bluuebunny/crossref_metadata_2025 huggingface dataset:
Youth employment in Ghana: economic and social development policies perspective
Authors: Jumpah Emmanuel Tetteh , Ampadu-Ameyaw Richard , Owusu-Arthur Johnny
Published: November 2020

Purpose

Creating employment opportunities for the youth remains a dilemma for policymakers. In many cases, policies and programmes to tackle youth unemployment have produced little results, because such initiatives have failed to consider some fundamental inputs. In Ghana, youth unemployment rate has doubled or more than doubled the national average unemployment rate in recent years. The current study, therefore, examines how policies in the past two decades have affected youth unemployment rate and other development outcomes.

Design/methodology/approach

The study reviewed national economic development policy documents from 1996 to 2017 and other relevant policies aimed at creating employment opportunities for the youth, applying the content analysis procedure. Four main policy documents were reviewed in this regard. Data from secondary sources including International Labour Organisation (ILO), World Bank (WB), United Nations Development Programme (UNDP) and Ghana Statistical Service (GSS) were analysed to examine the trends in youth unemployment rate, human development index and GDP growth rate in Ghana over the years. There were also formal and informal consultations with youth and development practitioners.

Findings

The results of the study show that policies that promote general growth in the economy reduce youth unemployment, while continuation of existing youth programmes, expansion, as well as addition of new ones by new governments reduces youth unemployment rate. In particular, GDP growth and youth unemployment rate trend in opposite direction; periods of increased growth have reduced youth unemployment rate and vice versa. The period of Ghana Shared Growth and Development Agenda I & II witnessed better reduction (5.7%) in youth unemployment rate than any of the policy periods. This was not sustained, and despite the current youth employment initiatives, unemployment among young people still remained higher than the national average.

Research limitations/implications

The study provides relevant information on how development policies and programmes affect youth unemployment rate over time. In as much as it is not the interest of the study, the study stops short of empirical estimation to determine the level of GDP growth rate that can reduce a particular level of youth unemployment, which is a case for further research. Nevertheless, the outcome of the study reflects the data and methodology used.

Originality/value

To the best of the knowledge of the authors, this is a first study in Ghana that has attempted to directly link development outcomes such as youth unemployment to national economic development policies, although there are studies that have analysed the policy gaps and implementation challenges. This paper, therefore, bridges the knowledge of how development policies affect youth employment opportunities, particularly for Ghana.
Contrasting responses of plant and lichen carbon‐based secondary compounds across an elevational gradient
Authors: Asplund Johan , van Zuijlen Kristel , Roos Ruben E. , Birkemoe Tone , Klanderud Kari , Lang Simone I. , Wardle David A. , Nybakken Line
Published: November 2020

Vascular plants and lichens often produce a diversity of carbon‐based secondary compounds (CBSCs) to protect them against biotic and abiotic stresses. These compounds play important but often compound‐specific roles in community and ecosystem processes by affecting herbivore and decomposer activity. However, our understanding of what drives community‐level CBSCs among ecosystems or across environmental gradients is limited.

We measured concentrations and compositions of CBSCs for all dominant vascular plant and lichen species present across a 500‐m alpine elevational gradient. These measurements were combined with data on species composition and abundance to obtain whole‐community measures of plant and lichen CBSCs across the gradient.

At the whole community level, plant CBSCs had the lowest concentrations while lichen CBSCs had the highest concentrations at the highest elevations. Further, plant CBCSs shifted from those associated with herbivore defence towards those protecting against light and oxidative stress as elevation increased, while lichen CBSCs showed the opposite pattern.

Synthesis. Our findings that individual compounds show contrasting responses to the same environmental gradient highlight the importance of studying qualitative as well as quantitative changes in CBSCs. Further, the divergent responses between vascular plants and lichens reveal that in systems where both groups are abundant, they need to be considered simultaneously to better understand how future environmental changes may impact on ecosystem‐level processes.

A free Plain Language Summary can be found within the Supporting Information of this article.
Olfactory perception of herbivore‐induced plant volatiles elicits counter‐defences in larvae of the tobacco cutworm
Authors: Sun Zhongxiang , Lin Yibin , Wang Rumeng , Li Qilin , Shi Qi , Baerson Scott R. , Chen Li , Zeng Rensen , Song Yuanyuan
Published: November 2020

Herbivore attack leads to increased emission of herbivore‐induced plant volatiles (HIPVs) that protect plants by eliciting direct anti‐herbivore defences and indirect defences via attraction of natural enemies. Whether herbivorous insects can develop counter‐defences against host plants in response to HIPVs is largely unexplored.

Using a directed airflow apparatus, we investigated the influence of HIPVs emitted from tobacco cutworm Spodoptera litura‐infested tomatoes on larval performance on herbivore‐pretreated tomatoes versus untreated tomatoes or on trypsin inhibitor‐amended artificial diets versus unamended diets, as well as the transcriptional responses of HIPV‐exposed larvae.

Spodoptera litura larval feeding on tomato plants led to increased emission of HIPVs. The HIPV‐exposed larvae showed significantly increased survival rates and weight gains on both herbivore‐pretreated tomato leaves and trypsin inhibitor‐supplemented diet but not on untreated tomato leaves and control diets, nor when they had been exposed to HIPVs emitted from spr8 mutant plants which barely emit terpenes. These results suggest that larval exposure to HIPVs from wild‐type plants enhanced their ability to cope with plant‐induced defences. The latter is supported by the observation that larval exposure to HIPVs led to enhanced transcript levels of eight genes encoding cuticle proteins, and seven genes encoding cytochrome P450s, an important class of detoxification enzymes.

Our studies revealed a mechanism by which larval olfactory perception of HIPVs elicits counter‐defences that enhance the ability of insect herbivores to withstand host plant chemical defences.
Biosensors for rapid detection of Salmonella in food: A review
Authors: Shen Yafang , Xu Lizhou , Li Yanbin
Published: November 2020

Salmonella is one of the main causes of foodborne infectious diseases, posing a serious threat to public health. It can enter the food supply chain at various stages of production, processing, distribution, and marketing. High prevalence of Salmonella necessitates efficient and effective approaches for its identification, detection, and monitoring at an early stage. Because conventional methods based on plate counting and real‐time polymerase chain reaction are time‐consuming and laborious, novel rapid detection methods are urgently needed for in‐field and on‐line applications. Biosensors provide many advantages over conventional laboratory assays in terms of sensitivity, specificity, and accuracy, and show superiority in rapid response and potential portability. They are now recognized as promising alternative tools and one of the most on‐site applicable and end user–accessible methods for rapid detection. In recent years, we have witnessed a flourishing of studies in the development of robust and elaborate biosensors for detection of Salmonella in food. This review aims to provide a comprehensive overview on Salmonella biosensors by highlighting different signal‐transducing mechanisms (optical, electrochemical, piezoelectric, etc.) and critically analyzing its recent trends, particularly in combination with nanomaterials, microfluidics, portable instruments, and smartphones. Furthermore, current challenges are emphasized and future perspectives are discussed.
Mesorif Gabbros (External Rif, North Morocco): Ophiolitic Suture Witness or a “Newly Discovered” Manifestation of the Central Atlantic Magmatic Province?
Authors: HAISSEN Faouziya , GIMENO‐Vives Oriol , MOHN Geoffroy , BOSSE Valérie , ZAGHLOUL Mohamed Najib , ATOUABAT Achraf , FRIZON DE LAMOTTE Dominique
Published: November 2020

The Rif Mountain located in Northern Morocco represents the westernmost extremity of the Peri‐Mediterranean Alpine orogenic system. This belt is classically subdivided into: 1) Internal zones (or Internal Rif which is an allochthonous metamorphic domain known worldwide thanks to the presence of large peridotite outcrops); 2) flysch zones (sediments corresponding to the original cover of the Maghrebian Tethys); and 3) External zones (or External Rif representing the North African margin remnants).

The External Rif is itself subdivided into Prerif, Mesorif and Intrarif domains from the South to the North and is composed by Upper Triassic to Cenozoic sediments structured in a nappe stack. Mafic rock intrusions were reported in this External Rif since the preliminary geological studies even if they were wrongly mapped as “granites”. Later careful fieldwork and mapping studies specified nevertheless their gabbroic nature. A more recent petrological and geochemical study of a few outcrops of those gabbroic intrusions conducted the corresponding authors, encouraged by the presence of ultramafic rocks (Beni Malek serpentines) in the eastern part of the External Rif to consider those gabbros as oceanic and so, associated to “an ophiolitic suture”. Nevertheless, a recent and extended survey on the architecture and the rifting history of the Mesozoic margin of the Maghrebian Tethys focusing mainly on the Mesorif domain favor another interpretation. The detailed petrography of those mafic intrusions (mainly gabbros + dolerites and rarely extrusive rocks); their geochemical fingerprints and mainly their geochronological data (ages around 200 Ma based on U‐Pb zircon LA‐ICP dating) all together indicate clearly that those mafic intrusions are rather a “newly discovered” manifestation of the Central Atlantic Magmatic Province activity “CAMP” in the External Rif belt. The CAMP magmatism has been largely well described and characterized in all the other geological domains of Morocco (Anti‐Atlas, High Atlas, Middle Atlas and Meseta) but never described until the date in the Rif belt which highlights the importance of the results reported here.
The role of postoperative radiotherapy after primary tumor resection in patients with de novo stage IV breast cancer
Authors: Kim Yeon Joo , Kim Su Ssan , Ahn Seung Do , Jung Jinhong , Ahn Sei‐Hyun , Son Byung Ho , Lee Jong Won , Kim Hee Jeong , Ko Beom Seok , Kim Sung‐Bae , Jung Kyung Hae , Ahn Jin‐Hee , Kim Jeong Eun , Choi Eun Kyung
Published: November 2020

Aim

This study was undertaken to investigate the role of postoperative radiotherapy (PORT) including post‐breast conserving radiotherapy (PBCRT) and post‐mastectomy radiotherapy (PMRT) in stage IV breast cancer patients who underwent planned primary tumor resection (PTR).

Methods

This study enrolled 112 patients diagnosed with de novo stage IV breast cancer who were treated with potentially curative PTR with or without PORT. The primary outcome was overall survival (OS), and the secondary outcomes were locoregional recurrence‐free survival (LRRFS) and distant progression‐free survival (DPFS).

Results

At a median follow‐up of 48.9 months (range, 3.5‐183.4 months), the median OS was 54.9 months (range, 5.3‐185.9 months) with a 5 year OS rate of 59.6%. Lower clinical T stage, Luminal A or B type tumors and PBCRT were significantly predictive of longer OS. The 5 year LRRFS and DMFS rates were 79.0% and 34.3%, respectively. In multivariate analysis for LRRFS, the PBCRT arm demonstrated significant superiority compared to the No PORT arm. A comparison of patients who did and did not receive PORT showed that patients with disseminated metastasis more likely did not receive PORT and were excluded from the analysis. PBCRT arm demonstrated significantly superior LRRFS of 100% while PMRT and No PORT arm demonstrated 81.5% and 84.0%, respectively

Conclusions

De novo stage IV breast cancer patients who received planned PTR showed favorable survival outcomes compared with historical cohorts. PTR may be predictive of a good prognosis, especially in patients with luminal A or B type tumors. PORT, especially PBCRT was predictive of LRRFS, suggesting that patients may benefit from this treatment.
How the coronavirus disease 2019 pandemic is impacting sexual and reproductive health and rights and response: Results from a global survey of providers, researchers, and policy‐makers
Authors: Endler Margit , Al‐Haidari Taghreed , Benedetto Chiara , Chowdhury Sameena , Christilaw Jan , El Kak Faysal , Galimberti Diana , Garcia‐Moreno Claudia , Gutierrez Miguel , Ibrahim Shaimaa , Kumari Shantha , McNicholas Colleen , Mostajo Flores Desirée , Muganda John , Ramirez‐Negrin Atziri , Senanayake Hemantha , Sohail Rubina , Temmerman Marleen , Gemzell‐Danielsson Kristina
Published: November 2020

Introduction

We aimed to give a global overview of trends in access to sexual and reproductive health and rights (SRHR) during the coronavirus disease 2019 (COVID‐19) pandemic and what is being done to mitigate its impact.

Material and methods

We performed a descriptive analysis and content analysis based on an online survey among clinicians, researchers, and organizations. Our data were extracted from multiple‐choice questions on access to SRHR services and risk of SRHR violations, and written responses to open‐ended questions on threats to access and required response.

Results

The survey was answered by 51 people representing 29 countries. Eighty‐six percent reported that access to contraceptive services was less or much less because of COVID‐19, corresponding figures for surgical and medical abortion were 62% and 46%. The increased risk of gender‐based and sexual violence was assessed as moderate or severe by 79%. Among countries with mildly restrictive abortion policies, 69% had implemented changes to facilitate access to abortion during the pandemic, compared with none among countries with severe restrictions (P < .001), 87.5% compared with 46% had implemented changes to facilitate access to contraception (P = .023). The content analysis showed that (a) prioritizations in health service delivery at the expense of SRHR, (b) lack of political will, (c) the detrimental effect of lockdown, and (d) the suspension of sexual education, were threats to SRHR access (theme 1). Requirements to mitigate these threats (theme 2) were (a) political will and support of universal access to SRH services, (b) the sensitization of providers, (c) free public transport, and (d) physical protective equipment. A contrasting third theme was the state of exception of the COVID‐19 pandemic as a window of opportunity to push forward women's health and rights.

Conclusions

Many countries have seen decreased access to and increased violations of SRHR during the COVID‐19 pandemic. Countries with severe restrictions on abortion seem less likely to have implemented changes to SRHR delivery to mitigate this impact. Political will to support the advancement of SRHR is often lacking, which is fundamental to ensuring both continued access and, in a minority of cases, the solidification of gains made to SRHR during the pandemic.
Statistical inference for association studies using electronic health records: handling both selection bias and outcome misclassification
Authors: Beesley Lauren J. , Mukherjee Bhramar
Published: November 2020

Health research using electronic health records (EHR) has gained popularity, but misclassification of EHR‐derived disease status and lack of representativeness of the study sample can result in substantial bias in effect estimates and can impact power and type I error. In this paper, we develop new strategies for handling disease status misclassification and selection bias in EHR‐based association studies. We first focus on each type of bias separately. For misclassification, we propose three novel likelihood‐based bias correction strategies. A distinguishing feature of the EHR setting is that misclassification may be related to patient‐varying factors, and the proposed methods leverage data in the EHR to estimate misclassification rates without gold standard labels. For addressing selection bias, we describe how calibration and inverse probability weighting methods from the survey sampling literature can be extended and applied to the EHR setting.

Addressing misclassification and selection biases simultaneously is a more challenging problem than dealing with each on its own, and we propose several new strategies. For all methods proposed, we derive valid standard error estimators and provide software for implementation. We provide a new suite of statistical estimation and inference strategies for addressing misclassification and selection bias simultaneously that is tailored to problems arising in EHR data analysis. We apply these methods to data from The Michigan Genomics Initiative, a longitudinal EHR‐linked biorepository.
Inhibition of Na+/H+ exchanger isoform 3 improves gut fluidity and alkalinity in cystic fibrosis transmembrane conductance regulator‐deficient and F508del mutant mice
Authors: Tan Qinghai , di Stefano Gabriella , Tan Xinjie , Renjie Xiu , Römermann Dorothee , Talbot Steven R. , Seidler Ursula E.
Published: November 2020

Background and Purpose

Constipation and intestinal obstructive episodes are major health problems in cystic fibrosis (CF) patients. Three FDA‐approved drugs against constipation‐prone irritable bowel syndrome were tested for their ability to increase luminal fluidity and alkalinity in cystic fibrosis transmembrane conductance regulator (CFTR) null (cftr−/−) and F508del mutant (F508delmut/mut) murine intestine.

Experimental Approach

Guanylate cyclase C agonist linaclotide, PGE1 analogue lubiprostone and intestine‐specific NHE3 inhibitor tenapanor were perfused through a ~3 cm jejunal, proximal or mid‐distal colonic segment in anaesthetized cftr−/−, F508delmut/mut and WT mice. Net fluid balance was determined gravimetrically and alkaline output by pH‐stat back titration.

Key Results

Basal jejunal fluid absorptive rates were significantly higher and basal HCO3− output was significantly lower in cftr−/− and F508delmut/mut compared to WT mice. In cftr−/− and F508delmut/mut mice, all three drugs significantly inhibited the fluid absorptive rate and increased alkaline output in the jejunum and tenapanor and lubiprostone, but not linaclotide, in the colon. After tenapanor pre‐incubation, linaclotide elicited a robust fluid secretory response in WT jejunum, while no further change in absorptive rates was observed in cftr−/− and F508delmut/mut jejunum, suggesting that the increase in gut fluidity and alkalinity by linaclotide in CF gut is mediated via NHE3 inhibition. Lubiprostone also inhibited fluid absorption in cftr−/− and F508delmut/mut jejunum via NHE3 inhibition but had a residual NHE3‐independent effect.

Conclusion and Implications

Linaclotide, lubiprostone and tenapanor reduced fluid absorption and increased alkaline output in the CF gut. Their application may ameliorate constipation and reduce obstructive episodes in CF patients.
Genetic spectrum of Charcot–Marie–Tooth disease associated with myelin protein zero gene variants in Japan
Authors: Taniguchi Takaki , Ando Masahiro , Okamoto Yuji , Yoshimura Akiko , Higuchi Yujiro , Hashiguchi Akihiro , Shiga Kensuke , Hayashida Arisa , Hatano Taku , Ishiura Hiroyuki , Mitsui Jun , Hattori Nobutaka , Mizuno Toshiki , Nakagawa Masanori , Tsuji Shoji , Takashima Hiroshi
Published: November 2020

We aimed to reveal the genetic features associated with MPZ variants in Japan. From April 2007 to August 2017, 64 patients with 23 reported MPZ variants and 21 patients with 17 novel MPZ variants were investigated retrospectively. Variation in MPZ variants and the pathogenicity of novel variants was examined according to the American College of Medical Genetics standards and guidelines. Age of onset, cranial nerve involvement, serum creatine kinase (CK), and cerebrospinal fluid (CSF) protein were also analyzed. We identified 64 CMT patients with reported MPZ variants. The common variants observed in Japan were different from those observed in other countries. We identified 11 novel pathogenic variants from 13 patients. Six novel MPZ variants in eight patients were classified as likely benign or uncertain significance. Cranial nerve involvement was confirmed in 20 patients. Of 30 patients in whom serum CK levels were evaluated, eight had elevated levels. Most of the patients had age of onset >20 years. In another subset of 30 patients, 18 had elevated CSF protein levels; four of these patients had spinal diseases and two had enlarged nerve root or cauda equina. Our results suggest genetic diversity across patients with MPZ variants.
Multivariate analysis of the influence of prosthodontic factors on peri‐implant bleeding index and marginal bone level in a molar site: A cross‐sectional study
Authors: Inoue Masaki , Nakano Tamaki , Shimomoto Takuya , Kabata Daijiro , Shintani Ayumi , Yatani Hirofumi
Published: November 2020

Background

Peri‐implant tissue condition can result from prosthodontic, surgical and bacteriological factors.

Purpose

This study investigated the effects of prosthodontic factors on peri‐implant tissue.

Materials and Methods

Subjects were 140 patients with 310 implants from Osaka University Dental Hospital. Prosthodontic factors examined were the connection type, the suprastructure retention type, the material of the abutment and the mesiodistal and buccolingual prosthetic form of the superstructure as emergence angle. The objective variables were the modified bleeding index (mBI) and marginal bone level (MBL). Statistical analysis was used as a generalized estimation equation.

Results

The taper joint had a significantly smaller MBL than the butt joint (P < .001). There was no significant difference in mBI and MBL between cement and screw retaining. Zirconium and titanium resulted in a significantly smaller mBI than gold alloy (zirconium/gold alloy: P = .037, titanium / gold alloy: P = .021), but there was no significant difference in the MBL. Both mBI and MBL tended to be smaller when the emergence angle was around 20° to 40°, although this difference was not significant.

Conclusion

As a result of multivariate analysis, our findings suggest that to reduce MBL from the perspective of prosthodontic factors it is preferable to use an implant with a taper joint connection positioned with an emergence angle of 20° to 40°.
Time trends in diabetes medication prescription and factors associated with metformin discontinuation in people with newly diagnosed type 2 diabetes: A national population‐based study
Authors: Aguadé Anne‐Sophie , Gastaldi‐Ménager Chrystelle , Fontaine Pierre , Karsenty Diane , Fagot‐Campagna Anne , Amadou Coralie
Published: November 2020

Objective

To describe, based on the French National Health Insurance (NHI) data, time trends in diabetes medications after treatment initiation in two consecutive cohorts of people newly treated for type 2 diabetes (T2D) in 2008 (1st cohort) and 2013 (2nd cohort).

Materials and methods

People, aged 45 years and older, newly treated for T2D in 2008 and 2013 were identified in the French NHI Data System. Treatment changes were collected for each year of follow‐up. Logistic regression was performed to identify factors associated with metformin discontinuation.

Results

Respectively, 157 940 and 160 670 beneficiaries (mean age: 63 and 64 years; men proportion: 53 and 52%) of the French NHI general scheme initiated a diabetes treatment in 2008 and 2013. Metformin was the first monotherapy and increased in use: 67% of monotherapies in 2008 versus 77% in 2013. Monotherapy percentage decreased from the second year onwards in both cohorts. A marked increase in metformin‐DPP4i combination therapy was observed (14% of dual therapies in 2008 vs. 46% in 2015 in the first cohort), replacing the metformin–sulfonylureas combination as a second‐line treatment. Metformin discontinuation was statistically associated with female gender, social deprivation, age and anti‐diabetic polypharmacy. Discontinuation of diabetes treatment was observed after 5 years for, respectively, 10% and 13% in the first and second cohorts.

Conclusion

Descriptive analysis of two consecutive national cohorts showed an evolution in the prescription patterns of anti‐diabetic treatments over a short period. With early treatment intensification, increasing rate of metformin monotherapy, and changes in dual‐therapy strategy.
Association of British Clinical Diabetologists (ABCD) and Diabetes UK joint position statement and recommendations on the use of sodium–glucose cotransporter inhibitors with insulin for treatment of type 1 diabetes (Updated October 2020)
Authors: Dashora Umesh , Patel Dipesh C. , Gregory Robert , Winocour Peter , Dhatariya Ketan , Rowles Susannah , Macklin Andrew , Rayman Gerry , Nagi Dinesh ,   the ABCD executive committee, supported by Diabetes UK
Published: November 2020

Dapagliflozin (SGLT‐2 inhibitor) and sotagliflozin (SGLT1/2 inhibitor) are two of the drugs of SGLT inhibitor class which have been recommended by the National Institute for Health and Care Excellence (NICE) in people with type 1 diabetes with BMI ≥27 kg/m2. Dapagliflozin is licensed in the UK for use in the NHS while sotagliflozin may be available in future. These and possibly other SGLT inhibitors may be increasingly used in people with type 1 diabetes as new licences are obtained. These drugs have the potential to improve glycaemic control in people with type 1 diabetes with the added benefit of weight loss, better control of blood pressure and more time in optimal glucose range. However, SGLT inhibitors are associated with a higher incidence of diabetic ketoacidosis without significant hyperglycaemia. The present ABCD/Diabetes UK joint updated position statement is to guide people with type 1 diabetes and clinicians using these drugs help mitigate this risk and other potential complications. Particularly, caution needs to be exercised in people who are at risk of diabetic ketoacidosis due to low calorie diets, illnesses, injuries, starvation, excessive exercise, excessive alcohol consumption and reduced insulin administration among other precipitating factors for diabetic ketoacidosis.
Comparative analysis of preclinical dental students' working postures using dental loupes and dental operating microscope
Authors: Bud Marius , Pricope Razvan , Pop Razvan C. , Onaca Razvan , Swerts Pieter‐Jan , Lucaciu Ondine , Delean Ada
Published: November 2020

Background

Dentists are susceptible to musculoskeletal disorders due to prolonged static postures during dental treatments. Using a magnification tool like dental operating microscope (DOM) or the dental loupes may correct the operator's posture. Up until now, few studies have focused on preclinical dental students' posture when working with the DOM, while most of them have focused on the loupes. The aim of this study was to comparatively analyse the working posture of preclinical students during a dental restoration procedure, working with two different magnification methods.

Materials and methods

This study used a randomised cross‐over design in which seventeen third year students were randomly divided into three groups. The exclusion criteria were previous contact with magnification systems and previous clinical working experience. Each student prepared 3 Black class 1 cavities on artificial lower molars: first with no magnification, following dental loupes and DOM. They were video‐recorded throughout the preparation. Trunk, neck and upper‐arm position were evaluated using the Posture Assessment Instrument. Students completed a questionnaire on their subjective perception of the two magnification systems.

Results

The statistical analysis showed significant improvement of the working posture using magnification systems compared to direct vision. The biggest improvement was obtained through the use of DOM, followed by the dental loupes. Students perceived dental loupes as being the most comfortable and easy to adapt to. They reported being more focused when using DOM.

Conclusions

Both magnification systems had a positive impact on the working posture, DOM having the best results. Loupes showed better adaptability while DOM showed better concentration.
Patient‐Centred Care in Dentistry: Definitions and Models ‐ Commentary
Authors: Alrawiai Sumaiah , Asimakopoulou Koula , Scambler Sasha
Published: November 2020

Patient‐centred care is an important approach that is currently being adopted, to varying degrees of success, in a number of healthcare settings, particularly in family medicine and nursing. However, patient‐centred care is relatively understudied in dentistry. This commentary aims to provide a general overview of patient‐centred care studies conducted in dentistry, of how the approach is defined in this setting, and of the different models that have aimed to operationalize the concept. This concept is particularly relevant to dental education as current guidelines for dentists encourage and require them to adopt different dimensions of this approach. In addition to policies and guidelines, there is evidence that suggests that the adoption of patient‐centred care would result in positive outcomes.
Sediment availability provokes a shift from Brownian to Lévy‐like clonal expansion in a dune building grass
Authors: Reijers Valérie C. , Hoeks Selwyn , van Belzen Jim , Siteur Koen , de Rond Anne J. A. , van de Ven Clea N. , Lammers Carlijn , van de Koppel Johan , van der Heide Tjisse
Published: November 2020

In biogeomorphic landscapes, plant traits can steer landscape development through plant‐mediated feedback interactions. Interspecific differences in clonal expansion strategy can therefore lead to the emergence of different landscape organisations. Yet, whether landscape‐forming plants adopt different clonal expansion strategies depending on their physical environment remains to be tested. Here, we use a field survey and a complementary mesocosm approach to investigate whether sediment deposition affects the clonal expansion strategy employed by dune‐building marram grass individuals. Our results reveal a consistent shift in expansion pattern from more clumped, Brownian‐like, movement in sediment‐poor conditions, to patchier, Lévy‐like, movement under high sediment supply rates. Additional model simulations illustrate that the sediment‐dependent shift in movement strategies induces a shift in optimisation of the cost–benefit relation between landscape engineering (i.e. dune formation) and expansion. Plasticity in expansion strategy may therefore allow landscape‐forming plants to optimise their engineering ability depending on their physical landscape.
Intracellular escape strategies of Staphylococcus aureus in persistent cutaneous infections
Authors: Huitema Leonie , Phillips Taylor , Alexeev Vitali , Tomic‐Canic Marjana , Pastar Irena , Igoucheva Olga
Published: November 2020

Pathogenic invasion of Staphylococcus aureus is a major concern in patients with chronic skin diseases like atopic dermatitis (AD), epidermolysis bullosa (EB), or chronic diabetic foot and venous leg ulcers, and can result in persistent and life‐threatening chronic non‐healing wounds. Staphylococcus aureus is generally recognized as extracellular pathogens. However, S. aureus can also invade, hide and persist in skin cells to contribute to wound chronicity. The intracellular life cycle of S. aureus is currently incompletely understood, although published studies indicate that its intracellular escape strategies play an important role in persistent cutaneous infections. This review provides current scientific knowledge about the intracellular life cycle of S. aureus in skin cells, which can be classified into professional and non‐professional antigen‐presenting cells, and its strategies to escape adaptive defense mechanisms. First, we discuss phenotypic switch of S. aureus, which affects intracellular routing and degradation. This review also evaluates potential intracellular escape mechanism of S. aureus to avoid intracellular degradation and antigen presentation, preventing an immune response. Furthermore, we discuss potential drug targets that can interfere with the intracellular life cycle of S. aureus. Taken together, this review aimed to increase scientific understanding about the intracellular life cycle of S. aureus into skin cells and its strategies to evade the host immune response, information that is crucial to reduce pathogenic invasion and life‐threatening persistence of S. aureus in chronic cutaneous infections.
A patient and public involvement workshop using visual art and priority setting to provide patients with a voice to describe quality and safety concerns: Vitamin B12 deficiency and pernicious anaemia
Authors: Tyler Natasha , Giles Sally , Daker‐White Gavin , McManus Beth Clare , Panagioti Maria
Published: November 2020

Background

Patient and public involvement and engagement (PPIE) is recognized as important for improved quality in health service provision and research. Vitamin B12 deficiency is one area where PPIE has potential to benefit patients, as patients often report sub‐optimal care due to diagnostic delay, insufficient treatment and poor relationships with health professionals.

Objective

In an effort to engage an understudied patient population in health‐care quality and safety discussions, and provide patients with an opportunity to have a voice, contribute to research priorities and express their current quality and safety concerns, we hosted a PPIE workshop.

Methods

One researcher (with lived experience) facilitated a one day workshop with 12 patients with varied demographics. The workshop had four components (a) one‐to‐one sessions with an artist, (b) quality and safety research/education priority setting, (c) comments on research proposals, and (d) development of a PPIE group for future research.

Results

All elements of the workshop elicited a number of quality and safety priorities for the group. Priority setting highlighted issues with interpretation of test results, symptom‐based treatment, self‐medication and relationship with primary care health‐care professionals. One of the major safety issues highlighted in the visual art element was feeling ignored, silenced or not listened too by health‐care professionals.

Discussion

Visual art methods to express experiences of health, and research priority setting tasks achieved the aim of providing patients with an opportunity to have a voice and express concerns about health‐care quality and safety issues. The addition of visual art allowed patients to articulate emotions and impacts on everyday life associated with quality and safety.

Patient or public contribution

A public contributor was involved in preparation of this manuscript. The event aimed to enable PPIE contribution in future research.
Acute coronary artery occlusion and ischemia‐related ventricular tachycardia during catheter ablation in the right ventricular outflow tract
Authors: Nakatani Yosuke , Vlachos Konstantinos , Ramirez F. Daniel , Nakashima Takashi , Jais Pierre , Sacher Frédéric , Romain Tixier
Published: November 2020

Coronary artery injury is a rare complication of catheter ablation in the right ventricular outflow tract (RVOT). Furthermore, acute myocardial ischemia usually causes polymorphic ventricular tachycardia (VT) or ventricular fibrillation. We herein describe a case in which catheter ablation for VT originating from the RVOT provoked ischemia‐related VTs due to acute occlusion of the left anterior descending artery.
Is periodontal disease a risk indicator for colorectal cancer? A systematic review and meta‐analysis
Authors: Li Weiqi , Xu Jiaying , Zhang Ruya , Li Yuting , Wang Jiadai , Zhang Xuan , Lin Li
Published: November 2020

Aims

Existing epidemiological studies have suggested that periodontal disease (PD) may be a risk indicator for colorectal cancer (CRC). However, no formal systematic review and meta‐analysis have been performed. Therefore, we aimed to evaluate the association between PD and CRC risk in this study.

Materials and Methods

We used the PubMed, EMBASE, Cochrane Library and Web of Science to search for related articles published from 1 January 1966 to 16 July 2020. Stata (Version 15) software was used to calculate the total risk ratio (RR) and 95% confidence interval (CI) of the included studies through the random‐effects model to assess the association between PD and CRC risk.

Results

Nine studies were included in the narrative synthesis, and seven studies were included in the meta‐analysis. Results showed that PD significantly increased the risk of CRC by 44% (RR, 1.44; 95% CI, 1.18–1.76; I2, 55.2%).

Conclusion

We found an association between PD and CRC. PD can be a potential risk indicator for the occurrence and development of CRC, and further studies are needed to assess causality. Hence, effective periodontal treatment could be a valuable preventive measure for CRC.
Pyogenic psoas abscess on the dorsal side, and bacterial meningitis and spinal epidural abscess on the ventral side, both of which were induced by spontaneous discitis in a patient with diabetes mellitus: A case report
Authors: Horiya Megumi , Anno Takatoshi , Kawada Mayuko , Yamada Haruki , Takahashi Kaiou , Takenouchi Haruka , Iwamoto Hideyuki , Kawasaki Fumiko , Kurokawa Katsumi , Kaneto Hideaki , Kaku Kohei , Tomoda Koichi
Published: November 2020

Type 2 diabetes mellitus patients are immunocompromised, particularly under poorly controlled conditions, and thereby they could develop rare inflammatory diseases, such as spontaneous discitis, pyogenic psoas abscess, spinal epidural abscess and bacterial meningitis. Herein we report a pyogenic psoas abscess on the dorsal side, and bacterial meningitis and spinal epidural abscess on the ventral side, both of which were induced by spontaneous discitis in a patient with poorly controlled type 2 diabetes mellitus. This case was very rare and interesting, because we successfully treated various infections with antibiotics over a long period of time, complicated by hyperglycemic crises, although the patient suffered severe bone destruction and required rehabilitation for a long time.
“At Home, with Care”: Lessons from New York City Home‐based Primary Care Practices Managing COVID‐19
Authors: Franzosa Emily , Gorbenko Ksenia , Brody Abraham A. , Leff Bruce , Ritchie Christine S. , Kinosian Bruce , Ornstein Katherine A. , Federman Alex D.
Published: November 2020

Background/Objectives

COVID‐19 required rapid innovation throughout the healthcare system. Home‐based primary care (HBPC) practices faced unique challenges maintaining services for medically complex older populations for whom they needed to adapt a traditionally hands‐on, model of care to accommodate restrictions on in‐person contact. Our aim was to determine strategies used by New York City (NYC)‐area HBPC practices to provide patient care during the first wave of the COVID‐19 pandemic with the goal of informing planning and preparation for home‐based practices nationwide.

Design

Cross‐sectional qualitative design using semi‐structured interviews.

Setting

HBPC practices in the NYC metro area during spring 2020.

Participants

HBPC leadership including clinical/medical directors, program managers, nurse practitioners/nursing coordinators, and social workers/social work coordinators (n = 13) at 6 NYC‐area practices.

Measurements

Semi‐structured interviews explored HBPC practices' COVID‐19 care delivery challenges, adaptations, and advice for providers. Interviewers probed patient care, end‐of‐life care, telehealth, community‐based services and staffing. Interviews were recorded and transcribed. Data were analyzed through a combined inductive and deductive thematic approach.

Results

Participants described care delivery and operational adaptations similar to those universally adopted across healthcare settings during COVID‐19, such as patient outreach and telehealth. HBPC‐specific adaptations included mental health services for patients experiencing depression and isolation, using multiple modalities of patient interactions to balance virtual care with necessary in‐person contact, strategies to maintain patient trust, and supporting team connection of staff through daily huddles and emotional support during the surge of deaths among long‐standing patients.

Conclusion

NYC‐area HBPC providers adapted care delivery and operations rapidly during the height of the COVID‐19 pandemic. Keeping older, medically complex patients safe in their homes required considerable flexibility, transparency, teamwork, and partnerships with outside providers. As the pandemic continues to surge around the United States, HBPC providers may apply these lessons and consider resources needed to prepare for future challenges.
Utility of stimulus induced after discharges in the evaluation of peripheral nerve hyperexcitability: Old wine in a new bottle?
Authors: Nair Aditya Vijayakrishnan , Mani Arun , Vijayaraghavan Asish , Alexander Pullumpallil , Shaikh Atif , Ninan Rohit , Prabhakar A.T. , Sivadasan Ajith , Aaron Sanjit , Jude John , Mathew Vivek , Alexander Mathew
Published: November 2020

Limited literature is available on stimulus induced after discharges (SIAD) in patients with peripheral nerve hyperexcitability (PNH). The aim of the study was to examine the diagnostic utility of SIAD in the diagnosis and monitoring of primary PNH disorders. In this retrospective study, we studied 26 patients who were admitted with a diagnosis of primary PNH to the department of Neurology from January 2013 to April 2019. Their clinical profile, immunological characteristics were extracted from the database and nerve conduction studies were relooked for the presence of SIAD. 76% of patients in the primary PNH cohort had SIAD with 90% of them being voltage‐gated potassium channel complex antibody positive; predominantly against contactin‐associated protein‐2 antigen and rest being paraneoplastic. There was also resolution of SIAD following treatment indicating reversible hyperexcitability. SIAD is a sensitive marker for Primary PNH syndrome with monitoring and diagnostic implications.
Factors associated with return to work following myocardial infarction: A systematic review of observational studies
Authors: Sun Weizhe , Gholizadeh Leila , Perry Lin , Kang Kyoungrim , Heydari Mehrdad
Published: November 2020

Objectives

To identify and critically synthesise literature on return to work of patients following a myocardial infarction and to identify factors that are associated with this.

Background

Understanding when patients return to work after myocardial infarction and what factors are associated with this may be helpful in designing person‐centred treatment plans to facilitate patients' rehabilitation and return to work.

Design

A narrative systematic review.

Review methods

Six databases, MEDLINE, CINAHL, Academic Search Complete, EMBASE, SCOPUS and ProQuest Health and Medicine, and the search engine Google were searched to retrieve peer‐reviewed articles published in English from January 2008–January 2020. In total, 22,217 papers were sourced and screened, with 18 papers retained for quality appraisal using the Joanna Briggs Institute Critical Appraisal Tools.

Results

The mean time to return to work varied between 46–192 days; about half the participants resumed work by 3 months. Patients who were male, younger, educated, non‐manual workers or owned their own business, and those who evaluated their general and mental health highly, and had shorter hospitalisation, fewer comorbidities, complications and mental health issues were more likely to return to work after myocardial infarction.

Relevance to clinical practice

Findings may help nurses detect patients at increased risk of failure to return to work and provide appropriate support to facilitate this.
Abnormal thyroid function is common in takotsubo syndrome and depends on two distinct mechanisms: results of a multicentre observational study
Authors: Aweimer A. , El‐Battrawy I. , Akin I. , Borggrefe M. , Mügge A. , Patsalis P. C. , Urban A. , Kummer M. , Vasileva S. , Stachon A. , Hering S. , Dietrich J. W.
Published: November 2020

Background

Several reports have described Takotsubo syndrome (TTS) secondary to thyrotoxicosis. A complex interaction of central and peripheral catecholamines with thyroid homeostasis has been suggested. In this study, we analysed sequential thyroid hormone profiles during the acute phase of TTS.

Methods

Thyrotropin (TSH), free T4 (FT4) and free T3 (FT3) concentrations were analysed at predefined time points in 32 patients presenting with TTS or acute coronary syndrome (ACS, n = 16 in each group) in a 2‐year period in two German university hospitals. Data were compared to age‐ and sex‐matched controls (10 samples, each of 16 subjects), and an unsupervised machine learning (ML) algorithm identified patterns in the hormone signature. Subjects with thyroid disease and patients receiving amiodarone were excluded from follow‐up.

Results

Among patients with TTS, FT4 concentrations were significantly higher when compared to controls or ACS. Four subjects (25%) suffered from subclinical or overt thyrotoxicosis. Two additional patients developed subclinical or overt thyrotoxicosis during stay in hospital. In four subjects (25%), FT4 concentrations were increased, despite nonsuppressed TSH concentration, representing an elevated set point of thyroid homeostasis. The thyroid hormone profile was normal in only six patients (38%) presenting with TTS.

Conclusion

Abnormal thyroid function is frequent in patients with TTS. Primary hyperthyroidism and an elevated set point of thyroid homeostasis are common in TTS, suggesting a stress‐dependent endocrine response or type 2 thyroid allostasis. Thyroid function may be a worthwhile target in treating or preventing TTS.