bluuebunny/crossref_metadata_2025 huggingface dataset:
Hohe Prävalenz und geringes Bewusstsein bei Patienten mit chronisch‐entzündlichen Hauterkrankungen und genitaler Beteiligung
Authors: Staubach Petra , Plavic‐Radeka Natascha , Peveling‐Oberhag Adriane , Sohn Anna , Zimmer Sebastian , Weyer‐Elberich Veronika , Lang Berenice Mareen
Published: October 2021

Hintergrund

Eine genitale Beteiligung bei Patienten mit chronisch‐entzündlichen Hauterkrankungen ist zwar häufig, wird jedoch nicht ausreichend erkannt.

Ziel

Die Beurteilung der Prävalenz genitaler Symptome bei Patienten mit Psoriasis und chronischer Urtikaria, der Effekte auf die Lebensqualität, die Arzt‐Patienten‐ Beziehung sowie des Krankheitsmanagements.

Patienten und Methoden

Es wurden 100 Patienten mit Psoriasis und 100 Patienten mit chronischer Urtikaria aus unserer ambulanten Abteilung sowie 50 gesunde Kontrollen in die Studie aufgenommen. Die Datenerhebung erfolgte mittels Fragebögen, die von dermatologischen Experten entwickelt wurden.

Ergebnisse

74 % der 250 Teilnehmer litten schon einmal an genitalen Symptomen – 70 % der Psoriasis‐Patienten und 58 % der Urtikaria‐Patienten. Sieben von zehn Teilnehmern klagten sogar über eine wiederholte genitale Beteiligung. 50 % der Psoriasis‐Patienten und 41 % der Urtikaria‐Patienten berichteten von einem Einfluss auf die Lebensqualität. Bei 41 % war genitaler Pruritus das Hauptsymptom, wobei einer von drei Patienten eine bessere Behandlung für dieses spezifische Problem erwartete. Darüber hinaus beklagten 74 % mangelndes Bewusstsein der Ärzte: 79 % der Urtikaria‐Patienten und 58 % der Psoriasis‐Patienten gaben an, niemals von ihren Ärzten zu genitalen Symptomen befragt worden zu sein.

Schlussfolgerungen

Der Großteil der Patienten mit Psoriasis und chronischer Urtikaria leidet an einer genitalen Beteiligung und dadurch an einer Beeinträchtigung der Lebensqualität. Die Therapiebeurteilungen von Patienten und Ärzten sollten genitale Symptome als Einflussfaktor auf die Lebensqualität enthalten.
Screening auf Depression bei Psoriasis‐Patienten während einer dermatologischen Konsultation: ein erster Schritt in Richtung Behandlung
Authors: Kromer Christian , Mohr Johannes , Celis Daniel , Poortinga Sietske , Gerdes Sascha , Mössner Rotraut , Wilsmann‐Theis Dagmar
Published: October 2021

Hintergrund und Ziele

Depression ist bei Psoriasis‐Patienten eine Begleiterkrankung mit hoher Prävalenz. Das Ziel dieser prospektiven Studie war die Nachbeobachtung von Psoriasis‐Patienten mit Depressionsrisiko und die Beurteilung individueller Wege zu psychosozialer Versorgung sowie der Wirksamkeit eines Depressions‐Screenings in einem realen Umfeld.

Patienten und Methoden

In dieser prospektiven multizentrischen Studie wurden 355 Patienten mit Psoriasis anhand des Beck‐Depressions‐Inventars (BDI‐II) auf Symptome einer Depression untersucht. Hausärzte von Patienten mit Depressionsrisiko wurden um weitere Beurteilung gebeten. Ein Jahr später wurden Informationen zur psychosozialen Versorgung erfasst.

Ergebnisse

130 Patienten wurden positiv auf Symptome einer Depression untersucht und 71 Patienten wurden nachbeobachtet (Nachverfolgungsrate: 54,6 %). Eine psychiatrische Behandlung wurde 28,2 % der Patienten empfohlen und von 23,9 % akzeptiert. Parameter der Krankheitsaktivität der Psoriasis (PASI: 3,1, ∆: –1,7, P = 0,018), der Lebensqualität (dermatologischer Lebensqualitätsindex [DLQI]: 6,5, ∆: –2,8, P = 0,005) und Depressionssymptome (BDI‐II: 13,2, ∆: –8.3, P < 0,001) verbesserten sich signifikant. Die Abnahme des BDI‐II‐Wertes war bei Patienten mit starker Abnahme des PASI deutlicher.

Schlussfolgerungen

Screening nach Depressionssymptomen führte zu erhöhter Inanspruchnahme von psychosozialer Versorgung und einer Verbesserung der Psoriasis, der depressiven Symptome und der Lebensqualität. Daher sollte ein Depressions‐Screening in die Routinebehandlung integriert werden, um die Patientenversorgung zu optimieren.
Komplikationsrisiken im Zusammenhang mit Antithrombotika bei Hautoperationen: Systematischer Review und Metaanalyse
Authors: Scherer Fabian David , Dressler Corinna , Avila Valles Gabriela , Nast Alexander
Published: October 2021

Hintergrund und Zielsetzung: Unser Ziel war es, das Komplikationsrisiko bei Operationen an der Haut beim perioperativen Pausieren im Vergleich zum Fortführen von Antithrombotika und beim perioperativen Bridging von Vitamin‐K‐Antagonisten mit Heparin im Vergleich zum Fortführen der Vitamin‐K‐Antagonisten zu evaluieren.

Methodik: Wir führten einen systematischen Review durch und haben drei Datenbanken nach einschlussfähigen Studien durchsucht. Die Methodik folgte dem Cochrane Handbook. Wir verwendeten RoB 2 und ROBINS‐I, um das Verzerrungsrisiko zu bewerten. Die Qualität der Evidenz wurde bewertet (GRADE) und fixed‐effect‐Metaanalysen wurden durchgeführt.

Ergebnisse: Zwei randomisierte kontrollierte Studien und 19 prospektive Kohortenstudien wurden eingeschlossen. Es ist unklar, ob das perioperative Fortführen von Acetylsalicylsäure das Risiko signifikanter postoperativer Blutungen (SPB) im Vergleich zum Pausieren erhöht (Risikodifferenz (RD) 0,004, 95 %‐Konfidenzintervall (KI) –0,003 bis 0,019).

Im Vergleich zum perioperativen Pausieren kann das Fortführen von Phenprocoumon das Risiko für SPB erhöhen (RD 0,02, 95 %‐KI 0,00 bis 0,05). Im Vergleich zum perioperativen Fortführen kann das Bridging von Phenprocoumon mit Heparin das Risiko für SPB erhöhen (RD 0,07, 95 %‐KI 0,01 bis 0,22). Für direkte orale Antikoagulantien wurde keine Evidenz hinsichtlich der Blutungsrisiken gefunden.

Schlussfolgerungen: Es wurden keine eindeutigen Hinweise für erhebliche Blutungsrisiken beim perioperativen Fortführen von Antithrombotika bei kleineren Operationen an der Haut gefunden. Allerdings war die Qualität der Evidenz sehr niedrig.
Magnifying observation by flooding immersion for duodenal pseudomelanosis
Authors: Tanaka Akihito , Kanmura Shuji , Ido Akio
Published: October 2021

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Incidence, hospitalization and mortality and their changes over time in people with a first ever diabetic foot ulcer
Authors: Røikjer Johan , Werkman Nikki C. C. , Ejskjaer Niels , van den Bergh Joop P. W. , Vestergaard Peter , Schaper Nicolaas C. , Jensen Morten Hasselstrøm , Klungel Olaf , de Vries Frank , Nielen Johannes T. H. , Driessen Johanna H. M.
Published: October 2021

Aims

A diabetic foot ulcer (DFU) is a severe condition associated with morbidity and mortality. Population‐based studies are rare and limited by access to reliable data. Without this data, efforts in primary prevention cannot be evaluated. Therefore, we examined the incidence and changes over time for the first DFU in people with diabetes. We also examined hospitalization and all‐cause mortality and their changes over time.

Methods

From the UK primary care CPRD GOLD database (2007–2017), we identified 129,624 people with diabetes by a prescription for insulin or a non‐insulin anti‐diabetic drug. DFUs were identified using Read codes and expressed as incidence rates (IRs). Changes over time were described using Poisson and logistic regression and expressed as incidence rate ratios (IRRs) and odds ratios (ORs) respectively.

Results

The mean IR of first registered DFUs was 2.5 [95% CI: 2.1–2.9] per 1000 person‐years for people with type 2 diabetes and 1.6 [1.3–1.9] per 1000 person‐years for people with type 1. The IRs declined for people with type 2 diabetes (IRR per year: 0.97 [0.96–0.99]), while no changes were observed for people with type 1 diabetes (IRR per year: 0.96 [0.89–1.04]). Average hospitalization and 1‐year mortality risk for people with type 2 diabetes were 8.2% [SD: 4.7] and 11.7% [SD: 2.2] respectively. Both declined over time (OR: 0.89 [0.84, 0.94] and 0.94 [0.89, 0.99]).

Conclusion

The decline in all IRs, hospitalizations and mortality in people with type 2 diabetes suggests that prevention and care of the first DFU has improved for this group in primary care in the UK.
A case of variant parachute mitral valve associated with mitral annular disjunction arrhythmic syndrome
Authors: Datta Ishita , Dawdy John , Afonso Luis
Published: October 2021

Parachute mitral valve (PMV) is a rare congenital cardiac valvular anomaly often associated with other congenital cardiac defects, particularly Shone's complex, but may infrequently occur in isolation. PMV and its variants are predominantly associated with mitral stenosis (MS) or rarely mitral regurgitation (MR). We present the case of a middle‐aged female who was evaluated for a syncopal episode and found to have an atypical variant PMV with disproportionately long anterior mitral leaflet, bileaflet mitral valve prolapse, and mitral annular disjunction, without associated MS or MR. This is the first case report to highlight this particular constellation of findings.
Soil pH drives poplar rhizosphere soil microbial community responses to ozone pollution and nitrogen addition
Authors: Li Pin , Yin Rongbin , Zhou Huimin , Yuan Xiangyang , Feng Zhaozhong
Published: October 2021

Ground‐level ozone (O3) pollution frequently coincides with the deposition of anthropogenic nitrogen (N), and both factors can influence the structure and functionality of both above‐ and belowground ecosystems. Elevated O3 levels have been shown to adversely impact plants in many prior reports, but the interacting effects of high O3 levels and N addition on exposed plants remain to be clearly defined, and the changes in rhizosphere microbial community composition in this context have yet to be studied. The direct and indirect mechanisms and interactions among plants, microbes, and the soil that shape these O3 and N responses are also poorly understood. Herein, we explored the interactive effects of O3 exposure (five levels) and soil N (four levels) on the composition of rhizosphere soil microbial communities associated with poplar trees (Populus euramericana cv. ‘74/76’). In these analyses, exposure to higher levels of O3 was linked to significant decreases in bacteria, fungi, arbuscular mycorrhizal fungi, and to a reduction in the ratio of fungi‐to‐bacteria, whereas soil N addition had no impact on these parameters. No interactive effects between O3 and N were observed in the context of alterations in soil microbial community composition, and equivalent performance was observed for concentration‐based (AOT40, cumulative exposure to hourly O3 concentrations >40 ppb) and flux‐based [POD1 and POD7, cumulative stomatal uptake of O3 > 1 or 7 nmol O3 m−1 PLA (projected leaf area) s−1] dose–response analyses. Structural equation modelling revealed that changes in the composition of the microbial community were attributable to changes in soil pH but unrelated to plant characteristics. Overall, these findings indicated that increased O3 levels can induce soil alkalinisation and thereby influence soil microbial communities such that soil pH is a reliable predictor of O3 pollution‐related changes in these communities.

Highlights

Elevated O3 exhibited an overall negative influence on microorganisms.

AOT40‐, POD1‐ and POD7‐based dose–responses performed equally well.

Soil pH is a reliable predictor of O3 pollution‐related changes in microbial communities.

N addition failed to affect O3 effects on soil microbial community.
Impact of adhesive primer and light‐curing on polymerization kinetics of self‐adhesive resin cement in association with free radical reaction
Authors: Ozaki Akane , Shishido Shunichi , Nakamura Keisuke , Harada Akio , Katsuda Yusuke , Kanno Taro , Egusa Hiroshi
Published: October 2021

This study analyzed the impact of adhesive primer and light‐curing on the polymerization kinetics of urethane dimethacrylate‐based self‐adhesive resin cement combined with free radical reaction. Specimens were prepared by mixing the cement paste with or without adhesive primer. Subsequently, specimens were light‐cured or set without light‐curing. The degree of conversion (DC), Vickers hardness (Hv), and free radical concentrations were repeatedly measured up to 168 h after the curing initiation. Irrespective of the curing procedures, DC, Hv, and free radical concentration rapidly increased during the initial 30 min of curing. The specimens cured with adhesive primer and/or light‐curing generally showed higher values of DC, Hv, and radical concentration than those set by chemical curing alone, especially during the initial polymerization phase. Kinetic analysis using a linear mixed model revealed that the adhesive primer had a higher coefficient estimate than light‐curing, indicating that the former had a higher impact on the polymerization. Additionally, the adhesive primer alleviated the Hv reduction caused by water and air during the initial polymerization phase, although light‐curing hardly prevented the polymerization inhibition. Therefore, we suggest that application of adhesive primer is beneficial to achieve higher degree of conversion and better mechanical properties of self‐adhesive resin cements by enhancing free radical reactions.
No increased risk of Kaposi sarcoma relapse in patients with controlled HIV‐1 infection after switching protease inhibitor‐based antiretroviral therapy
Authors: Lajaunie Rébecca , Cuzin Lise , Palich Romain , Makinson Alain , Bani‐Sadr Firouzé , Duvivier Claudine , Arvieux Cedric , Rey David , Poizot‐Martin Isabelle , Delpierre Cyril , Delobel Pierre , Martin‐Blondel Guillaume ,   And The Dat’AIDS study group
Published: October 2021

Objectives

Our aim was to assess if switching from a protease inhibitors (PI)‐based regimen to a PI‐free one is associated with an increased risk of Kaposi Sarcoma (KS) relapse among patients living with HIV (PLHIV) with history of KS and controlled HIV replication.

Methods

In a retrospective analysis of the prospectively collected Dat’AIDS database we selected patients who both had a past KS history and a HIV‐1 viral load below 200 copies/mL while being PI‐treated. We searched for KS relapses while persistent virological success was maintained for at least 6 months, whether patients kept taking the PI, or switched to PI‐free regimen.

Results

Among the 216 patients with past KS event and a history of HIV‐1 infection efficiently treated by a PI‐based regimen, 148 patients (68.5%) later switched to a PI‐sparing regimen. Their baseline characteristics were not different from non‐switching patients. We described 7 cases of relapse (3.2% of the 216 patients). Five cases of relapse occurred in switching patients (3.4%). The remaining two relapses occurred in PI‐treated patients (2.9%). At KS relapse, CD4 cell count was 459 cells/μL (range 225–560) for switching patients, compared with 362 and 136 cells/μL for the other two patients.

Conclusions

In this large cohort of PLHIV with a history of KS and ART‐controlled HIV replication, KS relapses were described in 3.2% of the patients, and were not more frequent when a PI‐containing ART regimen has been switched to a PI‐free regimen. Our results do not support a specific effect of PI on KS.
IL1R2 polymorphisms and their interaction are associated with osteoporosis susceptibility in the Chinese Han population
Authors: Rong Kai , Liang Zhiquan , Xiang Wenyuan , Wang Zhan , Wen Fengli , Lu Laijin
Published: October 2021

Aims

Interleukin 1 (IL‐1) inhibitory receptor type 2 (IL1R2) serves as a negative regulator of IL‐1 signalling and is involved in the pathogenesis of osteoporosis. This study aimed to determine the correlation between IL1R2 polymorphism and osteoporosis susceptibility in the Chinese Han population.

Methods

We recruited 594 osteoporosis patients and 599 healthy controls. Six single nucleotide polymorphisms (SNPs) in IL1R2 were selected for genotyping using the Agena MassARRAY platform. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis with adjustment for age and sex. Linkage disequilibrium analysis was plotted using Haploview v4.2. Multifactor dimension reduction (MDR) was performed to estimate the SNP‐SNP interactions of IL1R2 variants.

Results

Rs11674595 (OR = 1.86, p = 0.020), rs2072472 (OR = 1.26, p = 0.019) and rs4851527 (OR = 0.78, p = 0.007) were related to the risk of osteoporosis. Moreover, the contribution of IL1R2 polymorphisms to osteoporosis risk was associated with age, sex and body mass index. We found the relationships of Trs11674595Ars4851527 (OR = 0.80, p = 0.015), Crs11674595Grs4851527 (OR = 1.22, p = 0.043) and Ars3218977Grs2072472 (OR = 1.25, p = 0.022) haplotypes to osteoporosis occurrence, and a potential accumulated effect of IL1R2 SNPs (testing accuracy = 0.5783 and cross validation consistency = 10/10) on osteoporosis susceptibility.

Conclusion

IL1R2 polymorphisms (rs11674595, rs4851527, rs2072472 and rs3218977) may contribute to osteoporosis risk in the Chinese Han population. Our findings may increase our understanding of the effects of IL1R2 polymorphisms on the predisposition to osteoporosis.
Challenges and Opportunities: Creative Approaches to Museum and Gallery Learning during the Pandemic
Authors: Noble Kate
Published: October 2021

During the pandemic many museums and galleries pivoted from onsite, in‐person delivery to develop a remote offer and to create digital learning resources and activity packs for children and young people. In this article, I draw upon my experience as practitioner researcher on the schools and teachers’ programme at the Fitzwilliam Museum to consider different approaches to supporting participatory creative pedagogies while the museum was closed. After discussing how the work built on and extended existing programming for this audience, I consider effective strategies for facilitating authentic and inclusive encounters with objects and artworks remotely. While some were empowered to take part and to engage, others were locked out through the ever widening social and digital divide. How can we overcome these challenges and make the most of the opportunities which this work has revealed? What are the implications of this work for our understanding of the role, function and future of museum and gallery learning?
Exploring the mechanisms of coordinated chick provisioning in the Manx shearwater Puffinus puffinus
Authors: Gillies Natasha , Tyson Chris , Wynn Joe , Syposz Martyna , Vansteenberghe Cécile , Guilford Tim
Published: October 2021

Many species that provide care for their offspring in tandem with a partner coordinate their activities to maximise the efficiency of their investment. However, it is not well known exactly how this coordination is achieved. Manx shearwaters Puffinus puffinus are Procellariiform seabirds that exhibit a dual foraging strategy during chick provisioning in which long foraging trips to maintain condition are alternated with short, frequent trips to feed the offspring. This strategy is employed in a coordinated manner between the parents, with one making short trips while the other takes a single long trip. Previous work revealed that a complementary switch in foraging trip type is initiated by the parents following a synchronous visit to the nest. We used a combination of observational data and experimental manipulation to examine the mechanisms that may underlie this behaviour. Specifically, we investigated the evidence that physical reunion is necessary to induce a switch in trip type, whether parents change their behaviour to maximise the probability of partner encounter, and whether indirect cues gained from the chick could inform a switch in behaviour. In our experimental approach, we manipulated the information adults had available to them by supplementarily feeding chicks to alter their begging behaviour. We found no support for the role of physical reunion or indirect cues in the coordination of care in this species. We discuss the possibility that the patterns of alternated provisioning observed during chick rearing in Manx shearwaters may emerge through entrainment during the well‐coordinated incubation period preceding chick provisioning.
Contributions of NFKB1 ‐94insertion/deletion ATTG polymorphism to the susceptibility of gastrointestinal cancers: A meta‐analysis
Authors: Wu Hanqiang , Liang Jianrong
Published: October 2021

Nuclear factor‐kappa B1 (NF‐κB1), a pleiotropic transcription factor, functions as a critical contributor to tumorigenesis. Growing numbers of case‐control studies were carried out to analyse the potential contribution of NF‐κB1 gene variants to gastrointestinal cancer risk, yet remains conflicting conclusions. Therefore, we conducted this most up‐to‐date meta‐analysis to evaluate the relationship between NF‐κB1 gene insertion (I)/deletion (D) polymorphism, namely −94ins/delATTG or rs28362491, and the susceptibility to gastrointestinal cancers. We searched PubMed, EMBASE and MEDLINE databases updated in April 2021 for relevant studies. Meta‐analysis was carried out by software Stata11.0. The quantification of the relationship was determined by computing the combined odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Sensitivity analysis, the funnel plot and Begg's rank correlation test were also applied. Our findings indicate that −94ins/delATTG polymorphism could not significantly impact the susceptibility to gastrointestinal cancers. Under any five genetic models, −94ins/delATTG polymorphism was not remarkedly linked to the risk of colorectal, gastric and oesophageal cancer, respectively. The significant role of −94ins/delATTG was only observed in some certain subgroups. Findings here suggest that NF‐κB1 gene −94ins/delATTG polymorphism may not predispose to gastrointestinal cancer susceptibility.
Current controversies in trichology: a European expert consensus statement
Authors: Meyer‐Gonzalez T. , Bacqueville D. , Grimalt R. , Mengeaud V. , Piraccini B.M. , Rudnicka L. , Saceda‐Corralo D. , Vogt A. ,   Trichology Experts Network Group, Vano‐Galvan S.
Published: October 2021

Introduction

Hair disorders are one of the most common conditions within dermatology practice but, although new diagnostic tools and therapeutic options have arisen, the management of these patients still represents a major clinical challenge.

Objective

This study aimed at gathering information and achieving consensus on relevant recommendations on the latest advances in alopecia, trichoscopy and hair dermocosmetics.

Methods

Experts of the steering committee consulted the available evidence on trichology‐related areas from the past 5 years and formulated recommendations based on the evidence and their experience. A modified two‐round Delphi procedure was performed among 45 European dermatologists experts in trichology to consult their degree of agreement on twenty recommendations, using a 4‐point Likert scale. Consensus was defined as >80% of participants scoring either 1 (totally agree) or 2 (agree).

Results

In the first round of the Delphi questionnaire, 75% of the recommendations reached consensus. Those that were not agreed upon were reformulated by the steering committee and voted again after an online meeting, where consensus was achieved in all recommendations.

Conclusions

All recommendations reached consensus after the two‐round Delphi questionnaire and may be useful in clinical practice for dermatologists. The participants agreed that besides this consensus, further clinical studies are needed to assess the benefits of the emerging tools and treatments and to clarify the controversies that still exist in the field, aiming at improving patients' quality of life.
Firm‐level investment under imperfect capital markets in Ukraine
Authors: Shcherbakov Oleksandr
Published: October 2021

This paper develops and estimates a model of firm‐level fixed capital investment where firms may be unable to invest optimally due to liquidity and borrowing constraints. Firms rationally anticipate these constraints and make dynamically optimal investment decisions. Structural parameters are estimated using data from the Ukrainian manufacturing sector for the period 1993–1998. The estimation results suggest significant heterogeneity across industries, with 8%–29% of firms facing binding constraints on investment. These constraints are persistent over time. To make optimal investments, 24%–64% of firms must borrow to complement their own resources. The characteristics of constrained firms and the relationship between industry institutions and the level of financial constraints are discussed.
Assessing readiness to implement patient navigator programs in Toronto, Canada
Authors: Kokorelias Kristina M. , Gould Sarah , DasGupta Tracey , Cass Dan , Hitzig Sander L.
Published: October 2021

Objective

To explore factors influencing the implementation of patient navigator programs within a hospital for seniors with complex care needs.

Methods

A qualitative descriptive design using in‐depth interviews was conducted. Participant interviews were conducted in Toronto, Ontario between September 2020 and February 2021. Data were analysed using thematic analysis.

Results

Thirty‐five semi‐structured interviews were conducted with 38 participants from a large urban hospital (n = 21) and community healthcare organizations (n = 17), including organizational leaders, and acute care and rehabilitation providers. Follow‐up interviews occurred with 16 participants (7 from the community and nine from the hospital). This study identified five key factors influencing organizational readiness for successful implementation of a patient navigator program for seniors with complex conditions, which included: (a) vision from senior leadership, (b) technological infrastructure, (c) existing hospital‐community partnerships, (d) well‐established process for referrals, and (e) staff capacity. The overarching theme of communication was also identified.

Conclusions

The findings of this study provide a better understanding of hospital and community professionals' needs and challenges when implementing patient navigator programs for seniors with complex care conditions. There are a number of factors that influence an organization's readiness for program uptake and delivery, with the need for clear communication being paramount. Further research to test the effects of readiness on successful implementation outcomes is warranted.
Scoping study of definitions and instruments measuring vulnerability in older adults
Authors: Levasseur Mélanie , Lussier‐Therrien Marika , Biron Marie Lee , Dubois Marie‐France , Boissy Patrick , Naud Daniel , Dubuc Nicole , Coallier Jean‐Claude , Calvé Jessica , Audet Mélisa
Published: October 2021

Background

It is important to foster social participation and health equity, especially for older adults in situations of vulnerability. Despite growing interest in vulnerability, there is no consensus regarding how to define or measure this concept. This paper provides an inventory and synthesis of definitions of and instruments measuring vulnerability in older adults.

Methods

Using a scoping study framework, eight databases (Abstracts in Social Gerontology, Academic Search Complete, AgeLine, CINAHL, MEDLINE, SocINDEX, PsycInfo, Scopus) were searched with relevant keywords [Vulnerab* AND (Concept*, Defin*, Meaning, Terminology, Measurement, Assessment*, Indicator*, Instrument*, Scale*, Questionnaire* OR Test*) AND (Aging, Aging, Elder*, Gerontolog*, Older OR Senior*)].

Results

Thirty‐one original definitions and five measuring instruments were identified, content‐analyzed, and compared. Vulnerability definitions mostly focused on people under conditions that increased their risk of harm because of individual physical factors, the environment, and their interaction. Considering these definitions, experts in the field of aging, including two representing older adults, participated in a workshop, and a consensus was reached to define a situation of vulnerability as “a set of circumstances in which one or more individuals experience, at a specific moment in time, one or multiple physiological, psychological, socioeconomic or social difficulties that may interact to increase their risk of being harmed or having coping challenges that have a negative impact on their life.” Although none of the measures fully targeted this definition, the Perceived Vulnerability Scale (PVS) is one of the most complete measures, with 22 items considering feelings of vulnerability toward personal and environmental factors, and good psychometric properties.

Conclusions

The proposed definition and the PVS help to provide a common language and measure in health and social sciences research, policy and practice identifying and reaching older adults in situations of vulnerability and intervening to foster social participation and health equity.
Tell Me Your Story: Experiential learning using in‐home interviews of healthy older adults
Authors: Schrimpf Davis Susan , Regan Saundra , Goodnow Keesha , Gausvik Christian , Pallerla Harini , Schlaudecker Jeffrey D.
Published: October 2021

Purpose

To create a curriculum innovation for early preclinical medical students to explore personal perspectives by listening to and learning from the lived experience of community‐living older adults.

Method

Tell Me Your Story (TMYS) paired first‐year medical students (MS1s) with community‐dwelling older adult partners (OAPs) residing in the independent living portion of a continuing care retirement community (CCRC) for a half‐day educational experience. MS1s conducted 1‐hour semi‐structured interviews with their OAP and then formed small groups with geriatric faculty members to explore experiences and views that were either reinforced or challenged. The authors evaluated the effectiveness of this exercise using post‐activity surveys. A mixed‐methods analysis of 7 years of data (2013–2019) was conducted.

Results

TMYS had 1251 MS1 participants from 2013 to 2019. Students completed 1052 surveys for a response rate of 84%. During the semi‐structured interview with OAP, the frequency of issues discussed included relationships (94%), professionalism/art of medicine (91%), healthcare accessibility (83%), death/dying/grieving/loss (72%), nutrition (69%), ethics (64%), and cultural competence (61%). Exactly 97% (n = 1023) responded that the overall organization was “good, very good or excellent.” The most prominent themes identified by student responses highlighted person‐centered care, patient perspective, life experience/personal stories, and doctor–patient relationship. Fifty‐three faculty members completed the post‐program survey. Exactly 100% (53/53) rated the quality of this exercise as an educational experience high.

Conclusion

TMYS was highly valued by students and provided an important experiential learning activity in preclinical medical education. Themes related to person‐centered care emerged from the intervention.
Change in central nervous system‐active medication use following fall‐related injury in older adults
Authors: Hart Laura A. , Walker Rod , Phelan Elizabeth A. , Marcum Zachary A. , Schwartz Naomi R. M. , Crane Paul K. , Larson Eric B. , Gray Shelly L.
Published: October 2021

Background

Central nervous system (CNS)‐active medication use is an important modifiable risk factor for falls in older adults. A fall‐related injury should prompt providers to evaluate and reduce CNS‐active medications to prevent recurrent falls. We evaluated change in CNS‐active medications up to 12 months following a fall‐related injury in community‐dwelling older adults compared with a matched cohort without fall‐related injury.

Methods

Participants were from the Adult Changes in Thought study conducted at Kaiser Permanente Washington. Fall‐related injury codes between 1994 and 2014 defined index encounters in participants with no evidence of such injuries in the preceding year. We matched each fall‐related injury index encounter with up to five randomly selected clinical encounters from participants without injury. Using automated pharmacy data, we estimated the average change in CNS‐active medication use at 3, 6, and 12 months post‐index according to the presence or absence of CNS‐active medication use before index.

Results

One thousand five hundred sixteen participants with fall‐related injury index encounters (449 CNS‐active users, 1067 nonusers) were matched to 7014 index encounters from people without fall‐related injuries (1751 users, 5236 nonusers). Among CNS‐active users at the index encounter, those with fall‐related injury had an average decrease in standard daily doses (SDDs) at 12 months (−0.43; 95% CI: −0.63 to −0.23), and those without injury had a greater (p = 0.047) average decrease (−0.66; 95% CI: −0.78 to −0.55). Among nonusers at index, those with fall‐related injury had a smaller increase than those without injury (+0.17, 95% CI: +0.13 to +0.21, vs. +0.24, 95% CI: +0.20 to +0.28, p = 0.005).

Conclusions

The differences in CNS‐active medication use change over 12 months between those with and without fall‐related injury were small and unlikely to be clinically significant. These results suggest that fall risk‐increasing drug use is not reduced following a fall‐related injury, thus opportunities exist to reduce CNS‐active medications, a potentially modifiable risk factor for falls.
Reframing aging during COVID‐19: Familial role‐based framing of older adults linked to decreased ageism
Authors: Ng Reuben , Indran Nicole
Published: October 2021

Background

Contributions of older adults amid the COVID‐19 pandemic have been eclipsed by discourse positioning them as an at‐risk population. We assess whether age‐based framing (e.g., senior citizen) is associated with more negative stereotyping in the media compared to familial role‐based framing (e.g., grandparent) across 8 months, from a baseline period (October 2019–December 2019) to the onset of the pandemic (January 2020–May 2020).

Methods

Leveraging a 12‐billion‐word news media database—with over 30 million news articles from over 7000 websites—we identified the most common synonyms for age‐based framing (e.g., senior citizen) and familial role‐based framing (e.g., grandparent). For each framing category, we compiled the most frequently used descriptors every month, amassing 488,907 descriptors in total. All descriptors were rated from 1 (very negative) to 5 (very positive) to determine a Cumulative Aging Narrative Score (CANS) for age‐based and familial role‐based framing.

Results

Age‐based framing of older adults increased negative stereotyping in the media by seven times compared to familial role‐based framing during COVID‐19. The percentage of positive topics for age‐based framing was significantly lower during COVID‐19 (35%) than before (61%). Conversely, the percentage of positive topics for familial role‐based framing was higher during the pandemic (91%) than before (70%).

Conclusion

This is one of the first empirical studies on whether framing older adults based on age or role is linked to more negative stereotypes during COVID‐19. We argue for a more role‐centered approach in framing older adults so that their contributions are acknowledged and valued by society.
Thoughts and attitudes toward disasters among Japanese patients with type 1 diabetes: A qualitative descriptive study
Authors: Oyama Yusuke , Abiru Norio , Kit Ayano , Eyama Daigo , Noda Arisa , Nagata Akira
Published: October 2021

Aim

The purpose of this study was to clarify the thoughts and attitudes of patients with type 1 diabetes during disasters.

Methods

We conducted a qualitative descriptive study. The participants were 10 adult patients with type 1 diabetes who were selected through purposeful sampling. None of them had experienced a disaster. Data were collected through semi‐structured interviews. Thematic analysis was used to analyze the data.

Results

Type 1 diabetes patients described a variety of thoughts and attitudes regarding disaster and preparedness. Based on their experiences, 528 codes were extracted. The codes were categorized based on their patterns and similarities. Then, 11 sub‐themes and three main themes were identified. The three main themes were (a) “being unprepared since one could not relate to disasters”; (b) “managing well with insulin and food”; and (c) “hiding the fact that one has diabetes.”

Conclusions

This study identified three important characteristics of the thoughts and attitudes of patients with type 1 diabetes toward disasters. These provide perspectives for education in pre‐disaster preparation and support when disasters occur. Patients with type 1 diabetes are aware of the importance of insulin, food adjustment, and self‐management on a daily basis. Therefore, it is necessary to educate them so that they can apply their knowledge in times of disaster. In addition, healthcare providers who provide support in times of disaster need to be aware that there are victims who cannot talk readily about their illness.
Virtual reconstruction of orbital floor defects using a statistical shape model
Authors: Gass Mathieu , Füßinger Marc Anton , Metzger Marc Christian , Schwarz Steffen , Bähr Johannes Daniel , Brandenburg Leonard Simon , Weingart Julia , Schlager Stefan
Published: October 2021

Purpose

The current standard in reconstructing defects of the orbital floor, by using the concept of mirroring, is time‐consuming and ignores the natural asymmetry of the skull. By using a statistical shape model (SSM), the reconstruction can be automatized and improved in accuracy. The present study aims to show the possibilities of the virtual reconstruction of artificial defects of the orbital floor using an SSM and its potentials for clinical implementation.

Methods

Based on 131 unaffected CT scans of the midface, an SSM was created which contained the shape variability of the orbital floor. Nineteen midface CT scans, that were not included in the SSM, were manually segmented to establish ground truth (control group). Then artificial defects of larger and smaller sizes were created and reconstructed using SSM (Group I) and the gold standard of mirroring (Group II). Eventually, a comparison to the surface of the manual segmentation (control group) was performed.

Results

The proposed method of reconstruction using an SSM leads to more precise reconstruction results, compared with the conventional method of mirroring. Whereas mirroring led to the reconstruction errors of 0.7 mm for small defects and 0.73 mm for large defects, reconstruction using SSM led to deviations of 0.26 mm (small defect) and, respectively, 0.34 mm (large defect).

Conclusions

The presented approach is an effective and accurate method for reconstructing the orbital floor. In connection with modern computer‐aided design and manufacturing, individual patient‐specific implants could be produced according to SSM‐based reconstructions and could replace current methods using manual bending techniques. By acknowledging the natural asymmetry of the human skull, the SSM‐based approach achieves higher accuracy in reconstructing injured orbits.
Effects of golden tomato extract on skin appearance—outlook into gene expression in cultured dermal fibroblasts and on trans‐epidermal water loss and skin barrier in human subjects
Authors: Tarshish Elizabeth , Hermoni Karin , Sharoni Yoav , Wertz Philip W. , Dayan Nava
Published: October 2021

Scope

Two experiments were performed to test the effects of rich tomato extract (Golden Tomato Extract, GTE) on human skin. In one experiment, the effects of this extract on gene expression in cultured human dermal fibroblasts were examined. In a second experiment, human subjects consumed the extract and trans‐epidermal water loss (TEWL), and aspects of skin appearance were monitored.

Methods and results

Primary human dermal fibroblasts in culture were treated with the extract. After six hours, RNA was extracted, and gene expression was examined using Affymetrix Human Clariom D array processing. For the clinical study, 65 human subjects consumed a capsule once a day for 16 weeks, and various skin parameters were assessed at predetermined time intervals. Among the genes upregulated by GTE are genes that augment innate immunity, enhance DNA repair, and the ability to detoxify xenobiotics. GTE significantly reduced TEWL in subjects who had high TEWL at baseline, but it had no effect on TEWL in subjects who had lower TEWL at baseline.

Conclusions

Golden tomato extract may provide benefits to the skin by enhancing innate immunity and other defense mechanisms in the dermis and by providing antioxidants to the skin surface to optimize TEWL and the appearance of the skin.
Efficacy of combined fractional carbon dioxide laser and topical tazarotene in nail psoriasis treatment: A randomized intrapatient left‐to‐right study
Authors: Essa Abd Elazim Nagwa , Mahmoud Abdelsalam Ayat , Mohamed Awad Sara
Published: October 2021

Background

Treatment of nail psoriasis is disappointing; due to poor penetrability of topical therapies and variable efficacy of systemic therapies. Fractional carbon dioxide laser (FCL) may enhance penetration of topical therapy for nail psoriasis.

Objective

To evaluate the efficacy and safety of FCL plus topical tazarotene versus tazarotene monotherapy in the treatment of nail psoriasis.

Methods

Twenty‐seven patients with bilateral fingernail psoriasis randomly received 3 sessions of FCL at four‐week interval plus once‐daily tazarotene 0.1% gel for one hand, and once‐daily tazarotene 0.1% gel only for 3 months on the other hand. The primary outcome was modified Nail Psoriasis Severity Index (mNAPSI) at 3 and 6 months compared to baseline, and the secondary outcomes included dermoscopic examination and patient global assessment. Adverse events were reported.

Results

The total, nail matrix, and nail bed mNAPSI scores were significantly improved at 3 and 6 months by both regimens, but they decreased more after FCL/tazarotene combination (p = 0.001, p = 0.023, and p = 0.001, respectively). Combination therapy showed faster improvement of nail matrix signs and greater efficacy for nail bed signs. The dermoscopic features of the nail plate were the most responsive after both treatments. The combined therapy was more effective in improving the dermoscopic nail bed features. Patient's global assessment scores were significantly higher after the combined therapy. Both treatments were well tolerated.

Conclusion

Fractional CO2 laser is an effective and well‐tolerated treatment for nail psoriasis; it improves the outcomes of topical tazarotene especially in nail bed lesions.
Scientometric‐based analysis in business and economics: Introduction, examples, and guidelines
Authors: Abramo Giovanni , Oxley Les
Published: October 2021

In this introductory paper to the special issue on Scientometric Analysis in Business and Economics, we consider four related issues. First, we outline why we believe it is time to produce a special issue of the Journal of Economic Surveys dedicated to the scientometric analysis and its growing use in the fields of business and economics. Second, we focus on the topic of “evaluative scientometrics,” which revolves around the central, basic, original question: how much is a publication worth? The question then is: how do we measure scholarly impact? In answering the question, many pitfalls exist and we identify some of them. Third, we present a brief overview of the seven papers, authored by twelve scientometricians, that constitute the special issue. The manuscripts show the potential of scientometrics in terms of the wide range of fields of application. Finally, we present a set of Guidelines which, if prospective authors in business and economics follow them, we hope will increase readability, impact and the potential for their scientometric‐based research to be published.
Supermultipliers, ‘endogenous autonomous demand’ and functional finance
Authors: Skott Peter , Santos Júlio Fernando Costa , da Costa Oreiro José Luís
Published: October 2021

Recent supermultiplier models view autonomous demand as the driver of long‐run growth and as the key stabilizer of Harrodian instability. Attempts to endogenize autonomous demand effectively undermine the existence of a supermultiplier, however, and models with ‘endogenous autonomous demand’ show strong similarities with an earlier literature on feedback effects from the labor markets to aggregate demand. Government consumption could in principle be a source of exogenous autonomous demand in the long run. But an active fiscal policy guided by principles of functional finance can produce more powerful stabilization, avoid overheating and excessive utilization rates, and secure faster adjustments of the growth rate toward its target level.
An anatomical study of the subpulpal wall of abnormal multirooted teeth in the narrow‐ridged finless porpoise (Neophocaena asiaeorientalis)
Authors: Kodera Ryo , Uekusa Yasuhiro , Ito Kai , Kuroda Noriyuki , Kodera Haruto , Endo Hideki
Published: October 2021

Studies have shown that there are two mineralization patterns of roots in multirooted teeth: one forms dentin islands (subpulpal lobes) independent of the crown, and the other does not form any subpulpal lobes. In this study, we found abnormal multirooted teeth in porpoise specimens and focused on the developmental process of its root furcation. To examine the features of the tooth in detail, we used scanning electron microscopy for the morphology of the surface and micro‐computed tomography (micro‐CT) for the structure of the pulp cavity. The micro‐CT scanning showed that a triple‐rooted tooth had only one pulp chamber and one horn. In addition, we observed the intermediate bifurcational ridge‐like structure and dentinal bulges on the subpulpal wall, both of which suggest the formation of the subpulpal lobes. To our knowledge, this study is the first report about teeth with supernumerary roots in Phocoenidae and also the first study to focus on the process of furcation of tooth roots in modern cetaceans. We concluded that the cause of the triple‐rooted tooth was not secondary adhesion of several teeth but rather the furcation of the root at the developmental stage. Additionally, the tooth could have formed lobes during the root furcation.
COVID‐19–associated mucormycosis, diabetes and steroid therapy: Experience in a single centre in Western Mexico
Authors: Guzmán‐Castro Salvador , Chora‐Hernandez Luis David , Trujillo‐Alonso Gersain , Calvo‐Villalobos Ivan , Sanchez‐Rangel Antonio , Ferrer‐Alpuin Edgar , Ruiz‐Jimenez Miguel , Corzo‐Leon Dora E.
Published: October 2021

Background

COVID‐19–associated mucormycosis (CAM) has emerged as a challenging complication as the current pandemic has increased the population requiring treatment with corticosteroids. CAM has caused a massive outbreak in India, reported to be causing cases in Iran, Egypt and The Netherlands.

Objectives

To describe CAM cases occurring in a single centre in Western Mexico.

Methods

Our group carried out a retrospective study from May 2020 to May 2021 to identify CAM cases in patients with previous COVID‐19 diagnosis.

Results

Six CAM cases occurred in a single centre in Western Mexico during the study period, most of them with diabetes (n = 5/6) and all received corticosteroid therapy even when only three had severe COVID‐19. After analysing local COVID‐19 burden, it was estimated that in this region, CAM was 300 times more frequent among COVID individuals than the estimates for general population.

Conclusion

Similar to large reports in India and other countries, CAM cases reported in this study were diagnosed in individuals with diabetes, hyperglycaemic status and with history of previous use of corticosteroids. Identifying these individuals at risk can help the early identification of CAM. In addition, strict glycaemic control and avoidance of unnecessary corticosteroid in non‐severe COVID‐19 cases could help in preventing this complicated fungal infection.