bluuebunny/crossref_metadata_2025 huggingface dataset:
Dental care during COVID‐19 pandemic: Survey of experts’ opinion
Authors: Becker Kathrin , Brunello Giulia , Gurzawska‐Comis Katarzyna , Becker Jürgen , Sivolella Stefano , Schwarz Frank , Klinge Björn
Published: October 2020

Objectives

The current COVID‐19 outbreak in conjunction with the need to provide safe dental treatments and the limited knowledge on the efficacy of protective measures has posed dentists into a challenging situation. Therefore, the present article aimed at collecting experiences and recommendations of frontline clinical experts on critical aspects of dental treatment provision during pandemic.

Material & Methods

From a total of 32 European countries, one leading academic expert in Oral and Maxillofacial Surgery or Oral Surgery per country was asked to participate in an anonymous online 10‐item survey on COVID‐19 covering the topics of safety of dental settings, personal protective equipment (PPE), and patient‐related measures to reduce transmission risk. Data collection took place from April 12th to May 22nd, 2020.

Results

A total of 27 experts from different European countries completed the survey. The transmission risk of SARS‐CoV‐2 in dental settings for aerosol‐generating procedures was considered high by all experts except two. For aerosol‐free and aerosol‐generating procedures, more than 80% of the experts recommended face protection and caps for every single treatment. For aerosol‐generating procedures, additional measures (FFP2/FFP3 masks and gowns) were suggested by the vast majority of the experts. To reduce transmission risk, all experts recommended limiting aerosol‐generating procedures and reducing the number of patients in waiting areas as well as hand hygiene for the patients.

Conclusion

The limitation of aerosol‐generating procedures along with the usage of adequate personal protection equipment was considered to be crucial to protect dental healthcare providers and patients, thus reducing the transmission risk of COVID‐19.
Evaluation of diagnostic criteria and red flags of myelin oligodendrocyte glycoprotein encephalomyelitis in a clinical routine cohort
Authors: Veselaj Krenar , Kamber Nicole , Briner Myriam , Friedli Christoph , Diem Lara , Guse Kirsten , Miclea Andrei , Wiest Roland , Wagner Franca , Grabe Hilary , Abegg Mathias , Horn Michael P. , Bigi Sandra , Chan Andrew , Hoepner Robert , Salmen Anke
Published: October 2020

Aims

Myelin oligodendrocyte glycoprotein antibodies (MOG‐IgG) have been proposed to define “MOG encephalomyelitis” (MOG‐EM), with published diagnostic and “red flag” criteria. We aimed to evaluate these criteria in a routine clinical setting.

Methods

We retrospectively analyzed patients with borderline/positive MOG‐IgG and applied the diagnostic and red flag criteria to determine likelihood of MOG‐EM diagnosis. Para‐/clinical parameters were described and analyzed with chi‐square test.

Results

In total, 37 patients fulfilled MOG‐EM diagnostic criteria (female‐to‐male ratio: 1.6:1, median onset age: 28.0 years [IQR 18.5‐40.5], n = 8 with pediatric onset). In 24/37, red flags were present, predominantly MOG‐IgG at assay cutoff and/or MRI lesions suggestive of multiple sclerosis (MS). As proposed in the consensus criteria, these patients should rather be described as “possible” MOG‐EM. Of these, we classified 13 patients as “unlikely” MOG‐EM in the presence of the red flag “borderline MOG‐IgG” with negative MOG‐IgG retestorcoincidence of ≥1 additional red flag. This group mainly consisted of patients diagnosed with MS (n = 11). Frequency of cerebrospinal fluid (CSF‐)—specific oligoclonal bands (OCB) is significantly lower in definite vs possible and unlikely MOG‐EM (P = .0005).

Conclusion

Evaluation of diagnostic and red flag criteria, MOG‐IgG retesting (incl. change of assay), and CSF‐specific OCB are relevant in clinical routine cohorts to differentiate MOG‐EM from MS.
Large carnivore hunting and the social license to hunt
Authors: Darimont Chris T. , Hall Hannah , Eckert Lauren , Mihalik Ilona , Artelle Kyle , Treves Adrian , Paquet Paul C.
Published: October 2020

The social license to operate framework considers how society grants or withholds informal permission for resource extractors to exploit publicly owned resources. We developed a modified model, which we refer to as the social license to hunt (SLH). In it we similarly consider hunters as operators, given that wildlife are legally considered public resources in North America and Europe. We applied the SLH model to examine the controversial hunting of large carnivores, which are frequently killed for trophies. Killing for trophies is widespread, but undertaken by a minority of hunters, and can pose threats to the SLH for trophy‐seeking carnivore hunters and potentially beyond. Societal opposition to large carnivore hunting relates not only to conservation concerns but also to misalignment between killing for trophies and dominant public values and attitudes concerning the treatment of animals. We summarized cases related to the killing of grizzly bears (Ursus arctos), wolves (Canis lupus), and other large carnivores in Canada, the United States, and Europe to illustrate how opposition to large carnivore hunting, now expressed primarily on social media, can exert rapid and significant pressure on policy makers and politicians. Evidence of the potential for transformative change to wildlife management and conservation includes proposed and realized changes to legislation, business practice, and wildlife policy, including the banning of some large carnivore hunts. Given that policy is ultimately shaped by societal values and attitudes, research gaps include developing increased insight into public support of various hunting policies beyond that derived from monitoring of social media and public polling. Informed by increased evidence, the SLH model can provide a conceptual foundation for predicting the likelihood of transient versus enduring changes to wildlife conservation policy and practice for a wide variety of taxa and contexts.
The robotic colorectal experience: an outcomes and learning curve analysis of 502 patients
Authors: Parascandola Salvatore A. , Horsey Michael L. , Hota Salini , Paull Jessie Osborne , Graham Ada , Pudalov Natalie , Smith Savannah , Amdur Richard , Obias Vincent
Published: October 2020

Aim

This study aimed to present our experience with robotic colorectal surgery since its establishment at our institution in 2009. By examining the outcomes of over 500 patients, our experience provides a basis for assessing the introduction of a robotic platform in a colorectal practice. Specific measures investigated include intraoperative data and postoperative outcomes for all operations using the robotic platform. In addition, for our most commonly performed operations we wished to analyse the learning curve to improve operative proficiency. This is the largest single‐surgeon robotic database analysed to date.

Method

A prospectively maintained database of patients who underwent robotic colorectal surgery by a single surgeon at the George Washington University Hospital was retrospectively reviewed. Demographic data and perioperative outcomes were assessed. Additionally, an operating time learning curve analysis was performed.

Results

Inclusion criteria identified 502 patients who underwent robotic colorectal surgery between October 2009 and December 2018. The most common indications for surgery were diverticulitis (22.9%), colon adenocarcinoma (22.1%) and rectal adenocarcinoma (19.5%). The most common operations were anterior/low anterior resection (33.9%), right hemicolectomy/ileocaecectomy (24.9%) and left hemicolectomy/sigmoidectomy (21.9%). The rate of conversion to open surgery was 4.8%. The most common postoperative complications were wound infection (5.0%), anastomotic leakage (4.0%) and abscess formation (2.8%). The operating time learning curve plateaued at 55–65 cases for anterior and low anterior resection and 35–45 cases for left hemicolectomy and sigmoidectomy. A clear learning curve was not seen in right hemicolectomy.

Conclusion

Robotic‐assisted surgery can be performed in a diverse colorectal practice with low rates of conversion and postoperative complications. Plateau performance was achieved after 65 anterior/low anterior resections and 45 left and sigmoid colectomies.
Programmed cell death pathways in hearing loss: A review of apoptosis, autophagy and programmed necrosis
Authors: Wu Junhao , Ye Jing , Kong Weili , Zhang Shouyue , Zheng Yun
Published: October 2020

Programmed cell death (PCD)—apoptosis, autophagy and programmed necrosis—is any pathological form of cell death mediated by intracellular processes. Ototoxic drugs, ageing and noise exposure are some common pathogenic factors of sensorineural hearing loss (SNHL) that can induce the programmed death of auditory hair cells through different pathways, and eventually lead to the loss of hair cells. Furthermore, several mutations in apoptotic genes including DFNA5, DFNA51 and DFNB74 have been suggested to be responsible for the new functional classes of monogenic hearing loss (HL). Therefore, in this review, we elucidate the role of these three forms of PCD in different types of HL and discuss their guiding significance for HL treatment. We believe that further studies of PCD pathways are necessary to understand the pathogenesis of HL and guide scientists and clinicians to identify new drug targets for HL treatment.
Staring at the Sun: Tragedy, trauma, and ecological harmony
Authors: Gray Tyson‐Lord
Published: October 2020

Recently it has become increasingly evident that current theories of civilization are unsustainable. Within this essay I critique three alternative theories: bioregionalism, sustainable development, and The Universe Story. I argue that although these theories address ecological devastation, they fail to grapple with the legacy of white supremacy. Evoking Richard Wright's poem Between the World and Me, I argue that for minorities the landscape is often inscribed with trauma. Consequently, any theory of ecological harmony must take this into account. I refer to the task of contending with the legacy of slavery, colonization, and genocide as Staring at the Sun.
Impacts of the COVID‐19 pandemic on youth mental health among youth with physical health challenges
Authors: Hawke Lisa D. , Monga Suneeta , Korczak Daphne , Hayes Em , Relihan Jacqueline , Darnay Karleigh , Cleverley Kristin , Lunsky Yona , Szatmari Peter , Henderson Joanna
Published: October 2020

Aim

To examine mental health in conjunction with physical health during the COVID‐19 pandemic among youth with physical health conditions compared to those without.

Methods

A cross‐sectional survey of 622 youth aged 14 to 28 was conducted. Analyses were conducted to understand the changes in mental and physical health among youth in four groups: (a) participants with a friend or family member diagnosed with COVID‐19, (b) participants with symptoms associated with COVID‐19, (c) participants with atopic conditions (asthma and allergies), and (d) participants with other preexisting physical health conditions.

Results

Many participants with physical health concerns met screening criteria for an internalizing disorder, which was significantly higher than the rate found among participants without physical health conditions. Significantly greater declines in self‐reported mental health were observed during the COVID‐19 period compared to 3 months earlier among youth reporting physical health concerns compared to those without physical health concerns. Substance use does not appear to have been affected.

Conclusions

Mental health concerns are highly prevalent among youth with physical health concerns, and also appear to be exacerbated by the COVID‐19 pandemic. Physical health concerns appear to constitute risk factors for heightened mental health responses to the pandemic situation. System planners striving to adapt mental health services to meet social/physical distancing recommendations are urged to consider youth with physical health conditions and ensure that adequate integrated mental health and physical health supports are available to them.
Dirk Hartog Island ‘Return to 1616’ Project – The first six years (2014 to 2019)
Authors: Algar Dave , Morris Keith , Asher John , Cowen Saul
Published: October 2020

Early European land use of Dirk Hartog Island left a legacy of cats, sheep and goats that led to the local extinction of 10 of the Dirk Hartog Island’s 13 mammal species. A successful programme of eradication of these introduced species has resulted in improved habitat quality and is allowing the translocation of the island’s locally extinct native mammals. The island could potentially support one of the most diverse small‐medium‐sized terrestrial mammal assemblages in Australia and contribute significantly to their long‐term conservation.
THINKING THE DEATH DRIVE BEYOND DEATH IN DER FLIEGENDE HOLLÄNDER*
Authors: Lebiez Judith
Published: October 2020

This article argues that Richard Wagner's opera Der fliegende Holländer, which may seem representative of the death drive, is essentially concerned with birth. As Slavoj Žižek has suggested, the opera bears striking parallels to Freud's Jenseits des Lustprinzips (1920). Yet deeper insights on the opera can be reached in light of the theory developed by dissident psychoanalyst Otto Rank in Das Trauma der Geburt (1924). An analysis of the images used by Wagner in his libretto reveals an ambivalent relation to the maternal, with fantasies focusing on the close union between mother and child, the birth process that tears the child away from the mother, and the child's desire to return to the womb.
MOBILISING DISGUST AND COMPASSION: ELPIS MELENA'S GEMMA; ODER, TUGEND UND LASTER (1877) AND THE ANTI‐VIVISECTION MOVEMENT
Authors: Yanacek Holly A.
Published: October 2020

In the nineteenth century, keeping pets became increasingly common, and the relationships between humans and their companion animals became more moralised and affectively charged. These affective bonds between people and their pets paved the way for animal advocacy and the transnational anti‐vivisection movement. Gemma; oder, Tugend und Laster (1877), written by Anglo‐German author Marie Espérance von Schwartz (1818–99) under the pseudonym Elpis Melena, was one of the publications that launched the anti‐vivisection movement in Germany. This sentimental novel provides a model for late nineteenth‐century animal activism through the depiction of the title heroine, a young woman who is devoted to her pets and is determined to end vivisection in England. Published five years after Charles Darwin's The Expression of the Emotions in Man and Animals (1872), Gemma acknowledges strong relationships between humans and non‐human animals on the basis of common feelings and suffering. My analysis demonstrates how Gemma attempts to inspire compassion for animals by redirecting readers’ initial disgust at images and descriptions of vivisected animals to the vivisectors themselves. Yet at the centre of the novel's narrative structure are anthropocentric concerns, as if to acknowledge that feeling compassion towards non‐human animals – although it was gaining greater currency at the time – was still contested.
A Phillips curve for the euro area
Authors: Ball Laurence , Mazumder Sandeep
Published: October 2020

This paper asks whether a textbook Phillips curve can explain the behavior of core inflation in the euro area. A critical feature of the analysis is that we measure core inflation with the weighted median of industry inflation rates, which is less volatile than the common measure of inflation excluding food and energy prices. We find that fluctuations in core inflation since the creation of the euro are well explained by three factors: expected inflation (as measured by surveys of forecasters); the output gap (as measured by the Organisation for Economic Co‐operation and Development); and the pass‐through of movements in headline inflation. Our specification resolves the puzzle of a “missing disinflation” after the Great Recession, and it diminishes the puzzle of a “missing inflation” during the recent economic recovery.
Consumers living with psychosis: Perspectives on sexuality
Authors: Evans Alicia M. , Quinn Chris , McKenna Brian , Willis Karen
Published: October 2020

Mental health clinicians work within a recovery framework that is rights based and emphasizes positive and respectful approaches to working with mental health consumers. Mental health nurses’ practice is also predicated on holism and inclusiveness, yet consumers’ sexuality is sometimes neglected and rights in this area overlooked. Also overlooked is sexuality as an area for investigation, particularly from a consumer perspective, even though it constitutes part of consumers’ broader remit of sexual health. This paper reports findings from a case study where consumers were asked about their ability to negotiate and sustain sexual expression while residing in a long‐stay mental health rehabilitation facility. There were three main findings. First, the physical space of the facility, inclusive of consumers’ bedrooms, was policed by mental health clinicians with ongoing intrusions into consumers’ privacy, which inhibited their sexual expression. The creation of barriers to sexual expression is counter to polices that promote recovery. Second, consumers reported significant medication‐related weight gain which negatively affected their self‐image and sexual sense of self. Third, the consumers spoke about their sexuality in ordinary, everyday language devoid of any hallmark of psychosis. This highlights the importance of relating to consumers about their sexuality and sexual needs from a humane rather than technical framework. Further, it foregrounds the relational aspect of the mental health nurses’ role rather than the technical aspect. Yet sexuality is a topic that is often neglected, indicating that an upskilling of the mental health nursing workforce is required, to strengthen communication and relationship skills.
Amphibians in zoos: a global approach on distribution patterns of threatened amphibians in zoological collections
Authors: Jacken A. , Rödder D. , Ziegler T.
Published: October 2020

In 2008, the European Association of Zoos and Aquaria and Amphibian Ark proclaimed the ‘Year of the Frog’. In the present study, based on analyses conducted in April and May 2017, the selection of amphibian species in zoos was investigated almost 10 years after that campaign. Given the huge diversity of amphibians, their representation in zoological collections was still poor, with only around 7% (540 species) of all extant amphibian species kept in zoos (76% anurans, 22% caudates and 2% caecilians). Only 10·4% of the amphibians in zoos were kept in sufficient numbers in different collections, while a further 10·1% were represented by a single specimen. Only 4·3% of the amphibian species that were recommended by the Amphibian Ark for ex situ conservation were kept in zoos. Moreover, 44·3% of the globally threatened amphibians in zoos were each held by a single zoo only. With some exceptions, reproduction success of amphibians in zoos was low and reported for only 10% of amphibian species in two or more institutions within one year. In the present study, a richness analysis provided further insights into the focus areas of amphibians in zoological collections. Large numbers of zoos in North America and Europe maintained amphibian collections of global importance, although the distribution of these institutions did not match the natural distribution of target species that were most urgently in need of ex situ rescue. Investing in conservation‐breeding programmes and cooperation with local partners will help to increase the number of threatened amphibian taxa in zoos. Although the global zoo community’s response to the amphibian decline is slow, it still holds the capability to procure a shift from common to threatened taxa. By providing their expertise and facilities for the keeping and (conservation) breeding of threatened amphibian taxa, zoos can play a key role in amphibian conservation in terms of the ‘One Plan approach’.
Biogenic silver/silver chloride nanoparticles inhibit human glioblastoma stem cells growth in vitro and Ehrlich ascites carcinoma cell growth in vivo
Authors: Kabir Syed Rashel , Dai Zhi , Nurujjaman M. , Cui Xiaoyue , Asaduzzaman A. K. M. , Sun Bin , Zhang Xianning , Dai Hongjuan , Zhao Xudong
Published: October 2020

The importance of biogenic silver/silver chloride nanoparticles has become increasing day by day. In the present study, silver/silver chloride nanoparticles (Ag/AgCl‐NPs) were synthesized from Kaempferia rotunda tuberous rhizome extract to evaluate the antiproliferative activity against human glioblastoma stem cells (GSCs) in vitro and Ehrlich ascites carcinoma (EAC) cells in vivo in mice. Synthesis of nanoparticles was confirmed by colour change and UV‐visible spectrum and characterized by TEM, XRD, TGA, AFM and FTIR. K rotunda and recently synthesized Zizyphus mauritiana fruit extract‐mediated Ag/AgCl‐NPs inhibited 77.2% and 71% of GSCs growth at 32 µg/mL concentration with the IC50 values of 6.8 and 10.4 µg/mL, respectively. Cell morphological studies and caspase‐3 immunofluorescence assay revealed that both biogenic nanoparticles induced apoptosis in GSCs. Expression levels of several genes were checked by real‐time PCR after treatment with K rotunda tuberous rhizome‐mediated Ag/AgCl‐NPs. PARP, EGFR, NOTCH2 and STAT3 gene expression were decreased with the increase of NFκB, TLR9, IL1, TNFα, IKK and p21 gene that would be the cause of induction of apoptosis in GSCs. The cell cycle arrest at G2/M phase was confirmed by flow cytometric assay. Both nanoparticles were injected intraperitoneally to rapidly growing EAC cells for 5 consecutive days. Approximately, 32.3% and 55% EAC cells growth were inhibited by K rotunda tuberous rhizome‐mediated Ag/AgCl‐NPs at 6 and 12 mg/kg/day doses, respectively while only 20% cell growth inhibition was monitored at 12 mg/kg/day dose of Z mauritiana‐mediated Ag/AgCl‐NPs. From the above results, it can be concluded that presently synthesized nanoparticles would be a potent anticancer agent.
Identification of HN252 as a potent inhibitor of protein phosphatase PPM1B
Authors: Lu Zhiyuan , Xiao Peng , Zhou Yuan , Li Zhenyu , Yu Xiao , Sun Jinpeng , Shen Yuemao , Zhao Baobing
Published: October 2020

Protein phosphatase 1B (PPM1B), a member of metal‐dependent protein serine/threonine phosphatase family, is involved in the regulation of several signalling pathways. However, our understanding of its substrate interaction and physiological functions is still largely limited. There is no reported PPM1B inhibitor to date. In this study, we identified HN252, a p‐terphenyl derivative, as a potent PPM1B inhibitor (Ki = 0.52 ± 0.06 µM). HN252 binding to PPM1B displayed remarkable and specific inhibition of PPM1B in both in vitro and ex vivo. With the aid of this small molecular inhibitor, we identified 30 proteins’ serine/threonine phosphorylation as potential substrates of PPM1B, 5 of which were demonstrated by immunoprecipitation, including one known (CDK2) and 4 novel ones (AKT1, HSP90B, β‐catenin and BRCA1). Furthermore, GO and KEGG analysis of dramatically phosphorylated proteins by PPM1B inhibition indicated that PPM1B plays roles in the regulation of multiple cellular processes and signalling pathways, such as gene transcription, inflammatory regulation, ageing and tumorigenesis. Our work provides novel insights into further investigation of molecular mechanisms of PPM1B.
Volumetric soft tissue alterations in the early healing phase after peri‐ implant soft tissue contour augmentation with a porcine collagen matrix versus the autologous connective tissue graft: A controlled clinical trial
Authors: Schmitt Christian M. , Brückbauer Patrick , Schlegel Karl A. , Buchbender Mayte , Adler Werner , Matta Ragai E
Published: October 2020

Aim

This study evaluates the early volumetric changes after buccal soft tissue contour augmentation around implants with a porcine collagen matrix (CM) vs. the subepithelial connective tissue graft (SCTG) from the palate.

Materials and methods

14 patients were enrolled after early implant placement with simultaneous contour augmentation and persistent buccal tissue deficits. At implant exposure, buccal soft tissues were thickened with the CM (n = 7) or the SCTG (n = 7). Impressions were taken before and after surgery, after ten days, one, three and six months. Impressions were digitized and augmented regions 3D evaluated (soft tissue volume (mm3, %)/thickness (mm)).

Results

Volume increase (mm3) after 6 months was 19.56 ± 8.95 mm3 (CM) and 61.75 ± 52.69 mm3 (SCTG) (insignificant, p = .058). In percentage, this was a volume loss of the initially augmented soft tissue volume (100%) of 81.76% in the CM group and 56.39% in the SCTG group (6 months). The mean soft tissue thickness increase (mm) in the buccal contour after 6 months was 0.30 ± 0.16 mm (CM) and 0.80 ± 0.61 mm (SCTG) (insignificant, p = .071).

Conclusion

The early healing phase is associated with a significant volume loss of the soft tissues. The SCTG shows insignificant superiority compared to the CM.
No relationship between prenatal or early postnatal androgen exposure and autistic traits: evidence using anogenital distance and penile length measurements at birth and 3 months of age
Authors: Kung Karson T.F. , Thankamony Ajay , Ong Ken K.L. , Acerini Carlo L. , Dunger David B. , Hughes Ieuan A. , Hines Melissa
Published: October 2020

Background

Autism is more prevalent in males than in females. Hypotheses related to the extreme male brain theory of autism suggest that heightened androgen exposure during early development contributes to autistic traits. Whilst prior research focused mostly on the prenatal period, the current study tests the influences of androgen exposure during both the prenatal and the early postnatal periods on autistic traits during childhood.

Methods

Anthropometric measures that are putative biomarkers of early androgen exposure were employed. Anogenital distance (AGD) was measured at birth and 3 months of age in boys and girls. Penile length at birth and 3 months of age was also measured in boys. When the children were 9–13 years old, a parent‐reported questionnaire (the 10‐item children’s version of the Autism Spectrum Quotient; AQ‐10 Child) was used to assess autistic traits in 97 boys and 110 girls.

Results

There were no significant associations between any of the AGD or penile length measures and scores on the AQ‐10 Child in boys, girls or the entire sample.

Conclusions

The current study provides the first test of whether early measurements of AGD and/or penile length predict subsequent autistic traits. The current findings do not support a relationship between prenatal or early postnatal androgen exposure and autistic traits. The current study augments prior research showing no consistent relationship between early androgen exposure and autistic traits.
Unlicensed and off‐label prescription of drugs to children in primary health care: A systematic review
Authors: Andrade Sara Raquel Almeida , Santos Priscila Abigail Nascimento de Moraes , Andrade Paulo Henrique Santos , da Silva Wellington Barros
Published: October 2020

Objective

To evaluate unlicensed and off‐label prescription and use of drugs to children in primary health care.

Methods

This is a systematic review that was written based on Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA). The studies were extracted from the databases: LILACS, PubMed/MEDLINE, and Scopus. Studies in English, Spanish or Portuguese with abstract available regarding the use and prescription of off‐label and unlicensed drugs to children aged 0‐18 years in primary health care were included. The evaluation of the titles, abstracts and Full‐text were performed independently by two reviewers, and the divergences were resolved by a third reviewer.

Results

Six studies were included. The incidence of off‐label prescription varied from 29.5% to 51.7% in relation to the total number of drugs prescribed. The prevalence of off‐label drugs ranged from 31.7% to 93.5% in relation to the total number of drugs prescribed. It was observed a higher proportion of off‐label prescription related to age and dose. For unlicensed drugs, there was a small variation in incidence between 2.4% and 3.9%, relative to the total number of prescriptions, or between 2.4% and 10.0%, relative to the sample size. It was observed a higher proportion of unlicensed prescription related to children under 2 years of age.

Conclusions

The unlicensed and off‐label prescription of drugs is recurring in the pediatric population of primary health care. It is necessary to have better information on these drugs by the regulatory agencies and the pharmaceutical industries for rational use of drugs in children.
Bone Mineral Density in Older U.S. Filipino, Chinese, Japanese, and White Women
Authors: Lo Joan C. , Chandra Malini , Lee Catherine , Darbinian Jeanne A. , Ramaswamy Mohan , Ettinger Bruce
Published: October 2020

BACKGROUND/OBJECTIVES

Bone mineral density (BMD) reference data exist for U.S. White, Black, and Hispanic (Mexican American) populations but not for U.S. Asians. Few studies have compared BMD findings among different U.S. Asian ethnicities.

DESIGN

Retrospective observational study.

SETTING

Large northern California healthcare system.

PARTICIPANTS

Asian and White women aged 50 to 79 years with BMD testing from 1998 to 2017 excluding those with estrogen or osteoporosis treatment, recent fracture, or select disorders affecting skeletal health.

MEASUREMENTS

Femoral neck (FN)‐BMD and height data.

METHODS

Differences in FN‐BMD were examined by ethnicity and age, comparing Filipino, Chinese, and Japanese women and non‐Hispanic White women. Differences in BMD were also examined after adjustment for height.

RESULTS

There were 37,224 Asian women (including 11,147 Filipino, 10,648 Chinese, and 2,519 Japanese) and 115,318 non‐Hispanic White women. Mean height was similar among the Asian subgroups and about 6 to 8 cm lower than Whites. Mean FN‐BMDs differed by less than 3% for Filipino, Chinese, and Japanese and all were lower than Whites, with smaller Asian‐White differences among younger women (<3%; ages 50–59) and larger differences among older women (6–8%; ages 65–79). Adjusting FN‐BMD for height reduced White‐Asian differences by about 30% to 40%.

CONCLUSION

Mean FN‐BMD and height for Filipino, Chinese, and Japanese women were similar but consistently lower than White women, especially among older women. Although Asian‐White BMD differences were substantially attenuated after height adjustment; some differences persisted for older women. Future studies should investigate potential age‐cohort effects and the extent to which these BMD differences influence fracture risk and clinical care.
Influence of Physician Sex and Gender on Prescribing Practices Among Older Adults
Authors: Mishra Anamika , Read Stephanie H. , Rochon Paula A.
Published: October 2020

Although prescribing is the most common intervention provided by physicians, limited research has examined the role of physician sex and gender on prescribing practices. In this article, we briefly summarize research relating to differences in prescribing behaviors based on physician sex and gender. To identify articles, PubMed was searched for studies from the last 20 years reporting on prescribing differences by physician sex or gender for the general population and specifically for older adults. We describe major themes emerging from the studies, illustrate findings from key studies, and note the major gaps in the literature, notably the lack of evidence on prescribing for older adults. Given the paucity of research in this area, we also explore evidence on the impact of physician sex and gender on other aspects of healthcare delivery, such as communication within the patient‐physician relationship, and consider how these findings may also apply to prescribing behaviors. In general, we note that female physicians have been observed to engage in more careful and conservative healthcare provision including prescribing. A careful and conservative approach to prescribing may reduce the incidence of adverse drug events in older adults and be linked to a more patient‐centered approach to care. To what extent these differences in prescribing are important for patient health outcomes is unknown, and further research is required to identify optimal prescribing practices that minimize harms.
The Cost of a Fall Among Older Adults Requiring Emergency Services
Authors: Newgard Craig D. , Lin Amber , Caughey Aaron B. , Eckstrom Elizabeth , Bulger Eileen M. , Staudenmayer Kristan , Maughan Brandon , Malveau Susan , Griffiths Denise , McConnell K. John
Published: October 2020

BACKGROUND/OBJECTIVE

The cost of a fall among older adults requiring emergency services is unclear, especially beyond the acute care period. We evaluated medical expenditures (costs) to 1 year among community‐dwelling older adults who fell and required ambulance transport, including acute versus post‐acute periods, the primary drivers of cost, and comparison to baseline expenditures.

DESIGN

Retrospective cohort analysis.

SETTING

Forty‐four emergency medical services agencies transporting to 51 emergency department in seven northwest counties from January 1, 2011, to December 31, 2011, with follow‐up through December 31, 2012.

PARTICIPANTS

We included 2,494 community‐dwelling adults, 65 years and older, transported by ambulance after a fall with continuous fee‐for‐service Medicare coverage.

MEASUREMENTS

The primary outcome was total Medicare expenditures to 1 year (2019 U.S. dollars), with separation by acute versus post‐acute periods and by cost category. We included 48 variables in a standardized risk‐adjustment model to generate adjusted cost estimates.

RESULTS

The median age was 83 years, with 74% female, and 41.9% requiring admission during the index visit. The median total cost of a fall to 1 year was $26,143 (interquartile range (IQR) = $9,634–$68,086), including acute care median $1,957 (IQR = $1,298–$12,924) and post‐acute median $20,560 (IQR = $5,673–$58,074). Baseline costs for the previous year were median $8,642 (IQR = $479–$10,948). Costs increased across all categories except outpatient, with the largest increase for inpatient costs (baseline median $0 vs postfall median $9,477). In multivariable analysis, the following were associated with higher costs: high baseline costs, older age, comorbidities, extremity fractures (lower extremity, pelvis, and humerus), noninjury diagnoses, and surgical interventions. Compared with baseline, costs increased for 74.6% of patients, with a median increase of $12,682 (IQR = −$185 to $51,189).

CONCLUSION

Older adults who fall and require emergency services have increased healthcare expenditures compared with baseline, particularly during the post‐acute period. Comorbidities, noninjury medical conditions, fracture type, and surgical interventions were independently associated with increased costs.
Demonstration of the dangerous nature of ‘homemade’ sunscreen recipes
Authors: Couteau Céline , Dupont Coraline , Paparis Eva , Coiffard Laurence J. M.
Published: October 2020

Background

Following a growing mistrust in a certain number of ingredients used by the cosmetic industry, it has become popular in recent years for consumers to make their own products at home. This trend now touches on all areas of the industry, but is especially found in the hygiene sector, with shampoos and toothpaste, and the care sector, with moisturizers and sunscreen, products.

Objectives

The objective of this study is to analyze sunscreen recipes found on the Internet and to assess their level of photoprotective efficacy.

Materials and Methods

Fifteen Internet recipes were chosen, and then, the products were made in the laboratory following the protocols described. Using an in vitro method, the following efficacy indicators were determined for the preparations made: the Sun Protection Factor (SPF), the Production Factor in the UVA domain (PF‐UVA), and the critical wavelength (λc).

Results

Three of the 15 recipes studied do not contain any sunscreen and therefore constitute a major risk for users in case of exposure to the sun. The other 12 cannot be considered as sun protection products since all of them have an SPF under 6, the threshold value required in Europe.

Conclusion

The recipes that we collected on the Internet are very dangerous since some of them have no photoprotective effect whatsoever and most of them do not ensure a sufficient level of photoprotection for the persons using them.
Sexuality in people living with a serious mental illness: A meta‐synthesis of qualitative evidence
Authors: Hortal‐Mas Roger , Moreno‐Poyato Antonio Rafael , Granel‐Giménez Nina , Roviralta‐Vilella Maria , Watson‐Badia Carolina , Gómez‐Ibáñez Rebeca , Aguayo‐González Mariela Patricia , Giménez‐Díez David , Bernabeu‐Tamayo Maria Dolores , Leyva‐Moral Juan Manuel
Published: October 2020

Accessible summary

What is known on the subject

A serious mental illness influences sexual life and people affected have worries about their sexual health.

People living with a serious mental illness can and want to participate in interventions related to sexual health.

What the paper adds to existing knowledge

People who suffer a serious mental illness are interested in maintaining an active sex life.

People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health.

What are the implications for practice

Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends.

Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality.

Introduction

Sexuality‐related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality.

Aim

To explain how people with a serious mental illness perceive and experience their sexuality.

Method

A meta‐synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically.

Results

Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore,” which describes feelings emerging from the perceived limitations and the role of self‐acceptance; “Learning to manage intimate relationships,” which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality.

Discussion

Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma.

Implications for practice

Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.
Effects of particle size and moisture content of maize grits on physical properties of expanded snacks
Authors: Sharifi Sohrab , Majzoobi Mahsa , Farahnaky Asgar
Published: October 2020

The main aim of this research was to investigate the effects of simultaneous changing of maize grits particle size and moisture content on some physical properties and microstructure of the expanded snacks produced by an industrial single screw extruder. Maize grits with different particle sizes of 212–299, 300–474, 475–680, 681–870, 871–1,016, and 1,017–1,070 μm and various moisture contents of 15, 16, 17, and 18% were used to manufacture puffed products. The samples produced with larger particle sizes and higher moisture content exhibited lower water absorption and water solubility indices and less expansion and crispiness than other samples. As microstructure results revealed, these samples showed more uneven surface and thicker cross‐section. Overall, controlling both moisture content and particle size of maize grits had significant effects on the quality of the snacks. However, the impact of changing particle size on the snack properties was greater than changing the moisture content. This research has implications in food industry in production of puffed snacks using extrusion process. The results provide practical and green methods of improving the quality of the snacks by choosing the appropriate feed particle size and moisture content. The approach introduced in this paper is easy to impediment in the food industry without the need to change extruder configuration or adding to the list of ingredients and additives.
Meeboldia linearis sp. nov. (Apiaceae) from Xizang, China
Authors: Guo Xian‐Lin , Gou Wei , Xie Fu‐Min , Zhou Song‐Dong , He Xing‐Jin
Published: October 2020

Meeboldia linearis X. L. Guo, W. Gou&X. J. He (Apiaceae), a new species from Xizang, China, is described and illustrated. The new species resembles M. achilleifolia and M. yunnanensis by having taproot epidermis with annular scars, slender umbels, white petals with inflexed apex, lanceolate calyx teeth and ovoid mericarps with several vittae in each furrow (2–3) and commissure (4). However, M. linearis develops linear ultimate segments of the leaves, flaky remnant leaf sheaths, few rays (3–5) and narrowly ovoid mericarps with filiform ribs distinctively differing from those of M. achilleifolia and M. yunnanensis. In addition, a molecular phylogenetic analysis based on ITS sequences showed that M. linearis is sister to M. yunnanensis and all three Meeboldia species formed a well‐supported monophyletic group in the Acronema clade.
Long‐term changes in the phytobenthos of the southern Åland Islands, northern Baltic Sea
Authors: Eveleens Maarse Floriaan , Salovius‐Laurén Sonja , Snickars Martin
Published: October 2020

Marine macrophytes and ‐algae have undergone major changes in abundance and species composition over the last decades, primarily due to eutrophication. However, comparable studies conducted in the mid 20th century are rare, but potentially valuable for enabling insight into changes in the benthic communities from the early onset of the eutrophication of the Baltic Sea. In the present study, the submerged phytobenthic community in the exposed southern archipelago of the Åland Islands was examined in 2018 and compared with surveys conducted in 1956 and 1993, respectively. The aim was to analyze long‐term changes in the phytobenthic community in relation to the general large‐scale anthropogenic drivers since the 1950s. Between 1956 and 1993, a decrease in the total number of species/taxa, an increase of filamentous algae coverage and a decrease in the depth range of Fucus vesiculosus was observed. These changes in the phytobenthic community continued between 1993 and 2018, suggesting no changes in the previously described negative trends. Between 1956 and 2018, a general shift in the distribution of phytobenthic functional groups, (grouped according to morphology and type of algae; green, brown and red) occurred, with increased coverage of filamentous brown and green algae, and decline in red algae coverage. The depth range of F. vesiculosus also decreased by >50% between 1956 and 2018. The results support findings that the eutrophication of the northern Baltic Sea is still at a high level, which slows down or prevents the recovery of offshore phytobenthic communities, despite the progress seen in other areas. Thus, the likely main drivers behind the changes are the direct and indirect effects of eutrophication in combination with warmer water, i.e. an effect of climate change.
Fast pathway ablation unmasks nodoventricular fibers in a 15‐year‐old patient with supraventricular tachycardia
Authors: Izumi Gaku , Yokoshiki Hisashi , Sasaki Ryo , Chiba Yuki , Yamazawa Hirokuni , Takeda Atsuhito
Published: October 2020

We described a 15‐year‐old boy who underwent the catheter ablation for the nodoventricular (NV) tachycardia that had difficulty in differentiation from atrioventricular nodal reentrant tachycardia with upper common pathway. The modification of the fast pathway revealed an anterograde conduction of the NV fiber. We successfully performed the catheter ablation targeting for the right ventricular insertion site of the NV fiber.
How to implement policy: Coping with ambiguity and uncertainty
Authors: Fowler Luke
Published: October 2020

The author examines policy implementation as an exercise in coping with ambiguity (i.e., different ways of thinking about the same issues) on the one hand and uncertainty (i.e., lack of information) on the other. Functions are how implementers figure out the best way to make a policy work in practice and processes are how organizations formalize mechanisms that make behaviours more predictable. Using programme evaluation data from the US Environmental Protection Agency (EPA) and a mixed methods approach, findings identify specific implementation activities associated with both functions and processes and, while intertwined, these represent two distinct aspects of operationalizing policies. Conclusions suggest guidance on how to cope with ambiguity and uncertainty in practice, and connect functional and policy capacities to key avenues of public policy and administration scholarship.
CRISPR/Cas‐based precision genome editing via microhomology‐mediated end joining
Authors: Van Vu Tien , Thi Hai Doan Duong , Kim Jihae , Sung Yeon Woo , Thi Tran Mil , Song Young Jong , Das Swati , Kim Jae‐Yean
Published: October 2020

Gene editing and/or allele introgression with absolute precision and control appear to be the ultimate goals of genetic engineering. Precision genome editing in plants has been developed through various approaches, including oligonucleotide‐directed mutagenesis (ODM), base editing, prime editing and especially homologous recombination (HR)‐based gene targeting. With the advent of CRISPR/Cas for the targeted generation of DNA breaks (single‐stranded breaks (SSBs) or double‐stranded breaks (DSBs)), a substantial advancement in HR‐mediated precise editing frequencies has been achieved. Nonetheless, further research needs to be performed for commercially viable applications of precise genome editing; hence, an alternative innovative method for genome editing may be required. Within this scope, we summarize recent progress regarding precision genome editing mediated by microhomology‐mediated end joining (MMEJ) and discuss their potential applications in crop improvement.
Plant volatiles as cues and signals in plant communication
Authors: Ninkovic Velemir , Markovic Dimitrije , Rensing Merlin
Published: October 2020

Volatile organic compounds are important mediators of mutualistic interactions between plants and their physical and biological surroundings. Volatiles rapidly indicate competition or potential threat before these can take place, and they regulate and coordinate adaptation responses in neighbouring plants, fine‐tuning them to match the exact stress encountered. Ecological specificity and context‐dependency of plant–plant communication mediated by volatiles represent important factors that determine plant performance in specific environments. In this review, we synthesise the recent progress made in understanding the role of plant volatiles as mediators of plant interactions at the individual and community levels, highlighting the complexity of the plant receiver response to diverse volatile cues and signals and addressing how specific responses shape plant growth and survival. Finally, we outline the knowledge gaps and provide directions for future research. The complex dialogue between the emitter and receiver based on either volatile cues or signals determines the outcome of information exchange, which shapes the communication pattern between individuals at the community level and determines their ecological implications at other trophic levels.