bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of management and human resource factors on matrix support in secondary oral health care in Brazil
Authors: Abreu Mauro Henrique Nogueira Guimarães de , Amaral João Henrique Lara do , Guimarães Zina Lívia , Vasconcelos Mara , da Silveira Pinto Rafaela , Werneck Marcos Azeredo Furquim
Published: December 2021

Objectives

To investigate the association between health management and human resource factors on matrix support (MS) in a nationally representative sample of Dental Specialty Centres (DSCs) in Brazil.

Methods

This survey included 1042 DSCs (Response rate = 94.99%) in the second cycle of the National Program for the Improvement of the Quality and Access to the Dental Specialty Centres (PMAQ‐CEO, in Portuguese) in 2018. Previously trained interviewers extracted information on MS, health management and human resources of the DSC by using a structured instrument. An MS score was created by adding the number of positive answers to the 10 MS questions. Negative binomial regression models were used to estimate the unadjusted and adjusted rate ratios (RR) and corresponding 95% confidence interval (CI).

Results

Of all the DSCs (n = 1042), 116 (11.1%) performed all 10 MS procedures. Those DSCs with a manager who had a higher education degree in the area of Public Health or Public Management (RR = 1.01, 95% CI, 1.01–1.02) and with human resources that received incentives, bonuses or financial awards for performance related to the PMAQ‐CEO result (RR = 1.01 95% CI 1.01–1.02) are more likely to perform MS, when compared to the reference categories. The DSCs that are more likely to perform MS include those that developed actions as a result of periodic planning and evaluation with confirmatory documentation (RR = 1.06, 95% CI; 1.01–1.10); those that received support for planning and organizing the work scheme (RR = 1.03, 95% CI; 1.01–1.05); those that monitored and analysed the goals set for each specialty offered at the DSC, with (RR = 1.06, 95% CI; 1.01–1.10) or without confirmatory documentation (RR = 1.06, 95%CI; 1.02–1.11); those whose team periodically performed self‐assessment processes, using the Ministry of Health's formal self‐assessment (AMAQ in Portuguese) (RR = 1.04, 95% CI; 1.02–1.05); those who followed clinical guidelines (with confirmatory documentation) regarding the referral of patients from primary care to the DSC (RR = 1.02, 95% CI; 1.01–1.04). On the contrary, DSCs that did not use the results achieved in previous PMAQ cycles in the organization of the DSC's team work scheme proved to be less likely to perform MS (RR = 0.98, 95% CI; 0.96–0.99).

Conclusions

Matrix support is associated with human resources and management factors in secondary oral health care in Brazil. Continuing professional development and some management characteristics are important for secondary dental care quality and could be considered in health policy initiatives.
First use of the Adolescent Depression Rating Scale (ADRS) in the management of young people with severe acne treated with isotretinoin: a pilot study of an active monitoring of depressive disorders by dermatologists
Authors: Hefez L. , Micallef J. , Revah-Levy A. , Falissard B. , Jouve E. , Dreno B. , Chosidow O.
Published: December 2021

Background

During isotretinoin treatment, special attention is required to detect any symptom or change in the mental health of patients. The monitoring is complex for adolescents because of confounding factors such as mood changes associated with adolescence and puberty and the higher psychosocial impairment due to the acne itself.

Aim

To determine the utility of the Adolescent Depression Rating Scale (ADRS) for monitoring symptoms in adolescents before and during isotretinoin treatment in dermatology real-life practice.

Methods

This was a national, multicentre prospective study that enrolled a random sample of dermatologists treating adolescents. An algorithm including ADRS score and its changes between consecutive visits was used. At each visit, dermatologists rated their satisfaction with ADRS and its ease of use, while patients rated the acceptability of the ADRS.

Results

In total, 70 dermatologists used the algorithm for 1227 visits of 283 adolescents receiving isotretinoin. Of these 70 dermatologists, 80.8% were satisfied/very satisfied with the ADRS, 82.7% considered the use of the ADRS in clinical practice to be easy/very easy and 75% considered that the ADRS enabled them to discuss more easily the risk of depression with their patients. For the patients, acceptability of the ADRS was considered good by 93.8%.

Conclusions

The implementation of the ADRS could be valuable in dermatology practice, optimizing the monitoring of patients and the good use of isotretinoin.
Standardized documentation and synoptic reporting of complex intestinal anatomy in enteric fistulation and intestinal failure
Authors: Williams Katherine J. , Donnelly Suzanne , Gabe Simon , Gupta Arun , Holman Richard , Preston Stephen , Vaizey Carolynne J. , Corr Alison , Mehta Akash M.
Published: December 2021

Aim

In intestinal failure, delineation of both structure and function are key to controlling symptoms and planning further intervention. We have developed a template for developing an ‘anatomy at a glance’ patient‐specific map to aid decision making and counselling.

Method

A core dataset was developed and used to create an editable template to demonstrate the gastrointestinal tract, its relationship to the genitourinary tract, and specific anterior abdominal wall features. This was then used to create an anatomical template, specific to each patient, and stored in the electronic patient record and imaging archive.

Results

We have developed a technique for integration of multi‐modal information into one diagram, easily referenced by the multidisciplinary team. Radiology, endoscopy and previous operation notes can be used to fill out a core dataset, which is then transposed into a standardized template. A worked example is shown.

Conclusion

The mapping template has been successfully integrated into practice and aided decision making at all stages of the patient's therapeutic journey. It has been found helpful in planning routes of nutrition, preoperative optimization, surgical planning, interpreting postoperative imaging and managing patient expectations.
Clinical and functional outcome of surgery for posttraumatic cloacal deformity
Authors: Picciariello Arcangelo , Gallo Gaetano , Sturiale Alessandro , Litta Francesco , De Simone Veronica , Martines Gennaro , Naldini Gabriele , Ratto Carlo , Trompetto Mario , Rinaldi Marcella
Published: December 2021

Aim

Cloacal deformity is a disabling condition that severely affects a patient’s quality of life. Surgery to repair cloacal deformity remains the mainstay of treatment. The aim of this study is to assess the clinical and functional outcome of patients treated for traumatic cloacal deformity by three different techniques.

Method

A retrospective multicentre study was carried out using data from women operated on for cloacal deformity between 2015 and 2019. Demographic characteristics, the presence of urinary and/or faecal incontinence and manometric findings were collected. The main outcome measures were represented by St Mark’s and Rockwood faecal incontinence quality of life scores.

Results

Thirty eight women with a median age of 34 years [interquartile range (IQR) 31–39 years] were enrolled. Perineoplasty was performed in 23 patients by direct suture of the rectovaginal septum, in five using the X‐flap and in 10 by the Singapore flap. Median resting and squeezing pressures increased significantly from 28.15 (IQR 23–32.7) cmH2O to 45 (IQR 31–60.7) cmH2O (p = 0.0001) and from 47 (IQR 41.2–54.7) cmH2O to 97.2 (IQR 80–118) cmH2O (p = 0.0001), respectively. Maximum tolerable volume improved from 120 (IQR 90–137.5) ml to 137.5 (IQR 120–150) ml (p = 0.002). The St Mark’s score decreased from 18 (IQR 14–20) to 4.5 (IQR 2–8) after 20 months (p = 0001). Sexual activity was confirmed by 16 patients preoperatively and by 27 postoperatively. A diverting stoma was performed in three patients after X‐flap perineoplasty and in 14 treated by direct closure. No significant differences were found pre‐ and postoperatively between the three groups.

Conclusion

Regardless of the technique used, surgical repair significantly improves both clinical and functional outcomes irrespective of the presence of a covering stoma.
Higher order stress terms in sharp notch problems under pure‐out‐of‐plane loading
Authors: Mehraban Mohammad R. , Ayatollahi Majid R. , Bahrami Bahador , Berto Filippo
Published: December 2021

Current paper studies the effects of higher order terms (HOTs) on the stress and displacement fields around sharp V‐notched components under pure antiplane shear (mode III) loading. For this aim, two V‐notched test samples each containing four different notch angles are simulated in a finite element (FE) commercial software. Subsequently, the over‐deterministic technique is used as an approach to calculate the coefficients of singular and nonsingular terms out of the nodal displacement values. To verify the accuracy of the values calculated as the coefficients, the stress field reconstructed from the truncated series expansions is compared with the direct nodal outputs of FE analysis. The results demonstrate that the use of nonsingular terms of the asymptotic series expansion is necessary only in the case that the distribution of stress at far distances from the notch tip is sought and the notch angle is small. To check the stability of the results, some of the parameters which affect accurate determination of unknown coefficients and convergence of the numerical results are studied.
Views of healthcare consumer representatives on defensive practice: ‘We are your biggest advocate and supporter… not the enemy’
Authors: Ries Nola M. , Johnston Briony , Jansen Jesse
Published: December 2021

Background

The patient–clinician interaction is a site at which defensive practice could occur, when clinicians provide tests, procedures and treatments mainly to reduce perceived legal risks, rather than to advance patient care. Defensive practice is a driver of low‐value care and exposes patients to the risks of unnecessary interventions. To date, patient perspectives on defensive practice and its impacts on them are largely missing from the literature. This exploratory study conducted in Australia aimed to examine the views and experiences of healthcare consumer representatives in this under‐examined area.

Methods

Semi‐structured interviews were conducted with healthcare consumer representatives involved in healthcare consumer advocacy organisations in Australia. Data were transcribed and analysed thematically.

Results

Nine healthcare consumer representatives participated. Most had over 20 years of involvement and advocacy in healthcare, including personal experiences as a patient or carer and/or formal service roles on committees or complaint bodies for healthcare organisations. Participants uniformly viewed defensive practice as having a negative impact on the clinician–patient relationship. Themes identified the importance of fostering patient–clinician partnership, effective communication and informed decision‐making. The themes support a shift from the concept of defensive practice to preventive practice in partnership, which focuses on the shared interests of patients and clinicians in achieving safe and high‐value care.

Conclusion

This Australian study offers healthcare consumers' perspectives on the impacts of defensive practice on patients. The findings highlight the features of clinician–patient partnership that will help to improve communication and decision‐making, and prevent the defensive provision of low‐value care.

Patient or Public Contribution

Healthcare consumer representatives were involved as participants in this study.
Blaming others for their illness: The influence of health‐related implicit theories on blame and social support
Authors: Dohle Simone , Schreiber Mike , Wingen Tobias , Baumann Marie
Published: December 2021

Some people believe that their own health is rather malleable and can be changed (incremental theory), whereas other people believe that their health is relatively fixed (entity theory). Previous research suggests that individuals who hold a strong incremental theory of health have more positive health‐related attitudes and engage in more health‐promoting behaviors in everyday life. However, less is known about the interpersonal effects of an incremental theory of health. A strong incremental theory of health could have detrimental consequences, such as increasing blame and reducing social support towards others who are ill. To test this, two studies (Study 1: N = 433, Study 2: N = 397) were conducted in which implicit theories of health (incremental vs. entity) were experimentally manipulated, and participants were presented with vignettes describing individuals suffering from different illnesses. The dependent variables included blame, sympathy, outcome expectancy, and social support. Study 1 demonstrated that an incremental theory of health increased blame towards people suffering from an illness, regardless of whether a physical or mental illness was presented, and blame indirectly attenuated social support. Study 2 showed that an incremental theory increased outcome expectancy, which indirectly amplified social support. In sum, this research suggests that an incremental theory of health may decrease social support via blame, but increases in outcome expectancy may counteract this effect.
Council Checks of the Commission under the European Semester: Does Member State Power and Euroscepticism Still Matter?*
Authors: Baerg Nicole , Hallerberg Mark
Published: December 2021

The European Commission recommends evaluations of the economic plans of member states. The Council then provides final text. Previous research suggests that the Council selectively edits the Commission's recommendations. Both large member states and those with eurosceptic populations are likely to have the Council weaken what the Commission writes about them. We examine the determinants of the Council's editing of these texts after the introduction of the European Semester in the period 2011–18. We also account for different varieties of euroscepticism as the literature has become more differentiated. Using metrics of textual changes based on automated and hand‐coding, we find little evidence of a systematic relationship between euroscepticism and textual editing. We do, however, find evidence that member state's voting power and euro status matters. Our findings suggest that eurosceptic no longer affects textual editing of such documents under the European Semester.
The EU's New Economic Governance Framework and Budgetary Decision‐Making in the Member States: Boon or Bane for Throughput Legitimacy?*
Authors: Csehi Robert , Schulz Daniel F.
Published: December 2021

The euro crisis has sparked changes in the EU's economic governance framework and a crisis of legitimacy across the union. While the institutional repercussions of the crisis have been studied before, the democratic impact at the national level has received much less attention. This paper aims to fill this gap, focusing on the procedural changes that the EU's new economic governance (NEG) framework has brought to national budgetary decision‐making. Building upon the Varieties of Democracy framework, the paper adds empirical nuance and conceptual clarity to the notion of ‘throughput legitimacy’ and its components: openness, inclusiveness, transparency and accountability. Detailed case studies of post‐crisis Austria, Italy and Portugal show that the NEG improved access to national budgetary decision‐making and enhanced executive scrutiny, while excessive complexity remains the Achilles' heel of EU fiscal rules. We submit that these procedural changes are too meaningful to be overlooked in post‐crisis debates about EU democracy.
Healthcare resource utilization in patients treated with empagliflozin in East Asia
Authors: Sheu Wayne H‐H , Seino Yutaka , Tan Elise Chia‐Hui , Yabe Daisuke , Ha Kyoung Hwa , Nangaku Masaomi , Chung Wook‐Jin , Node Koichi , Yasui Atsutaka , Lei Wei‐Yu , Lee Sunwoo , Ustyugova Anastasia , Klement Riho , Deruaz‐Luyet Anouk , Kyaw Moe H , Kim Dae Jung ,   the EMPRISE East Asia study group
Published: December 2021

Aims/Introduction

We investigated the utilization of healthcare resources in patients with type 2 diabetes treated with empagliflozin, a sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor, versus dipeptidyl peptidase‐4 (DPP‐4) inhibitors in clinical practice in Japan, South Korea, and Taiwan.

Materials and Methods

We analyzed the Japanese Medical Data Vision database (December 2014–April 2018), the South Korean National Health Information Database, and the Taiwanese National Health Insurance claims database (both May 2016–December 2017). Patients with type 2 diabetes starting empagliflozin, 10 or 25 mg, or a DPP‐4 inhibitor were matched 1:1 via propensity scores (PS). We compared inpatient care needs, emergency room (ER) visits, and outpatient visits between the treatment groups using Poisson regression and Cox proportional hazards models, pooled across countries by random‐effects meta‐analysis.

Results

We identified 28,712 pairs of PS‐matched patients; the mean follow‐up was 5.7–6.8 months. Empagliflozin‐treated patients had a 27% lower risk of all‐cause hospitalization compared with DPP‐4 inhibitor–treated patients (rate ratio [RR] 0.73, 95% CI 0.67–0.79), and 23% reduced risk for first hospitalization (hazard ratio 0.77, 95% CI 0.73–0.81). The risk for an ER visit was 12% lower with empagliflozin than with DPP‐4 inhibitors (RR 0.88, 95% CI 0.83–0.94) while the risk for outpatient visit was 4% lower (RR 0.96, 95% CI 0.96–0.97). These findings were generally consistent across countries, regardless of baseline cardiovascular disease, and in the subgroup starting empagliflozin with the 10 mg dose.

Conclusions

Empagliflozin treatment was associated with lower inpatient care needs and other healthcare resource utilization than DPP‐4 inhibitors in routine clinical practice in East Asia in this study.
The electrophysiologic properties of gonadotropin‐releasing hormone neurons
Authors: Constantin Stephanie , Moenter Suzanne M. , Piet Richard
Published: December 2021

For about two decades, recordings of identified gonadotropin‐releasing hormone (GnRH) neurons have provided a wealth of information on their properties. We describe areas of consensus and debate the intrinsic electrophysiologic properties of these cells, their response to fast synaptic and neuromodulatory input, Ca2+ imaging correlates of action potential firing, and signaling pathways regulating these aspects. How steroid feedback and development change these properties, functions of GnRH neuron subcompartments and local networks, as revealed by chemo‐ and optogenetic approaches, are also considered.
Efficacy and safety of botulinum toxin type A for postoperative scar prevention and wound healing improvement: A systematic review and meta‐analysis
Authors: Fu Ziyao , Huang Hanzi , Huang Jiuzuo
Published: December 2021

Background

Botulinum toxin type A (BTXA) has shown underlying effects for wound healing improvement. New small clinical trials keep emerging every year and updated evidence‐based information is warranted. This study aimed to evaluate the efficacy and safety of BTXA for preventing scarring.

Methods

Four databases were searched to recruit randomized clinical trials (RCTs) which compared the surgical wounds treated with BTXA vs. those treated with placebo or blank control. The outcomes were primarily quantified by measures including the Vancouver Scar Scale (VSS), Visual Analog Scale (VAS), Stony Brook Scar Evaluation Scales (SBSES), modified SBSES (mSBSES), and scar width. Patients’ satisfaction and adverse events were also reported.

Results

In total, 16 RCTs involving 671 cases (510 patients) were included. The outcome showed significant superiority of BTXA in VSS (mean difference [MD] = −1.32, 95% confidence interval [CI]: −2.00 to −0.65, p = 0.0001), VAS (MD = 1.29, 95% CI: 1.05–1.52, p < 0.00001), SBSES or mSBSES (MD = −0.18, 95% CI: −0.27 to −0.10, p < 0.0001), scar width (MD = −0.18, 95% CI: −0.27 to −0.10, p < 0.0001), and patients’ satisfaction (risk ratio [RR] = 1.25, 95% CI: 1.06–1.49, p = 0.01). No significant difference of adverse events incidence was observed (RR = 1.46 95% CI: 0.64–3.33, p = 0.36).

Conclusions

Botulinum toxin type A is effective and safe for postoperative scar prevention and wound healing improvement, especially for facial wounds of Asians. Further studies should manage to standardize the treatment algorithm, while mSBSES is recommended for scar assessment.
Firm heterogeneity, variable markups, and multinational production: A review from trade policy perspective
Authors: Ding Ziran
Published: December 2021

This paper surveys the main ingredients and results of heterogeneous firms trade policy literature that has been developing since the early 2000s. First, I present the stylized facts regarding firm heterogeneity, firm‐level markups, and multinational production's (MP) global structure. I then survey the trade policy papers that build on the workhorse model of firm heterogeneity. Third, I summarize the recent development of theoretical approaches of modeling the firm‐level markups and its trade policy implication. Fourth, I discuss the theoretical frameworks that incorporate MP into heterogeneous firms' framework and their trade policy implication. Finally, I discuss directions for future research and offer suggestions for further readings.
Revisiting oral thrush in South‐East Asian patients: A review of published studies (2000–2020)
Authors: Karajacob Alexandria Sonia , Al‐Maleki Anis Rageh , Tay Sun Tee
Published: December 2021

Background

Oral thrush, a clinical condition due to an overgrowth of Candida yeasts in the oral cavity, is prominent in patients with immunosuppression. As recent updates on oral thrush in South‐East Asian (SEA) countries are lacking, this review aimed to address the epidemiology, clinical features and distribution of Candida species, based on published studies in SEA countries over the last two decades.

Methods

Published studies on oral candidiasis (2000–2020) were retrieved from PubMed, Scopus, ISI Web of Science and Google Scholar databases to provide information on the incidence and factors affecting oral thrush cases in SEA countries.

Results

A total of 22 cross‐sectional studies involving 3697 subjects from five SEA countries were reviewed in this study. The most frequently reported population were human immunodeficiency virus (HIV)–infected patients. The overall incidence rates amongst HIV‐infected patients ranged from 20.7% to 97.0%, while incidence rates ranging from 0% to 72.7% were recorded for non‐HIV‐infected populations. Pseudomembranous candidiasis and erythematous candidiasis were the most common clinical presentations of oral thrush lesions. Candida albicans was the most common species identified in SEA studies. As oral thrush assessments were made merely based on clinical diagnosis, culture results were not available for most studies.

Conclusion

This review highlights that most studies reporting on oral candidiasis in SEA countries were based on HIV‐positive patients. Data are still lacking on oral candidiasis amongst non‐HIV immunocompromised and immunocompetent patients. Increasing awareness on the diagnosis, treatment and consequences of this infection, and improved laboratory methods are essential for the management of oral candidiasis in this region.
The nonlinear association between grandiose and vulnerable narcissism: An individual data meta‐analysis
Authors: Jauk Emanuel , Ulbrich Lisa , Jorschick Paul , Höfler Michael , Kaufman Scott Barry , Kanske Philipp
Published: December 2021

Objective

Narcissism can manifest in grandiose and vulnerable patterns of experience and behavior. While largely unrelated in the general population, individuals with clinically relevant narcissism are thought to display both. Our previous studies showed that trait measures of grandiosity and vulnerability were unrelated at low‐to‐moderate levels of grandiose narcissism, but related at high levels.

Method

We replicate and extend these findings in a preregistered individual data meta‐analysis (“mega‐analysis”) using data from the Narcissistic Personality Inventory (NPI)/Hypersensitive Narcissism Scale (HSNS; N = 10,519, k = 28) and the Five‐Factor Narcissism Inventory (FFNI; N = 7,738, k = 17).

Results

There was strong evidence for the hypothesis in the FFNI (βGrandiose < 1SD = .08, βGrandiose > 1SD = .36, βGrandiose > 2SD = .53), and weaker evidence in the NPI/HSNS (βGrandiose < 1SD = .00, βGrandiose > 1SD = .12, βGrandiose > 2SD = .32). Nonlinearity increased with age but was invariant across other moderators. Higher vulnerability was predicted by elevated antagonistic and low agentic narcissism at subfactor level.

Conclusion

Narcissistic vulnerability increases at high levels of grandiosity. Interpreted along Whole Trait Theory, the effects are thought to reflect state changes echoing in trait measures and can help to link personality and clinical models.
Development of a classification (descriptive) system for a preference‐based quality of life measure for dental caries (dental caries utility index) among adolescents
Authors: Hettiarachchi Ruvini M. , Kularatna Sanjeewa , Byrnes Joshua , Chen Gang , Mulhern Brendan , Scuffham Paul A.
Published: December 2021

Objectives

Preference‐based quality‐of‐life measures (PBMs) have been developed in many clinical areas to aid estimation of more accurate utility values for economic evaluations. Existing oral health‐related quality‐of‐life (OHRQoL) instruments are non‐PBM and hence, cannot be used to generate utility values. The objective of this study was to develop a classification system for a new PBM (dental caries utility index‐DCUI) for the most prevalent childhood oral health condition: dental caries.

Methods

Possible domains and items to be included in the classification system were identified based on the reviewing available pediatric non‐PBM OHRQoL instruments, studies eliciting utility values for oral health outcomes and clinical dentistry textbooks and based on the findings, a draft classification system was developed. To refine the draft classification system, semi‐structured interviews were conducted among a convenience sample of 15 12–17‐year‐old adolescents who had experience with dental caries. The classification system was further refined and validated by a group of dental experts, using a modified Delphi technique.

Results

The classification system comprised five items (pain/discomfort, difficulty in eating food/drinking, worried, ability to participate in activities, and appearance) and each item had a four‐level response scale.

Conclusion

The classification system developed herein is considered an amenable tool for the subsequent development of a new PBM for dental caries. Once the scoring algorithm is completed, the classification system can be used to incorporate economic evaluations of dental caries health interventions.
Interventions to address cancer‐related financial toxicity: Recommendations from the field
Authors: Edward Jean , Petermann Victoria M. , Eberth Jan M. , Zahnd Whitney E. , Vanderpool Robin C. , Askelson Natoshia , Rohweder Catherine L. , Gonzalez Sarah Koopman , Stradtman Lindsay R. , Ko Linda K. , Farris Paige E.
Published: December 2021

Purpose

Addressing financial toxicity among cancer patients is a complex process that requires a multifaceted approach, particularly for rural patients who may face additional cost‐related barriers to care. In this study, we examined interventions being implemented by financial navigation staff at various cancer centers that help address financial toxicity experienced by oncology patients.

Methods

We conducted semistructured interviews with a convenience sample of financial navigation staff across 29 cancer centers in both rural and urban areas in 7 states. Interviews were audio‐recorded and transcribed. Descriptive coding and thematic analysis techniques were used to analyze the data.

Findings

Thirty‐five participants were interviewed, the majority of whom worked in cancer centers located in rural counties. Participants identified the use of screening tools, patient education, and access to tailored financial assistance resources as best practices. Immediate resource needs included additional financial navigation staff, including lay navigators and community health workers, to promote linkages to local resources. Suggested clinical areas for intervention included proactive and early implementation of financial assessments and discussions between providers and patients, along with training and access to regularly updated resources for those in financial navigator/counselor roles. Participants also discussed the need for policy‐level interventions to reform health systems (including employment protections) and health insurance programs.

Conclusions

Implementing proactive methods to screen for and address financial needs of patients is essential to improving cancer‐related outcomes. Additional programs and research are needed to help establish systematic and standardized methods to enhance financial navigation services, especially for underserved rural communities.
Utility of a corticotropin‐releasing hormone test to differentiate pituitary‐dependent hyperadrenocorticism from cortisol‐producing adrenal tumors in dogs
Authors: Tanaka Sachiyo , Suzuki Shuji , Sato Asaka , Teshima Takahiro , Mori Akihiro , Sako Toshinori , Tanaka Aki , Hara Yasushi
Published: December 2021

Background

Hyperadrenocorticism (HAC) is a common endocrine disorder in dogs; however, there are no reports on the use of the corticotropin‐releasing hormone test (CRHT) to differentiate between pituitary‐dependent hyperadrenocorticism (PDH) and cortisol‐producing adrenal tumors (CPATs), both causative of HAC.

Objectives

To evaluate the usefulness of CRHT as a tool to differentiate between PDH and CPAT in dogs and to determine the reference intervals for CRHT in healthy, PDH, and CPAT dogs.

Animals

Dogs diagnosed with PDH (n = 21), CPAT (n = 6), and healthy beagle dogs (n = 33).

Methods

This prospective study included dogs with a definitive diagnosis of PDH and CPAT and healthy beagle dogs, in which CRHT was performed, were prospectively evaluated. We investigated the correlations of CRHT (endogenous adrenocorticotropic hormone [ACTH] concentration, endogenous ACTH concentration [EAC], and poststimulation ACTH concentration [PAC]) with pituitary‐to‐brain ratio (PBR) (in PDH) and with indices of adrenal ultrasonography (smaller and larger adrenal gland dorsoventral thickness in PDH and CPAT).

Results

For EAC, the area under the curve (AUC) was 0.95, with a cutoff value of 26.3 pg/mL (sensitivity: 90.62%, specificity: 87.50%). The AUC for PAC was 0.96 with a cutoff value of 54.5 pg/mL (sensitivity: 100.00%, specificity: 66.67%). The 95% reference interval for CRHT in healthy (control) dogs ranged 5.00 to 79.8 pg/mL (1.10‐17.57 pmol/L) for EAC, and 1.92 to 153.42 pg/mL (0.42‐33.78 pmol/L) for PAC. There was no significant correlation between PBR and CRHT, nor adrenal size and CRHT.

Conclusions and Clinical Importance

CRHT appears to be a rapid and reliable test for differentiating PDH from CPAT in dogs.
Evaluating explanations for poverty selectivity in foreign aid
Authors: Heinrich Tobias , Kobayashi Yoshiharu
Published: December 2021

Ending global poverty has been at the forefront of the development agenda since the 1970s, but many donors have failed to target their funds toward this goal. Activists have tackled this issue by appealing to donors’ humanitarian motives, but we know little about what explains donors’ decisions on how much to give to the poorest countries. This paper develops the donor motivation and foreign policy approaches and identify donors’ development motives and their budget sizes as potential determinants of poverty selectivity. We evaluate their explanatory power by assessing whether their relationships with selectivity are in the hypothesized directions and generalize beyond a particular dataset. Employing cross‐validation and Bayesian Model Averaging, we find few measures of donor motivations provide a generalizable and hypothesized explanation for poverty selectivity. In contrast, donor budget sizes exhibit a relationship that is both hypothesized and externally valid. Our study offers the first systematic analysis of aid selectivity and generates implications for recent approaches to improve the quality of foreign aid and the conventional approach to study foreign aid allocation and donor motives.
Financial stress and economic growth: The moderating role of trust
Authors: Makrychoriti Panagiota , Pasiouras Fotios , Tasiou Menelaos
Published: December 2021

The literature suggests that trust can influence the behavior of economic agents and improve access to financing for both households and corporations. Subsequently, this might have implications for the consumption of households and the investments of corporations. Therefore, trust could mitigate the negative impact of financial stress on economic growth. To test this hypothesis, we use a sample of EU countries over the period 2002–2020 and examine the interaction of trust with financial stress in shaping GDP growth. The interaction term enters the estimations with a positive and statistically significant coefficient, and it therefore mitigates the negative impact of financial stress on economic growth. Furthermore, by disaggregating the GDP into its four main components, we find that the moderating effect of trust flows through the two main components of GDP mentioned above, namely households’ consumption and firms’ investments. Additionally, we observe that the interaction effect becomes weaker in countries with a higher economic freedom and is strengthened in centre and left‐wing governments compared to right‐wing economically oriented ones.
In vitro activities of 8 antifungal agents against geophilic dermatophyte isolates
Authors: Shamsizadeh Forough , Zarei Mahmoudabadi Ali , Shariat Nabavi Maryam , Guillot Jacques , Taghipour Simin , Rezaei‐Matehkolaei Ali
Published: December 2021

Background

Members of the Nannizzia gypsea complex are globally the most common geophilic dermatophytes which cause infection in animals and human. Although the susceptibility patterns of anthropophilic or zoophilic dermatophyte species to antifungal agents are well documented, the effectiveness of such drugs against geophilic species have rarely been explored.

Objectives

This study was aimed to evaluate the in vitro antifungal activity of common and new antifungals against a set of environmental and clinical geophilic dermatophyte isolates.

Methods

108 soil and clinical geophilic isolates from two genera Nannizzia (N. fulva n = 59; N. gypsea n = 43) and Arthroderma (A. quadrifidum n = 4; A. gertleri n = 1; A. tuberculatum n = 1) were included in the study. The in vitro antifungal susceptibility patterns of eight common and new antifungals against the isolates were determined according to broth microdilution method and by CLSI M38‐A3 (3rd edition) protocol.

Results

MIC values across all isolates from five species ranged as: luliconazole: 0.0002‐0.002 µg/ml, terbinafine: 0.008‐0.125 µg/ml, efinaconazole: 0.008‐0.125 µg/ml, ciclopirox olamine: 0.03‐0.5 µg/ml, itraconazole: 0.125‐1 µg/ml, amorolfine hydrochloride: 0.125‐4 µg/ml, griseofulvin: 0.25‐2 µg/ml and tavaborole: 1‐8 µg/ml, respectively.

Conclusion

Luliconazole, terbinafine and efinaconazole exhibited the highest in vitro efficacy, regardless of the dermatophyte species. Further surveillance studies are recommended to confirm the implication of such in vitro data for the clinical recovery rate of dermatophytosis with geophilic species following antifungal therapy.
Isolated sensory impairment of the ear auricle in a patient with cerebral infarction localized to the postcentral gyrus
Authors: Usami Toshihiko , Uchida Yuto , Sakurai Keita , Kano Yuya , Kuno Tomoyuki , Takada Koji , Matsukawa Noriyuki
Published: December 2021

Pure sensory stroke, a well‐defined clinical entity characterized by sensory symptoms, sometimes causes atypical distributions of sensory impairment. We herein report an 85‐year‐old man presenting with isolated sensory impairment of the right‐sided ear auricle due to postcentral gyrus infarction. The somatotopic representation in the human primary somatosensory cortex that corresponds to the ear has not been elucidated. This case suggests the possible cortical area for the ear.
Influence of leptin and compression in GAS‐6 mediated homeostasis of periodontal ligament cell
Authors: Yong Jiawen , Elisabeth. Groeger Sabine , Ruf Sabine , Ruiz‐Heiland Gisela
Published: December 2021

Growth arrest‐specific protein 6 (GAS‐6) regulates immunomodulatory and inflammatory mechanisms in periodontium and may participate in obesity predisposition. This study aimed to determine whether GAS‐6 is associated with the homeostasis of periodontal ligament (SV‐PDL) cells in the presence of adipokines or compressive forces. The SV‐PDL cell line was used. Western blots were employed for TAM receptors detection. Cells were stimulated using different concentrations of GAS‐6. The migration, viability, and proliferation were measured by a standard scratch test, MTS assay, and immunofluorescent staining. The mRNA expression was analyzed by RT‐PCR. Release of TGF‐β1, GAS‐6, and Axl were verified by ELISA. Western blot shows that TAM receptors are expressed in SV‐PDL cells. GAS‐6 has a promoting effect on cell migration and proliferation. RT‐PCR analysis showed that GAS‐6 induces Collagen‐1, Collagen‐3, Periostin, and TGF‐β1 mRNA expression whereas it reduces Caspase‐3, Caspase‐8, Caspase‐9, and IL‐6 mRNA expression. Further, secreted GAS‐6 in SV‐PDL is reduced in response to both compressive forces and leptin and upregulated by IL‐6. Additionally, ADAM‐10 inhibition reduces GAS‐6 and Axl release on SV‐PDL cells. TAM receptors especially Axl are identified as the receptors of GAS‐6. GAS‐6/TAM interactions contribute to periodontal ligament cells homeostasis. Leptin inhibits the GAS‐6 release independently of ADAM‐10 metalloprotease.
Relationship between pre‐pregnancy maternal body mass index and infant weight trajectories in HIV‐exposed and HIV‐unexposed infants
Authors: Bengtson Angela M. , le Roux Stanzi M. , Phillips Tamsin K. , Brittain Kirsty , Zerbe Allison , Madlala Hlengiwe P. , Malaba Thokozile R. , Petro Gregory , Abrams Elaine J. , Myer Landon
Published: December 2021

Background

Maternal HIV and antiretroviral therapy (ART) exposure in utero may influence infant weight, but the contribution of maternal y body mass index (BMI) to early life overweight and obesity is not clear.

Objective

To estimate associations between maternal BMI at entry to antenatal care (ANC) and infant weight through approximately 1 year of age and to evaluate whether associations were modified by maternal HIV status, maternal HIV and viral load, breastfeeding intensity through 6 months or timing of entry into ANC.

Methods

We followed HIV‐uninfected and ‐infected pregnant women initiating efavirenz‐based ART from first antenatal visit through 12 months postpartum. Infant weight was assessed via World Health Organization BMI and weight‐for‐length z‐scores (WLZ) at 6 weeks, 3, 6, 9 and 12 months. We used multivariable linear mixed‐effects models to estimate associations between maternal BMI and infant z‐scores over time.

Results

In 861 HIV‐uninfected infants (454 HIV‐exposed; 407 HIV‐unexposed), nearly 20% of infants were overweight or obese by 12 months of age, regardless of HIV exposure status. In multivariable analyses, increasing maternal BMI category was positively associated with higher infant BMIZ and WLZ scores between 6 weeks and 12 months of age and did not differ by HIV exposure status. However, HIV‐exposed infants had slightly lower BMIZ and WLZ trajectories through 12 months of age, compared with HIV‐unexposed infants across all maternal BMI categories. Differences in BMIZ and WLZ scores by HIV exposure were not explained by timing of entry into ANC or maternal viral load pre‐ART initiation, but z‐scores were slightly higher for HIV‐exposed infants who were predominantly or exclusively versus partially breastfed.

Conclusions

These findings suggest maternal BMI influences early infant weight gain, regardless of infant HIV exposure status. Intervention to reduce maternal BMI may help to address growing concerns about obesity among HIV‐uninfected children.
Prophylactic central neck dissection for well-differentiated thyroid carcinoma: results and methodological assessment of systematic reviews
Authors: Ramirez Adonis , Sanabria Alvaro
Published: December 2021

Objective:

The aim of this review was to assess the methodological quality of systematic reviews evaluating the effectivness of prophylactic central neck dissection plus thyroidectomy to decrease locoregional recurrence in patients with thyroid carcinoma.

Introduction:

Many systematic reviews have been published concerning prophylactic central neck dissection in well-differentiated thyroid carcinoma, finding inconsistent results regarding the risk of locoregional recurrence. Because systematic reviews are considered the best source on which to base clinical decisions, the assessment of methodological quality is important.

Inclusion criteria:

This paper included studies that mentioned that a systematic review was performed in adult patients with confirmed diagnosis of well-differentiated thyroid carcinoma without evidence of nodal metastatic disease who underwent total thyroidectomy. Reviews evaluated prophylactic central neck dissection compared with no neck diessection for decreasing locoregional recurrence.

Methods:

A systematic search was performed using MEDLINE, Embase, the Cochrane Database of Systematic Reviews, LILACS, Web of Science, CNKI, and Google Scholar. PROSPERO was searched for unpublished studies and gray literature. Data regarding the study characteristics, patient types, numbers of patients, and locoregional recurrence by group were extracted. Methodological characteristics, type of statistical analysis and summary estimator, heterogeneity, and publication bias were recorded. The methodological quality was measured using the AMSTAR 2 tool.

Results:

The search identified 12 systematic reviews. Only four systematic reviews reported adherence to methodological guidelines. The AMSTAR 2 critical criteria classified all the studies as critically low quality. The pooled risk difference for locoregional recurrence varied among studies from −5% to 0%. Most of the studies were published in high-impact journals.

Conclusions:

The published systematic reviews that assessed prophylactic central neck dissection as an intervention to decrease the rate of locoregional recurrence have a critically low methodological quality. The results and recommendations based on these studies should be used with caution. The evaluation of methodological quality by peer reviewers must be improved.
Design of Customized Virtual Reality Serious Games for the Cognitive Rehabilitation of Retrograde Amnesia After Brain Stroke
Authors: Lanzoni Daniel , Vitali Andrea , Regazzoni Daniele , Rizzi Caterina
Published: December 2021

This article presents a software platform to design serious games for the rehabilitation of severe memory loss by means of virtual reality (VR). In particular, the focus is on retrograde amnesia, a condition affecting patient's quality of life usually after brain stroke. Currently, the standard rehabilitation process includes showing pictures of familiar environments to help memory recover, while the proposed rehabilitation solution aims at developing patient-specific serious games for memory loss starting from 3D scanning of familiar environments. The Occipital Structure sensor and the Skanect application have been used for the virtualization of the real objects and the environment. Instead of following the traditional approach to design a video game during which the game logic is specifically developed for a virtual scene and the software code is not meant to be recombined, a modular procedure has been designed using Unity to interface the virtual objects of each acquired environment without modifying the game logic. In addition, the developed solution makes available a set of software modules for patient's monitoring and data management to automatically generate medical reports, which can be easily connected to each new serious game. A test has been performed to assess the main features of the VR platform and its usability recruiting ten testers. Medical personnel evaluated positively the platform, and they highlighted the importance of objective data to improve the ecological validity of the cognitive rehabilitation for retrograde amnesia.
User-Driven Computer-Assisted Reverse Engineering of Editable CAD Assembly Models
Authors: Shah Ghazanfar Ali , Polette Arnaud , Pernot Jean-Philippe , Giannini Franca , Monti Marina
Published: December 2021

This paper introduces a novel reverse engineering (RE) technique for the reconstruction of editable computer-aided design (CAD) models of mechanical parts’ assemblies. The input is a point cloud of a mechanical parts’ assembly that has been acquired as a whole, i.e., without disassembling it prior to its digitization. The proposed framework allows for the reconstruction of the parametric CAD assembly model through a multi-step reconstruction and fitting approach. It is modular and it supports various exploitation scenarios depending on the available data and starting point. It also handles incomplete datasets. The reconstruction process starts from roughly sketched and parameterized CAD geometries (i.e., 2D sketches, 3D parts, or assemblies) that are then used as input of a simulated annealing-based fitting algorithm, which minimizes the deviation between the point cloud and the adapted geometries. The coherence of the CAD models is maintained by a CAD modeler that performs the geometries’ updates while guaranteeing the possibly imposed constraints and model coherence. The optimization process leverages a two-level filtering technique able to capture and manage the boundaries of the geometries inside the overall point cloud in order to allow local fitting and interfaces detection. It is a user-driven approach where the user decides what are the most suitable steps and sequence to operate. It has been tested and validated on both real scanned point clouds and as-scanned virtually generated point clouds incorporating several artifacts that would appear with real acquisition devices.