bluuebunny/crossref_metadata_2025 huggingface dataset:
No immunological changes after factor VIII product switch: An in depth analysis in haemophilia A patients
Authors: Schep Sarah J. , Fischer Kathelijn , Boes Marianne , Schutgens Roger E. G.
Published: June 2023

Background

A challenging complication in the treatment of haemophilia A is the formation of neutralizing anti‐FVIII antibodies (inhibitors). There is ongoing debate on the effect of FVIII product and inhibitor risk, rendering patients and physicians reluctant to switch FVIII‐products.

Aim

This study aimed to evaluate changes in the immune profile of haemophilia A patients after switching FVIII products and their possible relation to inhibitor development. Secondary, FVIII efficacy after switching were assessed.

Methods

Patients, who switched FVIII‐products between 2017–2019, were included in this single centre cohort study. Prospective comparison of immunoregulatory cells and markers by flow‐cytometry before and after the switch was performed in a subgroup. For the total cohort clinical data regarding inhibitor development and FVIII efficacy 1 year before and after switching were retrospectively collected.

Results

One‐hundred patients (including 39 with prospective immunological assessment) were analyzed, of which 31% switched from plasma‐derived (pdFVIII) to recombinant standard half‐life FVIII (SHL‐rFVIII), 47% between different SHL‐rFVIII, and 22% from pdFVIII/SHL‐rFVIII to rFVIII‐Fc. No remarkable changes in immunoregulatory cell functions were observed after switching, regardless the type of switch. None of the patients developed an inhibitor. FVIII efficacy, that is, FVIII usage, half‐life and annual bleeding rate (ABR), was similar before and after switch for the SHL products, whereas rFVIII‐Fc associated with a longer half‐life (13.1 vs. 15.0 h) and lower ABR (3.0 vs. 1.0).

Conclusions

Switching to a different FVIII product was not associated with inhibitor development, nor with differences in the immune profile. Switching to rFVIII‐Fc lead to lower ABR.
Reported prevalence of von Willebrand disease worldwide in relation to income classification
Authors: Stonebraker Jeffrey S. , Iorio Alfonso , Lavin Michelle , Rezende Suely M. , Srivastava Alok , Pierce Glenn F. , Coffin Donna , Tootoonchian Ellia , Makris Michael
Published: June 2023

Introduction

The diagnosis of von Willebrand disease (VWD) is complex and challenging, especially when diagnostic resources are limited. This results in a lack of consistency in identifying and reporting the number of people with VWD and variations in the VWD prevalence worldwide.

Aim

To analyze the reported prevalence of VWD worldwide in relation to income classification.

Methods

Data on the VWD prevalence from the World Federation of Hemophilia Annual Global Survey, national registries of Australia, Canada, and the United Kingdom, and the literature were analysed. The income level of each country was classified according to the World Bank.

Results

The mean VWD prevalence worldwide was 25.6 per million people. The VWD prevalence for high‐income countries (HIC) of 60.3 per million people was significantly greater (p < .01) than upper middle (12.6), lower middle (2.5) and low (1.1) income countries. The type 3 VWD prevalence for HIC of 3.3 per million people was significantly greater (p < .01) than lower middle (1.3) and low income (0.7) countries. The reported VWD prevalence was greater among females than males.

Conclusion

The reported VWD prevalence varied considerably across and within income classifications. The variability of type 3 VWD prevalence was less than the VWD prevalence (all types). The variability in detection and diagnosis of type 1 VWD presents a challenge in forming a consistent prevalence value across countries and income classifications.
Outlining inbreeding in the Brazilian higher education system
Authors: de Miranda Grochocki Luís Filipe , Cabello Andrea Felippe
Published: June 2023

This study describes characteristics of academic inbreeding in the Brazilian higher education system. Results show the rate of inbreeding significantly differs among distinct types of institutions, fields of knowledge, states and university ranking tiers. According to this study, inbreeding is most likely to be found in established elite research institutions, concentrated in the Southeast of Brazil, in the STEM fields. These also happen to be the main providers and most prestigious consumers of the well‐trained local academic workforce, supporting the conclusion that both internal and external factors could be influencing the high concentration of inbred scholars at prominent alma maters. It contributes to international literature by evaluating the role of individual characteristics and by showing how the expansion of higher education to more geographically distant areas may establish different patterns of inbreeding.
Compromising your morals: The perils of new beginnings as an auditor
Authors: Rankin Robert , Driskill Trish , Hartmann Caroline , Cassle Jacqui
Published: June 2023

This real‐world inspired case describes an ethical dilemma for a recently hired auditor and new Certified Public Accountant (CPA)/Associate Chartered Accountant (ACA) who must choose between cheating on a mandatory firm audit training and exam and suffering the possibility of negatively affecting her advancement with the firm and future compensation. The purpose of this case is to provide students the opportunity to identify an ethical dilemma, apply accounting ethics codes to evaluate potential responses and recommend an ethical course of action. Students completing this case will (1) understand the common pressures and complexities associated with an ethical dilemma; (2) be exposed to the American Institute of Certified Public Accountants' (AICPA Code) Code of Professional Conduct and the International Ethics Standards Board (IESBA Code) International Code of Ethics for Professional Accountants; (3) apply knowledge of the AICPA Ethics Decision Tree to a real‐world inspired ethical dilemma; (4) evaluate and analyse the various courses of action to an ethical dilemma; and (5) demonstrate the impact tone at the top and organizational culture have on employees and the firm. The case was very effective in exposing and enhancing student's overall knowledge 4.28 (σ = 0.57) and application 4.28 (σ = 0.65) of the AICPA Code.
The fallacy of the lump of labour theory: Evidence for Latin America
Authors: APELLA Ignacio
Published: June 2023

In a context of population ageing, this article analyses the “lump of labour” theory using empirical evidence from Latin America. Instead of finding a crowding‐out effect, estimations using a fixed effects model on a panel of annual data drawn from household surveys in 11 countries between 2002 and 2019 suggest a positive correlation between the employment rates of older adults and young people. Additionally, results show a positive association between the labour incomes of older and young workers. These findings could indicate that an expansion in the employment of older adults maintains economic growth and, therefore, a greater demand for labour, which could be supplied by young people.
Nanoindentation‐induced evolution of atomic‐level properties in silicate glass: Insights from molecular dynamics simulations
Authors: Ding Linfeng , Lu Ranran , Wang Lianjun , Zheng Qiuju , Mauro John C. , Zhang Zhen
Published: June 2023

Indentation has been widely used for investigating the mechanical behavior of glasses. However, how the various microscopic properties (such as atomic structure and mechanics) of glass evolve from the immediate contact with the indenter to the far‐field regions, and how these observables are correlated to each other remain largely unknown. Here, using large‐scale molecular dynamics simulations, we investigate the response of a prototypical sodium silicate glass under shape contact load up to an indentation depth of 25 nm. Both the short‐ and intermediate‐range structures are found to exhibit notable changes below the indent, indicating that indentation deformation induces a more disordered and heterogeneous network structure. In addition, we find that the indentation‐induced changes of local properties all exhibit an exponential decaying behavior with increasing distance from the indent. Comparison of the characteristic decay lengths of these local properties indicates that the structural origins of shear flow and densification are the changes of the network modifier's coordination environment and the inter‐tetrahedral connection, respectively. The decay of densification is considerably slower than that of shear strain, implying that the former might contribute more to the deformation at the far‐field regions. Our findings not only contribute to an atomistic understanding of the indentation response of silicate glasses but also pave the way toward rational design of damage‐resistant glassy materials.
Stakeholder perspectives on intensive support teams for adults with intellectual disabilities who display behaviour that challenges in England
Authors: Kouroupa Athanasia , Hassiotis Angela , Hamza Leila , Courtenay Ken , Hall Ian , Langdon Peter E. , Taggart Laurence , Crossey Vicky , Lloyd‐Evans Brynmor , Morant Nicola
Published: June 2023

Background

Adults with intellectual disabilities often display behaviour that challenges that is a result of biological differences, psychological challenges, and lack of appropriate social support. Intensive Support Teams (IST) are recommended to support the care needs of this group and avoid hospitalisation. However, little attention has been paid to the perspectives of stakeholders who manage, work in, or use ISTs.

Method

Interviews and focus groups were conducted with 50 stakeholders (IST service managers and professionals, adults with intellectual disabilities, and family and paid carers) of ISTs. Services operated according to one of two service models previously identified in ISTs in England (enhanced or independent).

Results

Thematic analysis identified accessible and flexible support, individualised care, and the involvement of carers and other relevant agencies in management plans and reviews as features of good IST care highlighted by all stakeholder groups. IST managers and professionals described the key challenges of current IST provision as unclear referral criteria, limited interfaces with other local services, and perceived threats associated with funding and staff retention. Findings were similar between the two IST models.

Conclusions

ISTs are able to offer care and specialist support that is valued by families, service users and other care providers. However, they face several operational challenges that should be addressed if ISTs are to reach their potential along with community intellectual disability services in supporting adults with intellectual disabilities who display behaviour that challenges in the community.
School lunch portion sizes provided for children attending early years settings within primary schools: A cross‐sectional study
Authors: Pearce Jo , Wall Claire J.
Published: June 2023

Background

In England, many children attend an early years' setting (EYS) that is part of a primary school. Where a school lunch is available, this is often the same for both EYS and school children. This study explored how school lunch portion sizes served for 3–4‐year‐old EYS children compared with portion size guidance for EYS and schools, given that recommendations are different for EYS and school‐aged children.

Methods

Twelve schools were recruited in four local authorities, each of which provided a school lunch to children attending EYS (aged 3–4 years) and reception classes (aged 4–5 years) from the same menu. Two portions of each menu item were weighed, each day, for five consecutive days. Mean, median, standard deviation and correlation coefficient were calculated for each food item.

Results

Most caterers reported serving the same‐sized portions to both 3–4‐year‐olds and 5–7‐year‐olds. Food items falling outside of the typical range for EYS were more commonly above the range (10 food items) than below it (6 food items). Notably, portions of cakes and biscuits were larger than recommended. Portion weights falling outside of the recommended range for 4–10‐year‐olds were usually too small (12 of 14 items). Some foods provided by the schools in the study did not have typical portion sizes for EYS as they were not ‘good choices of foods to serve’.

Conclusions

These results suggest caterers may not be following guidelines appropriate for all the children they are catering for.
Development of the ward nurses' discharge‐oriented dietary support scale for older adult patients in Japan
Authors: Miyabe Akemi , Doi Mana , Kanoya Yuka
Published: June 2023

Aim

This study aimed to develop a ward nurses' dietary support scale, including physical, psychological, and social background factors in preparation for older adult patients' life after discharge.

Methods

We conducted a cross‐sectional study using a self‐reported questionnaire. Scale items were created based on a conceptual analysis, and refined by a Delphi survey. In total, 696 nurses across 16 acute care hospitals in Japan were eligible to participate. The questionnaire comprised 51 items that used a five‐point Likert‐type scale. These items were evaluated using exploratory factor analysis. Reliability was evaluated using Cronbach's alpha and intraclass correlation coefficients (ICC). Pearson's correlation coefficients were calculated to determine concurrent validity, and construct validity was analyzed using confirmatory factor analysis.

Results

Altogether, 241 surveys were included in the data analysis; 236 nurses participated in both the test and the retest. The exploratory factor analysis identified 20 items from three factors as follows: “Assessment for healthy eating behavior,” “Adjustment of the living environment, including family and caregiver, together with other professions,” and “Continual frailty assessment.” In the confirmatory factor analysis, the fitness indices supported these results. Cronbach's alpha was 0.932 and ICC was 0.867 for the overall scale. In the concurrent validity, the three factors had a moderate correlation (r = 0.295–0.537, P < .01 and r = 0.254–0.648, P < .01), except for one subscale.

Conclusions

We developed a ward nurses' dietary support scale, including physical, psychological, and social background factors in preparation for older adult patients' life after discharge. Its reliability and validity were confirmed.
The autoimmune vulnerability of the node of Ranvier
Authors: Querol Luis , Delmont Emilien , Lleixà Cinta
Published: June 2023

The nodes of Ranvier (NoR) are essential domains for nerve conduction and their disruption plays a key role in the pathophysiology of immune‐mediated neuropathies. Our understanding of the specialized nodal regions and the immune mechanisms that affect them is growing and has led to the update of peripheral neuropathy classification to include the autoimmune nodopathies, defined by the site of the autoimmune attack. Autoantibodies directed against molecules of the nodal region (as neurofascin‐140/186, neurofascin‐155, contactin‐1, contactin‐associated protein 1, contactin‐associated protein 2, gangliosides, LGI4, or myelin‐associated glycoprotein), macrophage‐induced paranodal demyelination, and phenotypic changes of the nodal domains of Schwann cells have been identified as key mechanisms in the pathogenesis of the autoimmune neuropathies. This review explores the current knowledge of the autoimmune vulnerability of the NoR, including the underlying mechanisms leading to dysfunction in the diverse autoimmune disorders.
Effect of combination of photobiomodulation 904 nm superpulsed laser therapy and Hippophae rhamnoides L. on third‐degree burn wound healing
Authors: Priyadarshi Ashok , Keshri Gaurav K. , Gupta Asheesh
Published: June 2023

Background

Burn is a traumatic injury and aesthetic scarless repair poses a great challenge in area of cosmetic dermatology. Focus on multimode therapeutic strategies to promote healing of burns by regulating various stages of healing is warranted. Photobiomodulation therapy (PBMT), a non‐invasive modality grabs the attention to repair impaired wounds. Seabuckthorn extract (SBTL‐ALE) is known to possess antioxidant, anti‐inflammation, and tissue‐repair abilities. Current study aims to assess the effect of combination treatment of PBM 904 nm superpulsed laser and SBTL‐ALE (2.5%) on repair of third‐degree burn in rats.

Methods

Rats were randomized into five groups: uninjured, control, SBTL‐ALE, 904 nm PBMT, and combination. A transdermal burn wound was induced on the dorsal side of rats of all groups except the uninjured group and respective treatment was applied for 7 days postwounding.

Results

Dual treatment increased wound area contraction compared to control and either treatment alone. Immunohistochemical analyses exhibited increased angiogenesis, dermal hydration, collagen synthesis, and maintained redox homeostasis as evidenced by enhanced expression (p < 0.05) of CD31, aquaporin3, collagen type 3, Nrf2, and HO1 in combination group compared with control. Conversely, pro‐inflammatory and oxidative stress markers exhibited reduced (p < 0.05) TNF‐α, IL‐6, IL‐1β, NOS‐2, ROS levels, and increased catalase activity in combined treatment. Furthermore, energy metabolizing enzymes viz. citrate synthase, CCO, and ATP contents were substantially (p < 0.05) increased, and LDH activity was reduced in the combination group.

Conclusions

Dual treatment (PBMT + SBTL‐ALE) prominently accelerates third‐degree burn wound healing in rats, which could pave the path for multimode therapeutic strategies for the management of burns and dermal cosmetic care.
Women with heart failure and their experiences of sexuality and intimacy: A qualitative content analysis
Authors: Markhus Lene Søyland , Mårtensson Jan , Keilegavlen Håvard , Fålun Nina
Published: June 2023

Aim and Objective

This study aimed to explore how women with heart failure experience intimacy and sexual activity.

Background

Knowledge about women diagnosed with heart failure and their sexual activity is scarce. By investigating the experience of sexual activity and intimacy of women diagnosed with heart failure, an alignment between current practice and patients' expectations and needs within this area might be obtained.

Design

A qualitative design was used.

Methods

Fifteen women diagnosed with heart failure were recruited from a heart failure outpatient clinic at a university hospital. The study was carried out from January to September 2018. The inclusion criteria were women >18 years, with estimated New York Heart Association Class II or III living together with a partner. Face‐to‐face semi‐structured interviews were undertaken at the hospital. The interviews were organised around a set of predetermined open‐ended questions, transcribed verbatim and analysed using a qualitative content analysis. COREQ guidelines were used.

Results

The analysis revealed one overarching theme characterises how living with heart failure has an impact on women's sexual relationship. Furthermore, three sub‐themes were identified: (1) redefining sexual activity, (2) reducing sexual activity and (3) maintaining sexual activity.

Conclusion

Women need information about sexual activity and heart failure in order to prevent fear and anxiety. It is important to include partners in patient consultations at heart failure outpatient clinics and in sexual counselling. It is furthermore essential to educate patients about sexual activity in relation to medication and comorbidities.

Relevance to Clinical Practice

Findings from this study support that information about sexuality and intimacy is a central part of the consultation in a heart failure outpatient clinic, and highlights the importance of not making assumptions about aging, frailty and interest in sexual expression.

Patient Contribution

Data were collected through face‐to‐face semi‐structured interviews.
Comparison of efficacy and usability of custom mandibular advancement devices fabricated with the conventional method and digital workflow: A pilot clinical study
Authors: Piskin Bulent , Yılmaz Savaş Tuba , Topal Sila Caglayan , Akbulut Kuddusi , Ezmek Bahadir , Uyar Alper , Sahin Nesrin , Karakoc Omer
Published: June 2023

Purpose

To compare the effects of fabricating methods of custom monoblock mandibular advancement devices (MADs) on usability and efficacy in patients with mild and moderate obstructive sleep apnea (OSA).

Materials and Methods

Digitally fabricated custom MADs (dMADs) were produced for 11 OSA participants who had previously used conventionally fabricated custom MADs (cMADs). The participants answered a modified usability questionnaire for both MADs, and the average scores that were given to the questionnaire were evaluated by age, sex, and body mass index (BMI), and the scores of cMADs and dMADs were compared. After 6 months of usage of each MAD, the apnea‐hypopnea index (AHI), mean and lowest oxygen saturations, and total sleep time were measured for efficacy assessment. Data were analyzed with Cronbach's alpha, Mann‐Whitney U, Kruskal‐Wallis, Wilcoxon signed‐rank, one‐way repeated measures analyses of variance, and Bonferroni tests (α = 0.05).

Results

Cronbach's alpha was found at 0.834 and 0.722 for the conventional and digital questionnaires, respectively. The usability scores of the dMADs were significantly higher than those of cMADs (p = 0.013). There was no difference in usability scores in terms of sex or BMI (p > 0.05). No statistically significant difference was found for cMAD (p = 0.113) among age groups; however, there was a significant difference for dMAD (p = 0.046). The AHI, mean, and lowest oxygen saturation values were significantly affected by MAD usage (p < 0.001). However, total sleep time values did not differ after the MAD treatments (p > 0.05). Significantly lower AHI and significantly higher lowest oxygen saturation values were observed with dMAD, while both appliances led to similar results for mean oxygen saturation and total sleep time values (p > 0.05).

Conclusions

Participant usability scores were higher for digitally manufactured MADs than conventionally manufactured MADs. However, both conventional and digital MADs were found effective in decreasing the AHI levels and increasing the mean and lowest oxygen saturation values of the participants.
Do African egg‐eating snakes (Dasypeltis) exhibit preference for eggs they eat?
Authors: Krupa J. J. , Slabach B. L.
Published: June 2023

African egg‐eating snakes (genus Dasypeltis) are medium‐sized obligate egg‐eating species capable of swallowing large eggs compared to facultative egg‐eating snakes of the same size. Dasypeltis have numerous adaptations for swallowing then crushing eggs to extract the content. Being dependent on an egg diet, it could be predicted that Dasypeltis have the ability to assess the quality of an egg then decide whether to reject or swallow it. For example, a small egg provides less food and takes less time to swallow than a large egg but swallowing a large egg could leave the snake more vulnerable to predation. Despite the possibility of Dasypeltis exhibiting egg preference, little research has addressed this. This study examined egg preference by five species of Dasypeltis in two laboratory experiments. In the first, five species of snakes were given a choice of the widest size range of eggs available from one order of birds. These included nine species of gallinaceous birds ranging from small, soft‐shelled king quail eggs to large, hard‐shelled turkey eggs. In the second experiment, snakes were given a choice of four eggs representing three genera of birds that occur in Africa represented by two galliform and two columbiform species. These eggs varied in volume, color, and hardness of shell. The results show Dasypeltis preferred certain eggs. Large snakes eat eggs of all sizes with preference for the largest, hardest eggs, while the smallest snakes ate only the smallest eggs. Snakes preferred columbiform eggs (dove and pigeon) over galliform eggs (king quail and Japanese quail). This study demonstrated that Dasypeltis in captivity do exhibit preferences for types and sizes of eggs.
The causal effects of inflammatory bowel disease on primary biliary cholangitis: A bidirectional two‐sample Mendelian randomization study
Authors: Zhang Hongchen , Chen Lanlan , Fan Zhongqi , Lv Guoyue
Published: June 2023

Background

Observational studies have indicated that the incidence of primary biliary cholangitis (PBC) is higher in inflammatory bowel disease (IBD) patients than that in healthy people. However, whether the correlation is causal remains unclear.

Methods

The genetic associations with IBD were obtained from publicly available genome‐wide association studies (GWAS) of European ancestry with 31 665 cases and 33 977 controls, consisting of 17 897 Crohn's disease (CD) and 13 768 ulcerative colitis (UC) cases. The genetic associations with PBC were obtained from a European GWAS with 2764 cases and 10 475 controls. A bidirectional two‐sample Mendelian randomization (MR) design was implemented to determine the causal relationship between IBD and PBC. In the forward MR, the IBD was treated as the exposure while the PBC was the exposure in the reverse MR. The inverse‐variance‐weighted (IVW) method was utilized as the main statistic method, and a series of sensitivity analyses were performed to detect heterogeneity and horizontal pleiotropy.

Results

A total of 99 valid instrumental variables (IVs) were selected for IBD and the number of IVs for PBC was 18. The forward MR analysis indicated that genetically predicted IBD (UC and CD) was significantly associated with an increased risk of PBC (IVW OR = 1.343; 95% CI: 1.220–1.466). Similar casual associations were observed in UC (IVW OR = 1.244; 95% CI: 1.057–1.430) and CD (IVW OR = 1.269; 95% CI: 1.159–1.379). Such results were still consistent in multiple MR methods. The reverse MR analysis implicated that genetic susceptibility to PBC might not alter the risk of IBD (IVW OR = 1.070; 95% CI: 0.984–1.164).

Conclusion

Our study found that genetically predicted IBD can increase the risk of PBC while not vice versa in the European population, which may enlighten the aetiology of PBC, together with the IBD patient management.
Comparison of the skeletodental effects of miniscrew‐anchored and tooth‐anchored facemask treatment in growing patients with skeletal class III malocclusions
Authors: Choi Youn‐Kyung , Park Jung Joo , Jeon Hyeran Helen , Kim Yong‐Il
Published: June 2023

Introduction

This retrospective study aimed to evaluate the skeletal and dental effects of the miniscrew‐anchored facemask in skeletal Class III growing patients and compare them with those of conventional tooth‐anchored facemasks.

Methods

Retrospectively a total of 50 patients with skeletal Class III (mean ANB: −1.12°) were investigated and divided into two groups according to the treatment modality. Twenty‐five patients were treated using the conventional tooth‐anchored facemask (T group: mean age 9.3 ± 1.1 years, mean ANB: −0.93°) whereas the other 25 were treated using a miniscrew‐anchored facemask (M group: mean age 9.7 ± 1.3 years. mean ANB: −1.61°). Two miniscrews were placed on the palate for bone anchorage. In both T and M groups, facemasks applied a force of 20–30° down on the occlusal plane, and the force increased from 200 g to 300–350 g per side throughout the treatments. The patients were instructed to wear facemasks for at least 14 h per day. A total of 16 angular and 11 linear cephalometric measurements were analysed to determine the skeletal and dental changes before and after facemask treatment. A paired t‐test was used to verify the effects before and after treatment in each group.

Results

All miniscrews were well maintained during treatment. The values of SNA, SN‐ANS, ANB and A to N‐Perp, which indicate anterior protraction of the maxilla, were significantly higher in the M group compared with the T group (P < .05). Proclination of the maxillary incisors, extrusion and mesialization of the maxillary molars were significantly greater in the T group (P < .05).

Conclusions

Miniscrew‐anchored facemask treatment increased the amount of maxillary protraction and reduced the dental side effects compared with conventional tooth‐anchored facemask treatment in growing patients with skeletal Class III malocclusion.
Emotional symptoms, dietary patterns and dental caries: A cross‐sectional study in adolescents
Authors: Guo Peirong , Zou Chaoyi , An Na , Huang Jianping , Yang Jie , Lu Qingyun
Published: June 2023

Objectives

This study investigates the relationship between emotional symptoms and dental caries in adolescents and the role of dietary patterns as mediating variables.

Methods

This cross‐sectional study used a multistage stratified random sample of schools, in Jiangsu, with a sample of 17,997 adolescents aged 11–19. Measures included emotional symptoms, dental caries, toothbrushing frequency, and dietary patterns. Logistic and Poisson regression models were conducted to test mediation hypotheses.

Results

The decayed, missing, and filled teeth index (DMFT) was related to depressive symptoms following adjustment for other variables (incidence rate ratios [IRR] = 1.09; p < 0.05), but not to anxiety symptoms level (IRR = 1.02; p > 0.05). The link between depressive symptoms and DMFT had a partial mediation impact on toothbrushing frequency (a, b, c′ all p < 0.05). Sugary foods, but not fried foods, partially mediated the link between depressive symptoms and caries when toothbrushing frequency was adjusted.

Conclusion

There are direct and indirect associations between emotional symptoms and caries; the latter may be due to changes in oral health behaviours that increase the risk of caries.
Permanent his bundle pacing: Description and comparison of four implantation techniques
Authors: Bontempi Luca , Fundaliotis Angelica , Moretti Marina , Sammartino Antonio Maria , Cantù Edoardo , Arabia Gianmarco , Baldassarre Irene , Giacopelli Daniele , Pitì Antonino , Curnis Antonio , Dell'Aquila Andrea
Published: June 2023

Introduction

Permanent His bundle pacing (HBP) is the most physiological pacing modality, and new implantation systems are now available. The aim of the present study was to describe and compare four different techniques to perform HBP.

Methods and results

We included all consecutive patients who underwent a HBP attempt in our initial experience between June 2020 and May 2022. The success and characteristics of the procedure were compared among four implantation techniques: the Biotronik Selectra 3D sheath with Solia S60 lead (Selectra 3D), the Boston Scientific Site Selective Pacing Catheter with Ingevity lead (SSPC), the Abbott steerable stylet locator with Tendril lead (Locator), and the use of a standard stylet manually pre‐shaped with a conventional pacing lead (Curved stylet). Ninety‐eight patients (median age 79 years [interquartile range, 73‐83], 83% men) were identified. The Selectra 3D technique was used in 43 procedures, SSPC in 26, Locator in 18 and Curved stylet in 11. The groups had similar clinical characteristics. Overall, procedural success was achieved in 91 patients (93%) with similar proportions among groups (p = .986). Fluoroscopy and procedural times were 6.0 (4.4‐8.5) and 60 (45‐75) min, respectively, without significant differences (p = .333 and p = .790). The rate of selective capture, the pacing threshold, and the paced QRS duration were also comparable. There was one pre‐discharge HBP lead dislodgment (1%) that required implant revision.

Conclusion

In our experience, four techniques for HBP achieved comparable results in terms of safety and effectiveness. The availability of different systems may lead to widespread use of physiological pacing.
Does disorganised attachment lead to auditory hallucinations via dissociation? An experimental study with an analogue sample
Authors: Puckett Joseph , Sood Monica , Newman‐Taylor Katherine
Published: June 2023

Objectives

Auditory hallucinations (such as hearing voices) are common in clinical and non‐clinical populations. Many people who hear voices also report early adversity and have an insecure attachment style. Current cognitive models suggest that dissociation mediates an association between disorganised attachment and auditory hallucinations, but this has not been tested experimentally.

Design

We recruited a non‐clinical analogue sample highly predisposed to auditory hallucinations and utilised an experimental design to examine the impact of disorganised attachment imagery on hallucinatory experiences, and whether dissociation mediates an expected association.

Methods

Participants completed self‐report measures of state auditory hallucinations and dissociation before and after random allocation to secure or disorganised attachment conditions.

Results

Attachment imagery did not affect auditory hallucinations. Both secure and disorganised attachment conditions increased state dissociation. Secure attachment imagery reduced paranoia, but state dissociation did not mediate this effect. An exploratory analysis found that trait dissociation fully accounted for the association between trait‐disorganised attachment and hallucinatory experience while controlling for paranoia.

Conclusions

Secure attachment imagery reduces paranoia but not auditory hallucinations and the impact on paranoia is not mediated by dissociation. Secure attachment imagery may be useful in reducing fears and distress associated with voices, rather than the frequency or severity of hallucinations. Disorganised attachment may increase hallucinatory experiences for people vulnerable to dissociation. Trait dissociation should be assessed in clinical settings and addressed where indicated as a means of targeting vulnerability to distressing voices.
Public policy research in Colombia: State of the art (phase 1), 2008–2018
Authors: Whittingham María Victoria
Published: June 2023

This review article presents the results of an exploratory study for illuminating the state of the research concerning public policy in Colombia. A core assumption of the project is that the national capacity (intellectual capital) for producing relevant and thorough research in public policy, theory and practice, is a key element for the quality of its democracy and the sustainability of the system. A systematic documentary review of the research papers produced between 2008 and 2018 was conducted, spanning a total of 1010 papers. The results point to the relevance of continuing this type of study within Colombia and to the need of involving all the stakeholders in a dialogue about how to improve the country's capacity to design, implement, and evaluate sound public policies.

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Testing emotional response coherence assumptions: Comparing emotional versus non‐emotional states
Authors: Constantinou Elena , Vlemincx Elke , Panayiotou Georgia
Published: June 2023

Although central to theories of emotion, emotional response coherence, that is, coordination among various emotion response systems, has received inconsistent empirical support. This study tests a basic assumption of response coherence, that is, that it characterizes emotional states defining their beginning and end. To do so, we (a) compare response coherence between emotional versus non‐emotional states and (b) examine how emotional coherence changes over time, before, during, and after an emotional episode. Seventy‐nine participants viewed neutral, pleasant, and unpleasant film clips and rated continuously how pleasant they felt (experience) before (anticipation), during, and after (recovery) each clip. Autonomic physiological arousal responses (skin conductance level, heart rate; physiology) and facial expressions (corrugator, zygomatic activity; expression) were recorded. Within‐person cross‐correlations between all emotional response pairs were calculated for each phase. Analyses comparing coherence during emotional versus neutral film viewing showed that only experience‐expression coherence was higher for emotional versus neutral films, indicating specificity for emotional states. Examining coherence across phases indicated that coherence increased from anticipation to emotional film viewing, as expected, for experience‐expression and experience‐physiology pairs (SCL only). Of those pairs, increased coherence returned to baseline during recovery, as theoretically assumed, only for experience‐corrugator activity coherence. Current findings provide empirical support for theoretical views of response coherence as a defining feature of emotional episodes, but mostly for the coherence between experience and facial expressions. Further research needs to investigate the role of sympathetic arousal indices, as well as the role of response coherence in emotional recovery.
The Challenges and Joys of Publicly Engaged Sociology
Authors: Misra Joya
Published: June 2023

In this essay, I lay out my motivations for doing publicly engaged sociology, emphasizing both the joys and the challenges of this work, and some of the key lessons that I have learned. I explore my attempts to impact policy at the federal level and the local level of my university, as well as efforts to shape changes across academia during the COVID‐19 crisis. I have found it meaningful to be working toward all of these changes. Moreover, making sense of the spaces that I inhabit, collecting data, exploring patterns, and connecting it to social theory, has deepened my thinking as a sociologist, and bettered my research more broadly.
Automatic International Hidradenitis Suppurativa Severity Score System (AIHS4): A novel tool to assess the severity of hidradenitis suppurativa using artificial intelligence
Authors: Hernández Montilla Ignacio , Medela Alfonso , Mac Carthy Taig , Aguilar Andy , Gómez Tejerina Pedro , Vilas Sueiro Alejandro , González Pérez Ana María , Vergara de la Campa Laura , Luna Bastante Loreto , García Castro Rubén , Alfageme Roldán Fernando
Published: June 2023

Background

Hidradenitis suppurativa (HS) is a painful chronic inflammatory skin disease that affects up to 4% of the European adult population. International Hidradenitis Suppurativa Severity Score System (IHS4) is a dynamic scoring tool that was developed to be incorporated into the doctor's daily clinical practice and clinical studies. This helps measure disease severity and guides the therapeutic strategy. However, IHS4 assessment is a time‐consuming and manual process, with high inter‐observer variability and high dependence on the observer's expertise.

Materials and methods

We introduce the Automatic International Hidradenitis Suppurativa Severity Score System (AIHS4), an automatic equivalent of IHS4 that deploys a deep learning model for lesion detection, called Legit.Health‐IHS4net, based on the YOLOv5 architecture. AIHS4 was trained on Legit.Health‐HS‐IHS4, a collection of HS images manually annotated by six specialists and processed by a novel knowledge unification algorithm.

Results

Our results show that, with the current dataset size, our tool assesses the severity of HS cases with a performance comparable to that of the most expert physician. Furthermore, the model can be implemented into CADx systems to support doctors in their clinical practice and act as a new endpoint in clinical trials.

Conclusion

Our work proves the potential usefulness of artificial intelligence in the practice of evidence‐based dermatology: models trained on the consensus of large clinical boards have the potential to empower dermatologists in their daily practice and replace current standard clinical endpoints.
Long‐term rice cultivation improved coastal saline soil properties and multifunctionality of subsoil layers
Authors: Zhu Yun , Sun Lei , Fu Qinling , Guo Bin , Lin Yicheng , Liu Xia
Published: June 2023

Rice cultivation has been found to be an effective and feasible approach for improving saline soils and increasing food production. Most studies on the improvement of rice cultivation on saline soil have focused on the several individual soil properties in the topsoil, and we know little about the importance of rice cultivation for improving multifunctionality in coastal saline soils. We investigated basic soil properties (soil physical sand content, soil physical clay content, pH, EC, soil organic carbon, total nitrogen, alkaline hydrolysis nitrogen, available potassium, available phosphorus), enzyme activities (urease, catalase, protease) and soil multifunctionality (SMF) in 0–20 cm, 20–40 cm, 40–60 cm, 60–80 cm and 80–100 cm soil layers with rice cultivated for 0 (tidal flat; CK), 20 (R20), 44 (R44) and 70 years (R70). We found that soil EC was alleviated markedly in the first 20 years after rice cultivation. Soil physical sand content, pH, EC and available potassium (AK) decreased while total nitrogen (TN), alkaline hydrolysis nitrogen (AN), urease (URE), catalase (CAT) activities and SMF increased with the increase in rice cultivation years. The highest soil total organic carbon (SOC) was shown in R44. Soil pH, EC, AK and physical sand content increased while SOC, TN, AN, enzyme activities decreased with the increase in soil depth. Redundancy (RDA) analysis showed soil physicochemical properties explained 97.53% of the variation in soil enzyme activities. Soil CAT, URE and protease (PRO) had a positive correlation with soil physical clay content, SOC, TN, AN and AP while negatively correlated with pH and AK. The increased SOC and clay content by rice cultivation might be the main reasons stimulating soil enzyme activities. In summary, long‐term rice cultivation could alleviate soil salinity, increased SMF down to 1 m, implying that rice cultivation effectively improved coastal saline soil, and the improvement could last for 70 years.
Framework for constructing multimodal transport networks and routing using a graph database: A case study in London
Authors: Park Seula , Cheng Tao
Published: June 2023

Most prior multimodal transport networks have been organized as relational databases with multilayer structures to support transport management and routing; however, database expandability and update efficiency in new networks and timetables are low due to the strict database schemas. This study aimed to develop multimodal transport networks using a graph database that can accommodate efficient updates and extensions, high relation‐based query performance, and flexible integration in multimodal routing. As a case study, a database was constructed for London transport networks, and routing tests were performed under various conditions. The constructed multimodal graph database showed stable performance in processing iterative queries, and efficient multi‐stop routing was particularly enhanced. By applying the proposed framework, databases for multimodal routing can be readily constructed for other regions, while enabling responses to diversified routings, such as personalized routing through integration with various unstructured information, due to the flexible schema of the graph database.
Conditional analyses of options for action: A partial defence
Authors: Rosenthal Jacob
Published: June 2023

The idea of multiple options for action in a specific situation is essential for choice and deliberation. But what exactly is an option for action? A simple and natural approach to this question is via conditional analyses. While conditional analyses ofdispositionsandabilitiesface well‐known objections and are widely considered untenable, I argue that several of these objections do not apply to conditional analyses ofoptions. Others do, but the analyses can be modified or interpreted in a suitable way so as to deal with them. One central difficulty, however, remains and can only partially be resolved. Still, all things considered, the prospects of conditional analyses of options for action are quite good; they should not be lightly dismissed.
Complex considerations – Fever and pancytopenia after solid organ transplantation
Authors: Francí Elena Valdés , Adekunle Ruth O. , Nucci Marcio , Pouch Stephanie M.
Published: June 2023

This case describes a 42‐year‐old man who underwent kidney transplantation and developed fevers, pancytopenia, and elevated liver function tests starting on post‐operative day 9. An extensive microbiologic and molecular workup was performed, ultimately leading to a diagnosis of donor‐derived toxoplasmosis with associated hemophagocytic lymphohistiocytosis in the recipient. This case highlights the potential for post‐transplant toxoplasmosis in high‐risk mismatch (D+/R‐) recipients, as well as the role of Toxoplasma‐targeted prophylaxis in such patients.
Evaluating antimicrobial duration for Gram‐negative bacteremia in patients with neutropenia due to hematologic malignancy or hematopoietic stem cell transplantation
Authors: Ranganath Nischal , Yetmar Zachary A. , McCandless Audrey R. , Rivera Christina G. , Lahr Brian D. , Tande Aaron J. , Shah Aditya S.
Published: June 2023

Background

In the management of Gram‐negative bloodstream infection (GN‐BSI), short antimicrobial courses have been increasingly demonstrated to be non‐inferior to prolonged therapy, with lower risk of Clostridioides difficile infection (CDI) and emergence of multi‐drug resistant (MDR) organisms. However, immunocompromised hosts were excluded from these studies. We investigated outcomes of short (≤10 days), intermediate (11–14 days), and prolonged (≥15 days) antimicrobial durations for GN‐BSI in neutropenic patients.

Methods

A retrospective cohort study was conducted on neutropenic patients with monomicrobial GN‐BSI between 2018 and 2022. The primary outcome was a composite of all‐cause mortality and microbiologic relapse within 90 days after therapy completion. The secondary outcome was a composite of 90‐day CDI and development of MDR‐GN bacteria. Cox regression analysis with propensity score (PS) adjustment was used to compare outcomes between the three groups.

Results

A total of 206 patients were classified into short (n = 67), intermediate (n = 81), or prolonged (n = 58) duration. Neutropenia was predominantly secondary to hematopoietic stem cell transplantation (48%) or hematologic malignancy (35%). The primary sources of infection included intra‐abdominal (51%), vascular catheter (27%), and urinary (8%). Most patients received definitive therapy with cefepime or carbapenem. No significant difference in the primary composite endpoint was observed for intermediate versus short (PS‐adjusted hazard ratio [aHR] 0.89; 95% confidence interval [95% CI] 0.39–2.03) or prolonged versus short therapy (PS‐aHR 1.20; 95% CI 0.52–2.74). There was no significant difference in the secondary composite endpoint of CDI or MDR‐GN emergence.

Conclusion

Our data suggest that short antimicrobial courses had comparable 90‐day outcomes as intermediate and prolonged regimens for GN‐BSI among immunocompromised patients with neutropenia.

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