bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of advanced age‐related macular degeneration on the National Eye Institute’s Visual Function Questionnaire‐25
Authors: Patnaik Jennifer L. , Lynch Anne M. , Pecen Paula E. , Jasso Maria , Hanson Kara , Mathias Marc T. , Palestine Alan G. , Mandava Naresh
Published: December 2020

Purpose

To assess visual function among patients diagnosed with age‐related macular degeneration (AMD) by stage of disease and laterality.

Methods

This is a cross‐sectional cohort study of 739 AMD patients and their responses to the National Eye Institute Visual Function Questionnaire‐25 (NEI VFQ‐25) at time of study enrolment. Patients with AMD were categorized into Early/Intermediate AMD and three groups of advanced AMD: (i) neovascular AMD (NV), (ii) geographic atrophy (GA) and (iii) Both Advanced forms. These three advanced stages were further stratified into unilateral or bilateral advanced disease. Mean composite scores and subscale scores for 12 different areas were based on a 100‐point scale with the lowest and highest possible scores set at 0 and 100, respectively. Scores for the advanced AMD groups were compared with Early/Intermediate AMD using general linear modelling.

Results

A total of 739 AMD patients (294 Early/Intermediate, 115 GA, 168 NVAMD and 162 Both Advanced) were included in the analysis. Mean composite scores were highest among Early/Intermediate patients (89.9), followed by patients diagnosed with unilateral disease in the Both Advanced (88.0) and NV (86.1) groups. Mean composite scores were similar for bilateral NV (82.9) and unilateral GA (81.7), and mean scores were lowest for the bilateral GA (71.3) and bilateral Both Advanced (68.5) groups. In general, this pattern persisted across the twelve subscales as well. Subscale scores ranged from a low of 35.1 for driving among bilateral Both Advanced patients to a high of 99.2 for colour vision among patients with unilateral Both Advanced. Overall, patients with unilateral advanced disease consistently had higher mean scores than their bilateral counterparts. The largest difference was 19.5 composite score points between the unilateral and bilateral Both Advanced groups, there was a difference of 10.4 points between the GA groups, and a relatively small difference of 3.2 points between the NV groups.

Conclusions

We found large differences in visual function as reported from the VFQ‐25 across the different types of advanced stage AMD groups and number of eyes affected with advanced AMD. These findings demonstrate the importance of accounting for the type and number of eyes affected by advanced stage AMD.
Daratumumab monotherapy for relapsed/refractory multiple myeloma, focussed on clinical trial‐unfit patients and subsequent therapy
Authors: Park Sung‐Soo , Min Byun Ja , Yoon Sung‐Soo , Kim Kihyun , Jung Sung‐Hoon , Lee Je‐Jung , Min Chang‐Ki
Published: December 2020

Real‐world outcomes of daratumumab monotherapy (DM) for relapsed/refractory multiple myeloma (RRMM) have remained unclear. We conducted a multicentre retrospective study of 107 patients receiving DM for RRMM. The cohort included 64 trial‐unfit patients whose characteristics could not meet inclusion criteria in two previous clinical trials (GEN501 and SIRIUS). The overall response rate (ORR), and median first and second progression‐free survival (PFS1 and PFS2) and overall survival were 42·1%, and 3·6, 8·1 and 11·9 months, respectively. Refractoriness to carfilzomib and/or lenalidomide, and neutropenia (<1.0 × 109/l) resulted in poorer ORRs. An Eastern Cooperative Oncology Group Performance Status of ≥3, neutropenia (<1.0 × 109/l), thrombocytopenia (<75 × 109/l), and renal failure (glomerular filtration rate of <20 ml/min/1·73 m2) were associated with poor PFS1 and PFS2 in respective univariate analysis. The modified trial‐unfit group, based on the above factors, showed significantly negative impacts on PFS1 and PFS2 (hazard ratio 2·823 and 3·677, all P < 0·001) in multivariate analysis despite having a 34% ORR. Fatal infections occurred more often in the modified trial‐unfit group than in the others (16·1% vs. 4·3%; P = 0·099). Despite failure of DM, subsequent therapy with pomalidomide‐based therapy or carfilzomib‐dexamethasone provided a 66·6% ORR. Real‐world DM showed favourable efficacies for RRMM and, potentially, additional benefits with subsequent therapies. However, characteristics corresponding with trial‐unfitness might offset the efficacy of DM.
Targeting the mutant PIK3CA gene by DNA‐alkylating pyrrole‐imidazole polyamide in cervical cancer
Authors: Krishnamurthy Sakthisri , Yoda Hiroyuki , Hiraoka Kiriko , Inoue Takahiro , Lin Jason , Shinozaki Yoshinao , Watanabe Takayoshi , Koshikawa Nobuko , Takatori Atsushi , Nagase Hiroki
Published: December 2020

PIK3CA is the most frequently mutated oncogene in cervical cancer, and somatic mutations in the PIK3CA gene result in increased activity of PI3K. In cervical cancer, the E545K mutation in PIK3CA leads to elevated cell proliferation and reduced apoptosis. In the present study, we designed and synthesized a novel pyrrole‐imidazole polyamide‐seco‐CBI conjugate, P3AE5K, to target the PIK3CA gene bearing the E545K mutation, rendered possible by nuclear access and the unique sequence specificity of pyrrole‐imidazole polyamides. P3AE5K interacted with double‐stranded DNA of the coding region containing the E545K mutation. When compared with conventional PI3K inhibitors, P3AE5K demonstrated strong cytotoxicity in E545K‐positive cervical cancer cells at lower concentrations. PIK3CA mutant cells exposed to P3AE5K exhibited reduced expression levels of PIK3CA mRNA and protein, and subsequent apoptotic cell death. Moreover, P3AE5K significantly decreased the tumor growth in mouse xenograft models derived from PIK3CA mutant cells. Overall, the present data strongly suggest that the alkylating pyrrole‐imidazole polyamide P3AE5K should be a promising new drug candidate targeting a constitutively activating mutation of PIK3CA in cervical cancer.
The Role of Alternative Theories and Anomalous Evidence in Children’s Scientific Belief Revision
Authors: Ganea Patricia A. , Larsen Nicole E. , Venkadasalam Vaunam P.
Published: December 2020

Children’s naive theories include misconceptions which can interfere with science learning. This research examined the effect of pairing anomalies with alternative theories, and their order of presentation, on children’s belief revision. Children believe that heavy objects sink and light ones float. In a pre‐, mid‐, and post‐test design, 5‐year‐olds (N = 96) were assigned to one of two conditions, where they were either exposed to an alternative theory about buoyancy and then observed anomalies (Explanation‐First), or the reverse (Anomalies‐First). At mid‐test, children were more likely to revise their beliefs after exposure to an alternative theory than anomalies alone. At post‐test, children revised their naïve belief when they had access to an alternative theory before the anomalous evidence than in the opposite order.
ClipFlip : Multi‐view Clipart Design
Authors: Shen I‐Chao , Liu Kuan‐Hung , Su Li‐Wen , Wu Yu‐Ting , Chen Bing‐Yu
Published: December 2020

We present an assistive system for clipart design by providing visual scaffolds from the unseen viewpoints. Inspired by the artists' creation process, our system constructs the visual scaffold by first synthesizing the reference 3D shape of the input clipart and rendering it from the desired viewpoint. The critical challenge of constructing this visual scaffold is to generate a reference 3D shape that matches the user's expectations in terms of object sizing and positioning while preserving the geometric style of the input clipart. To address this challenge, we propose a user‐assisted curve extrusion method to obtain the reference 3D shape. We render the synthesized reference 3D shape with a consistent style into the visual scaffold. By following the generated visual scaffold, the users can efficiently design clipart with their desired viewpoints. The user study conducted by an intuitive user interface and our generated visual scaffold suggests that our system is especially useful for estimating the ratio and scale between object parts and can save on average 57% of drawing time.
Endothelial glycocalyx as an important factor in composition of blood‐brain barrier
Authors: Zhao Fangfang , Zhong Liyuan , Luo Yumin
Published: December 2020

The blood‐brain barrier is a dynamic and complex neurovascular unit that protects neurons from somatic circulatory factors as well as regulates the internal environmental stability of the central nervous system. Endothelial glycocalyx is a critical component of an extended neurovascular unit that influences the structure of the blood‐brain barrier and plays various physiological functions, including an important role in maintaining normal neuronal homeostasis. Specifically, glycocalyx acts in physical and charge barriers, mechanical transduction, regulation of vascular permeability, modulation of inflammatory response, and anticoagulation. Since intact glycocalyx is necessary to maintain the stability and integrity of the internal environment of the blood‐brain barrier, damage to glycocalyx can lead to the dysfunction of the blood‐brain barrier. This review discusses the role of glycocalyx in the context of the substantial literature regarding the blood‐brain barrier research, in order to provide a theoretical basis for the diagnosis and treatment of neurological diseases as well as point to new breakthroughs and innovations in glycocalyx‐dependent blood‐brain barrier function.
How to diminish the geographical bias in IPBES and related science?
Authors: Báldi András , Palotás Brigitta
Published: December 2020

To tackle the current global environmental crisis, operational science‐policy interfaces are needed. The Intergovernmental Science‐policy Platform on Biodiversity and Ecosystem Services (IPBES) provides governments with policy advice via its assessment reports. To expand the evidence‐base and to support the uptake of IPBES products, participation needs to be balanced across the globe. We found imbalance in authors’ distribution at both the UN regional and country level. It is more pronounced for IPBES‐related scientific papers than for the IPBES global assessment. The more detached from politics the decision of getting involved is, the more imbalanced the representation of the regions becomes. To improve the IPBES’ geographical balance, a strategy to increase the number of active member states is called for. We argued that without explicit efforts to reach the balance—for example, providing an attractive research environment for excellent researchers in their home country, improving cooperation among countries across the UN regions, and granting publication opportunity for all authors—the idea of geographic equality diminishes.
A silver lining to REDD: Institutional growth despite programmatic failure
Authors: Borgerhoff Mulder Monique , Caro Tim , Ngwali Assa Sharif
Published: December 2020

What happens when conservation interventions ostensibly fail? We outline a REDD+ intervention on Zanzibar, Tanzania which is adapting to a failure to implement carbon compensation payments and to the increased global price of cloves. Using a mix of quantitative and qualitative methods we provide preliminary evidence that well‐managed shehia (wards) with registered Community Forestry Management Agreements (CoFMAs) are slowing their rates of deforestation. We also find an increase in the number of shehia with CoFMAs despite the absence of carbon payments. Using this island‐wide case study we make inferences about the mechanisms whereby institutional expansion has occurred in ways consistent with cultural evolutionary dynamics of institutional change. We draw lessons for planning and practice that may help with the design of future conservation interventions and with bolstering the morale and effectiveness of disappointed partners.
An overview of COVID‐19 in people with diabetes: Pathophysiology and considerations in the inpatient setting
Authors: Fleming Nicola , Sacks Lori J. , Pham Cecilia T. , Neoh Sandra L. , Ekinci Elif I.
Published: December 2020

Introduction

The coronavirus disease (COVID‐19) pandemic has continued to have a devastating impact on health worldwide. There has been a rapid evolution of evidence, establishing an increased risk of morbidity and mortality associated with diabetes and concurrent COVID‐19. The objective of this review is to explore the current evidence for inpatient assessment and management of diabetes during the COVID‐19 pandemic and highlight areas requiring further exploration.

Methods

A literature search of databases was conducted to November 2020 using variations on keywords SARS‐CoV‐2, COVID‐19, SARS, MERS and diabetes. Information relating to the impact of diabetes on severity of COVID‐19 infection, the impact of COVID‐19 infection on diabetes management and diabetes‐related complications was integrated to create a narrative review.

Discussion

People with diabetes and COVID‐19 are at an increased risk of morbidity and mortality. It is important that people with both known and previously unrecognised diabetes and COVID‐19 be promptly identified and assessed during acute illness, with close monitoring for clinical deterioration or complications. People with diabetes may require titration or alteration of their glycaemic management due to the potential for worse outcomes with hyperglycaemia and COVID‐19 infection. Comprehensive discharge planning is vital to optimise ongoing glycaemic management.

Conclusion

Further understanding of the risk of adverse outcomes and optimisation of glycaemic management for people with diabetes during COVID‐19 is required to improve outcomes. Increased glucose and ketone monitoring, substitution of insulin for some oral anti‐hyperglycaemic medications and careful monitoring for complications of diabetes such as diabetic ketoacidosis should be considered.
Monetary payoffs modulate reciprocity expectations in outcome evaluations: An event‐related potential study
Authors: Li Jin , Xu Nian , Zhong Yiping
Published: December 2020

Choosing cooperation or aggression relies on reciprocity preferences which refer to the tendency of an individual to return cooperative or aggressive action for cooperative or aggressive action (i.e., positive or negative reciprocity preference). The reciprocity preference is positively correlated with reciprocity expectation, wherein individuals with stronger reciprocity preferences may have higher expectations than future cooperative or aggressive behavior should be delivered by beneficiaries (positive reciprocity expectation) or victims (negative reciprocity expectation). Although previous studies have demonstrated that the presence of monetary payoffs enhances reciprocity preferences, the modulation of monetary payoffs in reciprocity expectations remains unclear. Using event‐related potentials (ERPs), we examined how monetary payoffs modulated reciprocity expectations by adopting the Chicken game. Participants were asked to choose between cooperation and aggression with a putative opponent in the Chicken game involving the monetary (vs. non‐monetary) payoffs. Participants’ electroencephalogram (EEG) was recorded when they saw the opponent's cooperative or aggressive decision. Results showed that compared to the non‐monetary payoff trials, the feedback‐related negativity (FRN) effect in response to the opponent's decisions was stronger following the participant's aggressive decision in the monetary payoff trials, whereas P3 was insensitive to monetary payoffs. These findings suggest that monetary payoffs heighten expectations of negative reciprocity at the earlier and automatic outcome processing stage.
Correlation between total homocysteine and cerebral small vessel disease: A Mendelian randomization study
Authors: Cao Yuze , Su Ning , Zhang Dingding , Zhou Lixin , Yao Ming , Zhang Shuyang , Cui Liying , Zhu Yicheng , Ni Jun
Published: December 2020

Background and purpose

Cerebral small vessel disease (CSVD) is a clinical imaging syndrome with diverse etiology. Total homocysteine (HCY) level might increase the risk of myocardial and cerebral infarction by damaging the vascular endothelium. We aimed to explore the correlation between total HCY and CSVD imaging burden, based on Mendelian randomization methods.

Methods

A total of 1,023 participants of the Shunyi study, a population‐based cohort study, were included. Vascular risk factors, total HCY levels and methylenetetrahydrofolate reductase (MTHFR) gene mutations (C677T and A1298C) were examined. CSVD imaging markers, including lacunes, cerebral microbleeds, white matter hyperintensity, enlarged perivascular space and brain parenchymal fraction (BPF) were also assessed.

Results

Mutations of C677T were significantly correlated with increased total HCY levels (CC→TT: β = 0.28, p < 0.0001), while mutations of A1298C were correlated with decreased total HCY levels (AA→AC: β = −0.13, p < 0.0001; AA→CC: β = −0.25, p = 0.004). In the Mendelian randomization study, the C677T genotype was significantly associated with lacunes (CC→CT: odds ratio [OR] 2.76, p = 0.008; CC→TT: OR 2.50, p = 0.018), and the A1298C genotype was significantly correlated with BPF (AA→CC: β = 1.32, p = 0.015). Similarly, in multivariate regression analysis, total HCY levels were significantly correlated with lacunes (OR 2.14, p < 0.0001) and negatively correlated with BPF (β = −0.55, p = 0.004). Age, sex and vascular risk factors were adjusted for.

Conclusions

Total HCY level was correlated with imaging burden of CSVD, especially with lacunes and brain volume loss. For individuals with risk genetic predisposition, enhanced homocysteine‐lowering strategies might be necessary to reduce the risk and progress of CSVD.
From connection to collusion: How college admissions bow to powerful alumni in China
Authors: Li Tao , Mo Kun
Published: December 2020

Access to college is critical for social mobility in China. Using a detailed college admission database that includes essentially all four‐year public universities from 2005 to 2013, we demonstrate that Chinese universities preallocate more admission seats to provinces that happen to fall under the leadership of their alumni. Moreover, we demonstrate that the identified admission favoritism constitutes a political exchange between public universities and their powerful alumni in the sense that (a) universities and the connected provinces tend to sign formal partnership agreements; and (b) university leaders who sign formal partnership agreements receive indirect personal gains in terms of career advancement in the party‐state bureaucracy. Our article provides causal evidence that social connections facilitate powerful government insiders' collusion and capture of public resources in a weak institutional environment.
The role of wind fetch in structuring Antarctic seabird breeding occupancy
Authors: Schrimpf Michael , Lynch Heather
Published: December 2020

Avian breeding sites located along shorelines may allow easy access to aquatic food sources, but risk exposing birds and nests to high wind and wave action. One measure of exposure is wind fetch, the distance of open water over which wind can blow uninterrupted. By calculating fetch weighted by prevailing wind direction for breeding colonies of pursuit‐diving seabirds in the Antarctic Peninsula, we show that different members of this guild have opposing relationships to coastline exposure. Gentoo Penguins Pygoscelis papua preferentially occupied more enclosed sites with lower fetch. Surprisingly, however, Chinstrap Penguins Pygoscelis antarcticus and Antarctic Shags Leucocarbo bransfieldensis appear to prefer more exposed sites. Although considerable research has been devoted to understanding Antarctic seabird habitat suitability, the role of wind and wave exposure has not been considered in depth, in part because comprehensive data on colony presence and absence have only recently been made available. We propose several mechanisms for why fetch may act to differentiate niches among this guild. These findings may increase our ability to identify suitable breeding areas for these and other near‐shore breeding species as they respond to climate change.
Upwelling systems in the migration ecology of Roseate Terns (Sterna dougallii) breeding in northwest Europe
Authors: Redfern Chris P. F. , Kinchin‐Smith David , Newton Stephen , Morrison Paul , Bolton Mark , Piec Daniel
Published: December 2020

For migratory seabirds, staging and wintering areas may be important targets for conservation. Declines of Roseate TernSterna dougalliipopulations have led to conservation initiatives at breeding sites on both sides of the North Atlantic. However, these could be compromised by environmental conditions in non‐breeding areas. The migratory ecology of Roseate Terns is poorly known and we used light‐level biologgers (geolocators) to identify the migratory routes, staging and wintering areas of Roseate Terns from two European colonies. Most birds wintered off the Ghanaian coast in the Gulf of Guinea, but some wintered further west off Sierra Leone and Liberia, or changed locations during the winter. In these areas, cold‐water upwellings of the Guinea Current Large Marine Ecosystem (GCLME) may provide vital foraging resources. Geolocations in combination with temperature measurements and satellite sea‐surface temperature data show that cold‐water upwellings of the Canary Current Large Marine Ecosystem (CCLME) were important areas for migratory staging, particularly on the return migration which was slower than the outward journey. These results emphasize the importance of productive cold‐water upwellings in the migratory ecology of Roseate Terns. The GCLME and CCLME are under threat from over‐exploitation, pollution and climate change; effective conservation of these environments will be important to secure the long‐term future of these and other seabirds.
A cross‐sectional study on dermatoses among underwater workers: a new clinical sign of peculiar distribution pattern of lesions in sea urchin prick reaction revealed
Authors: Nikhila Pappinisseri Komalalayam , Sukumarakurup Sreekanth , Abdul Latheef Ettappurath N. , Kidangazhiathmana Ajithkumar , Raman Rajendran Vadukkot , George Biju , Riyaz Najeeba , Binitha Manikoth Payyanadan
Published: December 2020

Background

The pattern of dermatoses among underwater workers is undocumented and, hence, worth studying. The objective of the study was to document the pattern of dermatoses among underwater workers in a tropical seaside area.

Methods

A population‐based cross‐sectional study of 1 year from April 2015 among people regularly involved in underwater occupation, especially the collection of mollusks.

Results

Among 62 participants analyzed, the commonly noted dermatoses were scars of previous injuries, sea urchin prick reaction, onychomycosis, tinea versicolor, dermatophytosis, warts, and intertrigo. These workers stabilize their position under water by fixing elbows and knees to rocks, where they get accidentally pricked by sea urchins attached to the rocks. Hands also get pricked by sea urchins while trying to pluck mollusks from rocks, thus leading to the predominance of lesions in elbows, knees, and hands.

Conclusion

Documenting the pattern of dermatological diseases in any group of underwater workers has not been done previously. Along with doing that, the study also brought to light the existence of a rare disease, sea urchin prick reaction, in notable proportions among an underprivileged group. This study also detected a previously unrecorded clinical finding of a peculiar distribution pattern of lesions over the body in patients with sea urchin prick reaction. The evidence toward possible commensalism between the two species of organisms noted in this study extends its scope beyond the realms of dermatology and opens new areas for research in other branches of science also.
Spatial heterogeneity in temporal dynamics of Alpine bird communities along an elevational gradient
Authors: García‐Navas Vicente , Sattler Thomas , Schmid Hans , Ozgul Arpat
Published: December 2020

Aim

Mountains are biodiversity hotspots and are among the most sensitive ecosystems to ongoing global change being thus of conservation concern. Under this scenario, assessing how biological communities vary over time along elevational gradients and the relative effects of niche‐based deterministic processes and stochastic events in structuring assemblages is essential. Here, we examined how the temporal trends of bird communities vary with elevation over a 20 year‐period (1999–2018). We also tested for differences in temporal dynamics among habitat types (among‐community variability) and functional groups (within‐community variability).

Taxon

97 species of common breeding birds.

Location

Swiss Alps.

Methods

We used abundance data from the Swiss breeding bird survey to compute different temporal dynamic metrics (temporal turnover, synchrony, rate of community change and community‐level of covariance among species). We also examined the relative contribution of deterministic and stochastic processes in community assembly using the Raup‐Crick method and the normalized stochasticity ratio.

Results

We found that, with greater elevation, temporal species turnover increased while the rate of overall community change over successive years decreased, suggesting that high‐elevation communities display more erratic dynamics with no clear trend. Despite this, we found a more deterministic assembly of alpine communities in comparison to those located at lower elevations. Deterministic processes had greater influence than stochastic processes on community assembly along the entire elevational gradient (80% of communities). Forest communities exhibited higher synchrony in comparison to the remaining habitats likely because they consisted of species with greater functional redundancy, whereas alpine communities were the least stable as a result of their low taxonomic richness (‘portfolio’ effect).

Main conclusions

Community‐level synchrony was overall positive supporting the idea that compensatory mechanisms are rare in natural biological communities. Our results suggest that rather than competition, the existence of differences in the ecological strategies of species may have a stabilizing effect on bird communities by weakening the concordance of species responses to fluctuations in environmental conditions (i.e. enhanced interspecific temporal asynchrony). This study provides evidence that, although species turnover in metacommunities is frequent, a high temporal turnover does not necessarily imply the overriding importance of stochastic processes.
Specific electrogram characteristics impact substrate ablation target area in patients with scar‐related ventricular tachycardia—insights from automated ultrahigh‐density mapping
Authors: Schwarzl Jana M. , Schleberger Ruben , Kahle Ann‐Kathrin , Höller Alexandra , Schwarzl Michael , Schaeffer Benjamin N. , Münkler Paula , Moser Julia , Akbulak Ruken Ö. , Eickholt Christian , Dinshaw Leon , Dickow Jannis , Maury Philippe , Sacher Frederic , Martin Claire A. , Wong Tom , Estner Heidi L. , Jaïs Pierre , Willems Stephan , Meyer Christian
Published: December 2020

Introduction

Substrate‐based catheter ablation approaches to ventricular tachycardia (VT) focus on low‐voltage areas and abnormal electrograms. However, specific electrogram characteristics in sinus rhythm are not clearly defined and can be subject to variable interpretation. We analyzed the potential ablation target size using automatic abnormal electrogram detection and studied findings during substrate mapping in the VT isthmus area.

Methods and Results

Electrogram characteristics in 61 patients undergoing scar‐related VT ablation using ultrahigh‐density 3D‐mapping with a 64‐electrode mini‐basket catheter were analyzed retrospectively. Forty‐four complete substrate maps with a mean number of 10319 ± 889 points were acquired. Fractionated potentials detected by automated annotation and manual review were present in 43 ± 21% of the entire low‐voltage area (<1.0 mV), highly fractionated potentials in 7 ± 8%, late potentials in 13 ± 15%, fractionated late potentials in 7 ± 9% and isolated late potentials in 2 ± 4%, respectively. Highly fractionated potentials (>10 ± 1 fractionations) were found in all isthmus areas of identified VT during substrate mapping, while isolated late potentials were distant from the critical isthmus area in 29%.

Conclusion

The ablation target area varies enormously in size, depending on the definition of abnormal electrograms. Clear linking of abnormal electrograms with critical VT isthmus areas during substrate mapping remains difficult due to a lack of specificity rather than sensitivity. However, highly fractionated, low‐voltage electrograms were found to be present in all critical VT isthmus sites.
Long sleep duration and cardiovascular disease: Associations with arterial stiffness and blood pressure variability
Authors: Matsubayashi Hideaki , Nagai Michiaki , Dote Keigo , Turana Yuda , Siddique Saulat , Chia Yook‐Chin , Chen Chen‐Huan , Cheng Hao‐Min , Van Minh Huynh , Verma Narsingh , Chin Tay Jam , Wee Teo Boon , Kario Kazuomi
Published: December 2020

Although short and long sleep duration are both risk factors of cardiovascular disease (CVD), the recent meta‐analyses have been shown that long sleep duration was closely associated with CVD mortality. While the specific mechanism underlying the association between long sleep duration and CVD remains unclear, long sleep duration was shown to be associated with arterial stiffness and blood pressure variability (BPV) in many Asian populations. This review article will focus on the pathophysiology of long sleep duration, arterial stiffness, BPV and their effects on CVD. To set the stage for this review, we first summarize the current insights for the relationship between long sleep duration and CVD in relation to arterial stiffness and BPV.
Testing the Premises of International Society in the European Energy Union: The Pluralism/Solidarism Nexus
Authors: Stefanova Boyka M. , Zhelev Paskal
Published: December 2020

This paper sheds new light on the policy reality of the European Energy Union on the example of the EU natural gas market. The paper argues that, as the energy union preserves the treaty‐based parallelism between the competences of the EU and the member states, the resolution of conflicts between individual preferences and shared priorities has emerged as a measure of consolidation in the EU energy domain. Which logic prevails: the common good or the consensus will? The paper applies the concept of international society to test key hypotheses related to the pluralism/solidarism nexus in the European Energy Union.

The paper concludes that individual interests and collective decision‐making in the EU natural gas market are reconciled along the premises of pragmatic solidarism with demonstration effects for the regional energy system, indicative of the EU's vanguard role as a regional regulator setting the rules of energy investment and trade in Europe.
Feedback on Forensic Mental Health Assessments in a Juvenile Court Clinic Certification Program
Authors: DiCataldo Frank , Serafinski Rachel L. , Beam Danielle C. , Grisso Thomas
Published: December 2020

Public‐sector mental health systems have set forth specialized practice competencies for forensic mental health clinicians conducting court‐ordered examinations. This study examined a sample of feedback letters to clinicians who submitted mid‐training and final reports for review as part of the requirements for certification as a juvenile court clinician. The most common feedback points were insufficient/irrelevant historical data, problems with clarity/organization of the report, problems with interview/mental status examination, and problems with competency to stand trial data/opinions. Clinicians had fewer deficiencies in their final report compared to their mid‐training report, supporting the perspective that forensic training and supervision is associated with better quality reports.
Evidence‐Based Guidance for Self‐Administration of Injectable Contraception
Authors: Marx Megan
Published: December 2020

The requirement of in‐person visits every 3 months for a health care provider to administer intramuscular depot medroxyprogesterone acetate (DMPA‐IM) is a significant barrier to its use, particularly in the wake of the coronavirus pandemic. Time and travel costs as well as scheduling conflicts also negatively impact the receipt of subsequent contraceptive injections, which can result in unintended pregnancies. Subcutaneous depot medroxyprogesterone acetate (DMPA‐SC) can be self‐administered by individuals at home, expanding contraceptive access, convenience, and reproductive autonomy. With 30% less progestin, DMPA‐SC improves upon the DMPA‐IM formulation while retaining efficacy. As part of comprehensive contraceptive counseling, health care providers should consider offering DMPA‐SC to eligible individuals interested in self‐administration. Using a case study approach, evidence‐based recommendations are reviewed for the off‐label use of self‐administered DMPA‐SC in the United States.
Clinical academic research internships: What works for nurses and the wider nursing, midwifery and allied health professional workforce
Authors: Olive Philippa , Maxton Fiona , Bell Cate Ann , Bench Suzanne , Tinkler Linda , Jones Steph , Kenkre Joyce
Published: December 2020

Nurse‐led research and innovation is key to improving health experiences and outcomes and reducing health inequalities. Clinical academic training programmes for nurses to develop research and innovation skills alongside continued development of their clinical practice are becoming increasingly established at national, regional and local levels. Though widely supported, geographical variation in the range and scope of opportunities available remains. It is imperative that clinical academic opportunities for nurses continue to grow to ensure equity of access and opportunity so that the potential of nurse‐led clinical academic research to improve quality of care, health experience and health outcomes can be realised. In this paper, we describe and report on clinical academic internship opportunities available to nurses to share internationally, a range of innovative programmes currently in operation across the UK. Examples of some of the tangible benefits for patients, professional development, clinical teams and NHS organisations resulting from these clinical academic internships are illustrated. Information from local evaluations of internship programmes was collated to report what has worked well alongside ‘real‐world’ set‐up and sustainability challenges faced in practice. Clinical academic internship schemes are often opportunistically developed, making use of hybrid models of delivery and funding responsive to local needs and available resources. Key enablers of successful clinical academic internship programmes for nurses were support from senior clinical leaders and established relationships with local universities and wider organisations committed to research capacity building.
A challenging balancing act to engage children and their families in a healthy lifestyle – Nurses' experiences of child‐centred health dialogue in child health services in Sweden
Authors: Castor Charlotte , Derwig Mariette , Borg Sofie Johanna , Ollhage Malin Elisabeth , Tiberg Iren
Published: December 2020

Aims and objectives

To describe nurses' experiences of a child‐centred family guided intervention of obesity tested within the child health services targeting children identified with overweight and their caregivers.

Background

Interventions aiming to support families towards a healthier lifestyle can lead to decreased risk of overweight evolving into obesity in a child. At the same time, nurses have found dialogues on weight challenging and may therefore avoid them.

Design

Qualitative descriptive inductive design following content analysis applying to the COREQ guidelines.

Methods

Content analysis was used to analyse 13 individual semi‐structured interviews with nurses in the child health service in Sweden after completed training in CCHD, including how to facilitate the dialogue with the use of illustrations.

Results

The theme Health dialogue about weight is a challenging balancing act facilitated by a supportive intervention emerged through eight subcategories in three main categories. Nurses experienced that CCHD with children identified with overweight and their caregivers provoked an emotional response both for themselves and for the caregivers of the child. The training in child‐centred health dialogues promoted the nurses' work with structure and professionalism, as the nurses carefully took tentative steps to engage the family for a healthy lifestyle.

Conclusions

Emotional and practical challenges in performing CCHD still remained among nurses after customised training, which might comprise the child's rights to be involved in his or her own care when the child was identified as overweight. However, training for nurses, including lectures and tutorials, was found to increase the quality and professionalism of performing CCHD by providing structure, tools and tutorial support.

Relevance to clinical practice

Customised training and illustrations can support nurses when performing a structured intervention such as child‐centred health dialogues.
Randomised controlled trial of a smartphone application‐based dietary self‐management program on haemodialysis patients
Authors: Pack Songyi , Lee Jia
Published: December 2020

Aims and objectives

To develop a smartphone application‐based dietary self‐management program for haemodialysis patients and to examine its effects on biochemical indicators, self‐efficacy and quality of life.

Background

Lack of dietary management in haemodialysis patients can lead to serious complications such as oedema, hyponatremia, hyperkalaemia, hypertension, uraemia and eventually death; however, studies using smartphone applications for dietary self‐management in haemodialysis patients are rare.

Design

A prospective, single‐blind, randomised, controlled design with repeated measures was followed with 75 haemodialysis patients at a haemodialysis centre. Data were collected from 10 January 2017–6 May 2018. The study applied the Consolidated Standards of Reporting Trials statement.

Methods

The 8‐week smartphone application‐based dietary self‐management program was developed through collaboration with a haemodialysis equipment company. The experimental group took this program while the control group took an 8‐week general program. Study variables were serum phosphorus, potassium and albumin, self‐efficacy and quality of life. They were measured at pretest, and 8 weeks and 12 weeks after the programs, and analysed using two‐way repeated measures analysis of variance.

Findings

The smartphone application‐based program significantly improved serum phosphorus, potassium, self‐efficacy and quality of life over time compared with the general program. There was no significant difference in albumin level changes between the groups.

Conclusions

The smartphone application‐based dietary self‐management program is an opportune and effective nursing intervention to lower serum phosphorus and potassium levels in haemodialysis patients over time. Trial registration was performed on www.cris.nih.go.kr (KCT0005366).

Relevance to clinical practice

Haemodialysis patients can easily use the smartphone application to manage their diet anytime and anywhere. They can get real‐time feedback and solutions to prevent haemodialysis complications. Nurses can provide tailored high‐quality care based on an individual's lifelog data from the smartphone application.
Promoting safer sex in the context of heterosexual anal intercourse: A scoping review
Authors: Stewart Joanne , Douglas Gillian , O'Rourke Tammy , Gammel Carolyn
Published: December 2020

Aims and objectives

To locate and summarise existing literature regarding safer sex practices specific to heterosexual anal intercourse and identify promising health promotion strategies.

Background

Much of the literature regarding anal intercourse and safer sex is related to men who have sex with men. However, some studies suggest there are more women than men engaging in unprotected receptive anal intercourse. The risks associated with this sexual practice have been well documented, although many healthcare providers fail to ask about anal intercourse while addressing safer sex in the heterosexual population.

Design

The study was based on Arksey and O’Malley's 2005 five‐step methodology.

Methods

A search was conducted of MEDLINE; CINAHL; PsycInfo; Cochrane; and PubMed. Databases were searched from 1990–2020. The 72 studies selected were classified according to their main area of focus. A grey literature search was also included. This scientific submission has been assessed for accuracy and completeness using the PRISMA‐ScR guideline criteria (File S1).

Results

The literature in this area is heterogeneous in terms of method and topic. Prevalence and incidence (n = 26) in addition to sexually transmitted infection risks (n = 26) related to heterosexual anal intercourse are well understood. However, there is limited information on condom use (n = 6), factors that influence heterosexual anal intercourse (n = 10) and health promotion strategies for this population and practice (n = 4). Two websites that mentioned heterosexual anal intercourse risk reduction activities were included.

Conclusions

Although heterosexual anal intercourse appears to be an increasingly common sexual practice, very little is known about health promotion strategies nurses might use for encouraging safer sex in this population.

Relevance to clinical practice

Increased awareness of the prevalence and risks of heterosexual anal intercourse could enhance nurses’ harm reduction strategies. Screening for sexually transmitted infections may be based on incorrect assumptions about sexual practices or due to stigma linked with anal intercourse. Reducing unprotected heterosexual anal intercourse will reduce sexually transmitted infections and their long‐term sequelae.
Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta‐analysis
Authors: Bucci Rosaria , Rongo Roberto , Bucci Paolo , Valletta Rosa , Michelotti Ambrosina , D’Antò Vincenzo
Published: December 2020

Aim

To systematically review the effects of surgical mandibular advancement (SMA) regarding changes of the upper airways in adult patients with skeletal Class II malocclusion.

Materials and Methods

Five electronic databases were searched up to April 2020. Human studies focusing on the morphology and dimension of the upper airways after SMA were included. ‘Quality assessment for Before‐After (Pre‐Post) Studies’ was used to assess the risk of bias of the individual studies. Standard mean differences (SMD) with 95% confidence intervals (CI) were calculated for random effect model meta‐analysis. The certainty of evidence was assessed using the GRADE tool.

Results

Twenty cohort studies of only treated patients without control group were eligible for qualitative synthesis, of which 17 were used for quantitative synthesis. Very low certainty of evidence indicated that SMA resulted in significant increase of the volume and of the smallest cross‐sectional area (SMC) of the nasopharynx (volume SMD: 1.43, CI: 0.62, 2.24, P = .001, I2 = 87.8%; SMC SMD: 1.53, CI: 0.59, 2.47, P = .001, I2 = 90.5%) and oropharynx (volume SMD: 1.36, CI: 0.37,2.35, P = .007, I2 = 92.1%; SMC SMD: 1.21, CI: 0.11,2.32, P = .032, I2 = 93.1%). Significant augmentation of the distances between the posterior pharynx wall and the uvala (SMD: 0.73, CI: 0.46,0.98, P < .001, I2 = 72.7%), the posterior border of the tongue (SMD: 0.52, CI: 0.21,0.84, P = .001; I2: 60.5%), the gonion (SMD: 1.24, CI: 0.56,1.91, P < .001; I2 = 88.8%) and the epiglottis (SMD: 0.40, CI: 0.06,0.74, P = .033; I2 = 84.8%) were observed.

Conclusions

Weak evidence suggests enlargement of the upper airways of adult Class II subjects following SMA, with major increases in the oropharynx.
Association between sleep bruxism and stress symptoms in adults: A systematic review and meta‐analysis
Authors: Polmann Helena , Réus Jéssica Conti , Massignan Carla , Serra‐Negra Junia Maria , Dick Bruce D. , Flores‐Mir Carlos , Lavigne Gilles J. , De Luca Canto Graziela
Published: December 2020

To synthesise and critically review the association between sleep bruxism (SB) and stress symptoms in adults. A systematic review was performed. The search was completed using seven primary electronic databases in addition to a grey literature search. Two reviewers blindly selected studies based on pre‐defined eligibility criteria. Risk of bias of the included articles was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross‐Sectional Studies. RevMan 5.4 was used to perform the meta‐analysis. The quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Ten studies were included for qualitative analysis, of which three were included for quantitative analysis. Three studies were evaluated to have low risk of bias, and seven were assessed with moderate risk of bias. Quality of evidence was classified as very low for all outcomes. Individuals with SB were found to have higher levels of some self‐reported stress symptoms as assessed through questionnaires with a mean difference of 4.59 (95% CI 0.26‐8.92). Biomarkers like epinephrine, norepinephrine, cortisol, adrenaline, dopamine, noradrenaline and prolidase enzyme levels also showed a positive association with SB. Although some associations were identified between probable SB and self‐reported stress symptoms and biomarkers of stress in adults, given that the quality of evidence was found to be very low, caution should be exercised in interpreting these results. These findings suggest that additional and better designed studies are warranted in order to clarify the link between SB and stress.
School Flexible Learning Spaces, Student Movement Behavior and Educational Outcomes among Adolescents: A Mixed‐Methods Systematic Review
Authors: Kariippanon Katharina E. , Cliff Dylan P. , Ellis Yvonne G. , Ucci Marcella , Okely Anthony D. , Parrish Anne‐Maree
Published: December 2020

BACKGROUND

To achieve sustainability, we must consider scalable improvements in student movement behavior in the classroom setting, educational priorities. Flexible learning spaces that employ student‐centered pedagogy and contain a range of furniture and layout options, implemented to improve educational outcomes, may enable unintended health benefits. In this review, we summarize the evidence on the effects of flexible learning spaces on adolescent student movement behaviors and educational outcomes.

METHODS

We searched 5 databases, retrieving 5 quantitative and one qualitative article meeting the review criteria.

RESULTS

Students in flexible learning spaces spent less time sitting, and more time standing and moving. Students were also more engaged, on‐task, and collaborated and interacted more. Academic results for English, Mathematics and Humanities for those in flexible learning spaces were higher than peers in traditional classrooms.

CONCLUSION

Evidence from the reviewed studies suggests that there may be beneficial outcomes across some movement behaviors as well as learning outcomes in classrooms that employ student‐centered pedagogy and use a built environment that facilitates autonomy and choice around where and how to learn. These learning environments present an opportunity for an interdisciplinary approach to address sedentary behavior in classrooms.