermentation and blood metabolites of dairy calves during the pre‐ and post‐weaning periods. Forty‐four Holstein‐Friesian female dairy calves were randomly assigned to four treatments: control (CON, starter without straw; n = 11), low straw (LS, starter feed containing 10% dry matter basis straw; n = 11), medium straw (MS, starter feed containing 15% dry matter basis straw; n = 11) and high straw (HS, starter feed containing 20% dry matter basis straw; n = 11). Starter intake and total dry matter intake were recorded daily, and bodyweight weekly until 84 days of age. The highest starter intake and total dry matter intake were noted in the LS and MS treatments during the post‐weaning, and overall experiment periods. Also, the average daily gain was greater during the pre‐weaning period for LS and MS than HS. Increasing chopped straw content in the starter feeds from 0% to 15% increased ruminal pH, especially at day 28, and molar concentration of acetate, and decreased concentrations of total volatile fatty acids and propionate throughout the trial. Concentrations of butyrate in the rumen were lower at day 28, and higher at day 56 and 84 in straw‐supplemented calves compared to the CON treatment. Increasing chopped straw content in the starters feeds from 0% to 15% increased the total counts of bacteria and protozoa, but then this counts decreased with the content of 20% chopped straw. In conclusion, the inclusion of chopped triticale straw from 10% to 15% in the diet with pelleted starter feed can improve performance, and rumen fermentation in calves; however, increasing the dietary inclusion of straw to 20% can negatively affect growth performance.
The Effects of Stressful Life Events and Negative Emotions in Relation to the Quality of Sleep: A Comparison between Chinese and Japanese Undergraduate Students and Chinese International Students
Authors: Wang Shang , Matsuda Eiko
Published: June 2021

This study investigated the effects of stressful life events (SLE) on the quality of sleep among university students. The subjects were 410 Chinese undergraduate students (CU), 201 Japanese undergraduate students (JU), and 111 Chinese international students living in Japan (CI). Four questionnaires were administered: (a) the Pittsburgh Sleep Quality Index; (b) the Depression Anxiety Stress Scale‐21; (c) the Negative Life Events checklist; and (d) the Adolescent Self‐Rating Life Events Checklist. Structural Equation Modeling (SEM) indicated that the experience of SLE directly affects and decreases the quality of sleep, and also increases negative emotions thereby indirectly influencing sleep quality. The multiple‐group SEM suggested that negative emotions elicited from SLE, influencing the quality of sleep, were higher for CU and CI than for JU. Thus, it could be suggested that measures to improve the quality of sleep need to be managed differently for Japanese and Chinese students.
A pilot study of transdermal gabapentin in cats
Authors: Slovak Jennifer E. , Costa Ana P.
Published: June 2021

Background

Clinical use of gabapentin has increased; transdermal delivery in cats is incompletely studied.

Objective

To evaluate if gabapentin permeates feline skin in vitro and in vivo and to determine if pain scores improve after administration.

Animals

In vitro: cadaver skin from 6 cats; phase 1: 8 young, healthy client‐owned cats; phase 2: 15 client‐owned geriatric cats.

Methods

In vitro, gabapentin applied every q12h to ear or cervical skin in diffusion cells. Samples collected at 0, 2, 4, 12, and 24 hours after application. Phase 1: Cats assigned to 1 of 4 groups: 5 mg/kg or 10 mg/kg applied q8h for 5 days to either ear or cervical skin. Serum samples collected predose, and after 1 and 5 days. Phase 2: 10 mg/kg applied q8h for 5 days. Two validated pain scores recorded predose, and after days 1, 5, and 8. Serum samples collected predose, and after days 1 and 5. Samples were frozen at −80°C for concentration analysis utilizing a validated high‐performance liquid chromatography mass‐spectrometry method.

Results

Gabapentin was identified in all samples. Significant differences in gabapentin concentrations were observed from day 1 to day 5 (P < .02) and in pain scores from predose to day 5 (P < .05) and day 1 to day 5 (P < .05). No differences in pain scores were observed from predose to day 8 (P = .3).

Conclusions and Clinical Relevance

Gabapentin in a transdermal base penetrates feline skin in vitro, is absorbed systemically in cats, and may help decrease pain scores.
Accessing local support online: Mothers' experiences of local Breastfeeding Support Facebook groups
Authors: Morse Holly , Brown Amy
Published: June 2021

The importance of support to breastfeeding success is well established, as are the difficulties many mothers face in accessing the support they need. With the majority of UK mothers now accessing social media for support, Breastfeeding Support Facebook (BSF) groups have increased exponentially. BSF groups vary in type (local or national/international) and in moderation—overseen by breastfeeding mothers and by midwives or trained lactation specialists. Some groups aimed at supporting mothers in a specific geographical area also have associated face‐to‐face groups, facilitated as either professional or peer support. Little is currently known about these specific local groups, their prevalence, impact or value to mothers. This paper examines mothers' experiences of using local BSF groups and why they value them as part of a larger study exploring the impact of midwife moderation on these groups. An online survey consisting of open and closed questions was completed by 2028 mothers. Findings identified that local BSF groups are widely used and highly valued for their connection with local face‐to‐face services and other mothers. They offer access to expertise and shared experience in a format mothers find convenient and timely, improving confidence and self‐efficacy. Local BSF groups enable the formation of support networks and development of breastfeeding knowledge that mothers credit with increased well‐being, motivation and breastfeeding duration. As such, they have the potential to add value to local face‐to‐face services and improve breastfeeding experiences and knowledge in communities. The findings have important implications to support the development of integrated online interventions to improve public health.
Navigating landscapes of practice: A longitudinal qualitative study of physicians in medical education
Authors: Balmer Dorene F. , Rosenblatt Samuel , Boyer Donald
Published: June 2021

Introduction

Despite its widespread application in medical education, belonging to a single community of practice does not reflect the overall experience of physician‐educators. Knowing how physician‐educators find their way among different communities of practice (ie their landscape of practice) has implications for professional development but the limited description in the literature. In this longitudinal qualitative research, we explored how physicians who pursue graduate degrees in medical education navigate their landscape of practice.

Methods

11/29 physicians in one cohort of a masters in medical education programme were interviewed annually from 2016 (programme start) to 2020 (2 years post‐graduation). We iteratively collected and analysed data, creating inductive codes and categorising coded data by mode of identification (engagement, imagination, alignment) and time. We organised narratives into time‐ordered data matrices so that final analysis wove together mode, time and participant.

Results

All participants consistently spoke of navigating their landscape of practice, which included the community created in the graduate programme; but that single community ‘doesn't define the journey itself’. They shifted engagement from teaching individual learners to translating what they learned in the graduate programme to develop educational projects and produce scholarship. They shifted the imagination from relying on internal and external assessments to experience‐inspired versions of their future self. And they shifted alignment from belonging to the graduate programme's community of practice, then belonging to different communities in their landscape of practice and ultimately focussing on communities that mattered most to them.

Discussion

Physicians in a graduate programme in medical education navigated their dynamic landscape of practice by shifting how they engaged in medical education, as well as what they imagined and who they aligned with as physician‐educators. Our work offers novel insights into how knowledgeability emerges through time as overlapping modes of identification.
Exploring the use of rating scales with entrustment anchors in workplace‐based assessment
Authors: Robinson Trevor J. G. , Wagner Natalie , Szulewski Adam , Dudek Nancy , Cheung Warren J. , Hall Andrew K.
Published: June 2021

Purpose

Competency‐based medical education (CBME) has prompted widespread implementation of workplace‐based assessment (WBA) tools using entrustment anchors. This study aimed to identify factors that influence faculty's rating choices immediately following assessment and explore their experiences using WBAs with entrustment anchors, specifically the Ottawa Surgical Competency Operating Room Evaluation scale.

Method

A convenience sample of 50 semi‐structured interviews with Emergency Medicine (EM) physicians from a single Canadian hospital were conducted between July and August 2019. All interviews occurred within two hours of faculty completing a WBA of a trainee. Faculty were asked what they considered when rating the trainee's performance and whether they considered an alternate rating. Two team members independently analysed interview transcripts using conventional content analysis with line‐by‐line coding to identify themes.

Results

Interviews captured interactions between 70% (26/37) of full‐time EM faculty and 86% (19/22) of EM trainees. Faculty most commonly identified the amount of guidance the trainee required as influencing their rating. Other variables such as clinical context, trainee experience, past experiences with the trainee, perceived competence and confidence were also identified. While most faculty did not struggle to assign ratings, some had difficulty interpreting the language of entrustment anchors, being unsure whether their assessment should be retrospective or prospective in nature, and if/how the assessment should change whether they were ‘in the room’ or not.

Conclusions

By going to the frontline during WBA encounters, this study captured authentic and honest reflections from physicians immediately engaged in assessment using entrustment anchors. While many of the factors identified are consistent with previous retrospective work, we highlight how some faculty consider factors outside the prescribed approach and struggle with the language of entrustment anchors. These results further our understanding of ‘in‐the‐moment’ assessments using entrustment anchors and may facilitate effective faculty development regarding WBA in CBME.
Making it fair: Learners’ and assessors’ perspectives of the attributes of fair judgement
Authors: Valentine Nyoli , Shanahan Ernst Michael , Durning Steven J. , Schuwirth Lambert
Published: June 2021

Introduction

Optimising the use of subjective human judgement in assessment requires understanding what makes judgement fair. Whilst fairness cannot be simplistically defined, the underpinnings of fair judgement within the literature have been previously combined to create a theoretically‐constructed conceptual model. However understanding assessors’ and learners’ perceptions of what is fair human judgement is also necessary. The aim of this study is to explore assessors’ and learners’ perceptions of fair human judgement, and to compare these to the conceptual model.

Methods

A thematic analysis approach was used. A purposive sample of twelve assessors and eight post‐graduate trainees undertook semi‐structured interviews using vignettes. Themes were identified using the process of constant comparison. Collection, analysis and coding of the data occurred simultaneously in an iterative manner until saturation was reached.

Results

This study supported the literature‐derived conceptual model suggesting fairness is a multi‐dimensional construct with components at individual, system and environmental levels. At an individual level, contextual, longitudinally‐collected evidence, which is supported by narrative, and falls within ill‐defined boundaries is essential for fair judgement. Assessor agility and expertise are needed to interpret and interrogate evidence, identify boundaries and provide narrative feedback to allow for improvement. At a system level, factors such as multiple opportunities to demonstrate competence and improvement, multiple assessors to allow for different perspectives to be triangulated, and documentation are needed for fair judgement. These system features can be optimized through procedural fairness. Finally, appropriate learning and working environments which considers patient needs and learners personal circumstances are needed for fair judgments.

Discussion

This study builds on the theory‐derived conceptual model demonstrating the components of fair judgement can be explicitly articulated whilst embracing the complexity and contextual nature of health‐professions assessment. Thus it provides a narrative to support dialogue between learner, assessor and institutions about ensuring fair judgements in assessment.
‘Nurses whisper.’ Identities in nurses’ patient safety narratives of nurse‐trainee doctors’ interactions
Authors: Samuriwo Ray , Bullock Alison , Webb Katie , Monrouxe Lynn V.
Published: June 2021

Context

Nurses are integral to patient safety, but little is known about their narrative constructions of identity in relation to their dyadic interactions with trainee doctors about patient safety and competence during the trajectory of a medical career.

Aim

We sought to examine how identities are constructed by experienced nurses in their narratives of patient safety encounters with trainee doctors.

Methods

Our qualitative study gathered narrative data through semi‐structured interviews with nurses of different professional standing (n = 20). Purposive sampling was used to recruit the first eight participants, with the remainder recruited through theoretical sampling. Audio recordings were transcribed verbatim and analysed inductively through a social constructionist framework and deductively using a competence framework.

Results

We classified seven identities that participants constructed in their narratives of dyadic interactions with trainee doctors in relation to patient safety: nurses as teacher, guardian of patient wellbeing, provider of emotional support, provider of general support, expert advisor, navigator and team player. These identities related to the two key roles of nurses as educators and as practitioners. As they narrated these dyadic interactions, participants constructed identities that positioned trainee doctors in character tropes, suggesting gaps in professional competence: nurses as provider of general support was commonly narrated in the context of perceived deficits of personal or functional capabilities and nurses as team player was mainly associated with concerns (or reassurances) around ethical capabilities.

Discussion and Conclusion

Our findings are consistent with, and extend the wider literature on the development of professional competence, interprofessional collaboration in health care, and the nature and organisation of nursing work. Nurses' work in ensuring patient safety and support trainee doctors’ professional development merits greater formal recognition and legitimation.
Neurodegenerative disorders affecting the autonomic nervous system: Pure autonomic failure and multiple system atrophy
Authors: Yamanaka Yoshitaka , Araki Nobuyuki , Kuwabara Satoshi
Published: June 2021

Pure autonomic failure (PAF) and multiple system atrophy (MSA) are representative neurodegerative diseases present with a severe autonomic dysfunction in the urinary, cardiovascular, and pupillary systems, as well as the gastrointestinal tract and skin/sweat glands. Clinically PAF is characterized by chronic progressive pure autonomic dysfunction occasionally associated with parkinsonism or cognitive dysfunction (Lewy body disease), whereas MSA is associated with cerebellar manifestation and/or parkinsonism. Pathology of both PAF and MSA is characterized by α‐synuclein deposition, but in PAF major involvement exists in the sympathetic ganglion and postganglionic autonomic nerve fibers, whereas MSA mainly affects the central autonomic system, such as the vagal nerve lateral nucleus, locus coeruleus, spinal cord medial lateral nucleus, and sacral Onuf's nucleus. Therefore, it is necessary to evaluate whether peripheral or central autonomic function is predominantly affected by the differential diagnosis of PAF and MSA. Autonomic dysfunction is also frequently present in patients with Parkinson's disease, but usually not so severe as in PAF or MSA. This review summarizes features of autonomic dysfunction in PAF and MSA.
Alterations in the CO2 availability induce alterations in the phosphoproteome of the cyanobacterium Synechocystis sp. PCC 6803
Authors: Spät Philipp , Barske Thomas , Maček Boris , Hagemann Martin
Published: June 2021

Cyanobacteria are the only prokaryotes that perform plant‐like oxygenic photosynthesis. They evolved an inorganic carbon‐concentrating mechanism to adapt to low CO2 conditions.

Quantitative phosphoproteomics was applied to analyze regulatory features during the acclimation to low CO2 conditions in the model cyanobacterium Synechocystis sp. PCC 6803.

Overall, more than 2500 proteins were quantified, equivalent to c. 70% of the Synechocystis theoretical proteome. Proteins with changing abundances correlated largely with mRNA expression levels. Functional annotation of the noncorrelating proteins revealed an enrichment of key metabolic processes fundamental for maintaining cellular homeostasis. Furthermore, 105 phosphoproteins harboring over 200 site‐specific phosphorylation events were identified. Subunits of the bicarbonate transporter BCT1 and the redox switch protein CP12 were among phosphoproteins with reduced phosphorylation levels at lower CO2, whereas the serine/threonine protein kinase SpkC revealed increased phosphorylation levels. The corresponding ΔspkC mutant was characterized and showed decreased ability to acclimate to low CO2 conditions. Possible phosphorylation targets of SpkC including a BCT1 subunit were identified by phosphoproteomics.

Collectively, our study highlights the importance of posttranscriptional regulation of protein abundances as well as posttranslational regulation by protein phosphorylation for the successful acclimation towards low CO2 conditions in Synechocystis and possibly among cyanobacteria.
Can patients’ narratives in nursing enhance the healing process?
Authors: Damsgaard Janne Brammer , Simonÿ Charlotte , Missel Malene , Beck Malene , Birkelund Regner
Published: June 2021

Although there is a growing acknowledgement of the potential of a more nuanced healthcare paradigm and practice, the discourses of health promotion—and with that nursing and other healthcare professionals’ practice—still tend to focus on the medical diagnosis, disease and the rationale of biomedicine. There is a need for shifting to a human practice that draws on a broader perspective related to illness. This requires a transformation of practices which can be constructed within a narrative understanding. A narrative approach appreciates the importance of emotion and intersubjective relation in the telling and listening that occur in the clinical encounter. The essence of nursing lies in the creative imagination, the sensitive spirit and the intelligent understanding of the individuals’ possibilities of becoming empowered in his or her own life. This entails that the focus of the use of patients’ narratives is, ultimately, not the story itself, but the nurses’ and other healthcare professionals’ ability to support the patients in finding useful meaning in their stories. Herein, it is of particular importance to let the patients narrate about what is sparkling moments or events in the lived life. Stories with such focus can open up for patients’ hopes and dreams, which gives inspiration for finding meaningful ways to cope in life empowering personal recovery. It is, therefore, crucial to transform clinical settings into places that acknowledge the need for imagination and creativity, aiming at creating the opportunity for sensibility and vision essential to encouraging a narrative approach and thereby the ability to reflect upon and promote a healing process.
Pharmacologic neuroprotection in ischemic brain injury after cardiac arrest
Authors: Katz Alyson , Brosnahan Shari B. , Papadopoulos John , Parnia Sam , Lam Jason Q.
Published: June 2021

Cardiac arrest has many implications for morbidity and mortality. Few interventions have been shown to improve return of spontaneous circulation (ROSC) and long‐term outcomes after cardiac arrest. Ischemic‐reperfusion injury upon achieving ROSC creates an imbalance between oxygen supply and demand. Multiple events occur in the postcardiac arrest period, including excitotoxicity, mitochondrial dysfunction, and oxidative stress and inflammation, all of which contribute to ongoing brain injury and cellular death. Given that complex pathophysiology underlies global brain hypoxic ischemia, neuroprotective strategies targeting multiple stages of the neuropathologic cascade should be considered as a means of mitigating secondary neuronal injury and improving neurologic outcomes and survival in cardiac arrest victims. In this review article, we discuss a number of different pharmacologic agents that may have a potential role in targeting these injurious pathways following cardiac arrest. Pharmacologic therapies most relevant for discussion currently include memantine, perampanel, magnesium, propofol, thiamine, methylene blue, vitamin C, vitamin E, coenzyme Q10, minocycline, steroids, and aspirin.
Improving newborn skin health: Effects of diaper care regimens on skin pH and erythema
Authors: Gustin Jennifer , Bohman Lisa , Ogle Julie , Fadayel Gina , Mitchell Maria C. , Narendran Vivek , Visscher Marty O. , Carr Andrew N.
Published: June 2021

Background/Objective

Newborn infant skin is functional but immature, and diapering products can play a significant role in infant diapered skin health. Previous work demonstrated a regimen consisting of a diaper with an emollient and apertures on the inner liner (topsheet) with an acidic, pH‐buffered wipe (Regimen A) lowered newborn skin pH and reduced the enzymatic activity on skin post‐stool cleaning versus a regimen without these features (Regimen B). This study extends these findings to determine the impact of Regimen A on diaper area erythema severity over a 2‐week use period.

Methods

This IRB‐approved, blinded, randomized, crossover study enrolled newborn infants >7 days and ≤8 weeks. Participants exclusively used two unique diaper and wipe combinations, Regimen A and Regimen B (non‐emollient, non‐aperture containing topsheet and wipe with limited buffering capacity), each for 14 days and preceded by a 3‐day washout regimen.

Results

Diapered skin pH was reduced during Regimen A use to values similar to that of a non‐diapered control site (chest), while use of Regimen B was associated with a more alkaline skin pH. Regimen A resulted in significantly fewer severe erythema episodes. At the site of highest erythema, the perianal space, the average erythema score was significantly lower and more newborns were free of erythema while using Regimen A vs. Regimen B (P < .05).

Conclusions

These findings demonstrate that diapering products can have a significant impact on newborn skin. They reinforce the need to support the physiological normalization of skin pH and protection from skin irritation and damage.
Vaccines: Considerations for pediatric dermatology patients on immunosuppressive agents
Authors: Munshi Mumtaz A. , Noe Megan H. , Chiu Yvonne E. , Streicher Jenna L.
Published: June 2021

Pediatric dermatologists should be aware of immunization schedules and special recommendations for patients on immunosuppressive agents due to the increased risk of vaccine‐preventable infections. Prior to initiating immunosuppressive therapy, pediatric dermatologists should review a vaccine history and administer any necessary age‐appropriate or catch‐up vaccines. Live vaccines are typically contraindicated while on immunosuppressive therapy, while inactivated vaccines are generally safe to administer.
Mycobacteriumabscessus infection in a patient with ornithine transcarbamylase deficiency and liver transplant
Authors: Li Yumeng M. , Desai Karishma , Saad Ali G. , Galimberti Fabrizio V.
Published: June 2021

Rapidly growing mycobacteria, including Mycobacterium abscessus, have become a common cause of post‐procedural infections and are notoriously difficult to diagnose and treat. Here, we report a 10‐month‐old male status post‐orthotopic liver transplantation due to ornithine transcarbamylase deficiency who presented with a 4‐month history of hypertrophic and friable granulation tissue of surgical wounds refractory to treatment with broad spectrum antibiotics and surgical debridement. Skin biopsy and tissue culture yielded a diagnosis of M abscessus infection that demonstrated excellent clinical response to appropriate antibiotic and surgical treatment.
Factors influencing school re‐entry among adolescents in Kenya
Authors: Henzan Hanae , Takeuchi Rie , Njenga Sammy M. , Gregorio Ernesto R. , Ichinose Yoshio , Nonaka Daisuke , Kobayashi Jun
Published: June 2021

Background

The number of out‐of‐school children and adolescents has been increasing globally. In sub‐Saharan Africa, an estimated 23 million adolescents leave school due to poverty, teenage pregnancy, and unspecified illnesses. The reasons for absenteeism are well‐known but the factors involved in the decision to return to school have not been analyzed. This study aimed to identify the factors that promote primary school re‐entry among chronic adolescent absentees in rural sub‐Saharan Africa.

Methods

Qualitative data were gathered through participant observation, in‐depth interviews, and focus group discussions involving nine pupils who returned to school after chronic absenteeism and 140 adult stakeholders in Mbita sub‐county, Kenya. Data were analyzed using thematic analysis.

Results

The thematic analysis results showed that four factors promoted school re‐entry, namely: (1) social norms: “school for a better life”; (2) linkage of community and school; (3) supportive environment; and (4) using discipline to make adolescents serious about their education.

Conclusions

School re‐entry among chronic absentees in Mbita sub‐county is promoted by both community and school factors. It was observed that social norms regarded an education as a “passport to a better life.” Adolescents, teachers, and community leaders view education as a means of improving one’s socio‐economic status. Two essential elements of health‐promoting schools, a supportive environment and a linkage with community, effectively promoted returning to the school among adolescents. The introduction of health‐promoting schools was recommended to implement a school re‐entry policy in Kenya effectively.
Multi‐laboratory study of hybrid diffuse reflectance spectroscopy to assess sunscreen SPF and UVA‐PFs
Authors: Ruvolo Eduardo , Rohr Mathias , Oliveira Sergio , Nogueira Luciano , Carvalho José , Cole Curtis
Published: June 2021

Background

Proof‐of‐principle studies have established the use of Hybrid Diffuse Reflectance Spectroscopy (HDRS) methods to assess both Ultraviolet‐A Protection Factor (UVA‐PF) and Sun Protection Factor (SPF) indices in individual laboratories.

Methods

Multiple laboratories evaluated 23 emulsions and two spray sunscreen products to evaluate repeatability and accuracy of assessment of SPF and UVA‐PF values, using HDRS test systems from various manufacturers using different designs.

Results

All of the laboratories reported similar SPF and UVA‐PF values within a narrow range of values to establish the reliability of the HDRS methodology across laboratories, independent of equipment manufacturer or operator.

Conclusion

HDRS test methodology provides a reliable objective instrumental estimation of sunscreen SPF and UVA‐PF. These data were provided to ISO‐TC217 WG7 to substantiate the ongoing development of an ISO Standard HDRS Method.
Maternal periconceptional folic acid supplements use and fetus risk for limb defects
Authors: Zhang Jie , Jin Lei , Wang Di , Wang Cheng , Tong Mingkun , Yu Jinhui , Meng Wenying , Ren Aiguo , Jin Lei
Published: June 2021

Background

Associations between the periconceptional folic acid only (FAO) or multiple micronutrients containing folic acid (MMFA) supplementation and risk for limb defects are inconsistent.

Objective

To explore the association between periconceptional folic acid supplements use and risk for limb defects, including clubfoot, polydactyly, syndactyly, and limb deficiencies.

Methods

Data were derived from a cohort based on a pregnancy registry in a district of Beijing, China, from 2013 to 2018. Information on maternal periconceptional FAO and MMFA supplementation was collected via face‐to‐face interviews at first trimester. Pregnancy outcomes including limb defects were ascertained in livebirths, stillbirths, and elective pregnancy terminations and were recorded into the system. Propensity score methods were used to adjust for potential confounders.

Results

A total of 63 969 women with a singleton delivery were included. The overall prevalence of limb defects was 47.5 per 10 000 (n = 63 969) singleton deliveries. Decreased prevalence of limb defects was found among FAO/MMFA users compared with women who did not take supplements (nonusers) (46.1 vs. 61.9 per 10 000 births, adjusted risk ratio [RR] 0.80, 95% confidence interval [CI] 0.56, 1.12). Compared with nonusers (n = 6462, 10.2%), women who took either FAO (n = 26 567, 42.0%) or MMFA (n = 30 259, 47.8%) had a lower risk for total clubfoot (RR 0.40, 95% CI 0.20, 0.84), and for isolated clubfoot (RR 0.41, 95% CI 0.17, 0.97). For other limb defects except clubfoot, FAO supplementation did not appear to be associated with reduced risk, while MMFA supplementation group had 30%‐50% reduced risks for other limb defects. A lower risk for limb defects or isolated limb defects was found with MMFA supplementation when FAO supplementation was used as a control.

Conclusions

Maternal periconceptional supplements with either FAO or MMFA had inverse association with clubfoot in offspring, and MMFA was associated with lower risk for isolated limb defects compared with FAO.
Apathy and executive functioning among non‐demented community‐dwelling elderly individuals in an everyday environment: the mediating effect of impulsivity
Authors: Cuvillier Cécilia , Bayard Sophie
Published: June 2021

Background

Apathy is common in normal ageing and widely recognized as a predictor of cognitive decline, especially in executive functions. Much less characterized than apathy in the elderly is impulsivity, which increases with ageing. It is also frequently described in comorbidity with apathy in various clinical populations, in whom it is associated with poorer executive functioning. In the present study, by capitalizing on a multidimensional approach, we explore the mediating role of facets of impulsivity on the bidirectional relationships between apathy dimensions and executive functioning in non‐demented community‐dwelling elderly individuals in daily life.

Methods

A sample of non‐demented community‐dwelling older adults (n = 101) completed self‐rated questionnaires. Apathy was measured by the Apathy Evaluation Scale; impulsivity was examined through the Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency (UPPS‐P) Impulsive Behaviour Scale; and executive functioning in daily life was assessed by the Behaviour Rating Inventory of Executive Function‐Adult (BRIEF‐A). Two models positing mediation were tested using conditional process modelling.

Results

Hierarchical regressions controlling for depressive symptoms indicated that the cognitive apathy dimension was associated with the UPPS‐P facets sensation seeking, lack of perseverance, and premeditation. Among the UPPS‐P facets, lack of perseverance and negative urgency were found to contribute significantly to BRIEF‐A Metacognitive index variance. Finally, in both models, lack of perseverance was found to totally mediate the relationship between cognitive apathy and the BRIEF‐A Metacognitive index.

Conclusions

These preliminary findings suggest that, in normal ageing, apathy may share an overlap with impulsivity, contradicting the notion they represent opposite ends of a single behavioural spectrum. Our results argue for bidirectional relationship between a specific apathy dimension (i.e. cognitive apathy) and executive functioning. Moreover, they shed new light on the underlying psychological process implicated (i.e. lack of perseverance) among older adults without dementia and represent an interesting prospect for psychological interventions.
Unusual intraclast conglomerates in a stormy, hot‐house lake: The Early Triassic North China Basin
Authors: Ji Kaixuan , Wignall Paul B. , Peakall Jeff , Tong Jinnan , Chu Daoliang , Pruss Sara B.
Published: June 2021

Early Triassic temperatures were some of the hottest of the Phanerozoic, sea‐surface temperatures approached 40°C, with profound consequences for both the sedimentology and faunal distributions in the oceans. However, the impact of these temperatures in terrestrial settings is unclear. This study examines shallow lacustrine sediments from the Lower Triassic succession of North China. These consist of diverse fluvial to shallow lacustrine sandstones and also spectacular, coarse conglomerates composed of diverse, intraformational clasts reworked from the interbedded sediments. The conglomerate beds can show inverse grading and high angle, flat‐pebble imbrication in their lower part and vertically orientated flat pebbles in their upper part. The cobbles include cemented and reworked conglomerate intraclasts and sandstone concentrically‐laminated concretions that record multi‐step histories of growth and reworking, pointing to rapid cementation of the sandy lake bed (likely facilitated by high temperatures). The conglomerates record frequent, high‐energy events that were capable of brecciating a lithified lake bed and transporting cobbles in wave‐influenced sediment‐gravity flows. Initially, powerful oscillatory flows brecciated and deflated the lake bed and subsequently helped to sustain turbulence during short‐distance lateral flow. It is possible that hurricanes, originating from the adjacent hyper‐warm, Palaeo‐Tethyan Ocean travelled into the major lakes of the North China continent during the Early Triassic.
Conceptualizing death: How do suicidal adolescents view the end of their lives?
Authors: Tezanos Katherine M. , Pollak Olivia H. , Cha Christine B.
Published: June 2021

Objective

Adolescence marks an important time to detect suicide risk, as suicidal ideation often emerges during this developmental period. Death‐themed cognitions represent a promising domain of risk factors for suicidal ideation, but they have been understudied among adolescents. To address this knowledge gap, the present study examines the association between adolescents’ attitudes and beliefs about death, hereafter referred to as death conceptualizations, and suicidal ideation.

Methods

Seventy‐four adolescents (12–19 years) completed a self‐report measure assessing three types of death conceptualizations: Death Avoidance (i.e., suppression of death‐related thoughts), Neutral Acceptance (i.e., belief that death is a natural part of life), and Escape Acceptance (i.e., belief that death is a viable escape from pain). Suicidal ideation was assessed at baseline, as well as 3 and 6 months later.

Results

At baseline, suicidal adolescents endorsed higher Escape Acceptance and lower Death Avoidance. Suicidal and nonsuicidal adolescents did not differ in their degree of Neutral Acceptance. Death conceptualizations, especially Escape Acceptance, also predicted future suicidal ideation.

Conclusions

Initial findings suggest that suicidal adolescents are more likely to believe that death is a viable escape from pain and that this death‐related cognition is a risk factor for suicidal ideation.