bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleep, circadian rhythms, and type 2 diabetes mellitus
Authors: Parameswaran Gokul , Ray David W.
Published: October 2021

Over the last 60 years we have seen a significant rise in metabolic disease, especially type 2 diabetes. In the same period, the emergence of electricity and artificial lighting has allowed our behavioural cycles to be independent of external patterns of sunlight. This has led to a corresponding increase in sleep deprivation, estimated to be about 1 hour per night, as well as circadian misalignment (living against the clock). Evidence from experimental animals as well as controlled human subjects have shown that sleep deprivation and circadian misalignment can both directly drive metabolic dysfunction, causing diabetes. However, the precise mechanism by which these processes contribute to insulin resistance remains poorly understood. In this article, we will review the new literature in the field and propose a model attempting to reconcile the experimental observations made. We believe our model will serve as a useful point of reference to understand how metabolic dysfunction can emerge from sleep or circadian rhythm disruptions, providing new directions for research and therapy.
Impact of persistent subclinical hypothyroidism on clinical outcomes in non‐ST‐segment elevation acute coronary syndrome undergoing percutaneous coronary intervention
Authors: Han Chuyi , Xu Kaihang , Wang Le , Zhang Yingyi , Zhang Rui , Wei Ao , Dong Lijie , Hu Yuecheng , Xu Jinghan , Li Wenyu , Li Tingting , Liu Chunwei , Qi Wei , Jin Dongxia , Zhang Jingxia , Cong Hongliang
Published: October 2021

Background

Data on the association of subclinical hypothyroidism (SCH) with the severity of coronary artery disease and major adverse cardiovascular and cerebral events (MACCE) in patients with non‐ST‐segment elevation acute coronary syndrome (NSTE‐ACS) after percutaneous coronary intervention (PCI) are limited and conflicting.

Objective

We established the baseline rate of SCH and followed the trajectory of thyroid‐stimulating hormone (TSH) values during and after hospitalisation for PCI for up to six months and determined whether persistent SCH was associated with the severity of coronary artery disease and MACCE in patients with NSTE‐ACS after PCI.

Design

Population‐based prospective cohort study.

Patients

We included patients with NSTE‐ACS who underwent PCI with simple balloon angioplasty or stent implantation for coronary heart disease.

Measurements

Thyroid function tests of patients before PCI and 1 day, 1 week, 1 and 6 months after PCI were performed. Cases showing transient SCH were excluded. Patients were divided into two groups based on the results of four TSH tests: 0.27–4.2 mIU/L (n = 1472, 89.7%) and >4.2 mIU/L (n = 170, 10.4%). The risk factors for the severity of coronary artery lesions were estimated using multinomial logistic regression analysis. Univariate and multivariate Cox regression analyses were used to study the relationship between TSH and MACCE.

Results

Among 1642 patients, there were 1070 males (65.2%) and 572 females (34.8%), with an average age of 62.5 ± 9.6 years. SCH patients had a wider range of diseased vessels and a higher number of diseased vessels (p < .05). TSH level was an independent risk factor for moderate [odds ratio (OR) = 1.144, 95% confidence interval (95% CI): 1.057–1.237, p = .001] and severe (OR = 1.131, 95% CI: 1.043–1.226, p = .003) coronary artery lesions. After adjusting for covariates, the risk of MACCE [hazard ratio (HR): 4.067, p < .001], nonfatal myocardial infarction (HR: 14.724, p = .003), and unplanned PCI (HR: 5.028, p < .001) were higher in the SCH group than in the euthyroidism group. There were no significant differences in the incidence of heart failure (HR: 6.012, p = .175), nonfatal stroke (HR: 2.039, p = .302), unplanned coronary artery bypass grafting (CABG) (HR: 1.541, p = .57), or cardiac death (HR: 2.704, p = .375) between the two groups.

Conclusions

Preoperative TSH levels and changes in thyroid hormone levels several months post‐PCI in NSTE‐ACS patients are highly significant in practice. Persistent SCH is associated with severe coronary artery lesions and MACCE, and may be a predictor for evaluating the prognosis of PCI‐treated NSTE‐ACS patients.
Soft tissue metric parameters, methods and aesthetic indices in implant dentistry: A critical review
Authors: Cosyn Jan , Wessels Retief , Garcia Cabeza Ricardo , Ackerman Julie , Eeckhout Célien , Christiaens Véronique
Published: October 2021

Objectives

The primary objective was to provide an overview of soft tissue metric parameters, methods, and aesthetic indices in implant dentistry. The secondary objective was to describe reliability and validity of aesthetic indices.

Materials and methods

Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase, and Cochrane databases up to October 2020 to identify studies on soft tissue metric parameters, methods, and aesthetic indices. Aesthetic indices were evaluated in terms of reliability and validity. Data extraction was performed by the same reviewers.

Results

Five metric parameters (papilla height, linear changes in soft tissue level, color assessment, soft tissue thickness, and profilometric soft tissue changes) registered by means of several methods (intra‐oral registrations, radiographic assessments, digital analyses, and ultrasonic assessments), and 15 aesthetic indices (Papilla Index (PI), ad hoc questions scored with Visual Analogue Scales, Pink Esthetic Score (PES), Implant Crown Aesthetic Index (ICAI), Implant Aesthetic Score (IAS), Rompen Index, Subjective Esthetic Score, White Esthetic Score, Copenhagen Index, Complex Esthetic Index, Californian Dental Association Index (CDAI), Peri‐Implant, and Crown Index, Functional Implant Prosthodontic Score, Implant Restoration Esthetic Index (IREI), and Mucosal Scarring Index (MSI)) could be identified. With respect to metric parameters and methods, intra‐oral registrations were least accurate whereas profilometric soft tissue changes on the basis of digital surface models were most accurate. Six aesthetic indices showed good inter‐rater reliability (PI, PES, ICAI, CDAI, IREI, and MSI). Good validity could only be shown for two indices (PES and CEI). Given this and on the basis of ease of use and ease of interpretation, PES qualified best for clinical research on single implants. None of the indices fulfilled the quality criteria for clinical research on multiple implants.

Conclusion

Many soft tissue assessment methods with varying reliability and validity have been described and used, which hampers uniform reporting in implant dentistry. Clinical investigators are advised to measure linear and profilometric soft tissue changes using digital surface models, and to use a reliable and validated aesthetic index. Currently, PES qualifies best for aesthetic evaluation of single implants. An index is to be developed to assess the aesthetic outcome of rehabilitations on multiple implants.
Patient‐reported outcome measures following soft‐tissue grafting at implant sites: A systematic review
Authors: Stefanini Martina , Tavelli Lorenzo , Barootchi Shayan , Sangiorgi Matteo , Zucchelli Giovanni
Published: October 2021

Objectives

To review the available literature on patient‐reported outcome measures (PROMs) following soft tissue augmentation at implant sites.

Materials and Methods

A comprehensive electronic and manual search was performed to identify clinical studies that involved soft tissue augmentation around dental implants and reported PROMs, including post‐operative morbidity, painkillers intake, quality of life, aesthetics and satisfactions.

Results

Nineteen articles were included in the qualitative analysis. Autogenous grafts (free gingival graft and connective tissue graft), acellular dermal matrix and xenogeneic collagen matrix were utilized, either with a bilaminar‐ or an apically positioned flap approach. PROMs reported in the literature included perceived hardship of the procedure and pain during the surgery, post‐operative morbidity, painkillers intake, number of days with discomfort, satisfaction, aesthetic evaluation, quality of life and willingness to undergo the treatment again. Most of the included studies showed similar PROMs between autogenous grafts and substitutes, in terms of post‐operative morbidity, painkillers intake, quality of life, aesthetic assessment and satisfaction. Nevertheless, a trend towards lower post‐operative discomfort was observed for graft substitutes. High scores for patient satisfaction and aesthetic evaluation were observed in all the interventions compared to non‐grafted sites.

Conclusions

PROMs represent a crucial endpoint of clinical studies evaluating the outcomes of soft tissue grafts at implant sites. Most of the studies did not find significant differences in terms of patient morbidity and painkillers between autogenous grafts and substitutes. Soft tissue grafting can enhance patient satisfaction and aesthetic evaluation compared to non‐grafted sites.
Impact of timing of dental implant placement and loading: Summary and consensus statements of group 1—The 6th EAO Consensus Conference 2021
Authors: Donos Nikos , Asche Nele Van , Akbar Aron Naim , Francisco Helena , Gonzales Oscar , Gotfredsen Klaus , Haas Robert , Happe Arndt , Leow Natalie , Navarro Jose Manuel , Ornekol Turker , Payer Michael , Renouard Franck , Schliephake Henning
Published: October 2021

Objectives

This publication reports on the EAO workshop group 1 summaries, discussions and consensus statements based on four systematic reviews evaluating the impact of timing of dental implant placement and loading.

Materials and methods

The first of the systematic reviews was on the influence of the timing of implant placement and loading in the biological outcomes of implant‐supported fixed partial dentures. The second systematic review evaluated the influence of the timing of implant placement and loading on the aesthetic outcomes in single‐tooth implants. The third systematic review was on the long‐term outcomes of maxillary single‐tooth implants in relation to timing protocols of implant placement and loading and the fourth on patient's perception of timing concepts in implant dentistry. The group evaluated these systematic reviews, provided comments and additions as required and agreed on the relevant consensus statements as well as on clinical and research recommendations.

Results

Different timings of implant placement/loading presented with high implant survival rates. The systematic reviews evaluated from this working group provided a number of conclusions based on the available/current literature. However, the specific topic of timing is an area that further research is required in order to provide detailed guidelines for the different protocols to be employed.
Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri‐implant mucositis and peri‐implantitis: A critical review
Authors: Mattheos Nikos , Janda Martin , Acharya Aneesha , Pekarski Stephanie , Larsson Christel
Published: October 2021

Objective

The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri‐implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri‐implant mucositis and peri‐implantitis.

Methods

Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri‐implant mucositis and peri‐implantitis were included.

Results

Emerging evidence with bone‐level implants suggests a link between EA combined with convex EP and peri‐implantitis. Depth of the peri‐implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri‐implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti‐infective treatment of peri‐implant mucositis. Limited evidence points to no difference with regard to the risk for peri‐implant mucositis between tissue‐ and bone‐level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri‐implantitis. Literature with regard to prosthesis retention type and risk for peri‐implantitis is inconclusive.

Conclusions

Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri‐implant mucositis/peri‐implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose‐designed studies are required to clarify current observations.
Changes in peri‐implant soft tissue levels following surgical treatment of peri‐implantitis: A systematic review and meta‐analysis
Authors: Sanz‐Martín Ignacio , Cha Jae‐Kook , Sanz‐Sánchez Ignacio , Figuero Elena , Herrera David , Sanz Mariano
Published: October 2021

Aim

To assess the changes in peri‐implant soft tissue levels after the surgical treatment of peri‐implantitis.

Methods

Randomized controlled trials, controlled clinical trials, cohort studies and case series, evaluating the changes in the position of the mucosal margin before and after surgical treatment of peri‐implantitis, were searched. Secondary outcomes were changes in keratinized mucosa (KM), radiographic bone levels, probing depths (PD), plaque indices, bleeding on probing and patient perception. Meta‐analyses were performed to determine weighted mean differences (WMD) or effects (WME).

Results

Twenty‐six articles, reporting 20 investigations, were included. Reconstructive approaches yielded significantly less increase in mucosal recession, when compared to access flaps (n = 3, WMD = −1.35 mm, 95% confidence interval [CI] [−2.62; −0.07], p = .038). When comparing among reconstructive surgical interventions similar outcomes were observed irrespective of the use of a barrier membrane (n = 3, WMD = −0.01 mm, 95% CI [−0.15; 0.13], p = .917). When considering the effects over time, limited mucosal recession was observed after reconstructive procedures (n = 23, WME = 0.389 mm, 95% CI [0.204; 0.574]), p = .001), while increased recession was reported with either resective or access flap surgery (n = 6, WME = 1.21 mm, 95% CI [0.70; 1.72], p = <.001; and n = 3, WME = 0.95 mm, 95% CI [0.20; 2.10], p = .106; respectively). When resective and reconstructive approaches were combined the highest values on peri‐implant recession were reported (n = 2, WME = 1.97 mm, 95% CI [0.81; 3.14], p < .001). Reconstructive surgical interventions were associated with greater radiographic bone level gains, while similar values were reported for PD reduction when comparing reconstructive, access and resective procedures.

Conclusions

Resective surgical procedures were associated with significant post‐surgical recession while minimal recession was observed in regenerative interventions.
Patient‐reported outcome measures (PROMs) of implant‐supported reconstructions using digital workflows: A systematic review and meta‐analysis
Authors: Bishti Shaza , Tuna Taskin , Rittich Anne , Wolfart Stefan
Published: October 2021

Objectives

To summarize the existing evidence on patient‐reported outcome measures (PROMs) of implant‐supported restorations fabricated using a digital workflow in comparison to conventional manufacturing procedures.

Methods

A PICO strategy was executed using an electronic and manual search focusing on clinical studies evaluating PROMs of implant‐supported restorations. Only clinical trials assessing conventional versus digital workflows for implant‐supported restorations were included. PROMS on implant impression procedures and fabrication of final restorations were evaluated using random and fixed effects meta‐analyses, while implant planning/placement was reported descriptively.

Results

Among 1062 titles identified, 14 studies were finally included, and only seven studies were eligible for meta‐analysis. For implant planning and placement, only a qualitative analysis was possible due to heterogeneity between the studies. For impression procedures, the random effects model revealed statistically significant differences in taste, anxiety, nausea, pain, shortness of breath, and discomfort in favor of optical impressions. No significant difference in the subjective perception of the duration of an impression could be reported. For the final fabrication of restorations, no significant difference between veneered and monolithic posterior restorations was found in terms of esthetic, function, and general satisfaction.

Conclusion

Most of the studies reporting about PROMs were published during the last ten years and limited to implant‐supported single crowns in the posterior region. Based on PROMs, no scientifically proven recommendation for guided implant placement could be given at this time. Patients showed high preference for optical impressions, whereas no differences between veneered and monolithic restorations could be reported.
Does the timing of implant placement and loading influence biological outcomes of implant‐supported multiple‐unit fixed dental prosthesis—A systematic review with meta‐analyses
Authors: Aiquel Louise Leite , Pitta João , Antonoglou Georgios N. , Mischak Irene , Sailer Irena , Payer Michael
Published: October 2021

Objective

To investigate the impact of timing of implant placement and loading on implant survival and biological outcomes of multiple‐unit implant‐supported fixed dental prosthesis (FDPs).

Material and Methods

A literature search was performed by three independent reviewers for studies reporting on ≥10 patients with FPDs supported by ≥two implants over ≥3 years of follow‐up. Data were analyzed on implant survival and biological complications as primary outcomes and biological events, including changes in peri‐implant marginal bone level (MBL), probing depth, soft‐tissue level, and health condition as secondary outcomes.

Results

7002 titles were identified, 360 full‐texts were screened, and 14 studies were included. These comprised 6 randomized controlled studies (RCTs), 5 cohort studies, and 3 case series with identifiable implant placement and loading protocols in five of 09 possible combinations. All groups but one (IPIL) showed implant survival rates >90%. A meta‐analysis based on 3 RCTs found no differences in survival rate between DPIL and DPDL (p = .227).

Conclusions

High survival rates for all studied implant placement and loading combinations were shown for FPDs over ≥3 years of follow‐up. When a delayed implant placement protocol is applied, immediate or delayed loading demonstrated similar survival rates. The heterogeneity of the data did not allow to draw any further conclusions on the occurrence of biological complications related to timing of implant placement/loading.
Multistakeholder Partnerships for Development and the Financialization of Development Assistance
Authors: Erdem Türkelli Gamze
Published: October 2021

Multistakeholder partnerships (MSPs) for development are being revitalized in the post‐2015 era as essential vehicles in financing and realizing sustainable development. This article argues that MSPs for development play a central role as new financial actors in shaping the legal and ideational structures of development assistance, pushing for a financialized development assistance model that relies on the steady multiplication of new financial markets and instruments. The article tracks the trajectory of MSPs and their transition over time into key actors in the financialization of development assistance. After summarizing the key axes of this financialization, the article describes how MSPs have become new financial actors by offering to play a four‐in‐one role (gap‐filling, catalysing, brokering and optimizing) in development financing. To do so, they use private legal mechanisms to create and roll‐out so‐called ‘innovative’ financial instruments and mechanisms such as up‐front incentives and subsidies, frontloading mechanisms, results‐based instruments and debt swaps. The resulting financialized development assistance model has amplified the power and influence of MSPs and their private donors over development governance and led to accountability shortcomings by downplaying the possible socio‐economic impacts of new proposed instruments and by creating risks of increased development assistance policy fragmentation.
Humanizing Security through Action‐oriented Research in Latin America
Authors: Pearce Jenny , Abello Colak Alexandra
Published: October 2021

This article critically reflects on the use of action‐oriented participatory research to rethink violence and security in Latin America. The authors draw on 12 years of such research (2008‒20) in Colombia, El Salvador, Guatemala, Honduras, Jamaica and Mexico, working with communities living in the midst of chronic violence and criminality. Despite innovative experiments, security policies and practices in the region continue to be dominated by counterproductive militarized responses that have failed to address violence and crime. This article argues that in order to challenge politically potent punitive approaches to security and to highlight the interconnected social and economic drivers of insecurity, communities living these realities need to develop their own understanding of ‘security’. This can be used to inform sustainable solutions that address people's complex experiences of insecurity on the ground. The article brings the agency of those living amidst chronic violence into the security debate through participatory action research. It demonstrates that people living amidst such violence can contribute to making public security equitable, accessible and capable of protecting them while addressing the conditions that reproduce violence and crime without reproducing further violence. This is what is meant by ‘humanizing security’.
Identifying children with developmental coordination disorder and modifiable factors to increase participation
Authors: De Roubaix Amy , Van Waelvelde Hilde
Published: October 2021

This commentary is on the original article by Delgado‐Lobete et al. on pages 220–227 of this issue.
Four decades of the Bart’s Oxford study: Improved tests to predict type 1 diabetes
Authors: Gillespie Kathleen M. , Fareed Rana , Mortimer Georgina L.
Published: October 2021

Recent success in clinical trials to delay the onset of type 1 diabetes has heralded a new era of type 1 diabetes research focused on the most accurate methods to predict risk and progression rate in the general population. Risk prediction for type 1 diabetes has been ongoing since the 1970s and 1980s when human leucocyte antigen (HLA) variants and islet autoantibodies associated with type 1 diabetes were first described. Development of prediction methodologies has relied on well‐characterised cohorts and samples. The Bart's Oxford (BOX) study of type 1 diabetes has been recruiting children with type 1 diabetes and their first (and second)‐degree relatives since 1985. In this review, we use the timeline of the study to review the accompanying basic science developments which have facilitated improved prediction by genetic (HLA analysis through to genetic risk scores) and biochemical strategies (islet cell autoantibodies through to improved individual tests for antibodies to insulin, glutamate decarboxylase, the tyrosine phosphatase IA‐2, zinc transporter 8 and tetraspanin 7). The type 1 diabetes community are poised to move forward using the best predictive markers to predict and delay the onset of type 1 diabetes
Hyperlactatemia in diabetic ketoacidosis
Authors: Masharani Umesh , Strycker Lisa A. , Lazar Ann A. , Wu Karin , Brooks George A.
Published: October 2021

Aims

The study examined the prevalence and degree of lactate elevation in diabetic ketoacidosis, and explored which biochemical abnormalities predicted L‐lactate levels.

Methods

We reviewed episodes of diabetic ketoacidosis from 79 diabetes patients (one episode per patient). Separate univariate linear regression models were specified to predict lactate level from each of nine biochemical variables. Significant predictors from the univariate models were included in a final multivariate linear regression model to predict lactate levels.

Results

Mean (SD) lactate level was 3.05 (1.66) mmol/L; about 65% of patients had lactate levels >2 mmol/L. In the final multivariate linear regression model (R2 = 0.45), higher lactate levels were associated with greater hydrogen ion concentration (standardised β = .60, t = 4.16, p < 0.0001), higher blood glucose (standardised β = .28, t = 2.67, p = 0.009) and lower glomerular filtration rate estimated from creatinine (standardised β = −.23, t = 2.29, p = 0.025). Bicarbonate, beta‐hydroxybutyrate, body mass index, mean arterial pressure and calculated osmolality were not significant predictors of lactate level. There were three distinct patterns of lactate levels with treatment of diabetic ketoacidosis: group 1 = gradual decline, group 2 = initial increase and then decline and group 3 = initial decline followed by a transient peak and subsequent decline.

Conclusions

Elevated lactate level is the norm in patients with diabetic ketoacidosis. Higher blood glucose levels and higher hydrogen ion concentrations are related to greater lactate. With treatment, there are different patterns of decline in lactate levels.
“Formalizing rights: The case for linking legal rights to noncitizen statuses in Jordan”
Authors: Frost Lillian
Published: October 2021

How can Jordan's experiences hosting Palestinian refugees inform policymaking toward Syrian refugees? As the 10‐year anniversary of the Syrian uprisings approaches, Syrian refugees remain displaced with limited opportunities for repatriation, resettlement, or naturalization. Although there are many important differences between Syrian and Palestinian refugees—particularly Syrians' right to a sovereign state's nationality—there are increasing similarities between these two protracted refugee groups. One of the most critical among these similarities is holding ambiguous membership statuses in Jordan, where groups hold more rights than other non‐Jordanians but fewer rights than Jordanian citizens. The experiences of noncitizen Palestinian refugees, such as those who fled to Jordan from the Gaza Strip after the 1967 war, highlight the destructive precarities that accompany an absence of legal rights, including insecure access to work, education, and healthcare. These experiences suggest that securing some Syrian rights in law can help mitigate the precarity of sustained refugee status. Further, Jordan has expressed a willingness to provide legal rights to some noncitizen groups, including investors and the children of Jordanian women and non‐Jordanian men. Overall, formalizing critical, less politicized rights in law is one tangible way to improve the daily lives of Syrian, as well as other, protracted refugees.
Education and alienation: The case of displaced Syrians and refugees
Authors: Zeno Basileus
Published: October 2021

Before the Syrian uprising (2011) and the subsequent war, Syria's literacy rates were among the highest in the Middle East and North Africa region. However, after a decade‐long humanitarian crisis and devastating war, all aspects of life, including education, have been fundamentally transformed. Building on ethnographic fieldwork (2014–2019) that includes 76 interviews with Syrian refugees and asylum seekers in the United States and six remote interviews with displaced families inside Syria, this contribution examines the impact of the Syrian conflict on education by showing the challenges that contribute to the alienation of displaced Syrian children and youth inside Syria as well as in the United States. Inside Syria, I discuss the institutionalization of violence and the construction of internal “othering” through the implementation of different and competing educational curriculums that invest in identity politics. Outside Syria, I examine how educational gaps affected asylum seekers and refugees in the United States. I show the ways in which the lack of systematic and sustainable support to address linguistic, cultural, and financial challenges that displaced Syrians face sustained this gap. I conclude by proposing policy recommendations that address these challenges which, I argue are key determinants to any future efforts of peacebuilding and reconciliation in Syria.
Vitamin E supplementation in inflammatory skin diseases
Authors: Berardesca Enzo , Cameli Norma
Published: October 2021

Vitamin E is a powerful lipophilic antioxidant that protects membranes from lipid peroxidation, and consequently, oxidative damage. Oxidative stress plays a role in the development of neurodegenerative diseases. Vitamin E supplementation is recommended in patients with vitamin E deficiency due to fat malabsorption. The addition of vitamin E to the diet slows Alzheimer's disease progression and protects older patients against respiratory infections. Recent studies also point to the involvement of oxidative stress in the pathology of immune‐mediated skin diseases, such as atopic dermatitis and psoriasis. We reviewed the available clinical trials that investigated the role of vitamin E supplementation in preventing and treating atopic dermatitis and psoriasis. Data from these studies point to a positive role of vitamin E supplementation in these diseases. Still, due to limitations in study design, further evidence is needed to reach a definite conclusion.
AgRP neuronal activity across feeding‐related behaviours
Authors: Gouveia Ayden , de Oliveira Beleza Rui , Steculorum Sophie M.
Published: October 2021

AgRP neurons trigger one of the most potent orexigenic responses and are both necessary and sufficient for feeding. Recent technical advances for monitoring in vivo neuronal activity have revisited a previously well‐established model of AgRP neurons' feeding regulatory effects. Our current understanding of AgRP neurons has increased in complexity and revealed a fine‐tuned regulation of their activity dynamics across the whole sequence of feeding‐related behaviours. This review focuses on recent studies that refined and re‐evaluated our understanding of the regulatory principles and behavioural effects of AgRP circuits. We aim to cover major discoveries on the dynamic regulation of AgRP neuronal activity by exteroceptive and interoceptive food‐related cues, their pleiotropic effects in feeding and whole‐body homeostasis, and the associated AgRP circuits. The function and regulation of AgRP neuron will be sequentially discussed across the temporal series of behavioural and physiological changes occurring during the appetitive (food craving and foraging), the anticipatory (discovery of food‐predicting cues), and the consummatory/post‐ingestive phase of feeding (calorie ingestion).
Periodic and rhythmic patterns in critically ill children: Incidence, interrater agreement, and seizures
Authors: Fung France W. , Parikh Darshana S. , Massey Shavonne L. , Fitzgerald Mark P. , Vala Lisa , Donnelly Maureen , Jacobwitz Marin , Kessler Sudha K. , Topjian Alexis A. , Abend Nicholas S.
Published: October 2021

Objectives

We aimed to determine the incidence of periodic and rhythmic patterns (PRP), assess the interrater agreement between electroencephalographers scoring PRP using standardized terminology, and analyze associations between PRP and electrographic seizures (ES) in critically ill children.

Methods

This was a prospective observational study of consecutive critically ill children undergoing continuous electroencephalographic monitoring (CEEG). PRP were identified by one electroencephalographer, and then two pediatric electroencephalographers independently scored the first 1‐h epoch that contained PRP using standardized terminology. We determined the incidence of PRPs, evaluated interrater agreement between electroencephalographers scoring PRP, and evaluated associations between PRP and ES.

Results

One thousand three hundred ninety‐nine patients underwent CEEG. ES occurred in 345 (25%) subjects. PRP, ES + PRP, and ictal–interictal continuum (IIC) patterns occurred in 142 (10%), 81 (6%), and 93 (7%) subjects, respectively. The most common PRP were generalized periodic discharges (GPD; 43, 30%), lateralized periodic discharges (LPD; 34, 24%), generalized rhythmic delta activity (GRDA; 34, 24%), bilateral independent periodic discharges (BIPD; 14, 10%), and lateralized rhythmic delta activity (LRDA; 11, 8%). ES risk varied by PRP type (p < .01). ES occurrence was associated with GPD (odds ratio [OR] = 6.35, p < .01), LPD (OR = 10.45, p < .01), BIPD (OR = 6.77, p < .01), and LRDA (OR = 6.58, p < .01). Some modifying features increased the risk of ES for each of those PRP. GRDA was not significantly associated with ES (OR = 1.34, p = .44). Each of the IIC patterns was associated with ES (OR = 6.83–8.81, p < .01). ES and PRP occurred within 6 h (before or after) in 45 (56%) subjects.

Significance

PRP occurred in 10% of critically ill children who underwent CEEG. The most common patterns were GPD, LPD, GRDA, BIPD, and LRDA. The GPD, LPD, BIPD, LRDA, and IIC patterns were associated with ES. GRDA was not associated with ES.
Automatic segmentation algorithm for magnetic resonance imaging in prediction of breast tumour histological grading
Authors: He Qingyu , Pan Ruigen
Published: October 2021

To analyse the application value of dynamic contrast enhanced magnetic resonance imaging (DCE‐MRI) based on computer semi‐automatic segmentation (CSS) algorithm in tumour histological grading of breast cancer patients, the CSS algorithm of DCE‐MRI breast image was established based on Canny edge detection operator and dynamic binarization (DB) algorithm to compare with the fuzzy‐c‐means (FCM) algorithm based on FCM clustering and wavelet transform (WT) algorithm. Besides, CSS was applied to DCE‐MRI image diagnosis in 121 breast cancer patients, who were then classified as grade I, II, and III according to the 2019 edition of the World Health Organization Histological Grading Criteria for Breast Tumors. The results showed that the false positive rate (FPR) of CSS was sharply lower than that of FCM and WT, while the true positive rate (TPR) of CSS increased greatly in contrast to FCM and WT, indicating that there were statistically significant (p < 0.05). The area under the curve (AUC) predicted by FCM, WT, and CSS for histological classification were 0.818, 0.801, and 0.924, respectively. The fractional anisotropy (FA) value of patients with grade III was less than that of patients with grade I and II, while the apparent diffusion coefficient (ADC) value of patients with grade III was greater than that of patients with grade I and II (p < 0.05). The tumour diameter, number of lesions, and number of lymph node metastasis of patients with grade III increased markedly compared to patients with grade I and II (p < 0.05). To sum up, DCE‐MRI image segmentation results based on CSS were superior to FCM and WT in the evaluation of breast tumour histological grading. What's more, there were substantial differences in the obtained tumour diameter, FA value, ADC value, and number of lymph node metastasis based on DCE‐MRI of patients with grade I, II, and III, which could be applied to predict the histological grading of patients with breast cancer.
Effective coparenting in stepfamilies: Empirical evidence of what works
Authors: Ganong Lawrence , Sanner Caroline , Berkley Steven , Coleman Marilyn
Published: October 2021

Objective

The purpose of this review is to examine research evidence about effective childrearing of stepchildren by coparents in stepfamilies (i.e., childrearing that contributes to children's physical, cognitive, and emotional well‐being).

Background

Childrearing after parental repartnering is likely to involve coparenting within stepfamily households (i.e., by parents and stepparents), across stepfamily households (i.e., by biological parent dyads), and a combination of intra‐ and inter‐household coparenting subsystems. Effective coparenting of children in stepfamilies benefits individual, relational, and stepfamily well‐being and effective family functioning.

Method

We reviewed 58 studies in which empirical evidence of effective childrearing of stepchildren by coparents in stepfamilies was obtained.

Results

Children in stepfamilies fare better when coparents work collaboratively in focusing on children's well‐being, managing conflicts, being careful when communicating to children and to coparents, and keeping children out of parental issues. Coparenting within stepfamily households works when coparents agree on childrearing rules and roles, communicate clearly, and engage in parenting styles that emphasize high warmth. Step‐household coparents also foster children's well‐being by creating cohesive stepfamily dynamics and modifying expectations. Few researchers studied coparental triads that include both parents and a stepparent.

Conclusions

Stepfamily members benefit from effective coparenting.

Implications

Effective childrearing by stepfamily coparent subsystems is complex, but a key is focusing on children's well‐being.
Rab‐like small GTPases in the regulation of ciliary Bardet‐Biedl syndrome (BBS) complex transport
Authors: Yan Xiumin , Shen Yidong
Published: October 2021

Primary cilia, microtubule‐based hair‐like structures protruding from most cells, contain membranes enriched in signaling molecules and function as sensory and regulatory organelles critical for development and tissue homeostasis. Intraflagellar transport (IFT), cilia‐specific bidirectional transport, is required for the assembly, maintenance, and function of cilia. BBSome, the coat complex, acts as the adaptor between the IFT complex and membrane proteins and is therefore essential for establishing the specific compartmentalization of signaling molecules in the cilia. Recent findings have revealed that three ciliary Rab‐like small GTPases, IFT27, IFT22, and Rabl2, play critical regulatory roles in ciliary BBSome transport. In this review, we provide an overview of these three Rab‐like small GTPases and their relationship with BBSome.
Modelling key variables for understanding the effects of grazing and nutrient recycling by zooplankton on the freshwater microbial loop
Authors: Schenone Luca , Modenutti Beatriz , Martyniuk Nicolás , Bastidas Navarro Marcela , Laspoumaderes Cecilia , Balseiro Esteban
Published: October 2021

Pelagic microbial food webs are structured by zooplankton through grazing and nutrient recycling. Cladocerans and copepods are assumed to have different effects on the microbial loop by grazing on different prey sizes and releasing phosphorus (P) differentially. Here, we assessed this effect of differential zooplankton grazing and nutrient recycling on microbial loop dynamics using a combination of experimental and modelling approaches.

We performed field incubation experiments in an oligotrophic mountain lake (north‐Patagonian Andes) using the natural microbial community and the two dominant zooplankton taxa: a cladoceran (Diaphanosoma chilense) and a copepod (Boeckella gibbosa). The effect of zooplankton grazing and nutrient recycling were assessed separately in different treatments with direct and indirect zooplankton presence, respectively. We built a mechanistic model to estimate zooplankton grazing and P recycling and prey P quotas. The model was parameterised with the results from our field experiment and with prior information from size‐based traits and zooplankton C:P using a Bayesian approach. Laboratory experiments for zooplankton P excretion were also performed to test the predictive accuracy of our model.

Our model showed that copepods and cladocerans have contrasting effects on the microbial loop. Diaphanosoma chilense grazed mainly on picoplankton while B. gibbosa grazed on nanoflagellates and algae. Diaphanosoma chilense reduced the biomass and increased P quota of picoplankton, and reduced the P quota of nanoflagellates. In contrast, B. gibbosa released more P, increasing the picoplankton biomass and reducing the biomass of nanoflagellates, but increasing its P quota.

Based on our experimental and model results, copepod grazing favours higher P acquisition rates for cladocerans by releasing more P for picoplankton. By contrast, cladocerans would have a mixed effect on the main food items of copepods by increasing P quotas of the strict osmotrophic algae but decreasing P quotas of nanoflagellates.

Our mechanistic model is useful to quantitatively assess key planktonic variables, which are usually difficult to measure in the field, such as zooplankton P excretion rates and microbial P quotas, by using more conspicuous variables such as biomass of the different microbial compartments and dissolved and particulate P concentrations.

The model presented here could be used to disentangle complex pathways in the microbial food web. The relative importance of phagotrophy and osmotrophy in P uptake, P quotas, and nutrient recycling by grazers result in key variables for understanding ecosystem matter flux and resource use efficiency.
THE FRIEDMAN RULE: EXPERIMENTAL EVIDENCE
Authors: Duffy John , Puzzello Daniela
Published: October 2021

We evaluate the Friedman rule for optimal monetary policy in a laboratory economy based on Lagos–Wright (Journal of Economic Theory 145 (2010), 1508–24). We explore two implementations of Friedman's rule: one involving deflationary monetary policy and another where interest is paid on money. We compare the welfare consequences of the Friedman rule with two other policies: a constant money supply regime and a regime where the money supply grows at a constant k%. Counter to theory, we find that the Friedman rule is not welfare‐improving, performing no better than the constant money regime. By one welfare measure, the k% money growth rate regime performs best.
Processing and 3D printing of SiCN polymer‐derived ceramics
Authors: Mahmoudi Mohammadreza , Kim Sungjin , Arifuzzaman Arif M. , Saito Tomonori , Cramer Corson L. , Minary‐Jolandan Majid
Published: October 2021

Preceramic polymer resins are attractive for the 3D printing of net‐shaped ceramic components. Recently various processes have been demonstrated for 3D printing of polymer‐derived ceramics (PDCs). Ultimately in these processes, the process outcomes strongly depend on the process parameters. In particular, for PDCs the ceramic density, and ceramic yield are affected by the catalyst concentration and cross‐linking duration. Here, we use thermal analysis and FTIR to quantify the interrelation of the process parameters on the process outcome for polysilazanes and demonstrate 3D printing of PDC components based on the best‐identified process parameters. The results of this work can be used as guidelines for future additive manufacturing of PDCs.
Note on collusion with network externalities in price versus quantity competition
Authors: Choi Kangsik , Lee DongJoon
Published: October 2021

We compare collusion stability under Bertrand and Cournot duopoly with differentiated network products. Contrast to previous studies, we show that (i) the range of collusion incentive is narrower under Cournot competition than under Bertrand competition, unless network externalities are sufficiently strong; (ii) collusion in prices (quantities) is more stable than in quantities (prices) if network externalities are strong (weak); and (iii) finally, regardless of the strength of network externalities, collusion under Bertrand competition is more stable for high levels of substitutability than under Cournot competition.
Safety and feasibility of urological procedures in Jehovah’s Witness patients
Authors: Han Jullet , Ahmadi Hamed , Ladi‐Seyedian Seyedeh‐Sanam , Clifford Thomas G , Douglawi Antoin , Xu Willem , Bazargani Soroush T , Mingo Samuel , Thangathurai Duraiyah , Daneshmand Siamak , Djaladat Hooman
Published: October 2021

Objectives

To describe the safety and feasibility of urological transfusion‐free surgeries in Jehovah’s Witness patients.

Methods

An institutional review board‐approved, retrospective review of Jehovah’s Witness patients who underwent urological transfusion‐free surgeries between 2003 and 2019 was carried out. Surgeries were stratified into low, intermediate and high risk based on complexity, invasiveness and bleeding potential. Patient demographics, perioperative data and clinical outcomes are reported.

Results

A total of 161 Jehovah’s Witness patients (median age 63.4 years) underwent 171 transfusion‐free surgeries, including 57 (33.3%) in low‐, 82 (47.9%) in intermediate‐ and 32 (18.8%) in high‐risk categories. The mean estimated blood loss increased with risk category at 48 mL (range 10–50 mL), 150 mL (range 50–200 mL) and 388 mL (range 137–500 mL), respectively (P < 0.001). Implementing blood augmentation and conservation techniques increased with each risk category (3.5% vs 29% vs 69%, respectively; P < 0.001). Average length of stay increased concordantly at 1.6 days (range 0–12 days), 2.9 days (range 1–13 days) and 5.6 days (range 2–12 days), respectively (P ≤ 0.001). However, there was no increase in complication rates and readmission rates attributed to bleeding among the risk categories at 30 days (P = 0.9 and 0.4, respectively) and 90 days (P = 0.7 and 0.7, respectively).

Conclusions

Transfusion free urological surgery can be safely carried out on Jehovah’s Witness patients using contemporary perioperative optimization. Additionally, these techniques can be expanded for use in the general patient population to avoid short‐ and long‐term consequences of perioperative blood transfusion.
Managing quality, supplier selection, and cold‐storage contracts in agrifood supply chain through stochastic optimization
Authors: Mateo‐Fornés Jordi , Soto‐Silva Wladimir , González‐Araya Marcela C. , Plà‐Aragonès Lluís M. , Solsona‐Tehas Francesc
Published: October 2021

The quality of such processed agrifood products as dehydrated apple is related to the quality and variety of fresh harvested products and connected with wastage reduction throughout the agrifood supply chain. For this purpose, cold‐storage management is important to avoid or mitigate the quality decay of fresh products stored in refrigerated systems. This paper explores the benefits of a two‐stage stochastic programming model for product quality through the selection of producers and the management of cold storage to mitigate deterioration and guarantee the maintenance of quality. A case study with real data from an agribusiness company is presented in the case study to illustrate and assess the suitability of the stochastic approach. Uncertainty regarding the conversion rate of fresh apples into the final dehydrated product and the purchase cost of the apples in the system are represented through scenarios generated from historical data. Recourse actions include the purchase of additional fruit and renting of additional cold stores to meet the demand. Based on the different scenarios, the value of the stochastic solution shows that modeling and solving the proposed stochastic model minimizes costs by an average of around 6.4%. In addition, the expected value of perfect information demonstrates that using a proactive strategy could reduce costs by up to 9%. These results ensure the applicability of this model in practice before and during the harvesting season for planning and replanning as uncertainty is revealed under a rolling horizon.