bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of bioimpedance‐derived 50‐kHz phase angle as marker of body composition with electrical parameters regarding the Cole‐Cole model
Authors: Yashiro Masatomo , Kotera Hirohisa
Published: June 2020

Our aim is to clarify the association of the bioelectrical impedance‐derived 50‐kHz phase angle (φ50) with electrical parameters regarding the Cole‐Cole model and clinical parameters. A total of 440 sets of bioelectrical impedance data from pre‐ and post‐hemodialysis from 157 patients were used. Resistance at infinite frequency (Rinf), resistance at 0 frequency (R0), capacitance of the cell membrane (Cm), and a parameter for the distribution of the time constant (α) were examined as electrical parameters. Normally hydrated lean tissue mass as a percentage of the dry weight (PNHLT), excess fluid mass as a percentage of the dry weight (PExF), body mass index (BMI), age, and sex (Nsex, 0 for male, 1 for female) were examined as clinical parameters. φ50 increased with the decrease in Rinf/R0 and α and also with the increase in Cm (multiple regression coefficients [β]: pre/post, −0.886/−0.936, −0.175/−0.212, and 0.167/0.141), which determined the ratio of intra‐ to extracellular fluid volume (ICV/ECV), tissue homogeneity, and total cell mass. φ50 increased with an increase in PNHLT and BMI and decrease in PExF, Nsex, and age (β: pre/post, 0.654/0.581, 0.466/0.412, −0.483/−0.473, −0.216/−0.154, and −0.145/−0.127). The concordance correlation coefficient between φ50 for pre‐ and post‐hemodialysis (ρ = 0.772) may be improved (ρ = 0.950) by adding a multiplication of 0.2 and PExF to φ50 for correction. φ50 may be used to estimate body composition through the association with ICV/ECV, tissue homogeneity, and total cell mass. The correction for excess fluid is essential in order to use φ50 as a marker of body composition related to nutrition.
Deletion of Tlr3 reduces acute tolerance to alcohol and alcohol consumption in the intermittent access procedure in male mice
Authors: Blednov Yuri A. , Da Costa Adriana , Mayfield Jody , Harris R. Adron , Messing Robert O.
Published: June 2020

Pharmacological studies implicate toll‐like receptor 3 (TLR3) signaling in alcohol drinking. We examined the role of TLR3 in behavioral responses to alcohol and GABAergic drugs by studying Tlr3 −/− mice. Because of opposing signaling between TLR3 and MyD88 pathways, we also evaluated Myd88 −/− mice. Ethanol consumption and preference decreased in male but not in female Tlr3 −/− mice during two‐bottle choice every‐other‐day (2BC‐EOD) drinking. There were no genotype differences in either sex during continuous or limited‐access drinking. Null mutations in Tlr3 or Myd88 did not alter conditioned taste aversion to alcohol and had small or no effects on conditioned place preference. The Tlr3 null mutation did not alter acute alcohol withdrawal. Male, but not female, Tlr3 −/− mice took longer than wild‐type littermates to recover from ataxia by ethanol or diazepam and longer to recover from sedative‐hypnotic effects of ethanol or gaboxadol, indicating regulation of GABAergic signaling by TLR3. Acute functional tolerance (AFT) to alcohol‐induced ataxia was decreased in Tlr3 −/− mice but was increased in Myd88 −/− mice. Thus, MyD88 and TLR3 pathways coordinately regulate alcohol consumption and tolerance to intoxicating doses of alcohol and GABAergic drugs. Despite similar alcohol metabolism and similar amounts of total alcohol consumed during 2BC and 2BC‐EOD procedures in C57BL/6J mice, only 2BC‐EOD drinking induced tolerance to alcohol‐induced ataxia. Ataxia recovery was inversely correlated with level of drinking in wild‐type and Tlr3 −/− littermates. Thus, deleting Tlr3 reduces alcohol consumption by reducing AFT to alcohol and not by altering tolerance induced by 2BC‐EOD drinking.
Changes in aqueous and vitreous inflammatory cytokine levels in neovascular age‐related macular degeneration: a systematic review and meta‐analysis
Authors: Minaker Samuel A. , Mason Ryan H. , Lahaie Luna Gabriela , Bapat Priya , Muni Rajeev H.
Published: June 2020

Inflammatory cytokines are involved in the pathogenesis of neovascular age‐related macular degeneration (nAMD) and have been shown to be useful as diagnostic and predictive biomarkers. Given the heterogeneity of data within the literature, we aimed to quantitatively summarize data related to inflammatory cytokines in nAMD. A systematic search without year limitation was performed up to 13 April 2020. Studies were included if they provided data on aqueous or vitreous cytokine concentrations in patients with nAMD. Data were extracted from 95 studies that encompassed 3105 study eyes with nAMD and 1209 control eyes. Effect sizes were generated as standardized mean differences (SMDs) of cytokine concentrations between patients with nAMD and controls. Among the 4314 eyes in 95 studies, aqueous concentrations (standard mean difference, 95% confidence interval and p‐value) of MCP‐1 (0.43, 0.09 to 0.77 and p = 0.01), MIG (0.63, 0.31 to 0.94 and p = 0.0001), TGF‐β (0.45, 0.07 to 0.82 and p = 0.02) and VEGF (0.64, 0.31 to 0.98 and p = 0.0001) were significantly higher in patients with nAMD compared to healthy controls. No differences, failed sensitivity analyses or insufficient data were found between patients with nAMD and healthy controls for the concentrations of the remaining cytokines and with all vitreous samples. Previous studies had shown conflicting associations with nAMD for all 27 cytokines assessed. Our analysis indicates multiple candidate cytokines other than VEGF that are implicated in nAMD and adds clarity to the previous literature. This will help focus translational research in nAMD investigating biomarkers and therapeutic targets.
Geometry of the ideal free distribution: individual behavioural variation and annual reproductive success in aggregations of a social ungulate
Authors: Bonar Maegwin , Lewis Keith P. , Webber Quinn M. R. , Dobbin Maria , Laforge Michel P. , Vander Wal Eric
Published: June 2020

Variation in social environment can mitigate risks and rewards associated with occupying a particular patch. We aim to integrate Ideal Free Distribution (IFD) and Geometry of the Selfish Herd (GSH) to address an apparent conflict in their predictions of equal mean fitness between patches (IFD) and declining fitness benefits within a patch (GSH). We tested these hypotheses in a socio‐spatial context using individual caribou that were aggregated or disaggregated during calving and varied in their annual reproductive success (ARS). We then tested individual consistency of these spatial tactics. We reveal that two socio‐spatial tactics accorded similar mean ARS (IFD); however, ARS for aggregated individuals declined near the periphery (GSH). Individuals near the aggregation periphery exhibited flexibility, whereas others were consistent. The integration of classical theories through a contemporary lens of consistent individual differences provides evidence for an integrated GSH and IFD strategy that may represent an evolutionary stable state.
Bioenergy with Carbon Capture and Storage (BECCS): Finding the win–wins for energy, negative emissions and ecosystem services—size matters
Authors: Donnison Caspar , Holland Robert A. , Hastings Astley , Armstrong Lindsay‐Marie , Eigenbrod Felix , Taylor Gail
Published: June 2020

Bioenergy with Carbon Capture and Storage (BECCS) features heavily in the energy scenarios designed to meet the Paris Agreement targets, but the models used to generate these scenarios do not address environmental and social implications of BECCS at the regional scale. We integrate ecosystem service values into a land‐use optimization tool to determine the favourability of six potential UK locations for a 500 MW BECCS power plant operating on local biomass resources. Annually, each BECCS plant requires 2.33 Mt of biomass and generates 2.99 Mt CO2of negative emissions and 3.72 TWh of electricity. We make three important discoveries: (a) the impacts of BECCS on ecosystem services are spatially discrete, with the most favourable locations for UK BECCS identified at Drax and Easington, where net annual welfare values (from the basket of ecosystems services quantified) of £39 and £25 million were generated, respectively, with notably lower annual welfare values at Barrow (−£6 million) and Thames (£2 million); (b) larger BECCS deployment beyond 500 MW reduces net social welfare values, with a 1 GW BECCS plant at Drax generating a net annual welfare value of £19 million (a 50% decline compared with the 500 MW deployment), and a welfare loss at all other sites; (c) BECCS can be deployed to generate net welfare gains, but trade‐offs and co‐benefits between ecosystem services are highly site and context specific, and these landscape‐scale, site‐specific impacts should be central to future BECCS policy developments. For the United Kingdom, meeting the Paris Agreement targets through reliance on BECCS requires over 1 GW at each of the six locations considered here and is likely, therefore, to result in a significant welfare loss. This implies that an increased number of smaller BECCS deployments will be needed to ensure a win–win for energy, negative emissions and ecosystem services.
An alternate level of care plan: Co‐designing components of an intervention with patients, caregivers and providers to address delayed hospital discharge challenges
Authors: Kuluski Kerry , Ho Julia W , Cadel Lauren , Shearkhani Sara , Levy Charissa , Marcinow Michelle , Peckham Allie , Sandercock Jane , Willison Donald J , Guilcher Sara JT
Published: June 2020

Objective

To engage with patients, caregivers and care providers to co‐design components of an intervention that aims to improve delayed hospital discharge experiences.

Design

This is a qualitative study, which entailed working groups and co‐design sessions utilizing World Café and deliberative dialogue techniques to continually refine the intervention.

Setting and Participants

Our team engaged with 61 participants (patients, caregivers and care providers) in urban and rural communities across Ontario, Canada. A 7‐member Patient and Caregiver Advisory Council participated in all stages of the research.

Results

Key challenges experienced during a delayed discharge by patients, caregivers and care providers were poor communication and a lack of care services. Participants recommended a communication guide to support on‐going conversation between care providers, patients and caregivers. The guide included key topics to cover and questions to ask during initial and on‐going conversations to manage expectations and better understand the priorities and goals of patients and caregivers. Service recommendations included getting out of bed and dressed each day, addressing the psycho‐social needs of patients through tailored activities and having a storyboard at the bedside to facilitate on‐going engagement.

Discussion and Conclusions

Our findings outline ways to meaningfully engage patients and caregivers during a delayed hospital discharge. Combining this with a minimal basket of services can potentially facilitate a better care experience and outcomes for patients, their care providers and families.
Influence of access cavity design and use of operating microscope and ultrasonic troughing to detect middle mesial canals in extracted mandibular first molars
Authors: Mendes E. B. , Soares A. J. , Martins J. N. R. , Silva E. J. N. L. , Frozoni M. R.
Published: June 2020

Aim

To evaluate the influence of various endodontic access cavity designs and the use of an operating microscope (OM) with or without ultrasonic troughing to detect middle mesial canals (MMCs) in extracted mandibular first molars.

Methodology

Sixty extracted mandibular first molars were evaluated by cone beam computed tomography (CBCT) in order to detect the presence of MMCs and then divided into two groups (n = 30) with an equal proportion of 1 molar with MMC for each 3 molars. A specific access cavity design was performed for each group, either a conservative access cavity (CAC) or a traditional access cavity (TAC). Root canals were detected in three assessment stages: (i) no magnification, (ii) using an OM and (iii) using an OM together with ultrasonic troughing. Evaluations were performed on a mannequin head in an ergonomic working position. The confidence obtained in the assessment stages was portrayed by sensitivity, specificity and accuracy, calculated by the area under the ROC curve. The difference in the proportion of correct diagnoses in identifying the MMC using either CAC or TAC preparation, at each of the three stages, was checked using Cochran's Q tests. Binomial tests were performed at each stage to investigate whether there was a difference between the types of endodontic access designs to detect MMCs. Significance was set at P < 0.05.

Results

Accuracy increased at each assessment stage. At the third stage, both groups provided perfect accuracy (1.00). Cochran's Q tests indicated that the confidence of MMC detection for both TAC and CAC groups (P < 0.05) increased significantly at each stage. Binomial tests demonstrated that there was no significant difference between the TAC and CAC groups, when evaluation was performed without magnification (P > 0.05), with OM (P > 0.05), or with OM associated with ultrasonic troughing (P > 0.05).

Conclusion

The access cavity design did not significantly affect detection of middle mesial canals in extracted mandibular first molars placed in a mannequin. However, the use of OM increased the accuracy of the MMC identification, especially when associated with ultrasonic troughing.
MTT versus other cell viability assays to evaluate the biocompatibility of root canal filling materials: a systematic review
Authors: Pintor A. V. B. , Queiroz L. D. , Barcelos R. , Primo L. S. G. , Maia L. C. , Alves G. G.
Published: June 2020

Objectives

This systematic review aimed to compare the cytotoxicity of root canal filling materials (RCFMs) assessed using tetrazolium salt‐based tests (TSBT), including the 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl tetrazolium bromide (MTT) assay, with those obtained using other cell viability assays.

Methods

A search was performed on PubMed, Scopus, Web of Science and OpenGrey up to March 2019, followed by a manual search. According to the Participants, Exposure, Comparator and Outcomes (PECO) criteria, in vitro studies that evaluated the cytotoxic effect of RCFMss on animal and/or human cells through TSBT and at least one other viability assay were compared. The methodological quality of selected papers was assessed using ToxRTool® and SciRAP®. Data were analysed using Wilcoxon’s signed‐rank test for paired samples and linear weighting kappa.

Results

A total of 230 non‐duplicated records were identified. After applying the eligibility criteria, 55 studies were selected for methodological evaluation, seven were selected by manual searching, 22 were excluded for methodological reasons, and 40 were included. A total of 410 comparisons were performed between TSBT and distinct cell viability tests (DCVT). MTT had moderate concordance with DCVT using human cells (n = 138 samples) (P = 0.507; k = 0.4225) and animal cells (n = 122 samples) (P = 0.124; k = 0.5775). XTT had good concordance using human (n = 110 samples) (P = 0.507; k = 0.6336) and animal cells (n = 12 samples) (P = 0.564; k = 0.6604). MTT, XTT, WST and MTS assays showed moderate concordance with DCVT (n = 410 samples) (P = 0.375; k = 0.5138) and complete agreement in 226 samples.

Discussion

The included studies had methodological heterogeneity that was minimized by the systematic review methodology.

Conclusions

MTT and XTT do not cause over‐ or underestimation of cell viability during cytotoxicity screening of root canal filling materials, implying that these assays can be considered reliable for this purpose. Nonetheless, the development of protocols for the cytotoxic screening of these materials on 3D tissue‐like cultures aiming to improve their predictability in the clinical scenario is suggested.
Health professional perspectives of expanded practice in rural community pharmacy in Australia
Authors: Taylor Selina , Cairns Alice , Glass Beverley
Published: June 2020

Objectives

Expanded pharmacy service delivery for rural and remote Australia has potential to address the rural health disparity. Pharmacists practising to their full scope are recognised as being most beneficial in rural and regional communities, where access to health professionals (HPs) is not comparable to those in metropolitan areas. However, research on HP perspectives on expanded pharmacy practice is limited. This study aims to determine rural and remote HP (doctors, nurses, allied health and other HPs) perspectives of expanded services to be delivered through community pharmacy.

Methods

Australian rural and remote HPs participated in a questionnaire survey which explored views on expanded pharmacy services in their local communities. Potential expanded pharmacy services were provided, and participants were asked to indicate what expanded pharmacy would benefit their local community and their level of support for the services. Analysis of the data included frequency analyses and one-way ANOVA tests with post hoc Tukey’s HSD tests using IBM SPSS Statistic 25.

Results

Health professionals (N = 121) from rural and remote locations participated. Sexually transmitted disease testing, vaccinations, diabetes and asthma management were the most frequently chosen services that HPs agreed would improve the health of people in their community. Doctors chose the least number of services (mean = 1 services) compared with all other HPs (mean => 5 services). Sixty-eight per cent of participants agreed/strongly agreed that providing these additional services would improve health, with participants (73%) agreeing/strongly agreeing that they would support the implementation of these additional services, not otherwise available in their community. Comparing professional groups, doctors were only half as supportive of expanded pharmacy services, when compared with all other HPs.

Conclusion

This study confirms the importance of a collaborative, local model to deliver expanded pharmacy services for rural communities. Health professionals were found to largely support expanding pharmacy practice, agreeing about the improved access to health care that would be provided for people living in rural and remote Australia.
Maternal Common Mental Disorders symptoms influence associated with early childhood dental caries: A cross‐sectional study in a southern Brazilian city
Authors: Andreola Beber Gomes Márcia , Polina Pereira da Costa Vanessa , Leão Goettems Marília , Sousa Azevedo Marina
Published: June 2020

Background

Maternal mental problems can interfere with the overall health and care of the child; some oral health studies have been trying to elucidate whether there is a relationship between maternal common mental disorders (CMD) and children's oral health status.

Aim

The aim was to investigate the influence of mothers that present CMD symptoms on their child's dental caries status.

Design

This cross‐sectional study was carried out in Pelotas with 530 mother/child (aged 2‐5 years old) dyads recruited from an epidemiological survey in August 2015 during the national vaccination campaign. A questionnaire was used to determine mother's CMD symptoms using the Self‐Reporting Questionnaire (SRQ‐20) and socioeconomic/demographic variables which were used for adjustment. Dental caries examination was performed. The outcome was obtained using the dmfs (decayed, missing, filled surfaces) index, based on OMS guidelines. Poisson regression with robust variance was used to estimate the risk ratio and 95% confidence interval (CI).

Results

Maternal CMD was positively associated with dental caries prevalence in children; the adjusted relative risk for every 1 SRQ‐20 score increase was 1.06 (95% CI 1.00‐1.12).

Conclusions

Our findings suggest that maternal mental health can impair children's oral health in relation to dental caries.
What factors are associated with early childhood dental caries? A longitudinal study of the Growing Up in New Zealand cohort
Authors: Thornley Simon , Bach Katie , Bird Amy , Farrar Rachel , Bronte Sarah , Turton Bathsheba , Atatoa Carr Polly , Fa’alili‐Fidow Jacinta , Morton Susan , Grant Cameron
Published: June 2020

Background

The relative importance of different strategies to prevent dental caries is not known.

Aim

We explored the relationship between oral health behaviours, diet, and the incidence of dental caries.

Design

We conducted a study of children participating in the ‘Growing Up in New Zealand’ cohort. Exposures were oral health behaviours, a food frequency questionnaire, and sociodemographic characteristics that were recorded when the child was nine months and two years old. Outcomes were records of dental caries at ages four to seven years.

Results

4111 children had dental examination records from between the ages of four and seven years. High levels of dental caries were reported in children of Pacific, Asian, and Māori ethnicity. Food frequency questionnaire information was summarised into two principal components. The major axis of variation was in the intake of food and drinks with high concentrations of sugar and refined starch, with this component strongly associated with caries (multivariable incidence rate ratio of caries 0.48; 95% confidence interval: 0.38‐0.61, comparing the extreme quintiles of the first principal component).

Conclusions

A diet high in sugar or refined starch was strongly linked to caries. Policies to reduce sugar and refined starch intake should be considered.
Comparison of sTREM‐1 and associated periodontal and bacterial factors before/after periodontal therapy, and impact of psychosocial factors
Authors: Dubar Marie , Frippiat Jean‐Pol , Remen Thomas , Boufenzer Amir , Alauzet Corentine , Baumann Cedric , Gibot Sebastien , Bisson Catherine
Published: June 2020

Aim

The immune receptor triggering receptor expressed on myeloid cell‐1 (TREM‐1) is responsible for an amplification of the immuno‐inflammatory response in inflammatory diseases. Its role in the aetiopathogenesis of periodontitis is underexplored. The aim of this case–control and before–after study was to determine the evolution of soluble form of TREM‐1 (sTREM‐1) concentrations after scaling and root planing (SRP), and its prognostic value and evaluate associated microbial, periodontal and psychosocial factors.

Methods

Gingival crevicular fluid was collected in two pathological sites (periodontal pocket depth (PPD) ≥ 5 mm) and one healthy site (PPD ≤ 3 mm) from thirty periodontitis patients (before/after SRP), and in one healthy site from thirty controls (patients without periodontal disease). Each patient filled‐in stress/anxiety self‐assessment questionnaires and provided a saliva sample. Diseased patients were followed for a total of 13–15 weeks in initial periodontal treatment. sTREM‐1 and salivary cortisol levels were determined by ELISA and periodontopathogens by PCR.

Results

Before SRP, higher crevicular sTREM‐1 levels were positively associated with some increased clinical parameters (Plaque Index, tooth mobility, bleeding on probing, p < .05) and inversely with Aggregatibacter actinomycetemcomitans abundance (p = .03). No correlation with psychological factors nor cortisol was found with salivary sTREM‐1 concentrations. After SRP, crevicular sTREM‐1 levels decreased (p < .001) and were not linked to a PPD decrease but remained higher in pathological than in healthy sites (p < .001). Higher concentrations were also found out in unimproved sites (no change or increase in PPD) compared to improved ones (p = .02). Higher sTREM‐1 levels were associated with Porphyromonas gingivalis, Treponema denticola and Campylobacter rectus in pathological sites after SRP (p < .05).

Conclusion

Crevicular sTREM‐1 level decreased after SRP but did not appear to be a site outcome predictive factor of periodontal healing and remained an inflammatory parameter.
Modeling and optimization of cooking process parameters to improve the nutritional profile of fried fish by robust hybrid artificial intelligence approach
Authors: Sadhu Tithli , Banerjee Indrani , Lahiri Sandip Kumar , Chakrabarty Jitamanyu
Published: June 2020

Fish, being a good source of nutrients, is often cooked by different methods before consumption, which affect the beneficial quality detrimentally. In this study, Catla catla, and mustard oil are selected as representative of fish and cooking oil for frying, respectively, because of their agricultural importance and worldwide demand. Extensive experiments are performed varying the effective processing variables of conventional frying viz., temperature (140 °C‐240 °C), time (5 min–20 min) and oil amount (25 ml/kg of fish‐100 ml/kg of fish) to correlate the drastic reduction of the nutritional quality indices, that is, ω‐3/ω‐6 and cis/trans‐fatty acids (FAs) profiles of fish after frying. To establish a nonlinear correlation between these inputs and outputs, an exhaustive search of all available artificial neural network (ANN) algorithms and activation functions is executed for the development of a model. The hybrid robust process approach integrating ANN with differential evolution (DE) and simulated annealing (SA) are employed to optimize the cooking parameters for regaining nutritional impact. After frying ω‐3/ω‐6 and cis/trans‐FAs ratio deteriorated by 76.65% and 92.68%, respectively, than the fresh samples. The ANN‐DE and ANN‐SA formalism efficiently enhanced these nutritional parameters up to 33.18% and 79%, respectively.

Practical applications

The present study applied artificial neural network (ANN) as an advanced alternative modeling tool to propose a generalized nonlinear correlation between temperature, time, oil amount, and nutritional values, that is, ω‐3/ω‐6 and cis/trans‐fatty acids (FAs) profiles of fried fish. Frying time provided a strong impact on food nutrition compared to other two input variables. Frying process detrimentally affected both the nutritional indices, that is, ω‐3/ω‐6 and cis/trans‐FAs profiles. The meta‐heuristic, stochastic optimization algorithms, namely differential evolution and simulated annealing along with ANN‐based processed model were implemented successfully to tune the cooking parameters, so that food quality indices of fish improved again to maximum value. The artificial intelligence modeling, along with optimizing methodology based parameters tuning approach described here is generic and can be advantageously extended to other experimentation of food process engineering. Besides, the finding of this study will benefit common people also.
Family Caregiving at the End of Life and Hospice Use: A National Study of Medicare Beneficiaries
Authors: Kumar Vedika , Ankuda Claire K. , Aldridge Melissa D. , Husain Mohammed , Ornstein Katherine A.
Published: June 2020

BACKGROUND/OBJECTIVES

Hospice care confers well‐documented benefits to patients and their families, but it is underutilized. One potential reason is inadequate family support to make end‐of‐life decisions and care for older adults on hospice at home. We assessed the association between amount of family support and hospice use among a population of decedents and among specific illness types.

DESIGN

Prospective cohort study using the National Health and Aging Trends Study waves 2011 to 2017, linked to Medicare claims data.

SETTING

Contiguous United States.

PARTICIPANTS

A total of 1,868 NHATS decedents.

MEASUREMENTS

Outcome variable was 1 day or longer of hospice. Family caregiving intensity was measured by self‐reported hours of care per week and number of caregivers. Covariates included probable dementia status and other demographic, clinical, and functional characteristics.

RESULTS

At the end of life, hours of family caregiving and numbers of helpers vary widely with individuals with dementia receiving the most hours of unpaid care (mean = 64.5 hours per week) and having 2.4 unpaid caregivers on average. In an adjusted analysis, older adults with cancer receiving 40 hours and more of unpaid care/week as compared with fewer than 6 hours per week were twice as likely to receive hospice care at the end of life (odds ratio = 2.0; 95% confidence interval = 1.0–4.1). This association was not seen among those with dementia or among decedents in general. No significant association was found between number of caregivers and hospice use at the end of life.

CONCLUSION

Older adults at the end of life receive a high number of hours of help at the end of life, many from more than one caregiver, which may shape hospice access. Better understanding of disparities in hospice use can facilitate timely access to care for older adults with a serious illness. J Am Geriatr Soc 68:2288–2296, 2020.
Do good things come in pairs? How personality traits help explain individuals' simultaneous pursuit of a healthy lifestyle and financially responsible behavior
Authors: Hoffmann Arvid O. I. , Risse Leonora
Published: June 2020

Both a healthy lifestyle and financially responsible behavior contribute to individual wellbeing and benefit society. Motivated by the fact that both types of behavior involve short‐term sacrifices in exchange for uncertain long‐term benefits and require self‐control, we examine individuals' consistency in behavior across the health and financial domains. Using a large‐scale data set of 3,752 employed Australians, we find that the majority of individuals behave in a consistently beneficial or detrimental way across both domains. This behavioral consistency relates to fundamental life outcomes, including physical and mental health, financial prosperity, and life satisfaction. In a new contribution to the literature, we show how personality traits—Locus of Control, the Big Five, Achievement Motivation—have a meaningful role in explaining the simultaneous pursuit of a healthy lifestyle and financially responsible behavior. These behavioral insights can guide policymakers in developing more effective strategies to steer individuals towards beneficial health and financial outcomes.
Potentials for implementing pressure‐controlled jet injection in management of keloids with intralesional 5FU and corticosteroids
Authors: Levenberg Alex , Vinshtok Yuri , Artzi Ofir
Published: June 2020

Background

Needle‐free jet injection implements kinetic energy of liquid jet for transcutaneous delivery of drugs into soft tissues. Combination therapy of intralesional 5‐fluorouracil and triamcinolone offers efficacious treatment for keloids with a reduced adverse effect of the drug monotherapy. This study evaluates safety and efficacy of the drug combination administered to keloid scars via intralesional jet injections.

Methods

A retrospective analysis of the keloid treatments was performed. Efficacy was assessed by reviewing pre‐ and post‐treatment scores of the Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) and by comparing baseline and photographs taken 3 months after the treatments. Safety and tolerability were collected and analyzed.

Results

Twenty‐one subjects (M/F = 11/10) with 39 keloids received the treatments. Treatments were well‐tolerated by all patients at mean injection pain of 2.0 ± 1.0 per Numeric Pain Rating Scale (NPRS). Self‐resolved lesion ulceration was observed in 4 patients. Post‐treatment evaluation demonstrated a 53% decrease in total VSS score (P < 0.05) and in all sub‐categories. Mean patient score of POSAS decreased in the color, stiffness, thickness, and irregularity components. Pain and pruritus lessened by 69% and 79% (P < 0.05 in both), respectively, among the patients with complaints prior to the treatment. Independent reviewers reported an average 51%‐75% reduction in keloids.

Conclusions

Improved appearance of keloids and symptomatic relief was achieved by intralesional administration of combined 5‐fluorouracil and corticosteroid through the high‐pressure jet injections. The synergy between the drug combination and the jet physical impact provided clinical effect.
Unconscious Processes of Organizing: Intergroup Conflict in Mental Health Care
Authors: Mikkelsen Elisabeth Naima , Gray Barbara , Petersen Anne
Published: June 2020

A critical but overlooked issue in Weick’s seminal work,The Social Psychology of Organizing(1969/1979), concerns ‘the heat’ of organizing processes, namely, the underground emotional processes underpinning the organizing of conflictual work relationships. We present a qualitative case study of psychiatric agencies mandated by public policy to collaborate but instead engaged in persistent conflict despite its deleterious effects on their working relationship and on the wellbeing of the clients they intended to serve. To explain these conflictual features of organizing, we integrate Weick’s organizing theory with systems psychodynamics to deepen the understanding of emotions in organizing, specifically the motivational forces underpinning sensemaking and actions between interacting psychiatric agencies. This integration of theories reveals a critical feature of the relationship between the conscious and unconscious organizing processes: When a threat is involved, sensemaking and action are overtaken by social defences, resulting in dysfunctional organizing of the primary task. Drawing on these findings, we enrich Weick’s seminal work by developing a model that portrays organizing as the ritualized interaction of emotions, sensemaking and behavioural responses.
Half of Rural Residents at High Risk of Serious Illness Due to COVID‐19, Creating Stress on Rural Hospitals
Authors: Kaufman Brystana G. , Whitaker Rebecca , Pink George , Holmes G. Mark
Published: June 2020

Purpose

During the COVID‐19 epidemic, it is critical to understand how the need for hospital care in rural areas aligns with the capacity across states.

Methods

We analyzed data from the 2018 Behavioral Risk Factor Surveillance System to estimate the number of adults who have an elevated risk of serious illness if they are infected with coronavirus in metropolitan, micropolitan, and rural areas for each state. Study data included 430,949 survey responses representing over 255.2 million noninstitutionalized US adults. For data on hospital beds, aggregate survey data were linked to data from the 2017 Area Health Resource Files by state and metropolitan status.

Findings

About 50% of rural residents are at high risk for hospitalization and serious illness if they are infected with COVID‐19, compared to 46.9% and 40.0% in micropolitan and metropolitan areas, respectively. In 19 states, more than 50% of rural populations are at high risk for serious illness if infected. Rural residents will generate an estimated 10% more hospitalizations for COVID‐19 per capita than urban residents given equal infection rates.

Conclusion

More than half of rural residents are at increased risk of hospitalization and death if infected with COVID‐19. Experts expect COVID‐19 burden to outpace hospital capacity across the country, and rural areas are no exception. Policy makers need to consider supply chain modifications, regulatory changes, and financial assistance policies to assist rural communities in caring for people affected by COVID‐19.
Telehealth Availability in US Hospitals in the Face of the COVID‐19 Pandemic
Authors: Puro Neeraj A. , Feyereisen Scott
Published: June 2020

Background

Telehealth is likely to play a crucial role in treating COVID‐19 patients. However, not all US hospitals possess telehealth capabilities. This brief report was designed to explore US hospitals’ readiness with respect to telehealth availability. We hope to gain deeper insight into the factors affecting possession of these valuable capabilities, and how this varies between rural and urban areas.

Methods

Based on 2017 data from the American Hospital Association survey, Area Health Resource Files and Medicare cost reports, we used logistic regression models to identify predictors of telehealth and eICU capabilities in US hospitals.

Results

We found that larger hospitals (OR(telehealth) = 1.013; P < .01) and system members (OR(telehealth) = 1.55; P < .01) (OR(eICU) = 1.65; P < .01) had higher odds of possessing telehealth and eICU capabilities. We also found evidence suggesting that telehealth and eICU capabilities are concentrated in particular regions; the West North Central region was the most likely to possess capabilities, given that these hospitals had higher odds of possessing telehealth (OR = 1.49; P < .10) and eICU capabilities (OR = 2.15; P < .05). Rural hospitals had higher odds of possessing telehealth capabilities as compared to their urban counterparts, although this relationship was marginally significant (OR = 1.34, P < .10).

Conclusions

US hospitals vary in their preparation to use telehealth to aid in the COVID‐19 battle, among other issues. Hospitals’ odds of possessing the capability to provide such services vary largely by region; overall, rural hospitals have more widespread telehealth capabilities than urban hospitals. There is still great potential to expand these capabilities further, especially in areas that have been hard hit by COVID‐19.
Breastfeeding practices and associated factors at the individual, family, health facility and environmental levels in China
Authors: Li Jia , Nguyen Tuan T. , Wang Xiaobei , Mathisen Roger , Fang Jin
Published: June 2020

We examined the association between breastfeeding practices and associated factors using cross‐sectional data from face‐to‐face interviews with 9,745 mother–child dyads in China. The study collected information on breastfeeding practices and potential associated factors at the individual, family, health facility and environmental levels in China. We used survey commands in Stata to consider sampling weight and survey design effects. Although breastfeeding was the norm (97.4% ever breastfed), the prevalence of early initiation of breastfeeding (EIBF) in 0–11 months old was 8.2%, exclusive breastfeeding (EBF) in 0–5 months old was 27.8% and breastfeeding on the previous day in 6–11 months old was 77.5%. The prevalence of EIBF was lower for caesarean delivery and among mothers belonging to ethnic minority groups. The prevalence of EBF was higher among mothers who practiced EIBF, received information that encouraged breastfeeding and knew that a baby should be breastfed on demand and exclusively. By contrast, the prevalence of EBF was lower in mothers who received infant formula advice or felt uneasy breastfeeding in public places. The prevalence of breastfeeding on the previous day was higher among mothers whose partners supported breastfeeding and who knew about timing of colostrum production, EBF for 6 months, and to nurse more to stimulate milk production. The prevalence of breastfeeding on the previous day was lower in mothers who received infant formula advice or felt uneasy breastfeeding in public places. In conclusion, we found that the prevalence of EIBF and EBF practices in China was low and associated with factors at individual, family, health facility and environmental levels.
Compromised regulation of the rat brain parenchymal arterioles in vasopressin‐associated acute hyponatremia
Authors: Aleksandrowicz Marta , Kozniewska Ewa
Published: June 2020

Objective

In this study, we examined the effect of acute hyponatremia associated with vasopressin (AVP) on the responses of the isolated rat's MCAs and PAs to acidosis, nitric oxide donor (SNAP) and to endothelium‐dependent vasodilator ATP.

Methods

The studies were performed on isolated, perfused and pressurized MCAs and PAs in control conditions and during AVP‐associated hyponatremia. Hyponatremia was induced in vitro by lowering Na+ concentration from 144 to 121 mmol/L in intra‐ and extravascular fluid in the presence of AVP.

Results

Parenchymal arterioles showed greater response to an increase in H+ and K+ ions concentration and to ATP in comparison with MCAs in control normonatremic conditions. Both PAs and MCAs constricted in response to acute hyponatremia associated with AVP. Interestingly, disordered regulation of vascular tone was observed in PAs but not in MCAs. The abnormalities in the regulation comprised a significant reduction of PA response to acidosis and the absence of the response to the administration of SNAP or ATP.

Conclusions

Arginine vasopressin‐associated hyponatremia leads to constriction and dysregulation of PAs which may impair neurovascular coupling.
Th17 lymphocytes in atypical cutaneous leishmaniasis caused by Leishmania (L.) infantum chagasi in Central America
Authors: Araujo Flores Gabriela Venicia , Sandoval Pacheco Carmen Maria , Sosa Ochoa Wilfredo Humberto , Gomes Cláudia Maria Castro , Zúniga Concepción , Corbett Carlos P. , Laurenti Marcia Dalastra
Published: June 2020

Skin lesions in nonulcerated cutaneous leishmaniasis (NUCL) caused by Leishmania (L.) infantum chagasi are characterized by a mononuclear inflammatory infiltrate in the dermis, which is composed mainly of lymphocytes, followed by macrophages, few plasma cells and epithelioid granulomas with mild tissue parasitism. Previous studies have shown that the main population of lymphocytes present in the dermal infiltrate is CD8+ T cells, followed by CD4+ T cells, which are correlated with IFN‐γ+ cells. To improve the knowledge of cellular immune responses in NUCL, skin biopsies were submitted to immunohistochemistry using anti‐ROR‐γt, anti‐IL‐17, anti‐IL‐6, anti‐TGF‐β, and anti‐IL‐23 antibodies to characterize the involvement of Th17 cells in the skin lesions of patients affected by NUCL. ROR‐γt+, IL‐17+, IL‐6+, TGF‐β+ and IL‐23+ cells were observed in the dermal inflammatory infiltrate of NUCL skin lesions. A positive correlation between CD4+ T‐lymphocytes and ROR‐γt+ and IL‐17+ cells suggests that some of the CD4+ T‐lymphocytes in NUCL could be Th17 lymphocytes. Moreover, a positive correlation between ROR‐γt+ cells and TGF‐β+, IL‐6+, IL‐17+ and IL‐23+ cells could indicate the role of these cytokines in the differentiation and maintenance of Th17 lymphocytes. Our findings improve knowledge of the pathogenesis of this rare and atypical clinical form of leishmaniasis.
Serum kisspeptin: New possible biomarker for sexual behaviour and sperm concentration in buffalo bulls
Authors: Bhardwaj Sonam , Kumar Pradeep , Jerome Andonissamy , Ravesh Suman , Patil Chandrashekhar , Singh Pawan , Lailer Puran Chand
Published: June 2020

The study was designed to decipher the inter‐relationship between peripheral hormones (kisspeptin and testosterone), sexual behaviour and seminal variables of Murrah buffalo bulls (n = 134). In this study, we recorded that 13%, 37%, 40%, 6% and 4% Murrah buffalo bulls had reaction time of <30, 31–60, 61–180, 181–300 and >300 s, respectively. Further, it was observed that 4%, 85% and 10% buffalo bulls were sexually aggressive, active and dull, respectively, during semen collection. The courtship behaviour was not found to be desirable for the bulls used for the semen collection. Mean of ejaculate volume, sperm concentration and mass motility (0–5 scale) were 3.57 ml, 977.11 million/ml, 2.7, respectively. Correlation studies revealed that the reaction time was positively correlated with courtship behaviour and body weight, and negatively correlated with sexual aggressiveness and sperm concentration. Serum kisspeptin in buffalo bulls, measured for the first time, was found to 3.8 ± 0.7 ng/ml. Serum kisspeptin and testosterone level are negatively correlated to each other and kisspeptin level influenced the sexual behaviour (reaction time, sexual aggressiveness and penile erection) of study bulls. Serum kisspeptin was higher in the buffalo bulls with higher sperm concentration indicating its role in spermatogenesis. In conclusion, for the first time basic information related to sexual behaviour of Murrah buffalo bulls in large population along with its inter‐relationship with peripheral hormones (kisspeptin and testosterone) has been documented.
Quasi-Bayes Properties of a Procedure for Sequential Learning in Mixture Models
Authors: Fortini Sandra , Petrone Sonia
Published: June 2020

Bayesian methods are often optimal, yet increasing pressure for fast computations, especially with streaming data, brings renewed interest in faster, possibly suboptimal, solutions. The extent to which these algorithms approximate Bayesian solutions is a question of interest, but often unanswered. We propose a methodology to address this question in predictive settings, when the algorithm can be reinterpreted as a probabilistic predictive rule. We specifically develop the proposed methodology for a recursive procedure for on-line learning in non-parametric mixture models, which is often referred to as Newton’s algorithm. This algorithm is simple and fast; however, its approximation properties are unclear. By reinterpreting it as a predictive rule, we can show that it underlies a statistical model which is, asymptotically, a Bayesian, exchangeable mixture model. In this sense, the recursive rule provides a quasi-Bayes solution. Although the algorithm offers only a point estimate, our clean statistical formulation enables us to provide the asymptotic posterior distribution and asymptotic credible intervals for the mixing distribution. Moreover, it gives insights for tuning the parameters, as we illustrate in simulation studies, and paves the way to extensions in various directions. Beyond mixture models, our approach can be applied to other predictive algorithms.
The key role of terminators on the expression and post‐transcriptional gene silencing of transgenes
Authors: F. de Felippes Felipe , McHale Marcus , Doran Rachel L. , Roden Sally , Eamens Andrew L. , Finnegan E. Jean , Waterhouse Peter M.
Published: June 2020

Transgenes have become essential to modern biology, being an important tool in functional genomic studies and also in the development of biotechnological products. One of the major challenges in the generation of transgenic lines concerns the expression of transgenes, which, compared to endogenes, are particularly susceptible to silencing mediated by small RNAs (sRNAs). Several reasons have been put forward to explain why transgenes often trigger the production of sRNAs, such as the high level of expression induced by commonly used strong constitutive promoters, the lack of introns, and features resembling viral and other exogenous sequences. However, the relative contributions of the different genomic elements with respect to protecting genes from the silencing machinery and their molecular mechanisms remain unclear. Here, we present the results of a mutagenesis screen conceived to identify features involved in the protection of endogenes against becoming a template for the production of sRNAs. Interestingly, all of the recovered mutants had alterations in genes with proposed function in transcription termination, suggesting a central role of terminators in this process. Indeed, using a GFP reporter system, we show that, among different genetic elements tested, the terminator sequence had the greatest effect on transgene‐derived sRNA accumulation and that a well‐defined poly(A) site might be especially important. Finally, we describe an unexpected mechanism, where transgenes containing certain intron/terminator combinations lead to an increase in the production of sRNAs, which appears to interfere with splicing.