bluuebunny/crossref_metadata_2025 huggingface dataset:
PAPR reduction using OQAM for spectrum sensing
Authors: N. Renuka , M. Satya Sairam
Published: December 2020

Purpose

The tremendous growth of wireless applications and the demand for high data rate, the spectrum utilization improvement has been the most crucial challenges for wireless communication. Adapting cognitive radio with orthogonal frequency division multiplexing or offset quadrature amplitude modulation (OFDM/OQAM) improves the spectrum and energy efficiencies.

Design/methodology/approach

Thus, it overcomes the spectral leakage problem at the transmitter side and leads to less interference from secondary user (SUs) to primary user (PUs) and between the SUs in cognitive radio technology. The benefit of exploiting pulse shape filtering in the OFDM/OQAM is to not only eliminate the requirement of the guard bands but also reduce the out of band energy transmission, which also improves the spectral isolation from the neighboring systems. But the high peak to average power ratio (PAPR) phenomenon is a common issue in the majority of the multicarrier modulation systems and thus OFDM/OQAM is no exception in this case.

Findings

Therefore, this paper aims to examine the effect of integrating the Walsh–Hadamard Transform (WHT) on the power spectral density and investigates the problem of PAPR in the WHT/OQAM system.

Originality/value

Thus, it overcomes the spectral leakage problem at the transmitter side and leads to less interference from SUs to PUs and between the SUs in cognitive radio technology. The benefit of exploiting pulse shape filtering in the OFDM/OQAM is to not only eliminate the requirement of the guard bands but also reduce the out of band energy transmission, which also improves the spectral isolation from the neighboring systems. But the high PAPR phenomenon is a common issue in the majority of the multicarrier modulation systems thus OFDM/OQAM is no exception in this case.
Self-care, A1C and stigmatization as predictors of a negative perception of insulin among adults with type 2 diabetes: a hospital-based study in Turkey
Authors: Arda Sürücü Hamdiye , Okur Arslan Hatice , Çetik Sıdıka
Published: December 2020

Purpose

The purpose of this study was to investigate diabetes self-care behaviors, stigmatization and A1C as predictors of a negative perception of insulin treatment in insulin-treated type 2 diabetic patients.

Design/methodology/approach

A descriptive cross-sectional and relational design was used. The study was carried out in the Diabetes Training Centre and Endocrine and Metabolism Clinic of a university hospital in the southeast of Turkey between May and October 2017. The research sample consisted of 100 type 2 diabetic patients determined by using a convenience sampling method. An introductory information form for type 2 diabetic patients, the Insulin Treatment Appraisal Scale (ITAS), Diabetes Self-Care Activities Survey (DSCAS) and Barriers to Insulin Treatment Scale (BIT) were used to collect the research data. The data were analyzed using descriptive statistics, correlations and step wise multi-linear regression.

Findings

The number of daily insulin injections, training received about insulin and stigmatization was significant predictors of a negative perception of insulin treatment.

Originality/value

Strategies to decrease diabetic individuals' fear of stigmatization should be utilized to minimize their negative insulin treatment perception (giving diabetic individuals training about diabetes, planning public training to inform society and using mass media tools). Diabetes educators should know that diabetic individuals' perception of the severity of the illness could influence the daily number of injections applied and decrease the negative perception regarding insulin.
Team learning in interdisciplinary research teams: antecedents and consequences
Authors: Zhang Xueyan , Wang Xiaohong
Published: December 2020

Purpose

Team learning is critical to interdisciplinary research teams (IDR teams) to use heterogeneous knowledge effectively. Nevertheless, team learning is rarely addressed in the IDR team literature. Also, few studies investigate the antecedents and consequences of team learning in IDR teams, leading to a lack of guidance for management practices. This study aims to investigate how team learning can be developed and how team learning influences team outcomes in IDR teams.

Design/methodology/approach

A questionnaire survey on 304 members of 37 IDR teams in a research university in China is conducted. Data are analyzed using a partial least square structural equation modeling.

Findings

The results support most hypotheses in general. For the antecedent variables, task interdependence, trust and constructive conflict positively affect team learning. For the outcome variables, team learning improves shared mental models, coordination quality and team performance significantly. Additionally, task uncertainty positively moderates the team learning-coordination quality relation and team learning-team performance relation. However, this paper does not find support for the moderating role of task uncertainty on the team learning-shared mental models relation.

Originality/value

To the best of the knowledge, this is the first study investigating the antecedents and consequences of team learning in IDR teams. A multidimensional measurement of team learning for the IDR team context is developed. This study investigates how team behavioral factors influence team learning and the effect of team learning on shared mental models, coordination quality and team performance. This study also explores the contingency role of task uncertainty in the effects of team learning.
“It gave me the strength and will to continue and to overcome”: police officers constructing resilience while under threat from criminals
Authors: Sigad Laura I.
Published: December 2020

Purpose

The study aims to contribute an insider's view of how members of law enforcement and their families cope with life-threatening situations.

Design/methodology/approach

The study at hand is guided by a descriptive phenomenological perspective, which is utilized to describe and analyze the experiences of five police officers living under high levels of threat from criminals.

Findings

The analysis presents a multifaceted picture of the officers’ experience of threat. The findings suggest that life under extreme threat is experienced by the officers as an upheaval of identity and loss of the structure of self. Yet with the aid of various individual protective factors as well as community and systemic support, the officers are able to mentally reframe this experience of vulnerability as one of personal agency. They demonstrate acceptance of the threat as part and parcel of their professional roles, a praxis of responsibility that gives them a sense of control. Emotional strain is ever-present as the reality of the threat infiltrates their personal lives and those of their families, yet the return to their core identity as protectors rather than victims allows for a reintegration of the self and is the foundation of their emerging resilience.

Originality/value

This novel identity-focused model can serve as the basis for a heuristic for interpreting responses to risk and fostering resilience and as the conceptual foundation for the development of practical interventions designed to foster resilience in those exposed to critical and traumatic circumstances both inside and outside the police community.
“There must be an ideal solution…”Assessing training methods of knife defense performance of police recruits
Authors: Koerner Swen , Staller Mario S. , Kecke André
Published: December 2020

Purpose

The study compares the impact of two different pedagogical approaches in police training by assessing the knife defense performance of German police recruits against different types of knife attacks. Linear or nonlinear – which pedagogical approach leads to more efficient knife defense performance?

Design/methodology/approach

A total of 20 German state police recruits (w = 5, m = 15) were assigned to linear and nonlinear groups. The linear and nonlinear groups' performance on knife defense was assessed in a pretest, after a three-week training intervention in a posttest and eight weeks thereafter in a retention test, utilizing a mixed-method design (Sendall et al., 2018).

Findings

Quantitative data on knife defense performance suggest a lastingly better performance of the nonlinear group: in the retention test, participants of the nonlinear group were hit less (p = 0.029), solved the attack faster (p = 0.044) and more often (81.8%) than participants of the linear group (55.6%). In contrast, qualitative data reveal that, despite of evidence for a high level of perceived competence, the nonlinear teaching of knife defense skills has been accompanied by considerable uncertainties, affected by the lack of techniques and the focus on principles and operational parameters only.

Originality/value

It is the first study assessing the impact of different pedagogical approaches in police training. For the practice of police trainers, the results provide empirical orientations for an evidence-based planning of and reflection on pedagogical demands within their training (Mitchell and Lewis, 2017).
Factors influencing PLS financing: the perspective of Indonesian Islamic banks employees
Authors: Nugraheni Peni , Alimin Istiqomah Nur
Published: December 2020

Purpose

This study aims to examine the factors that influence profit–loss sharing (PLS) financing in Indonesian Islamic banks from the perspective of Islamic banks’ employees. Islamic banks have important role in influencing the amount of PLS financing distribution through their screening process.

Design/methodology/approach

This study uses questionnaires in collecting data that are distributed to the employees who process or handle PLS financing in Islamic banks in Yogyakarta, Indonesia. The independent variables are risk, financing screening process, analysis of financial statement and competency of the employees of Islamic banks. The data are processed using multiple regression.

Findings

This study finds that risk, the quality of financing screening process and the analysis of financial statement have positive influence on the PLS financing, whereas competency of employees of Islamic banks does not influence PLS financing.

Practical implications

The results of this study are expected to give contribution to increase the role of Islamic banks in encouraging PLS financing. The adequate screening, controlling and monitoring system in Islamic banks should be strengthened to encourage the quality of financing distributed.

Originality/value

Primary data are used in this study to know the perspective of Islamic bank employees in the financing division on the PLS financing. This study attempts to identify the perspective of employees who have direct relationship with the decision of financing in Islamic banks.
The contribution of tourism towards a more sustainable and inclusive society: key guiding principles in times of crisis
Authors: Cardoso Carla
Published: December 2020

Purpose

At a time when tourism is embarking on the path to recovery from the COVID-19 crisis, this paper aims to put forward a set of principles guiding the development of tourism to enable global society to become more inclusive and sustainable.

Design/methodology/approach

This paper adopted a descriptive design using views and data mainly published by 11 international organisations and specialised agencies between March and mid-June 2020. Content analysis was carried out to enable the research to identify features and the presence of challenges for tourism within international organisations’ documents and leaders’ speeches to compare them.

Findings

The results revealed that there are five key principles that may have a significant impact on tourism development, suggesting that these could be adopted for building a more inclusive and sustainable economy, while mitigating the impact of the COVID-19 crisis.

Practical implications

Adopting the five key principles recommended in this paper can help tourism to emerge stronger and in a more sustainable way from COVID-19 or other future crises. Equally, this can incite changes in policies, business practices and consumers’ and locals’ behaviours with a view to building a truly sustainable sector.

Originality/value

This study helps to reconfirm existing knowledge in the COVID-19 context by highlighting five guiding principles that can help tourism players to respond to this crisis disruption and future ones via transformative innovation. In doing so, these will also be contributing to the achievement of the ideals and aims of the Sustainable Development Goals.
Replication Power and Regression to The Mean
Authors: Held Leonhard , Pawel Samuel , Schwab Simon
Published: December 2020

If a scientific study reports a discovery with a p-value at or around 0.05, how credible is it? And what are the chances that a replication of this study will produce a similarly “significant” finding? Leonhard Held, Samuel Pawel and Simon Schwab's answers may surprise you
Nightingale's Overlooked Scutari Statistics
Authors: Small Hugh
Published: December 2020

As Florence Nightingale's bicentenary year draws to a close, author Hugh Small shares and discusses some of her “long-neglected” but “most important” statistics, comparing death rates in hospitals in Crimea and Scutari during the Crimean War
What's The Big Idea? Ridge Regression and Regularisation
Authors: Vinod H. D.
Published: December 2020

H. D. Vinod marks the 50th anniversary of an idea that has become “an essential concept in data science”
How Scrambling your Data can Help you Think more Clearly
Authors: Barnett Adrian
Published: December 2020

To avoid arguments over disappointing results, Adrian Barnett suggests scrambling your statistics before sharing the final report
Association between gender and outcomes of acute burns patients
Authors: Perkins Monica , Abesamis Gerald M. , Cleland Heather , Gabbe Belinda J. , Tracy Lincoln M.
Published: December 2020

Background

Burn injuries are a complex and serious public health concern. Where the total body surface area of the burn exceeds 50%, mortality rates as high as 48% have been reported. While the association between gender and burn injury outcomes has been explored, findings are inconsistent.

Methods

Adult patients (>15 years) admitted between 1 July 2009 and 30 June 2018 to intensive care units of burn centres that provide specialist burn care in Australia and New Zealand were included. Raw mortality rates were examined and a multivariable Cox proportional hazards regression was used to investigate the association between gender and time to in‐hospital death.

Results

There were 2227 eligible burn injury admissions. Men comprised the majority (77.6%). The proportion of women who died in hospital was greater than men and the adjusted odds of in‐hospital mortality were 34% lower in men (odds ratio 0.66; 95% confidence interval (CI) 0.45–0.98). The unadjusted rate of in‐hospital mortality for men was 44% lower than women (hazard ratio 0.56; 95% CI 0.41–0.76). After adjusting for confounders, there was no association between gender and survival time (hazard ratio 0.76; 95% CI 0.54–1.06).

Conclusion

After adjustment for key differences in case‐mix between men and women, there was an association between gender and in‐hospital mortality and no association between gender and time to death. Our findings indicate that the worse outcomes observed for women are associated with different age and patterns of injury, and provide further information to direct and inform targeted prevention measures for vulnerable populations.
Ovine abortion and stillbirth investigations in Australia
Authors: Clune T , Beetson S , Besier S , Knowles G , Paskin R , Rawlin G , Suter R , Jacobson C
Published: December 2020

Fetal loss and lamb mortality between mid‐pregnancy and weaning are important economic and welfare issues for the Australian sheep industry. The aim of this study was to determine common causes of ovine abortion and stillbirths based on submissions to veterinary laboratories and identify factors that impact the determination of an aetiological diagnosis. Data for 529 investigations on abortion or stillbirth between 2000 and 2018 were retrieved from four state veterinary laboratories in Western Australia, South Australia, Victoria and Tasmania. An aetiological diagnosis was made for 57% of investigations. Investigations that included placental tissue samples were more than twice as likely to have an aetiological diagnosis compared to investigations without placenta (P = 0.017, 95% confidence interval 1.1, 4.5). Of the investigations where an aetiological diagnosis was made, 81% involved infectious abortion, withCampylobacterspp. (32%),Listeriaspp. (25%) andToxoplasma gondii(9%) being the three most common abortigenic pathogens implicated. The remaining 19% of investigations with an aetiological diagnosis included a wide range of infectious and non‐infectious diseases. Diagnoses made varied year to year and between states. No evidence of exotic abortigenic pathogens were reported. Veterinary practitioners can improve the probability of an aetiological diagnosis by emphasising to farmers the importance of collecting any aborted material, especially placenta, and appropriate storage of the tissues until they can be submitted to the laboratory. Some diseases that cause abortion in Australian sheep have zoonotic potential, and veterinary practitioners play an important role in educating clients about appropriate hygiene when handling pregnant and lambing ewes or any aborted material.
Developments allergy in 2019 through the eyes of Clinical and Experimental Allergy, Part II clinical allergy
Authors: Roberts Graham , Almqvist C. , Boyle R. , Crane J. , Hogan S.P. , Marsland B. , Saglani S. , Woodfolk J.A.
Published: December 2020

In the second of two linked articles, we describe the development in clinical as described by Clinical & Experimental Allergy and other journals in 2019. Epidemiology, clinical allergy, asthma and rhinitis are all covered. In this article, we described the development in the field of allergy as described by Clinical and Experimental Allergy in 2019. Epidemiology, clinical allergy, asthma and rhinitis are all covered.
Weight loss‐induced increase in fasting ghrelin concentration is a predictor of weight regain: Evidence from the Diabetes Remission Clinical Trial (DiRECT)
Authors: Thom George , McIntosh Alasdair , Messow Claudia‐Martina , Leslie Wilma S. , Barnes Alison C. , Brosnahan Naomi , McCombie Louise , Malkova Dalia , Al‐Mrabeh Ahmad , Zhyzhneuskaya Sviatlana , Welsh Paul , Sattar Naveed , Taylor Roy , Lean Michael E. J.
Published: December 2020

Aim

To investigate whether appetite‐related hormones were predictors of weight regain in the Diabetes Remission Clinical Trial (DiRECT).

Materials and Methods

DiRECT is a cluster‐randomized clinical trial, designed to assess the effect of weight loss on type 2 diabetes remission. For this post hoc analysis, data were available for 253 (147 interventions, 106 controls) individuals with type 2 diabetes (age 53.6 ± 7.5 years, body mass index 34.7 ± 4.4 kg/m2, 59% men). Intervention participants received a 24‐month weight management programme, and controls remained on usual diabetes care. Fasting plasma concentrations of leptin, ghrelin, glucagon‐like peptide‐1 and peptide YY were measured at baseline, 12 months and 24 months in all participants, and at 5 months in a subset of participants in the intervention (n = 56) and control groups (n = 22). Potential predictors were examined using multivariable linear regression models.

Results

The intervention group lost 14.3 ± 6.0% body weight at 5 months but regained weight over time, with weight losses of 10.0 ± 7.5% at 12 months and 7.6 ± 6.3% at 24 months. Weight loss in controls was 1.1 ± 3.7% and 2.1 ± 5.0% at 12 and 24 months, respectively. Body weight increased by 2.3% (95% confidence interval [CI] 0.4, 4.1; P = 0.019) between 12 and 24 months for every 1‐ng/mL increase in ghrelin between baseline and 12 months, and weight regain between 12 and 24 months was increased by 1.1% (95% CI 0.2, 2.0; P = 0.023) body weight for every 1‐ng/mL increase in ghrelin at 12 months.

Conclusion

The rise in ghrelin (but not any other measured hormone) during diet‐induced weight loss was a predictor of weight regain during follow‐up, and concentrations remained elevated over time, suggesting a small but significant compensatory drive to regain weight. Attenuating the effects of ghrelin may improve weight‐loss maintenance.
The structural basis of accelerated host cell entry by SARS‐CoV‐2†
Authors: Seyran Murat , Takayama Kazuo , Uversky Vladimir N. , Lundstrom Kenneth , Palù Giorgio , Sherchan Samendra P. , Attrish Diksha , Rezaei Nima , Aljabali Alaa A. A. , Ghosh Shinjini , Pizzol Damiano , Chauhan Gaurav , Adadi Parise , Mohamed Abd El‐Aziz Tarek , Soares Antonio G. , Kandimalla Ramesh , Tambuwala Murtaza , Hassan Sk. Sarif , Azad Gajendra Kumar , Pal Choudhury Pabitra , Baetas‐da‐Cruz Wagner , Serrano‐Aroca Ángel , Brufsky Adam M. , Uhal Bruce D.
Published: December 2020

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is the causative agent of the pandemic coronavirus disease 2019 (COVID‐19) that exhibits an overwhelming contagious capacity over other human coronaviruses (HCoVs). This structural snapshot describes the structural bases underlying the pandemic capacity of SARS‐CoV‐2 and explains its fast motion over respiratory epithelia that allow its rapid cellular entry. Based on notable viral spike (S) protein features, we propose that the flat sialic acid‐binding domain at the N‐terminal domain (NTD) of the S1 subunit leads to more effective first contact and interaction with the sialic acid layer over the epithelium, and this, in turn, allows faster viral ‘surfing’ of the epithelium and receptor scanning by SARS‐CoV‐2. Angiotensin‐converting enzyme 2 (ACE‐2) protein on the epithelial surface is the primary entry receptor for SARS‐CoV‐2, and protein–protein interaction assays demonstrate high‐affinity binding of the spike protein (S protein) to ACE‐2. To date, no high‐frequency mutations were detected at the C‐terminal domain of the S1 subunit in the S protein, where the receptor‐binding domain (RBD) is located. Tight binding to ACE‐2 by a conserved viral RBD suggests the ACE2‐RBD interaction is likely optimal. Moreover, the viral S subunit contains a cleavage site for furin and other proteases, which accelerates cell entry by SARS‐CoV‐2. The model proposed here describes a structural basis for the accelerated host cell entry by SARS‐CoV‐2 relative to other HCoVs and also discusses emerging hypotheses that are likely to contribute to the development of antiviral strategies to combat the pandemic capacity of SARS‐CoV‐2.
EcoSun Pass: A tool to evaluate the ecofriendliness of UV filters used in sunscreen products
Authors: Pawlowski S. , Herzog B. , Sohn M. , Petersen‐Thiery M. , Acker S.
Published: December 2020

Objective

Sunscreens play a major role in the EU sun protection strategy in order to prevent humans from UV light‐induced skin damage. In recent years, the demand for high‐quality sunscreen products including aspects of broad range and photostability of the UV protection, showing good spreadability onto human skin and excellent sensorial properties during and after application has increased. Environmental aspects are considered. Sunscreens are complex compositions, with UV filters being the key element in the formulations reaching up to about 30% in content in the final product. Some of these ingredients, however, may be regarded as hazardous for the aquatic environment. Nevertheless, the aquatic ecosystem represents only a single environmental compartment, which may be impacted by UV filters. Therefore, the EcoSun Pass (ESP) tool was developed in order to assess the overall environmental impact of UV filters in combination with its efficacy (Sun Protection Factor, SPF and UVA Protection Factor, UVA‐PF).

Methods

For that purpose, at first 24 of the EU‐approved UV filters for sunscreen applications were evaluated for their environmental hazard profiles. Nine example UV filter compositions representing both SPF 30 and 50 were evaluated for ecofriendliness using the ESP tool.

Results

The results revealed that two out of four SPF 30 compositions are considered as ecofriendly. Likewise, from the SPF 50 two out of five did meet the criteria for ecofriendliness. Furthermore, the results showed that most ecofriendly example formulations have also the lowest overall UV filter content in the product, based on the use of highly innovative and least hazardous UV filters.

Conclusion

These results demonstrate that the tool is applicable to various formulations being present on the market and thus allows for a selection of most ecofriendly and efficient UV filters to be used in sunscreens.
Dense TiN‐Ni cermets with improved sinterability, microstructure, and mechanical properties using Ni‐coated TiN powders
Authors: Xie Dan , Xiong Huiwen , Wu Yuxue , Gan Xueping , Li Zhiyou , Zhou Kechao
Published: December 2020

To solve the poor sinterability and wettability between TiN ceramic and pure metal via using coated composite powders, dense TiN‐Ni cermets with uniform microstructure and fine grains were developed at a low sintering temperature of 1300℃ in this work. TiN powders were firstly activated in a strong acid solution, in order to achieve a step‐like surface; Ni‐coated TiN powders showed an uniform and controllable morphology. Two types of TiN‐Ni cermets based on conventional milled powders and Ni‐coated TiN composite powders were fabricated by spark plasma sintering (SPS), and used for the comparison concerning the sintering behavior, microstructure and related mechanical properties. Results showed that Ni‐coated TiN composite powders helped to improve the sinterability between ceramic and metal, which is rather beneficial to obtain dense TiN‐Ni cermets with homogeneous microstructure and high mechanical properties. Compared to those of conventional TiN‐Ni, the relative density, Rockwell hardness and fracture toughness increased from 84.9% to 96.6%, 80.2 to 84.3, and 10.2 MPa·m1/2 to 14.7 MPa·m1/2, with a rather low sintering temperature of 1300 ℃, respectively.
Methods for prevention of early childhood caries: Overview of systematic reviews
Authors: Soares Renata Cristina , da Rosa Saulo Vinicius , Moysés Simone Tetu , Rocha Juliana Schaia , Bettega Patricia Vida Cassi , Werneck Renata Iani , Moysés Samuel Jorge
Published: December 2020

Early childhood caries (ECC) is a global problem, disproportionately affecting disadvantaged populations. The aim of this study was to evaluate systematically the available scientific evidence on the effectiveness of methods for ECC prevention. Six electronic databases were searched. Two independent reviewers selected the publications and analysed the quality of the included systematic reviews. Thirteen studies were included. Overall, eight reviews were classified with methodological quality critically low using the AMSTAR 2, whereas five reviews achieved a high risk of bias using the ROBIS tool. The methods identified that were positively related to the prevention of ECC were as follows: preventive dental programmes for pregnant women; advice on diet and feeding; prenatal oral health care; integration of maternal and children's oral health promotion into nursing practice; maternal oral health programmes undertaken by non‐dental health professionals; dental health education in combination with the use of fluoride for children; early preventive dental visits; and the use of fluoride varnish and toothpastes with more than 1000 ppm of fluoride. The currently available evidence supporting the effectiveness of methods for prevention of ECC, although suggesting some methods of greater potential, is still lacking due to the methodological quality of the systematic reviews and the included primary studies.
Influence of lightness difference of single anterior tooth to smile attractiveness
Authors: Ntovas Panagiotis , Diamantopoulou Sofia , Gogolas Nikolaos , Sarri Vasileia , Papandreou Andreas , Sakellaridi Eirini , Petrakos George , Papazoglou Efstratios
Published: December 2020

Objectives

To evaluate the influence of lightness difference of a single anterior maxillary tooth on difference smile attractiveness.

Methods

A frontal view full‐portrait image of a smiling male Caucasian, was digitally modified altering a single tooth, creating a series of images with varying lightness (ΔL) for the maxillary central, lateral and canine. A total of 160 participants (80 dentists, 80 laypersons) were asked to fill out a Visual Analog Scale questionnaire for every image recording smile attractiveness.

Results

For central incisors ΔL≥1 negatively affected attractiveness. There was a higher tolerance for lightness mismatch when one lateral incisor is lighter and the same applies when the canine was darker. Difference in lightness affected smile attractiveness both for dentists and laypersons. No difference between males and females was observed for the dentists. For laypersons, females perceived smiles with lightness difference as significantly less attractive compared to males. Dentist's age did not affect smile attractiveness perception. Younger laypersons perceived darker color, as less attractive.

Conclusions

Changes in lightness of a single anterior tooth significantly affected smile attractiveness in a different way for the central vs lateral vs canine. For the dentists, age and gender did not significantly affect smile perception, in contrast to laypeople.

Clinical significance

Lightness differences of a single anterior tooth affects smile attractiveness.
Adhesive dentistry: Current concepts and clinical considerations
Authors: Perdigão Jorge , Araujo Edson , Ramos Renato Q. , Gomes George , Pizzolotto Lucas
Published: December 2020

Objectives

To address contemporary concepts in adhesive dental materials with emphasis on the evidence behind their clinical use.

Overview

Adhesive dentistry has undergone major transformations within the last 20 years. New dental adhesives and composite resins have been launched with special focus on their user‐friendliness by reducing the number of components and/or clinical steps. The latest examples are universal adhesives and universal composite resins. While clinicians prefer multipurpose materials with shorter application times, the simplification of clinical procedures does not always result in the best clinical outcomes. This review summarizes the current evidence on adhesive restorative materials with focus on universal adhesives and universal composite resins.

Conclusions

(a) Although the clinical behavior of universal adhesives has exceeded expectations, dentists still need to etch enamel to achieve durable restorations; (b) there is no clinical evidence to back some of the popular adjunct techniques used with dental adhesives, including glutaraldehyde‐based desensitizers and matrix metalloproteinase inhibitors; and (c) the color adaptation potential of new universal composite resins has simplified their clinical application by combining multiple shades without using different translucencies of the same shade.

Clinical Significance

New adhesive restorative materials are easier to use than their predecessors, while providing excellent clinical outcomes without compromising the esthetic quality of the restorations.
Assessing Association Between Team Structure and Health Outcome and Cost by Social Network Analysis
Authors: Kuo Yong‐Fang , Agrawal Pooja , Chou Lin‐Na , Jupiter Daniel , Raji Mukaila A.
Published: December 2020

Background/Objective

To assess the impact of team structure composition and degree of collaboration among various providers on process and outcomes of primary care.

Design

Cross‐sectional study.

Setting

Data from 20% randomly selected primary care service areas in the 2015 Medicare claims was used to identified primary care practices.

Participants

449,460 patients with diabetes, heart failure, or chronic obstructive pulmonary disease cared for by the identified primary care practices.

Measurements

SNA network measures, including edge density, degree centralization, and betweenness centralization for each practice.

Results

When compared to practices with MDs and nurse practitioners (NPs) or/and physicians assistants (PAs), the practices with MDs only had lower degree of centralization and higher MD‐to‐MD connectedness. Within the primary care practices comprising MDs, NPs or/and PAs, the non‐physician providers were more connected (measured as edge density) to all providers in the practice but with higher degree of centralization compared to the MDs in the practice. After adjusting for patient characteristics and type of practice, higher edge density was associated with lower odds of hospitalization (odds ratio [OR]: 0.89, 95% Confidence Interval [CI]: 0.79–0.99), emergency department (ER) admission (OR: 0.80, 95% CI: 0.70–0.92), and total spending (cost ratio [CR]: 0.86, standard error of the mean [SE]: 0.038). Conversely, higher degree centralization was associated with higher rates of hospitalization (OR: 1.15, 95% CI: 1.03–1.28), ER admission (OR: 1.23, 95% CI: 1.08–1.40), and total spending (CR: 1.14, SE: 0.037). However, higher degree centralization was associated with lower rates of potentially inappropriate medications (OR: 0.90, 95% CI: 0.81, 0.99). Team leadership by an NP versus an MD were similar in the rate of ER admissions, hospitalizations, or total spending.

Conclusion

Our findings showed that highly connected primary care practices with high collaborative care and less top‐down MD‐centered authority have lower odds of hospitalization, fewer ER admissions, and less total spending; findings likely reflecting better communication and more coordinated care of older patients.
The health care utilization model: Application to dental care use for Black and Hispanic children
Authors: Song Jihee , Tomar Scott , Duncan R. Paul , Fogarty Kate , Johns Tracy , Kim Jeong Nam
Published: December 2020

Objectives

To explore the pathway associated with dental service use among Hispanic and non‐Hispanic Black children, applying Andersen's model of health care service utilization.

Methods

Samples of Hispanic (n = 5,055) and non‐Hispanic (NH) Black (n = 2,695) children aged 2–17 years from the 2016 National Survey of Children's Health (NSCH) were included in this study. We used structural equation modeling (SEM) to examine the path of the relationship between dental care visits and the three groups of characteristics in Andersen's behavioral model.

Results

In the models for Hispanic and non‐Hispanic Black children, parents' educational attainment directly and positively affected income and having insurance. Also, insurance (Hispanic children: β = 0.17, P ≤ 0.01; NH Black children: β = 0.25, P ≤ 0.01) and age of the child (Hispanic children: β = 0.14, P ≤ 0.01; NH Black: β = 0.21, P ≤ 0.01) directly and positively affected dental care use. However, there was no direct effect of the need factor on dental care use in either model.

Conclusions

Children may receive dental services that eliminate acute dental problems, probably as a result of the ACA and CHIP coverage. The patterns of findings suggest the need for policy changes to improve pediatric dental coverage and promote professional recommendations for effective dental hygiene.
Circulating cell‐free DNA species affect the risk of hepatocellular carcinoma in treated chronic hepatitis B patients
Authors: Papatheodoridi Alkistis , Chatzigeorgiou Antonios , Chrysavgis Lampros , Lembessis Panagiotis , Loglio Alessandro , Facchetti Floriana , Cholongitas Evangelos , Koutsilieris Michael , Lampertico Pietro , Papatheodoridis George
Published: December 2020

Hepatocellular carcinoma (HCC) may still develop in chronic hepatitis B (CHB) patients even under effective long‐term oral antiviral therapy, but its pathogenesis in the setting of long‐standing inhibition of viral replication has not been completely elucidated. We investigated whether species of circulating cell‐free DNA (cfDNA) may be involved in the process of hepatocarcinogenesis in treated CHB patients. Serum samples were obtained from HBeAg‐negative CHB patients with (HCC cases, n = 37) or without HCC development during the first 5 years of oral antiviral therapy (controls, n = 74). HCC cases and controls were matched 1:2 for age, sex and platelets. Determination of different circulating cfDNA species (before HCC diagnosis in HCC cases) including total cfDNA quantity, levels of Alu repeat DNA and RNase P coding DNA, copies of mitochondrial DNA and levels of 5‐methyl‐2′‐deoxycytidine as an indicator of DNA methylation was performed. HCC cases compared with controls had higher median levels of Alu247 (123 vs 69 genomic equivalent, p = .042) and RNase P coding DNA (68 vs 15 genomic equivalent, p < .001). In contrast, median cfDNA concentration, Alu115 levels, Alu247/Alu115 ratio as an index of DNA integrity and mitochondrial DNA copies did not differ significantly between HCC cases and controls. Receiver operating characteristic curve analysis showed that levels RNase P coding DNA offered good prediction of subsequent HCC development (c‐statistic: 0.80, p < .001). In conclusion, serum levels of RNase P coding DNA are increased years before HCC diagnosis and could be potentially helpful in the prediction of the HCC risk in treated HBeAg‐negative CHB patients.
Of clocks and coenzymes in plants: intimately connected cycles guiding central metabolism?
Authors: Fitzpatrick Teresa B. , Noordally Zeenat
Published: December 2020

Plant fitness is a measure of the capacity of a plant to survive and reproduce in its particular environment. It is inherently dependent on plant health. Molecular timekeepers like the circadian clock enhance fitness due to their ability to coordinate biochemical and physiological processes with the environment on a daily basis. Central metabolism underlies these events and it is well established that diel metabolite adjustments are intimately and reciprocally associated with the genetically encoded clock. Thus, metabolic pathway activities are time‐of‐day regulated. Metabolite rhythms are driven by enzymes, a major proportion of which rely on organic coenzymes to facilitate catalysis. The B vitamin complex is the key provider of coenzymes in all organisms. Emerging evidence suggests that B vitamin levels themselves undergo daily oscillations in animals but has not been studied in any depth in plants. Moreover, it is rarely considered that daily rhythmicity in coenzyme levels may dictate enzyme activity levels and therefore metabolite levels. Here we put forward the proposal that B‐vitamin‐derived coenzyme rhythmicity is intertwined with metabolic and clock derived rhythmicity to achieve a tripartite homeostasis integrated into plant fitness.
Elevational gradients in constitutive and induced oak defences based on individual traits and their correlated expression patterns
Authors: Galmán Andrea , Abdala‐Roberts Luis , Wartalska Pola , Covelo Felisa , Röder Gregory , Szenteczki Mark A. , Moreira Xoaquín , Rasmann Sergio
Published: December 2020

Elevational gradients are useful ecological settings for revealing the biotic and abiotic drivers of plant trait variation and plant–insect interactions. However, most work focusing on plant defences has looked at individual traits and few studies have assessed multiple traits simultaneously, their correlated expression patterns, and abiotic factors associated with such patterns across elevations. To address this knowledge gap, we studied elevational variation in direct (phenolic compounds) and indirect (volatile organic compounds) constitutive defences and their inducibility after feeding by a specialist beetleAltica quercetorumin saplings of 18 wild populations ofQuercus pyrenaica. We tested for: 1) clines in each defensive trait individually, 2) their patterns of correlated expression and 3) associations between any such clines and climatic factors. We found that constitutive direct defences (lignins and hydrolysable tannins) decreased with increasing elevation. We observed no elevational gradient for constitutive indirect defences (volatile organic compounds) or the inducibility of direct or indirect defensive traits when looking at groups of compounds. However, at individual tree‐level, increased induction of two monoterpenes (α‐fenchene and camphene) at higher elevation was shown. Furthermore, we show a significant pattern of co‐expression of constitutive and induced phenolics across populations, which weakened with increasing elevation. Finally, we found no evidence that climatic factors were associated with either individual or correlated trait expression patterns across elevations. Overall, these findings call for moving beyond elevational clines in individual plant defences, and argue that assessing elevational shifts in trait correlated expression patterns and their underlying mechanisms can increase our understanding of plant defence evolution and plant–herbivore interactions along environmental gradients.
Synergistic effect of platelet‐rich plasma in combination with fractional carbon dioxide laser versus its combination with pulsed dye laser in striae distensae: A comparative study
Authors: Neinaa Yomna Mazid El‐Hamd , Gheida Shereen Farouk , Mohamed Dareen Abd El‐Aziz
Published: December 2020

Background

Striae distensae (SD) are very common atrophic cutaneous scarring that are therapeutically challenging. Various kinds of laser had been suggested as effective treatment modalities for SD. In addition, platelet‐rich plasma (PRP) was recently recommended for its therapy.

Objective

To evaluate the synergistic role of PRP injection as a combined modality to fractional CO2 laser (Fr CO2) versus its combination with pulsed dye laser (PDL) in SD.

Patients and methods

Thirty SD patients were included in this study and treated by intradermal injection of autologous PRP on both sides, followed by laser therapy (Fr CO2 laser on right side and PDL on left side). They received 3 treatment sessions at 6 weeks interval.

Results

Both treatment sides reported significant clinical improvements of SD lesions, evidenced by significant reduction of width of striae lesions and significant improvement of skin texture. Furthermore, significantly higher degree of clinical improvements were observed in response to treatment sessions by combined PRP with Fr CO2 laser rather than combined PRP with PDL. Generally, post‐inflammatory hyperpigmentation (PIH) were mild in all patients. Histopathologically, SD lesions showed improvement of epidermal thickness, and more homogenization and regular orientation of dermal collagen fibers in both treatment sides, with more significant improvement on the side treated by combined PRP with Fr CO2 laser sessions rather than the other side.

Conclusions

PRP injection in combination with Fr CO2 laser or PDL is considered safe and effective therapeutic regimens for SD. However, its combination with Fr CO2 laser is more promising with better outcome and fewer side effects.
Prevalence of mild behavioural impairment: a systematic review and meta‐analysis
Authors: Pan Yining , Shea Yat‐Fung , Li Siwen , Chen Ruijun , Mak Henry Ka‐Fung , Chiu Patrick Ka‐Chun , Chu Leung‐Wing , Song You‐qiang
Published: December 2020

Aim

Mild behavioural impairment (MBI) is a neurobehavioural syndrome characterized by emergent neuropsychiatric symptoms in later life. There has been no systematic review or meta‐analysis on the prevalence of MBI. The main aim of the study is to calculate the pooled prevalence of MBI.

Methods

A search of the literature on MBI in mild cognitive impairment (MCI), cognitively normal (CN), and subjective cognitive impairment (SCI) and CN but at risk (CN‐AR) subjects published between 1 January 2003 and 28 September 2020 was conducted. Meta‐analysis using a random effects model was performed to determine the pooled estimate of the prevalence of MBI. Meta‐regression was performed to identify factors contributing to the variance of prevalence rate. A systematic review was also performed to study the impact of MBI in cognitive outcomes and its correlation to the pathology and genetics of Alzheimer's disease.

Results

Eleven studies conducted among 15 689 subjects underwent meta‐analysis, revealing the pooled prevalence of MBI to be 33.5% (95% confidence interval (CI): 22.6%–46.6%). Seven studies conducted among 1358 MCI subjects underwent meta‐analysis, revealing the pooled prevalence to be 45.5% (95%CI: 36.1%–55.3%). Four studies conducted among 13 153 CN subjects underwent meta‐analysis, revealing the pooled prevalence to be 17.0% (95%CI: 7.2%–34.9%). Five studies conducted among 1158 SCI or CN‐AR subjects underwent meta‐analysis, revealing the pooled prevalence to be 35.8% (95%CI: 21.4%–53.2%). A systematic review of 13 studies showed that MBI has a significant impact on cognitive deterioration and is associated with the pathology and genetics of Alzheimer's disease.

Conclusions

In MCI, CN, and SCI and CN‐AR subjects, MBI is common. Our finding is potentially useful in planning future clinical trials.
Influence of Manufacturing Variation on the Dynamic and Tribological Performance of Tilting Pad Journal Bearings
Authors: Urbiola-Soto Leonardo
Published: December 2020

A robust approach to investigate a tilting pad journal bearing (TPJB) as a whole tolerance stack-up assembly is presented. Normal component variation within actual design tolerances is considered. The vector loop is expanded via Taylor series for sensitive analysis. The bearing shell and tilting pad machined radiuses for each pad are found to be the more influential dimensional characteristics on the assembled clearance and preload. A leading edge relief (LER) was used to avoid unloaded pads fluttering, while maintaining a satisfactory bearing assembled clearance in the loaded pads throughout the resultant preload variation. Pivot flexibility and preload loss due to pad wear in service life were included in the preload variation assessment. Surface response multivariate multiresponse models were built for a 4-pad TPJB under load between pad (LBP) and load on pad (LOP) configurations. Desirability functions rendered the maximum and minimum rotordynamic coefficient and tribological parameter responses across speed. The LOP configuration showed more variation in the direct rotordynamic coefficients, while the LBP configuration indicated more sensitive cross-coupled coefficients with very strong sign change in some cases. Among the tribological performance parameters, the eccentricity and pad maximum pressure were more affected, followed by the minimum film thickness, and weakly by the power loss, and oil film temperature. The dispersion of the tribology parameters under normal manufacturing variation is found of importance. Four, and seven extreme geometrical state cases were identified for the LBP, and LOP bearing configurations, respectively.
Application of Ultrasonic Guided Wave in LMPH Tube of Ethylene Cracking Furnace
Authors: Ding Ju , Zhang Min , Liu Shuhong , Fu Minghai , Zhang Pugen , Wang Jielu
Published: December 2020

LMPH (Radiation heat exchange tube), the key section of ethylene cracking furnace, has various failure behaviors (e.g., carbonation, vulcanization, oxidation, and deformation) because of its rigorous working conditions and complicated structure [1]. In this paper, the ultrasonic guided wave is applicable to inspect the interior and surface of the LMPH tube. The results demonstrate that large components in the similar structure of the heat exchange bent tube bundle can be inspected effectively, efficiently, conveniently, compared with the traditional inspection method. One inspection example of an ethylene cracking furnace tube bundle is forwarded. The paper also provides an engineering application/case and valuable crafting process for the detection of similar structures by the ultrasonic guided wave method.