bluuebunny/crossref_metadata_2025 huggingface dataset:
Fractionated stereotactic radiotherapy for uveal melanoma: Long‐term outcome and control rates
Authors: van Beek Jackelien G. M. , van Rij Caroline M. , Baart Sara J. , Yavuzyigitoglu Serdar , Bergmann Michael J. , Paridaens Dion , Naus Nicole C. , Kiliç Emine
Published: September 2021

Purpose

The aim of our study is to evaluate local tumour control rates, radiation side‐effects, visual preservation and disease‐free survival (DFS) of uveal melanoma (UM) patients treated with fractionated stereotactic radiotherapy (fSRT).

Methods

A retrospective study of UM patients, who were treated with fSRT (N = 189), was performed by the Rotterdam Ocular Melanoma Study group (ROMS), the Netherlands, between 1999 and 2014 with a follow‐up of at least 5 years.

Results

The 1‐, 3‐, 5‐, 10‐ and 15‐year local tumour control rates were as follows: 99.4%, 92.8%, 92.2%, 89.3% and 89.3%, respectively. Cataract (67.8%) was the most common side‐effect of fSRT followed by retinopathy (35.1%), maculopathy (23.8%), vitreous haemorrhage (20.1%), neovascular glaucoma (NVG) (20.0%) and optic neuropathy (12.4%). Patients with anterior located UMs developed cataract more frequently (p = 0.047, multivariable analysis). By multivariable analysis, significant factors for secondary enucleation were tumour recurrence (p < 0.001) and NVG (p < 0.001). In multivariable analysis, risk factors for a worse DFS were larger UM (p = 0.024) and tumours with subretinal fluid (SRF) at baseline (p = 0.038). The 5‐year DFS was 77.0% and the best corrected visual acuity decreased significantly after treatment. After 5 years, 22.0% of patients and after 10 years 17.6% of patients had a visual acuity of ≤0.3 logMAR.

Conclusion

Fractionated stereotactic radiotherapy is a good treatment option for small‐, medium‐ and large‐sized tumours with 5‐year local tumour control of 92.2%. After 5 years, 22.0% of the patients had a good vision. Independently of tumour location, the visual acuity decreased significantly after treatment. Overall, the 5‐year DFS was 77.0%.
Multi‐organ dysfunction scoring in neonatal encephalopathy (MODE Score) and neurodevelopmental outcomes
Authors: Sweetman Deirdre Una , Strickland Tammy , Isweisi Eman , Kelly Lynne , Slevin Marie Therese , Donoghue Veronica , Meehan Judith , Boylan Geraldine , Murphy John Finbar Anthony , El‐Khuffash Afif , Molloy Eleanor J.
Published: September 2021

Aim

Neonatal encephalopathy (NE) is associated with an increased risk of multi‐organ injury. The lack of standardised definitions for multi‐organ dysfunction in NE hinders accurate quantification of these complications.

Methods

A simple multi‐organ dysfunction in neonatal encephalopathy scoring (MODE) system was created to include the cardiovascular, respiratory, gastrointestinal, haematological and neurological systems with a maximum score of 15. The MODE score was then compared with the grade of NE, Bayley Scales of Infant Development (Bayley‐III) at 2 years of age and mortality. The Bayley score was used as it gave an objective score making it easier to compare the MODE score. Bayley score of <90 and/or abnormal MRI as an adverse outcome.

Results

Infants with perinatal asphyxia (PA:n = 85) were prospectively enrolled (PA only n = 9; NE I = 23; NE II = 42; NE III = 11). Infants with higher MODE scores were significantly more likely to have moderate/severe NE (NE II/III: median scores (IQR) 7(5–10) versus mild NE 2 (1–3); p‐value < 0.001) The MODE score was highly predictive of mortality (AUC 0.96, p‐value = 0.002). Infants who had an abnormal neurological examination at discharge or abnormal Bayley‐III scores had significantly higher MODE scores (p‐value = 0.001).

Conclusion

Quantifying multi‐organ injury is important to plan optimal early management and long‐term follow‐up. Additional use of clinical biomarkers may be useful as surrogate endpoints in future clinical trials and link to multi‐organ longer‐term developmental follow‐up.
A new formal classification for Japanese forest vegetation based on traditional phytosociological concepts
Authors: Noriyuki Masaomi , Kondo Hirofumi , Shitara Takuto , Yoshikawa Masato , Hoshino Yoshinobu
Published: September 2021

Aims

To propose a comprehensive classification framework for Japanese forest vegetation, an expert system based on a traditional system was developed, using a large‐scale data set covering the whole of Japan.

Location

The entire Japanese archipelago.

Methods

A data set of 12,720 vegetation plots from the National Vegetation Survey database was established. Then, an expert system for automatic hierarchical classification was developed, based on the traditional system. The classification effectiveness was verified using fidelity measures, the occurrence of traditional characteristic species, consistency with semi‐supervised K‐means and modified TWINSPAN, and the similarity between each unit. To investigate correspondence to the environmental variables, a detrended correspondence analysis with the “envfit” function was used. Additionally, the occurring taxa were collated and compared with the flora lists of areas surrounding Japan.

Results

The Japanese forest data set was classified into 34 alliances by the expert system, and 14 orders and six classes were distinguished. Most of these units had diagnostic taxa including existing characteristic species and the heatmap of the Bray–Curtis index showed the independence of each unit, and the similarity of the plot groups assigned to the same unit. Out of 34 alliances, clustering with semi‐supervised K‐means supported 21 alliances, and modified TWINSPAN supported 16 alliances. The four classes correspond to the thermal conditions and support the existing concept of vegetation zones. The lower‐level vegetation units correspond to a narrower range of environmental variables than higher‐level units, and species composition varied with limited environmental variables. A floristic composition comparison emphasized the complexity of the species composition of Japanese forests.

Conclusions

This study proposes the first formal Japanese forest classification at the class, order, and alliance levels, reflecting traditional phytosociology systems and based on large‐scale vegetation plot data. Our classification provides an important foundation for the future revision of formal phytosociological systems throughout East Asia.
THE CONCISE GUIDE TO PHARMACOLOGY 2021/22: Nuclear hormone receptors
Authors: Alexander Stephen P H , Cidlowski John A , Kelly Eamonn , Mathie Alistair , Peters John A , Veale Emma L , Armstrong Jane F , Faccenda Elena , Harding Simon D , Pawson Adam J , Southan Christopher , Davies Jamie A , Coons Laurel , Fuller Peter J. , Korach Kenneth S. , Young Morag J.
Published: September 2021

The Concise Guide to PHARMACOLOGY 2021/22 is the fifth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of nearly 1900 human drug targets with an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. Although the Concise Guide constitutes over 500 pages, the material presented is substantially reduced compared to information and links presented on the website. It provides a permanent, citable, point‐in‐time record that will survive database updates. The full contents of this section can be found at http://onlinelibrary.wiley.com/doi/bph.15540. Nuclear hormone receptors are one of the six major pharmacological targets into which the Guide is divided, with the others being: G protein‐coupled receptors, catalytic receptors, enzymes and transporters. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. The landscape format of the Concise Guide is designed to facilitate comparison of related targets from material contemporary to mid‐2021, and supersedes data presented in the 2019/20, 2017/18, 2015/16 and 2013/14 Concise Guides and previous Guides to Receptors and Channels. It is produced in close conjunction with the Nomenclature and Standards Committee of the International Union of Basic and Clinical Pharmacology (NC‐IUPHAR), therefore, providing official IUPHAR classification and nomenclature for human drug targets, where appropriate.
THE CONCISE GUIDE TO PHARMACOLOGY 2021/22: Transporters
Authors: Alexander Stephen P H , Kelly Eamonn , Mathie Alistair , Peters John A , Veale Emma L , Armstrong Jane F , Faccenda Elena , Harding Simon D , Pawson Adam J , Southan Christopher , Davies Jamie A , Amarosi Laura , Anderson Catriona M. H. , Beart Philip Mark , Broer Stefan , Dawson Paul A. , Hagenbuch Bruno , Hammond James R. , Hancox Jules C , Inui Ken‐ichi , Kanai Yoshikatsu , Kemp Stephan , Stewart Gavin , Thwaites David T. , Verri Tiziano
Published: September 2021

The Concise Guide to PHARMACOLOGY 2021/22 is the fifth in this series of biennial publications. The Concise Guide provides concise overviews, mostly in tabular format, of the key properties of nearly 1900 human drug targets with an emphasis on selective pharmacology (where available), plus links to the open access knowledgebase source of drug targets and their ligands (www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. Although the Concise Guide constitutes over 500 pages, the material presented is substantially reduced compared to information and links presented on the website. It provides a permanent, citable, point‐in‐time record that will survive database updates. The full contents of this section can be found at http://onlinelibrary.wiley.com/doi/bph.15543. Transporters are one of the six major pharmacological targets into which the Guide is divided, with the others being: G protein‐coupled receptors, ion channels, nuclear hormone receptors, catalytic receptors and enzymes. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. The landscape format of the Concise Guide is designed to facilitate comparison of related targets from material contemporary to mid‐2021, and supersedes data presented in the 2019/20, 2017/18, 2015/16 and 2013/14 Concise Guides and previous Guides to Receptors and Channels. It is produced in close conjunction with the Nomenclature and Standards Committee of the International Union of Basic and Clinical Pharmacology (NC‐IUPHAR), therefore, providing official IUPHAR classification and nomenclature for human drug targets, where appropriate.
Safety of surgical tracheostomy under continued antithrombotic therapy: A retrospective cohort study
Authors: Sugaya Takayuki , Ueha Rumi , Sato Taku , Goto Takao , Yamauchi Akihito , Yamasoba Tatsuya
Published: September 2021

Objective

Although various guidelines have been established for the management of antithrombotic therapy during surgical treatments, surgical tracheostomy (ST) under continued antithrombotic therapy (CAT) remains challenging. Here, we investigated the risk factors for complications after ST by focusing on the application of CAT during ST.

Design

A retrospective cohort study with medical records from 2009 to 2020.

Setting

A single‐center study.

Participants

This study included patients who had undergone ST at the Department of Otolaryngology of our hospital

Main outcome measures

The primary outcomes were the incidence of complications and blood test results. Secondary outcomes were risk factors for postoperative complications.

Results

We identified 288 patients (median age: 64 years; 184 men [64%]), among whom 40 (median age: 67 years; 29 men [73%]) underwent CAT. Although the patients undergoing CAT had significantly longer activated partial thromboplastin time (p=0.002) and a higher prothrombin time‐international normalized ratio (p=0.006) compared to antithrombotic naïve patients, no statistically significant intergroup differences were observed for the risk of bleeding, infection, or subcutaneous emphysema. Instead, ST under local anesthesia (p=0.01) and ST for airway emergency (p=0.02) significantly increased the risk of early postoperative complications.

Conclusion

These results suggest that ST under CAT can be safely performed without any increased risk of postoperative complications. Nevertheless, surgeons should be extra cautious about early complications after ST under local anesthesia without intubation or ST for airway emergencies.
The harm in and of COVID‐19
Authors: Asogwa Nicholas Uchechukwu
Published: September 2021

Coronavirus‐19 (COVID‐19) is a trending topic that is currently engaging the attention of scholars all over the globe. Much has been said and written about it in terms of its nature, mode of infection, the ethics, the harm and, of course, the best resource allocation and triaging paradigm. While offering theoretical explanation of why we need to make a distinction between harms in and of COVID‐19, this paper, at the same time, exposes the harms in and of COVID‐19, as well as offer examples of where both forms could be seen, using three spheres of reality, namely economy, education, and reproductive rights (abortion). Whereas it notes that harms in COVID‐19 are those harms that are inherent in it and are direct vis‐à‐vis its victims, the paper observes that harms of COVID‐19 are those harms that are causally, but only indirectly related to COVID‐19. It concludes that knowledge of the distinction between harms in and of COVID‐19 will be of use to the masses across the globe in checkmating the antics of those state actors in their respective jurisdictions who may wish to hide under the guise of combating the spread and menace of COVID‐19 to carry out some hidden, selfish and vindictive agenda.
Does Rosie Like Riveting? Male and Female Occupational Choices
Authors: Lordan Grace , Pischke Jörn‐Steffen
Published: September 2021

Occupational segregation and pay gaps by gender remain large, while many of the constraints traditionally believed to be responsible for these gaps seem to have weakened over time. We explore the possibility that women and men have different tastes for the content of the work that they do. We relate job satisfaction and job mobility to measures that proxy for the content of the work in an occupation, which we label ‘people’, ‘brains’ and ‘brawn’. The results suggest that women value jobs high on ‘people’ content and low on ‘brawn’. Men care about job content in a similar fashion, but have much weaker preferences. High school students show similar preferences in a discrete choice experiment and indicate that they make their choices based mainly on preferences for the work itself. We argue that the more pronounced preferences of women can account for occupational sorting, which often leads them into careers with large pay penalties for interruptions due to childbearing.
A low‐dose rituximab regimen for first‐line treatment of acquired haemophilia A
Authors: Hunt Stewart , Robertson Jeremy , Conn Jason , Casey John , Royle Jane , Collins Joel , Hourigan Matthew , Richmond Joshua , Yang Wang Tzu , Mills Anthony , Mason Jane
Published: September 2021

A low‐dose rituximab regimen for first‐line treatment of acquired haemophilia A.

Introduction

Acquired haemophilia A (AHA) is a rare disease caused by the development of autoantibodies against FVIII. Diagnosis involves confirmation of FVIII deficiency and the presence of an inhibitor via the Bethesda assay. Severe bleeding is often managed with bypassing agents such as recombinant factor VII. This is then followed by eradication of the inhibitor with immunosuppression which typically includes a corticosteroid backbone.

Aim

Review the current management and outcomes of AHA in Queensland, Australia. Determine the incidence, demographics and clinical characteristics of AHA patients.

Methods

Retrospective case series of AHA diagnosed between May 2014 and August 2018. Data were derived from the Australian Bleeding Disorders Registry and state‐wide pathology database. Data collection proforma was completed by the treating haematologist and reviewed/compiled centrally.

Results

24 patients were identified (incidence 1 in 1.27 million). The median age was 76.5 years. Median follow‐up was 20 months. Index bleed was atraumatic and skin/soft tissue in the majority of patients. Recombinant FVIIa was the most commonly used haemostatic therapy and effective in 85% of patients. Immunosuppression and steroid usage were uniform. Upfront second agent was used in 75% of patients and was most commonly rituximab. 87.5% of patients achieved a complete remission in a median time of 48 days. Low‐dose rituximab was frequently used and equally as efficacious as standard dose.

Conclusion

Immunosuppression with combination therapy, notably rituximab, appears to be non‐inferior and has a favourable side effect profile.
The standard interpretation of Schopenhauer's compensation argument for pessimism: A nonstandard variant
Authors: Bather Woods David
Published: September 2021

According to Schopenhauer's compensation argument for pessimism, the non‐existence of the world is preferable to its existence because no goods can ever compensate for the mere existence of evil. Standard interpretations take this argument to be based on Schopenhauer's thesis that all goods are merely the negation of evils, from which they assume it follows that the apparent goods in life are in fact empty and without value. This article develops a non‐standard variant of the standard interpretation, which accepts the relevance of the negativity thesis but rejects that the argument assumes that life's goods are all empty and valueless. Instead, it argues that whatever value negative goods might possess, they do not have the kind of value to compensate for positive evils. This involves additional development of the negativity thesis and a defense of it against objections from Byron Simmons.
Increased delta power as a scalp marker of epileptic activity: a simultaneous scalp and intracranial electroencephalography study
Authors: De Stefano Pia , Carboni Margherita , Marquis Renaud , Spinelli Laurent , Seeck Margitta , Vulliemoz Serge
Published: September 2021

Background and purpose

The purpose was to evaluate whether intracranial interictal epileptiform discharges (IEDs) that are not visible on the scalp are associated with changes in the frequency spectrum on scalp electroencephalograms (EEGs).

Methods

Simultaneous scalp high‐density EEG and intracranial EEG recordings were recorded in nine patients undergoing pre‐surgical invasive recordings for pharmaco‐resistant temporal lobe epilepsy. Epochs with hippocampal IED visible on intracranial EEG (ic‐IED) but not on scalp EEG were selected, as well as control epochs without ic‐IED. Welch's power spectral density was computed for each scalp electrode and for each subject; the power spectral density was further averaged across the canonical frequency bands and compared between the two conditions with and without ic‐IED. For each patient the peak frequency in the delta band (the significantly strongest frequency band in all patients) was determined during periods of ic‐IED. The five electrodes showing strongest power at the peak frequency were also determined.

Results

It was found that intracranial IEDs are associated with an increase in delta power on scalp EEGs, in particular at a frequency ≥1.4 Hz. Electrodes showing slow frequency power changes associated with IEDs were consistent with the hemispheric lateralization of IEDs. Electrodes with maximum power of slow activity were not limited to temporal regions but also involved frontal (bilateral or unilateral) regions.

Conclusions

In patients with a clinical picture suggestive of temporal lobe epilepsy, the presence of delta slowing ≥1.4 Hz in anterior temporal regions can represent a scalp marker of hippocampal IEDs. To our best knowledge this is the first study that demonstrates the co‐occurrence of ic‐IED and increased delta power.
Fewer COVID‐19‐associated strokes and reduced severity during the second COVID‐19 wave: The Madrid Stroke Network
Authors: Fuentes Blanca , Alonso de Leciñana María , Rigual Ricardo , García‐Madrona Sebastián , Díaz‐Otero Fernando , Aguirre Clara , Calleja Patricia , Egido‐Herrero José A. , Carneado‐Ruiz Joaquín , Ruiz‐Ares Gerardo , Rodríguez‐Pardo Jorge , Rodríguez‐López Ángela , Ximénez‐Carrillo Álvaro , de Felipe Alicia , Ostos Fernando , González‐Ortega Guillermo , Simal Patricia , Gómez Escalonilla Carlos I. , Gómez‐Porro‐Sánchez Pablo , Cabal‐Paz Borja , Reig Gemma , Gil‐Núñez Antonio , Masjuán Jaime , Díez Tejedor Exuperio
Published: September 2021

Background and purpose

The experience gained during the first COVID‐19 wave could have mitigated the negative impact on stroke care in the following waves. Our aims were to analyze the characteristics and outcomes of patients with stroke admitted during the second COVID‐19 wave and to evaluate the differences in the stroke care provision compared with the first wave.

Methods

This retrospective multicenter cohort study included consecutive stroke patients admitted to any of the seven hospitals with stroke units (SUs) and endovascular treatment facilities in the Madrid Health Region. The characteristics of the stroke patients with or without a COVID‐19 diagnosis were compared and the organizational changes in stroke care between the first wave (25 February to 25 April 2020) and second wave (21 July to 21 November 2020) were analyzed.

Results

A total of 550 and 1191 stroke patients were admitted during the first and second COVID‐19 waves, respectively, with an average daily admission rate of nine patients in both waves. During the second wave, there was a decrease in stroke severity (median National Institutes of Health Stroke Scale 5 vs. 6; p = 0.000), in‐hospital strokes (3% vs. 8.1%) and in‐hospital mortality (9.9% vs. 15.9%). Furthermore, fewer patients experienced concurrent COVID‐19 (6.8% vs. 19.1%), and they presented milder COVID‐19 and less severe strokes. Fewer hospitals reported a reduction in the number of SU beds or deployment of SU personnel to COVID‐19 dedicated wards during the second wave.

Conclusions

During the second COVID‐19 wave, fewer stroke patients were diagnosed with COVID‐19, and they had less stroke severity and milder COVID‐19.
Cardiopulmonary function and intestinal blood flow in anaesthetised, experimentally endotoxaemic horses given a constant rate infusion of dexmedetomidine
Authors: Hector Rachel C. , Rezende Marlis L. , Nelson Brad B. , Monnet Eric
Published: September 2021

Background

Endotoxaemia causes untoward inflammatory‐mediated effects that might be attenuated by dexmedetomidine.

Objectives

To evaluate the effects of a dexmedetomidine intravenous (IV) infusion on systemic and intestinal haemodynamics and arterial blood gas values in sevoflurane‐anaesthetised horses administered Escherichia coli O55:B5 lipopolysaccharides (LPS).

Study design

Randomised controlled in vivo experiment.

Methods

A total of 13 horses weighing 456 ± 86 kg (mean ± standard deviation) and aged 13.9 ± 9.0 years donated for euthanasia underwent ventral midline celiotomy using sevoflurane anaesthesia. Baseline physiological variables were recorded after a 90‐minute equilibration period. All horses were given 0.1 mcg/kg bwt LPS IV. Horses were randomly assigned to no further treatment (group LPS; seven horses) or IV administration of dexmedetomidine (loading dose 1.75 mcg/kg bwt followed by 1.75 mcg/kg bwt/h; group LPS–Dex; six horses) with concurrent target sevoflurane dose reduction of 50%. Cardiac index (CI; thermodilution), intestinal blood flow, arterial blood parameters and plasma dexmedetomidine concentration measurements were recorded every 30 minutes until euthanasia at 390 minutes. Data were compared between and within groups to baseline using a mixed model analysis (significance P < .05).

Results

In LPS‐Dex horses, intestinal blood flow and CI were transiently decreased after the dexmedetomidine loading dose, but no significant differences were found compared with baseline during the infusion. Sevoflurane dose was reliably reduced by approximately 40%. Significant differences were identified in creatinine (115  umol/L LPS‐Dex; 195 umol/L LPS), bicarbonate (29.7 mmol/L LPS‐Dex; 23 mmol/L LPS) and base excess (2.0 mmol/L LPS‐Dex; −5.3 mmol/L LPS). Dexmedetomidine plasma concentrations were highest after the loading dose and stable during infusion dosing.

Main limitations

Experimental conditions are not reflective of clinical colic management.

Conclusions

A dexmedetomidine infusion with sevoflurane dose reduction attenuated some deleterious changes in anaesthetised horses administered LPS without sustained negative cardiovascular effects and may be beneficial during colic surgery.
Geo‐inspired science, engineering, construction, art and design
Authors: Butcher Alan R. , Corfe Ian J.
Published: September 2021

Geo‐inspiration explores the potential of naturally occurring earth materials as an inspiration for the creation, design and utilization of brand‐new materials and products. It draws on 4.5 billion years of earth history, over which time our planet has evolved significantly, with the formation of an ever‐increasing number of minerals. Through time these have combined in different ways to form rocks—with different compositions, textures and physical properties—all at different scales and forms of complexity. Many of these properties can be directly copied, mimicked or even improved upon, resulting in breakthrough developments for use in today's world. One might therefore be tempted to take the well‐known geological uniformitarianism principle—first suggested by William Whewell, then developed by English geologist James Hutton, and re‐phrased and popularized by Charles Lyell—who said …‘the present is the key to the past’, … and turn it around to say instead: ‘… the key to the future is the geological past!’
Impacts of the Triple bristles three‐sided sonic powered toothbrush on tooth shade, plaque control and gingival health
Authors: AL‐Omiri Mahmoud K. , Al‐Shayyab Mohammad H. , Alahmari Nasser M. , Aldosari Lujain I. , Alzoubi Ibrahim A. , Al Nazeh Abdullah A. , Majdalawi Farah , Alsafadi Lana , Lynch Edward
Published: September 2021

Objectives

To evaluate the efficacy of the Triple bristles three‐sided sonic powered toothbrush in plaque removal and its impact on tooth shade and gingival health, and to compare this with a conventional manual toothbrush.

Methods

Fifty two participants (26 males and 26 females; mean age [SD] = 22.48 [1.52], SE = 0.210, 95% CI = 22.06–22.90) were recruited into this controlled within‐subject, randomized, two‐treatment, 1‐month crossover and examiner‐blinded observational study between October 2020 and January 2021 in the School of Dentistry, University of Jordan. Within each participant, the upper and lower jaws were randomized to receive a brushing protocol either with the Triple bristles three‐sided sonic brush or with a soft manual standard toothbrush with flat trimmed bristles. Tooth shades were recorded for upper and lower anterior and premolar teeth. The Turesky‐Modified Quigley‐Hein Plaque Index (TMQHPI) and bleeding on probing (BOP) were evaluated at study baseline, 1 week and 1 month after applying the brushing protocol.

Results

Both tested brushes were associated with significant reduction in plaque scores and BOP (p < 0.05). The Triple bristles brush was more effective in reduction in plaque and BOP in the lower jaw and among females than the manual brush (p < 0.05).

Conclusions

The Triple bristles brush was more superior for reduction in plaque and probing on bleeding in the lower jaw and among females.
Fabrication and properties of alumina ceramics shaped by digital light processing as an additive manufacturing technology
Authors: Zhang Ling , Huang Jingyin , He Yu , Liu Kaige , Xiang Bingxi , Zhai Jianpang , Kong Ling Bing , Zhang Tianshu , Liu Yin
Published: September 2021

Ceramic slurries with different contents of Al2O3 were formulated and alumina ceramic parts with promising surface morphology were fabricated by using digital light processing photopolymerization‐based additive manufacturing technology. The factors influencing curing depth of the slurries were studied, while the effects of powder content on shrinkage of the green bodies and microstructure, density, and hardness of the sintered bodies were evaluated. Although the curing depth was decreased with increasing content of Al2O3, all the five groups of slurries could be well cured, as the exposure time was set to be 16 s. According to TG‐DTG curves, the weight loss of the samples was completed at about 580°C. Samples from the slurries with 70 and 75 wt.% Al2O3 had dense microstructure, without obvious cracks at both the macro‐ and micro‐scales. Furthermore, with increasing content of Al2O3 in slurries, the bulk density and hardness of sintered bodies were increased. It is believed that our results could be used as a reference for the fabrication of alumina ceramics through additive manufacturing technology.
Two‐year change in weight status and high carotid intima‐media thickness in Chinese children
Authors: Liu Qin , Xi Bo , Ma Shujing , Zhao Min , Magnussen Costan G.
Published: September 2021

Background

No studies have assessed the association between change in weight status and subclinical cardiovascular outcomes in children.

Objective

To examine the association of change in weight status over 2 years with carotid intima‐media thickness (cIMT) among Chinese children.

Methods

A total of 1184 children aged 6–11 years at baseline with complete data were included, and there were 1073 children after excluding those with cIMT ≥ sex‐ and age‐specific 90th percentile values at baseline. Overweight (including obesity) at baseline or follow‐up was defined by criteria for overweight and obesity for Chinese school‐aged children and adolescents. High cIMT at follow‐up was defined as cIMT ≥ age‐ and sex‐specific 90th percentile based on the study population at follow‐up.

Results

Compared with children who were in persistent normal‐weight group, those in the incident or persistent overweight groups had higher cIMT change (incident overweight: β = 0.0149, p < 0.05; persistent overweight: β = 0.0068, p < 0.05) and had higher odds of high cIMT at follow‐up (incident overweight: odds ratio [OR] = 3.58, 95% confidence interval [CI] = 1.34–9.61; persistent overweight: OR = 13.41, 95% CI = 7.58–23.73). In contrast, there was no significant increase in cIMT change (β = 0.0106, p > 0.05) and odds of high cIMT (OR = 2.50, 95% CI = 0.69–9.01) in the resolution group.

Conclusion

Children who developed overweight or maintained overweight over 2 years had increased odds of high cIMT, whereas those able to resolve their overweight status had a similar odds of developing high cIMT in childhood at follow‐up. These findings highlight the potential role of managing weight status among children to preserve vascular health.
The Impact of COVID‐19 Lockdown on Design Students’ Performance Case Study in the UAE
Authors: Amro Dana Khalid
Published: September 2021

In China and the rest of the world, the COVID‐19 pandemic has been spreading since December 2019. This pandemic had negative effects on the public in general and on students’ performance. This study aimed to evaluate the perceived performance of design students participating in online distance learning due to the COVID‐19 pandemic lockdown in the UAE. The evaluation of the students’ negative emotions and their impact on creativity and design performance was conducted in two design courses. The case study included 193 design students, 140 first year and 53 fourth year students who are enrolled from the College of Fine Arts and Design. An online survey was used as a post‐evaluation tool for the students. Two focus group interviews were conducted for instructors who were involved in the sudden remote teaching. The findings showed the instructors’ deep understanding of the students’ emotions and how such emotions are reflected on performance during the pandemic. First year students had higher anxiety levels than fourth students, which negatively affected their design practice and learning performance for the lack of design experience. However, first years produced creative projects. Fourth years also had high anxiety levels, but they showed a higher level of satisfaction in their performance than first years. This study explored the impact, changes and challenges brought about by the pandemic experience and how instructors could benefit from it in future. Online classes changed the way design was taught and delivered. Blended learning is considered as a motivational and creative learning process.
Genomic differentiation with gene flow in a widespread Amazonian floodplain‐specialist bird species
Authors: Luna Leilton Willians , Ribas Camila Cherem , Aleixo Alexandre
Published: September 2021

Aim

Ecological, climatic and palaeogeographical processes drive biological diversification. However, the evolutionary outcomes of those mechanisms are complex and difficult to discriminate. Here, we test how alternative drivers affected connectivity along the Amazonian floodplains generating current patterns of population structure and diversity within the Striped Woodcreeper, a widespread bird species tied to forests seasonally flooded by Amazonian rivers.

Location

Amazonian floodplains.

Taxon

Xiphorhynchus obsoletus (Aves, Furnariidae).

Methods

We sequenced 2213 loci of ultraconserved elements (UCEs) and 20 exons to investigate patterns of genetic structure and connectivity across the Striped Woodcreeper distribution, using a set of spatially explicit methods. Population genetics statistics were calculated for each sampled drainage and within each identified cluster. We tested alternative evolutionary scenarios and estimated past and current demographic parameters implementing a simulation‐based framework.

Results

Three genetic clusters with high admixture proportions were identified. These clusters are distributed in the western, central and eastern parts of the Amazon Basin and are not correlated with different river water types representing ecological gradients along the floodplains. Instead, migration rates indicate two putative historical barriers along the main channel of the Amazonas‐Solimões River. Demographic model tests suggest a process of sequential differentiation, partitioned across the Amazon Basin, with stable population sizes and continuous gene flow.

Main conclusion

Our results support the hypothesis that late Quaternary changes in connectivity between the eastern and western Amazonian drainages were responsible for driving genetic differentiation in the Striped Woodcreeper. Genomic differentiation occurred in the presence of long‐term gene flow throughout the X. obsoletus distribution, suggesting some degree of continuous historical connectivity across Amazonian floodplains. Compared to previous studies, our results suggest that although connectivity among populations of Amazonian bird species specialized in floodplain habitats varies in response to the same abiotic mechanisms, species‐specific differences in habitat use may be a strong predictor of population divergence.
Chinese herbal medicine (“3 medicines and 3 formulations”) for COVID‐19: rapid systematic review and meta‐analysis
Authors: Wang Yangzihan , Greenhalgh Trisha , Wardle Jon ,   Oxford TCM Rapid Review Team
Published: September 2021

Background

To evaluate the evidence behind claims that Chinese Herbal Medicine, specifically “three medicines and three formulations” (3M3F, comprising Jinhua Qinggan, Lianhua Qingwen, Xuebijing, Qingfei Paidu, Huashi Baidu, and Xuanfei Baidu), is an effective treatment for COVID‐19.

Methods

We searched PubMed, MEDLINE and CNKI databases, preprint servers, clinical trial registries and supplementary sources for Chinese‐ or English‐language randomized trials or non‐randomized studies with comparator groups, which tested the constituents of 3M3F in the treatment of COVID‐19 up to September 2020. Primary outcome was change in disease severity. Secondary outcomes included various symptoms. Meta‐analysis (using generic inverse variance random effects model) was performed when there were two or more studies reporting on the same symptom.

Results

Of 607 articles identified, 13 primary studies (6 RCTs and 7 retrospective non‐randomized comparative studies) with 1467 participants met our final inclusion criteria. Studies were small and had significant methodological limitations, most notably potential bias in assessment of outcomes. No study convincingly demonstrated a statistically significant impact on change in disease severity. Eight studies reported sufficiently similar secondary outcomes to be included in a meta‐analysis. Some statistically significant impacts on symptoms, chest CT manifestations, laboratory variables and length of stay were demonstrated, but such findings were sparse and many remain unreplicated.

Conclusions

These findings neither support nor refute the claim that 3M3F alters the severity of COVID‐19 or alleviates symptoms. More rigorous studies are required to properly ascertain the potential role of Chinese Herbal Medicine in COVID‐19.
Hedging uncertainty with cryptocurrencies: Is bitcoin your best bet?
Authors: Koutmos Dimitrios , King Timothy , Zopounidis Constantin
Published: September 2021

Are cryptocurrencies useful minimum‐variance hedging instruments? This paper develops a two‐step analytical framework to explore this question across time. First, it estimates dynamic optimal weights, calibrated when investing between the aggregate market and a respective sampled cryptocurrency. This is performed separately for 11 major cryptocurrencies using the dynamic conditional correlation approach of Engle. Second, using a fractional regression approach, it uncovers linkages between optimal weights in cryptocurrencies and sources of economic uncertainty. Overall, this paper makes the following important findings. First, optimal weights in cryptocurrencies all rose rapidly during the COVID‐19 pandemic. In all, bitcoin showed to be the leading cryptocurrency in terms of hedging effectiveness during this recent time period. Second, most cryptocurrencies exhibit zero or negative betas consistently across time, thus making them natural hedging instruments for investors seeking to reduce their portfolio's comovement with the market. Finally, cryptocurrencies serve as better hedges for economic uncertainties arising from equity and commodity markets. They are relatively less effective for uncertainties arising from risks in the banking industry and firm default risk. This paper contributes broadly to the asset pricing literature since our two‐step approach herein can tractably be extended to other asset classes or other econometric measures of systematic risk.
The public’s mixed emotional responses to violence directed at nurses: A mixed methods study
Authors: Warshawski Sigalit , Amit Aharon Anat , Itzhaki Michal
Published: September 2021

Aims and objectives

To understand whether exposure to an incident of violence directed at nurses, evoke among the public a sense of identification with the victim or with the perpetrator.

Background

Worldwide, evidence regarding workplace violence (WPV) in healthcare systems, explored the characteristics of the perpetrator, the healthcare settings and staff. Nevertheless, no studies examine the emotions of the public towards WPV in the healthcare systems.

Design

A convergent mixed method parallel design.

Methods

A structured questionnaire was distributed among 925 adults. Two scenarios were presented, with verbal and physical violence towards nurses. The participants rated how intensely they felt positive and negative emotions regarding the nurse and the perpetrator (quantitative stage). Sixty participants were also interviewed concerning their emotions regarding violence committed towards nurses (qualitative stage). Paired samples t‐test were used to compare the emotions that were aroused regarding the perpetrator and the nurse. The effect size and Bonferroni correction for multiple comparisons were calculated. Constant comparative analysis method was used to analyzed the qualitative data. The STROBE checklist for cross‐sectional studies and the COREQ guidelines for qualitative studies were used for reporting.

Results

Positive emotions were significantly higher towards the nurse than the perpetrator. Nevertheless, there were both positive and negative emotions towards the perpetrator and the nurse. The qualitative findings yielded two themes: (1) Mixed emotions towards the perpetrator, and (2) Mixed emotions towards the nurse.

Conclusions

The public may emotionally identify with both the nurse and the perpetrator while positive and negative emotions are intertwined. Likewise, positive emotions are more intensely felt for the victims in both verbally and physically violent scenarios.

Relevance to clinical practice

These complemented findings highlight the need for campaigns promoting positive emotions toward healthcare professionals in an attempt to reduce and eliminate WPV in healthcare.
Diets containing processed barley grain as a potential rumen bypass starch source enhance productive responses of lactating Holstein dairy cows
Authors: Naseroleslami Reza , Danesh Mesgaran Mohsen , Tahmasbi Abdolmansour , Vakili Alireza , Danesh Mesgaran Sadjad
Published: September 2021

Effect of diets containing untreated or processed barley grain [treated with sugar beet pulp extract (SBPE) or double sulphate of aluminium and potassium (ALUM)] and different levels of rumen undegradable crude protein (RUP) on production, rumen fermentation and blood metabolites of lactating Holstein cows were investigated. Untreated soybean meal (SBM) or xylose protected ‘Yasminomax soy® (YAS)’ was included to represent a low (LR, 4.2% DM) and high (HR, 5.4% DM) RUP diets, respectively. Experimental diet was as follows: (a) untreated barley grains with high RUP (HRCON); (b) untreated barley grains with low RUP (LRCON); (c) ALUM‐treated barley grain with high RUP (HRAL; (d) ALUM‐treated barley grain with low RUP (LRAL); (e) SBPE‐treated barley grain with high RUP (HRSE); and (f) SBPE‐treated barley grain with low RUP (LRSE). The experiment was conducted as a completely randomized design with lactating dairy cows (n = 36) averaging 215 ± 18 days in milk, milk yield 31.7 ± 5.8 kg/day, 620 ± 61 kg body weight. Diets containing processed barley grain increased feed intake, while decreased both rumination and eating (p < 0.001). Feed intake of dairy cows on Low RUP and High RUP were 23 and 24 kg/day, respectively (p < 0.01). Daily production of milk fat, protein, lactose and total solids was improved when the processed barley grain was included in the diets (p < 0.05). Present study pinpointed that the inclusion of the processed barley grain in diets might improve production indices of dairy cows.
Dietary affinities, resource overlap and core structure in Atlantic Forest phyllostomid bat communities
Authors: Stevens Richard D.
Published: September 2021

The Phyllostomidae is arguably the most diverse family‐level clade of mammals. Associated with this high diversity is considerable heterogeneity in resource utilisation among species and across locales of the Neotropics. Despite heterogeneity, few attempts have been made to synthesise dietary patterns even for smaller regions within the Neotropics. Atlantic Forest is a large dynamic ecoregion in the southern Neotropics that is distinct from other Tropical forests because of its extensive latitudinal extent, elevated climatic heterogeneity, biodiversity and long history of anthropogenic modification.

I obtained data on dietary affinities of 34 species of bats from 35 different sites spanning the entire Atlantic Forest. In Atlantic Forest, as in other places in the Neotropics, phyllostomids consumed arthropods, vertebrates, fruits, nectar and blood. Frugivores consumed and dispersed the fruits of 99 different species of plants and nectarivores pollinated an additional nine others.

Dietary overlap was modest, yet significantly greater than expected based on a null model. The main axis of variation in diet separated species that primarily consumed animal material from those that primarily consumed plant material and this axis was significantly related to phylogenetic affinities of species.

Unlike in other places in the Neotropics, frugivorous bats did not exhibit a core structure related to genus‐to‐genus matching of bat genera with plant genera. Generality of diets of frugivorous bats, further indicated by non‐randomly high dietary overlap, is likely to degrade core structure in these primarily Subtropical communities. Co‐occurrence of a large number of generalist bat species, seasonal climates and ubiquitous anthropogenic modification may serve to promote generality of resource utilisation of bats in Atlantic Forest.

The Neotropics is vast and the bats that live within it are diverse. Future studies should explore spatial dynamics of dietary affinities and resource overlap to increase understanding of the context of strong and weak core structure of phyllostomid bat communities.
A case of cutis verticis gyrata‐mental retardation syndrome accompanied by various neurological abnormalities
Authors: Ogawa Katsuhiko , Akimoto Takayoshi , Hara Makoto , Fujishiro Midori , Nakajima Hideto
Published: September 2021

We report a 44‐year‐old male with cutis verticis gyrate (CVG)‐mental retardation syndrome. His backhead skin formed several folds, which were diagnosed as CVG. Neurological examinations revealed bilateral marked visual acuity loss, deaf‐mutism, mild mental retardation, bilateral Babinski's sign, severe spastic paraplegia, and cerebellar ataxia. Brain magnetic resonance imaging showed atrophy of the cerebellum and the corpus callosum. The fundus showed bilateral optic nerve atrophy. The clinical features had the primary non‐essential form in the CVG classification. Our patient was important because of the low frequency of this form in mental retardation.
Development and piloting of four decision aids for implantable cardioverter‐defibrillators in different media formats
Authors: Wallace Bryan C. , Jones Jacqueline , Masoudi Frederick A. , Nowels Carolyn T. , Varosy Paul , Thomson Richard , Elwyn Glyn , Brega Angela G. , Vermilye Travis , Knoepke Christopher E. , Sandhu Amneet , Allen Larry A. , Matlock Daniel D.
Published: September 2021

Background

Using DAs for preference‐sensitive decisions is an evidence‐based way to improve patient‐centered decisions. Reimbursement mandates have increased the need for DAs in ICD care, although none have been formally evaluated. The objectives were to develop and pilot implantable cardioverter‐defibrillator (ICD) decision aids (DAs) for patients considering primary prevention ICDs.

Methods

Development Phase: An expert panel, including patients and physicians, iteratively developed four DAs: a one‐page Option GridTM conversation aid, a four‐page in‐depth paper tool, a 17‐minute video, and an interactive website. Trial Phase: At three sites, patients with heart failure who were eligible for primary prevention ICDs were randomly assigned 2:1 to intervention (received DAs) or control (usual care). We conducted a mixed‐methods evaluation exploring acceptability and feasibility.

Results

Twenty‐one eligible patients enrolled (15 intervention). Most intervention participants found the DAs to be unbiased (67%), helpful (89%), and would recommend them to others (100%). The pilot was feasible at all sites; however, using clinic staff to identify eligible patients was more efficient than chart review. Although the main goals were to measure acceptability and feasibility, intervention participants trended towards increased concordance between longevity values and ICD decisions (71% concordant vs. 29%, p = .06). Participants preferred the in‐depth paper tool and video DAs. Access to a nurse during the decision‐making window encouraged questions and improved participant‐perceived confidence.

Conclusions

Participants felt the DAs provided helpful, balanced information that they would recommend to other patients. Further exploration of this larger context of DA use and strategies to promote independent use related to electrophysiology (EP) visits are needed.