bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral health education in the undergraduate nursing curriculum of Australian and Malaysian institutions
Authors: Ahmad Mas S. , Abuzar Menaka A. , Razak Ishak A. , Rahman Sabariah A. , Borromeo Gelsomina L.
Published: October 2020

Introduction

A high degree of training is necessary to prepare student nurses for their roles as oral healthcare partners that can promote a holistic approach to health in the community. This study aims to determine the extent of oral health education in Australian and Malaysian nursing institutions, as well as investigate educators' perceptions of education and practice in this area of care.

Methodology

An audio‐recorded, semi‐structured qualitative phone interview was conducted with the heads of 42 nursing schools across Australia (n = 35) and Malaysia (n = 7) during the 2015 academic year. Qualitative data were analysed via thematic analysis. Quantitative data, wherever appropriate, were measured for frequencies.

Results

The response rate was 34.2% (n = 12) and 71.4% (n = 5) for the Australian and Malaysian subjects, respectively. Findings revealed that although all the nursing schools measured provided didactic and clinical training in oral health, curriculum content, expected learning outcomes, amount of clinical exposure and assessment approach lacked consistency. Most nursing educators across both countries perceived an overloaded curriculum as a barrier to providing oral health education. Whilst educators demonstrated their support for training in this area of care, they expressed the need for an established national guideline that highlights the educational requirement for future nurses in oral health maintenance and their scope of practice.

Conclusion

This study provides valuable information for further developing oral health education for nurses, to improve their competency and ultimately the health of the communities that they will serve.
Coexistence barriers confine the poleward range of a globally distributed plant
Authors: Armitage David W. , Jones Stuart E.
Published: October 2020

In the study of factors shaping species' poleward range boundaries, climatic constraints are often assigned greater importance than biotic interactions such as competition. However, theory suggests competition can truncate a species' fundamental niche in harsh environments. We test this by challenging a mechanistic niche model – containing explicit competition terms – to predict the poleward range boundaries of two globally distributed, ecologically similar aquatic plant species. Mechanistic competition models accurately predicted the northern range limits of our study species, outperforming competition‐free mechanistic models and matching the predictive ability of statistical niche models fit to occurrence records. Using the framework of modern coexistence theory, we found that relative nonlinearity in competitors' responses to temperature fluctuations maintains their coexistence boundary, highlighting the importance of this fluctuation‐dependent mechanism. Our results support a more nuanced, interactive role of climate and competition in determining range boundaries, and illustrate a practical, process‐based approach to understanding the determinants of range limits.
The influence of spatially heterogeneous anthropogenic change on bill size evolution in a coastal songbird
Authors: Benham Phred M. , Bowie Rauri C. K.
Published: October 2020

Natural history collections provide an unparalleled resource for documenting population responses to past anthropogenic change. However, in many cases, traits measured on specimens may vary temporally in response to a number of different anthropogenic pressures or demographic processes. While teasing apart these different drivers is challenging, approaches that integrate analyses of spatial and temporal series of specimens can provide a robust framework for examining whether traits exhibit common responses to ecological variation in space and time. We applied this approach to analyze bill morphology variation in California Savannah Sparrows (Passerculus sandwichensis). We found that bill surface area increased in birds from higher salinity tidal marshes that are hotter and drier. Only the coastal subspecies, alaudinus, exhibited a significant increase in bill size through time. As with patterns of spatial variation, alaudinus populations occupying higher salinity tidal marshes that have become warmer and drier over the past century exhibited the greatest increases in bill surface area. We also found a significant negative correlation between bill surface area and total evaporative water loss (TEWL) and estimated that observed increases in bill size could result in a reduction of up to 16.2% in daily water losses. Together, these patterns of spatial and temporal variation in bill size were consistent with the hypothesis that larger bills are favored in freshwater‐limited environments as a mechanism of dissipating heat, reducing reliance on evaporative cooling, and increasing water conservation. With museum collections increasingly being leveraged to understand past responses to global change, this work highlights the importance of considering the influence of many different axes of anthropogenic change and of integrating spatial and temporal analyses to better understand the influence of specific human impacts on population change over time.
Overview of the use of antimicrobial drugs for the treatment of bacterial infections in horses
Authors: Hardefeldt L. Y. , Bailey K. E. , Slater J.
Published: October 2020

The use of antimicrobials in veterinary medicine is under great scrutiny with the emergence of antimicrobial resistance in the human population. Equine veterinarians rely on antimicrobials as an essential tool for the treatment of infections in horses, but there is much criticism of some use, particularly prophylaxis. While the appropriate use of antimicrobials can be justified in equine medicine, the misuse cannot. The definition of appropriate use is complex and involves the indication for therapy, antimicrobial selection, dosing regimen and timing and route of administration, duration of therapy and modification of therapy based on microbial susceptibility and clinical response. The aim of this article is to provide guidance on these factors to assist equine veterinarians in determining what constitutes appropriate antimicrobial use in horses.
SIS3, a good candidate for the reverse of type 2 diabetes mellitus in mice
Authors: Wang Dao‐Cai , Yan Ting‐Ting , Chen Bin , Liu Feng , Liu Xiao‐Peng , Xie Yong‐Mei
Published: October 2020

TGF‐β signaling plays an extremely important role in the occurrence and development of type 2 diabetes mellitus (T2DM), and the blockade of TGF‐β/Smad3 pathway protests against the high‐fat diet‐induced obesity and diabetes. As a specific small molecule inhibitor of Smad3 protein, the biological activities of compound SIS3 were evaluated by high‐fat diet‐induced T2DM model mice. In vivo results indicated that SIS3 can not only significantly reduce the body weight, fat mass, and fasting blood glucose in high‐fat diet‐induced T2DM model mice, but also improve insulin sensitivity and oral glucose tolerance of high‐fat diet‐induced T2DM model mice after the injection of SIS3 with 5 mg/kg for 45 days.
Analysis on stress‐strain behavior and life prediction of P92 steel under creep‐fatigue interaction conditions
Authors: Zhao Lei , Xu Lianyong , Han Yongdian , Jing Hongyang
Published: October 2020

Considering the flexible operation conditions, the creep‐fatigue performance of P92 steel plays a crucial role in manufacturing structural components of ultra‐supercritical fossil power plants at 620°C–630°C. The creep‐fatigue interaction tests of P92 steel were conducted at 630°C in air with different duration periods, where the duration periods were simultaneously added on the peak tensile strain and valley compressive strain. The addition of hold time resulted in a rapid decrease of fatigue life, where the reduction amplitude increasing with the hold time. There was more than five times reduction as the hold time increased to 300 s. Moreover, the stress relaxation behavior during hold time exhibited a saturation behavior at long dwell time, where the limited relaxed stress gradually approached to the creep threshold stress. Furthermore, a modified strain energy density exhaustion model involving creep threshold stress was proposed and provided more accurate predictions in comparison with the conventional model, reducing the conservatism.
Mammalian herbivory shapes intraspecific trait responses to warmer climate and nutrient enrichment
Authors: Jessen Maria‐Theresa , Kaarlejärvi Elina , Olofsson Johan , Eskelinen Anu
Published: October 2020

Variation in intraspecific traits is one important mechanism that can allow plant species to respond to global changes. Understanding plant trait responses to environmental changes such as grazing patterns, nutrient enrichment and climate warming is, thus, essential for predicting the composition of future plant communities. We measured traits of eight common tundra species in a fully factorial field experiment with mammalian herbivore exclusion, fertilization, and passive warming, and assessed how trait responsiveness to the treatments was associated with abundance changes in those treatments. Herbivory exhibited the strongest impact on traits. Exclusion of herbivores increased vegetative plant height by 50% and specific leaf area (SLA) by 19%, and decreased foliar C:N by 11%; fertilization and warming also increased height and SLA but to a smaller extent. Herbivory also modulated intraspecific height, SLA and foliar C:N responses to fertilization and warming, and these interactions were species‐specific. Furthermore, herbivory affected how trait change translated into relative abundance change: increased height under warming and fertilization was more positively related to abundance change inside fences than in grazed plots. Our findings highlight the key role of mammalian herbivory when assessing intraspecific trait change in tundra and its consequences for plant performance under global changes.
Development and Internal Validation of a Multivariable Prediction Model for Individual Episodic Migraine Attacks Based on Daily Trigger Exposures
Authors: Holsteen Katherine K. , Hittle Michael , Barad Meredith , Nelson Lorene M.
Published: October 2020

Objective

To develop and internally validate a multivariable predictive model for days with new‐onset migraine headaches based on patient self‐prediction and exposure to common trigger factors.

Background

Accurate real‐time forecasting of one’s daily risk of migraine attack could help episodic migraine patients to target preventive medications for susceptible time periods and help decrease the burden of disease. Little is known about the predictive utility of common migraine trigger factors.

Methods

We recruited adults with episodic migraine through online forums to participate in a 90‐day prospective daily‐diary cohort study conducted through a custom research application for iPhone. Every evening, participants answered questions about migraine occurrence and potential predictors including stress, sleep, caffeine and alcohol consumption, menstruation, and self‐prediction. We developed and estimated multivariable multilevel logistic regression models for the risk of a new‐onset migraine day vs a healthy day and internally validated the models using repeated cross‐validation.

Results

We had 178 participants complete the study and qualify for the primary analysis which included 1870 migraine events. We found that a decrease in caffeine consumption, higher self‐predicted probability of headache, a higher level of stress, and times within 2 days of the onset of menstruation were positively associated with next‐day migraine risk. The multivariable model predicted migraine risk only slightly better than chance (within‐person C‐statistic: 0.56, 95% CI: 0.54, 0.58).

Conclusions

In this study, episodic migraine attacks were not predictable based on self‐prediction or on self‐reported exposure to common trigger factors. Improvements in accuracy and breadth of data collection are needed to build clinically useful migraine prediction models.
Gluten‐Free Diet and Migraine
Authors: Beuthin Justin , Veronesi Maria , Grosberg Brian , Evans Randolph W.
Published: October 2020

Migraine is common in celiac disease (CD) and usually improves on a gluten‐free diet (GFD). The benefit for people impacted by migraine without CD is poorly evidenced. A GFD may have adverse health consequences and is expensive.
Where are we with pre‐exposure prophylaxis use in Central and Eastern Europe? Data from the Euroguidelines in Central and Eastern Europe (ECEE) Network Group
Authors: Balayan T , Begovac J , Skrzat‐Klapaczyńska A , Aho I , Alexiev I , Bukovinova P , Salemovic D , Gokengin D , Harxhi A , Holban T , Jevtovic D , Kase K , Lakatos B , Latysheva I , Matulionyte R , Oprea C , Papadopoulos A , Rukhadze N , Sedlacek D , Tomazic J , Vassilenko A , Vasylyev M , Verhaz A , Yancheva N , Yurin O , Horban A , Kowalska JD ,   the ECEE Network Group
Published: October 2020

Objectives

Pre‐exposure prophylaxis (PrEP) for HIV infection is an important intervention for control of the HIV epidemic. The incidence of HIV infection is increasing in the countries of Central and Eastern Europe (CEE). Therefore, we investigated the change in PrEP use in CEE over time.

Methods

The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care for HIV and viral hepatitis infections in CEE. Data on access to PrEP were collected from 23 countries through online surveys in May–June 2017 (76 respondents) and in November 2018–May 2019 (28 respondents).

Results

About 34.2% of respondents stated that tenofovir/emtricitabine (TDF/FTC) was licensed for use in their country in 2017, and 66.7% that it was licensed for use in 2018 (P = 0.02). PrEP was recommended in national guidelines in 39.5% of responses in 2017 and 40.7% in 2018 (P = 0.378). About 70.7% of respondents were aware of “informal” PrEP use in 2017, while 66.6% were aware of this in 2018 (P = 0.698). In 2018, there were 53 centres offering PreP (the highest numbers in Poland and Romania), whereas six countries had no centres offering PreP. The estimated number of HIV‐negative people on PreP in the region was 4500 in 2018. Generic TDF/FTC costs (in Euros) ranged from €10 (Romania) to €256.92 (Slovakia), while brand TDF/FTC costs ranged from €60 (Albania) to €853 (Finland).

Conclusions

Although the process of licensing TDF/FTC use for PrEP has improved, this is not yet reflected in the guidelines, nor has there been a reduction in the “informal” use of PrEP. PrEP remains a rarely used preventive method in CEE countries.
The benefit of culture‐independent methods to detect bacteria and fungi in re‐infected root filled teeth: a pilot study
Authors: Al‐Sakati H. , Kowollik S. , Gabris S. , Balasiu A. , Ommerborn M. , Pfeffer K. , Henrich B. , Raab W. H.‐M.
Published: October 2020

Aim

To identify dominant microorganisms in root filled teeth with apical periodontitis by Pan‐PCRs in comparison with a culture‐dependent approach, focusing on fungal species profiling.

Methodology

The root filling material (gutta‐percha) removed from 42 teeth with periapical radiolucencies undergoing root canal retreatments was analysed by molecular genetics techniques. Real‐Time Pan‐PCRs were conducted for the diagnosis of predominant bacteria (targeting 16S rDNA) and fungi (targeting ITS1‐2 region). Identification of microorganisms was performed by Sanger sequencing of the PCR products and BLAST analysis. Additionally, subgingival plaque samples were collected and cultured to review the composition of the microbial flora. The McNemar test and the repeated measures anova were used for statistical analyses (significance level was set at P < 0.05).

Results

Overall, 42/42 plaque samples had bacterial growth, whereas 32/42 gutta‐percha samples had bacterial growth with a dominance of Streptococcus spp. (12/42) and Enterococcus faecalis (9/42). The mean number of bacterial taxa per gutta‐percha sample was 1.6 cultivatable taxa, significantly lower than in the plaque sample that had six taxa/sample (P < 0.001). Fungus‐specific cultures were negative for gutta‐percha samples, and only one plaque sample had growth of a fungus. In total, 36/42 plaque samples were positive in bacterial Pan‐PCRs. In bacterial Pan‐PCRs of 31/42 gutta‐percha samples, dominant microorganisms were identified including Streptococcus spp. (5/42) and E. faecalis (4/42). Moreover, in 7/42 gutta‐percha samples, DNA of bacteria which are difficult‐to‐cultivate in microbiology routine culture (Acinetobacter,Pyramidobacter,Bacteroidetes,Synergistes,Atopobium and Pseudoramibacter) was found. DNA of Candida spp. was detected in 5/42 root canals by fungal Pan‐PCR (1/5) and genus‐specific Candida‐PCR (5/5).

Conclusions

Pan‐PCR assays remain appropriate as a broad‐range approach for the detection of a dominant pathogen in gutta‐percha samples which have less diverse microbial composition. The molecular genetic Pan‐PCR approach has the advantage of detecting microorganisms that are as‐yet‐uncultivable or difficult‐to‐cultivate and should be therefore complement conventional microbiological diagnostics.
Primary prevention of fat and weight gain among obesity susceptible healthy weight preschool children. Main results from the “Healthy Start” randomized controlled intervention
Authors: Olsen Nanna Julie , Ängquist Lars , Frederiksen Peder , Lykke Mortensen Erik , Heitmann Berit Lilienthal
Published: October 2020

Background

A vital public health challenge lies in understanding the primary drivers behind excessive weight gain among healthy weight individuals.

Objectives

To examine if excessive weight and fat gain can be prevented among healthy weight, obesity susceptible children aged 2 to 6 years.

Methods

Eligible children were identified based on information on either a high birth weight, maternal pre‐pregnancy obesity or maternal low educational level from national registries, and randomized into an intervention group, a control group and a shadow control group. All children with overweight at baseline were excluded from subsequent analysis (n = 196), while healthy weight children were included (n = 926). The intervention was designed to deliver improvements in diet and physical activity habits, optimization of sleep quantity and quality, and reduction of family stress. The average intervention period was 1.3 years.

Results

Intention‐to‐treat analyses indicated a lower gain in percentage fat mass and a higher gain in fat‐free mass in the intervention group compared with the control group. However, the results should be interpreted with caution, as they were clinically small and borderline significant, only.

Conclusion

This primary prevention intervention among young healthy weight children with susceptibility to future obesity had clinically small effects on growth and body composition. More interventions, conducting primary obesity prevention, are urgently needed.
What are the building blocks of parent–infant coordinated attention in free‐flowing interaction?
Authors: Abney Drew H. , Suanda Sumarga H. , Smith Linda B. , Yu Chen
Published: October 2020

The present article investigated the composition of different joint gaze components used to operationalize various types of coordinated attention between parents and infants and which types of coordinated attention were associated with future vocabulary size. Twenty‐five 9‐month‐old infants and their parents wore head‐mounted eye trackers as they played with objects together. With high‐density gaze data, a variety of coordinated attention bout types were quantitatively measured by combining different gaze components, such as mutual gaze, joint object looks, face looks, and triadic gaze patterns. The key components of coordinated attention that were associated with vocabulary size at 12 and 15 months included the simultaneous combination of parent triadic gaze and infant object looking. The results from this article are discussed in terms of the importance of parent attentional monitoring and infant sustained attention for language development.
How do toddlers evaluate defensive actions toward third parties?
Authors: Geraci Alessandra
Published: October 2020

Defensive behavior is a central aspect of social life and provides benefits to the self and others. Recent evidence reveals that infants evaluate third parties’ prosocial and antisocial actions. Three experiments were carried out to assess toddlers’ reactions to defensive and non‐defensive events (N = 54). In two experiments, infants’ looking times and manual choices provided converging evidence that 20‐month‐olds understand and evaluate defensive actions, by showing that they prefer the defensive puppet over the non‐defensive puppet and that they reason on the bystander puppet's disposition. In the third experiment, toddlers rewarded the defensive puppet rather than the non‐defensive puppet, revealing how their evaluations guided awarding behaviors of defensive actions toward the third party. The results support the developmental stability and provide evidence of a rich and well‐organized prosociality that before the second year of life proves to be based on some moral principles and linked with a sophisticated psychological reasoning. The findings shed light on the claims that human capacities for the social evaluation of defensive behaviors toward third parties are rooted in evolved cooperative systems.
Exploring patient experiences of participating in a telephone‐based self‐management support intervention: Proactive Health Support (PaHS)
Authors: Winther Susanne , Fredens Mia , Skov Benthien Kirstine , Konstantin Nissen Nina , Palmhøj Nielsen Camilla , Grønkjær Mette
Published: October 2020

Aim

Proactive Health Support is a telephone‐based self‐management intervention that is carried out in Denmark by Registered Nurses who provide self‐management support to people at risk of hospital admission. We aimed to explore participants’ experiences of Proactive Health Support and to identify what the participants find important and meaningful during the intervention process.

Design

Qualitative design involving semi‐structured interview.

Methods

Using a phenomenological–hermeneutical framework, we conducted semi‐structured interviews with 62 participants in their own homes (32 women, 30 men; aged 20–81 years) in spring and fall 2018.

Results

The participants felt confident that they could discuss every matter with the nurses. Participants benefitted from accessibility to the nurses’ professional and medical competences and they felt relief that the nurses contacted them via the telephone due to their multiple health conditions. The participants felt that the nurses were available and helped them to navigate the healthcare system.

Conclusion

The participants valued the intervention because they benefitted from the nurses’ holistic approach. They described the nurses’ knowledge and professionalism in relation to their symptoms, treatments, and medicine as important and meaningful. Accordingly, the intervention seemed to promote feelings of independence and self‐management among the participants.

Impact

From a nursing perspective, the study highlights that it is possible to establish a close relationship and behavioural change among participants through regular telephone contact.
Multiple procedure outcomes for nonparoxysmal atrial fibrillation: Left atrial posterior wall isolation versus stepwise ablation
Authors: Barbhaiya Chirag R. , Knotts Robert J. , Beccarino Nicholas , Vargas‐Pelaez Alvaro F. , Jankelson Lior , Bernstein Scott , Park David , Holmes Douglas , Aizer Anthony , Chinitz Larry A.
Published: October 2020

Objective

To compare multiple‐procedure catheter ablation outcomes of a stepwise approach versus left atrial posterior wall isolation (LA PWI) in patients undergoing nonparoxysmal atrial fibrillation (NPAF) ablation.

Background

Unfavorable outcomes for stepwise ablation of NPAF in large clinical trials may be attributable to proarrhythmic effects of incomplete ablation lines. It is unknown if a more extensive initial ablation strategy results in improved outcomes following multiple ablation procedures.

Methods

Two hundred twenty two consecutive patients with NPAF underwent first‐time ablation using a contact‐force sensing ablation catheter utilizing either a stepwise (Group 1, n = 111) or LA PWI (Group 2, n = 111) approach. The duration of follow‐up was 36 months. The primary endpoint was freedom from atrial arrhythmia >30 s. Secondary endpoints were freedom from persistent arrhythmia, repeat ablation, and recurrent arrhythmia after repeat ablation.

Results

There was similar freedom from atrial arrhythmias after index ablation for both stepwise and LA PWI groups at 36 months (60% vs. 69%, p = .1). The stepwise group was more likely to present with persistent recurrent arrhythmia (29% vs. 14%, p = .005) and more likely to undergo second catheter ablation (32% vs. 12%, p < .001) compared to LA PWI patients. Recurrent arrhythmia after repeat ablation was more likely in the stepwise group compared to the LA PWI group (15% vs. 4%, p = .003).

Conclusions

Compared to a stepwise approach, LA PWI for patients with NPAF resulted in a similar incidence of any atrial arrhythmia, lower incidence of persistent arrhythmia, and fewer repeat ablations. Results for repeat ablation were not improved with a more extensive initial approach.
Supraventricular tachycardia in patients with coronary sinus stenosis/atresia: Prevalence, anatomical features, and ablation outcomes
Authors: Weng Sixian , Tang Min , Zhou Bin , Yu Fengyuan , Dong Xiaonan , Ma Yazhe , Qi Yingjie , Wang Xiaoqin , Jiang Yizhou , Fang Pihua , Zhang Shu
Published: October 2020

Background

Supraventricular tachycardia (SVT) with coronary sinus (CS) ostial atresia (CSA) or coronary sinus stenosis (CSS) causes difficulty in electrophysiological procedures, but its characteristics are poorly understood.

Objective

Study the anatomical and clinical features of SVT patients with CSA/CSS.

Methods

Of 6128 patients with SVT undergoing electrophysiological procedures, consecutive patients with CSA/CSS were enrolled, and the baseline characteristics, imaging materials, intraoperative data, and follow‐up outcomes were analyzed.

Results

Thirteen patients, seven with CSA and six with CSS, underwent the electrophysiological procedure. Decapolar catheters were placed into the proximal CS in three cases, while the rest were placed at the free wall of the right atrium. Fourteen arrhythmias were confirmed: four atrioventricular nodal reentrant tachycardias, five left‐sided accessory pathways, three paroxysmal atrial fibrillations, and two atrial flutters (AFLs). In addition to three patients who underwent only an electrophysiological study, the acute ablation success rate was 100% in 10 cases, with no procedure‐related complications. After a median follow‐up period of 59.6 months, only one case of atypical AFL recurred. For those cases (seven CSA and two CSS) with a total of 10 anomalous types of CS drainage, three types were classified: from the CS to the persistent left superior vena cava (n = 3), from an unroofed CS (n = 3), and from the CS to the small cardiac vein (n = 3) or Thebesian vein (n = 1).

Conclusion

Patients with CSA/CSS may develop different kinds of SVT. Electrophysiological procedures for such patients are feasible and effective. An individualized mapping strategy based on the three types of CS drainage will be helpful.
Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation
Authors: Field Michael E. , Gold Michael R. , Rahman Motiur , Goldstein Laura , Maccioni Sonia , Srivastava Abhishek , Khanna Rahul , Piccini Jonathan P. , Friedman Daniel J.
Published: October 2020

Background

Catheter ablation is an effective treatment for patients with atrial fibrillation (AF) and heart failure (HF). However, little is known about how healthcare utilization and cost change after ablation in this population. We sought to determine healthcare utilization and cost patterns among patients with AF and HF undergoing ablation.

Methods

Using a large United States administrative database, we identified (n = 1568) treated with ablation with a primary and secondary diagnosis of AF and HF, respectively, were evaluated 1‐year pre‐ and postablation for outcomes including inpatient admissions (AF or HF), emergency department (ED) visits, cardioversions, length of stay (LOS), and cost. A secondary analysis was extended to 3‐years postablation.

Results

Reductions were observed in AF‐related admissions (64%), LOS (65%), cardioversions (52%), ED visits (51%, all values, p < .0001), and HF‐related admissions (22%, p = .01). There was a 40% reduction in inpatient admission cost ($4165 preablation to $2510 postablation, p < .0001). In a sensitivity analysis excluding repeat‐ablation patients, a greater reduction in overall AF management cost was observed compared to the full cohort (−43% vs. −2%). Comparing 1‐year pre‐ to 3‐years postablation, both total mean AF‐management cost ($850 per‐patient per‐month 1‐year pre‐ to $546 3‐years postablation, p < .0001) and AF‐related healthcare utilization was reduced.

Conclusions

Catheter ablation in patients with AF and HF resulted in significant reductions in healthcare utilization and cost through 3‐years of follow‐up. This reduction was observed regardless of whether repeat ablation was performed, reflecting the positive impact of ablation on longer term cost reduction.
Comparison of commercially available 0.2% chlorhexidine mouthwash with and without anti‐discoloration system: A blinded, crossover clinical trial
Authors: Mauland Erik Klepsland , Preus Hans R. , Aass Anne Merete
Published: October 2020

Aim

To evaluate clinical performance and side effects of two commercially available 0.2% chlorhexidine mouthwashes after periodontal surgery, one with (test) and one without (control) an anti‐discoloration system.

Materials and methods

This single‐centre, crossover clinical trial included 38 patients undergoing two sessions of periodontal flap surgery. The participants used two different 0.2% chlorhexidine products, one with and one without an anti‐discoloration system, in the 14‐day post‐operative periods. Plaque, gingival inflammation, tooth staining, side effects and patient preference were evaluated.

Results

The control mouthwash (without an anti‐discolouring system) produced significantly lower plaque (p = 0.02) and gingival index (p = 0.01) compared to the test mouthwash. The test mouthwash produced significantly less staining in the gingival (p = 0.002) and approximal areas (p = 0.0004), but no difference was detected in the buccal area of the teeth. The patients did not show preference for any of the mouthwashes.

Conclusion

Chlorhexidine mouthwash without an anti‐discoloration system resulted in significantly lowered plaque and gingival index compared to chlorhexidine mouthwash with an anti‐discoloration following periodontal surgery. No difference in patient preference was found despite less side effects produced by the chlorhexidine mouthwash with the anti‐discoloration system.
Impact of novel processing techniques on the functional properties of egg products and derivatives: A review
Authors: Afraz Muhammad Talha , Khan Moazzam Rafiq , Roobab Ume , Noranizan Mohd Adzahan , Tiwari Brijesh K. , Rashid Muhammad Tayyab , Inam‐ur‐Raheem Muhammad , Hashemi Seyed Mohammad Bagher , Aadil Rana Muhammad
Published: October 2020

Eggs are an excellent source of quality proteins. Eggs as a whole and its components (egg white and egg yolk) are employed in a range of food preparations. Thermal processing employed for stabilizing and improving shelf‐life of egg components is known to have adverse effect on heat‐sensitive proteins leading to protein denaturation and aggregation thus, reducing the required functional, technological, and overall quality of egg proteins and other constituents. Therefore, the current challenge is to identify novel processing techniques that not only improve the intrinsic functional properties of eggs or its components, but also improve the quality of the product. This review focuses on the use of technologies such as ultrasound, pulsed electric field, high‐pressure processing, radiofrequency, ultraviolet light, microwave, and cold plasma for egg products. These novel technologies are known for their advantages over thermal treatments especially in protecting the heat sensitive nature and retaining the overall quality of the egg and egg products. Availability of alternatives processing has significantly improved the structural properties, techno‐functional, nutritional and as well improving the safety egg and egg products.

Practical Application

Eggs are consumed worldwide as whole egg or in some cases, consumed partly as egg whites or egg yolks. Egg components with improved techno‐functional properties can be used in various food industries (such as baking, confectionery, and culinary preparation, etc.). Value addition of new products can be achieved through modification of egg proteins. Additionally, these techniques also provide microbial safety and have a reduced impact on nutritional content and overall food quality.
Extended dynamic vapor sorption of glutinous rice flour observed in logarithmic time scale and its modeling as a process with varying activation energy
Authors: Zhao Xuewei , Zhang Hua , Li Xingke , Fan Wen
Published: October 2020

With the objective of characterizing water sorption kinetics of glutinous rice flour during extended water vapor exposure, water adsorption and desorption measurements were conducted at nine relative humidity (RH) levels for up to 1,500 min per step, and displayed in a logarithmic time scale. A three‐stage sorption kinetics was observed, and the final stage was characterized with a very long and slow process. The final sections of the kinetic curves were concave to log(t) axis for adsorption while linear for desorption, even after the flour was gelatinized. Increment in RH step and flour particle size, and variation in water content can only postpone starting of the linear stage. Analysis using an Elovich‐type model indicated that both adsorption and desorption can be treated as processes whose activation energy varied consistently during sorption. Reaction order difference between adsorption and desorption was the major contributor to their distinct kinetic responses in the final stages.

Practical Applications

Water sorption kinetic measurements are necessary for exploring mass transfer mechanism, and determining parameters such as water diffusivity and interfacial mass transfer coefficient. Extended measurement duration allows one to catch the entire characteristics of a kinetic process. Distinct kinetic features between adsorption and desorption of glutinous rice flour were observed when the data were plotted against logarithm of time. The later stage was a slow process. Further analysis using an Elovich‐type model indicated that both adsorption and desorption were processes with varying activation energy. This information can be potentially helpful in optimizing both the quality of food product and the economics of many food processes involving water transfer.
Treatment with functionalized designer self‐assembling peptide hydrogels promotes healing of experimental periodontal defects
Authors: Matsugami Daisuke , Murakami Tasuku , Yoshida Wataru , Imamura Kentaro , Bizenjima Takahiro , Seshima Fumi , Saito Atsushi
Published: October 2020

Background/Objectives

It has been reported that self‐assembling peptide (SAP) hydrogels with functionalized motifs enhance proliferation and migration of host cells. How these designer SAP hydrogels perform in the treatment of periodontal defects remains unknown. This study aimed to test the potential of local application of designer SAP hydrogels with two different functionalized motifs in the treatment of experimental periodontal defects.

Material and Methods

In vitro, viability/proliferation of rat periodontal ligament‐derived cells (PDLCs) cultured on an SAP hydrogel RADA16 and RADA16 with functionalized motifs, PRG (integrin binding sequence) and PDS (laminin cell adhesion motif), was assessed. Cell morphology was analyzed by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). In vivo, standardized periodontal defects were made mesially in the maxillary first molars of Wistar rats. Defects received RADA16, PRG, PDS or left unfilled. At 2 or 4 weeks postoperatively, healing was assessed by microcomputed tomography, histological and immunohistochemical methods.

Results

Viability/proliferation of PDLCs was significantly greater on PRG than on RADA16 or PDS at 72 hours. rPDLCs in the PRG group showed enhanced elongations and cell protrusions. In vivo, at 4 weeks, bone volume fractions in the PRG and PDS groups were significantly greater than the RADA16 group. Histologically, bone formation was more clearly observed in the PRG and PDS groups compared with the RADA16 group. At 4 weeks, epithelial downgrowth in the hydrogel groups was significantly reduced compared to the Unfilled group. In Azan‐Mallory staining, PDL‐like bundles ran in oblique direction in the hydrogel groups. At 2 weeks, in the area near the root, proliferating cell nuclear antigen (PCNA)‐positive cells were detected significantly more in the PRG group than other groups. At 4 weeks, in the middle part of the defect, a significantly greater level of vascular endothelial growth factor (VEGF)‐positive cells and α‐smooth muscle actin (SMA)‐positive blood vessels were observed in the PRG group than in other groups.

Conclusion

The results indicate that local application of the functionalized designer SAP hydrogels, especially PRG, promotes periodontal healing by increasing cell proliferation and angiogenesis.
A comparison of Northeast Atlantic killer whale (Orcinus orca) stereotyped call repertoires
Authors: Selbmann Anna , Deecke Volker B. , Fedutin Ivan D. , Filatova Olga A. , Miller Patrick J. O. , Svavarsson Jörundur , Samarra Filipa I. P.
Published: October 2020

Killer whale call repertoires can provide information on social connections among groups and populations. Killer whales in Iceland and Norway exhibit similar ecology and behavior, are genetically related, and are presumed to have been in contact before the collapse of the Atlanto‐Scandian herring stock in the 1960s. However, photo‐identification suggests no recent movements between Iceland and Norway but regular movement between Iceland and Shetland. Acoustic recordings collected between 2005 and 2016 in Iceland, Norway, and Shetland were used to undertake a comprehensive comparison of call repertoires of Northeast Atlantic killer whales. Measurements of time and frequency parameters of calls from Iceland (n = 4,037) and Norway (n = 1,715) largely overlapped in distribution, and a discriminant function analysis had low correct classification rate. No call type matches were confirmed between Iceland and Norway or Shetland and Norway. Three call types matched between Iceland and Shetland. Therefore, this study suggests overall similarities in time and frequency parameters but some divergence in call type repertoires. This argues against presumed past contact between Icelandic and Norwegian killer whales and suggests that they may not have been one completely mixed population.
Muscularis macrophages establish cell‐to‐cell contacts with telocytes/PDGFRα‐positive cells and smooth muscle cells in the human and mouse gastrointestinal tract
Authors: Ji Sihan , Traini Chiara , Mischopoulou Magdalini , Gibbons Simon J. , Ligresti Giovanni , Faussone‐Pellegrini Maria‐Simonetta , Sha Lei , Farrugia Gianrico , Vannucchi Maria Giuliana , Cipriani Gianluca
Published: October 2020

Background and Aim

Muscularis macrophages (MMs) not only mediate the innate immunity, but also functionally interact with cells important for gastrointestinal motility. The aim of this study was to determine the spatial relationship and types of contacts between the MMs and neighboring cells in the muscularis propria of human and mouse stomach, small intestine, and large intestine.

Methods

The distribution and morphology of MMs and their contacts with other cells were investigated by immunohistochemistry and transmission electron microscopy.

Key Results

Immunohistochemistry showed variable shape and number of MMs according to their location in different portions of the muscle coat. By double labeling, a close association between MMs and neighboring cells, that is, neurons, smooth muscle cells, interstitial cells of Cajal (ICCs), telocytes (TCs)/PDGFRα‐positive cells, was seen. Electron microscopy demonstrated that in the muscle layers of both animal species, MMs have similar ultrastructural features and have specialized cell‐to‐cell contacts with smooth muscle cells and TCs/PDGFRα‐positive cells but not with ICCs and enteric neurons.

Conclusion & Inferences

This study describes varying patterns of distribution of MMs between different regions of the gut, and reports the presence of distinct and extended cell‐to‐cell contacts between MMs and smooth muscle cells and between MMs and TCs/PDGFRα‐positive cells. In contrast, MMs, although close to ICCs and nerve elements, did not make contact with them. These findings indicate specialized and variable roles for MMs in the modulation of gastrointestinal motility whose significance should be more closely investigated in normal and pathological conditions.
Biomarkers of diagnosis and resolution of food allergy
Authors: Foong Ru‐Xin , Santos Alexandra F.
Published: October 2020

Food allergy is increasing in prevalence, affecting up to 10% of children in developed countries. Food allergy can significantly affect the quality of life and well‐being of patients and their families; therefore, an accurate diagnosis is of extreme importance. Some food allergies can spontaneously resolve in 50%‐60% of cow’s milk and egg‐allergic, 20% of peanut‐allergic and 9% of tree nut‐allergic children by school age. For that reason, food‐allergic status should be monitored over time to determine when to reintroduce the food back into the child’s diet. The gold‐standard to confirm the diagnosis and the resolution of food allergy is an oral food challenge; however, this involves the risk of causing an acute‐allergic reaction and requires clinical experience and resources to treat allergic reactions of any degree of severity. In the clinical setting, biomarkers have been used and validated to enable an accurate diagnosis when combined with the clinical history, deferring the oral food challenge, whenever possible. In this review, we cover the tools available to support the diagnosis of food allergies and to predict food allergy resolution over time. We review the latest evidence on different testing modalities and how effective they are in guiding clinical decision making in practice. We also evaluate predictive test cut‐offs for the more common food allergens to try and provide guidance on when challenges might be most successful in determining oral tolerance in children.
Clinical characteristics of childhood acute tubulointerstitial nephritis
Authors: Güngör Tülin , Çakıcı Evrim Kargın , Yazılıtaş Fatma , Eroğlu Fehime Kara , Özdel Semanur , Kurt‐Sukur Eda Didem , Çelikkaya Evra , Karakaya Deniz , Bağlan Esra , Bülbül Mehmet
Published: October 2020

Background

Acute tubulointerstitial nephritis (ATIN) is a rare cause of acute kidney injury in children that can lead to chronic kidney disease. The aim of this study was to describe the presenting features, etiology, and clinical characteristics of childhood ATIN, and to evaluate treatment modalities and renal outcomes.

Methods

The study included 38 patients who had been diagnosed with ATIN, were younger than 18 years old, and were admitted for at least 6 months of follow up.

Results

The median age at diagnosis was 13.1 years (range 1.2–16.6 years). The female / male ratio was 1.37. The most common symptoms were abdominal pain (65.7%) and nausea / vomiting (55.2%). Twenty‐three of the patients had a history of drug intake (60.5%), and the most active drugs in the etiology were non‐steroidal anti‐inflammatory drugs (56.5%). Eleven patients were given steroid therapy due to severe kidney involvement and rapid increases in serum creatinine values, and ten of those patients were drug‐related ATIN cases. Other patients were given symptomatic treatment. Four patients needed several sessions of dialysis due to the severity of their acute renal failure. The follow‐up creatinine and estimated glomerular filtration rate levels were not statistically different between the symptomatic and corticosteroid treated groups (P > 0.05).

Conclusions

Although our study was unable to show the beneficial effect of corticosteroid therapy on the extent of renal recovery, the use of steroids may be preferable in severe nephritis because of the rapid recovery of estimated glomerular filtration rate with corticosteroid therapy.
Attitudes toward xenotransplantation: A survey of parents and pediatric cardiac providers
Authors: Padilla Luz A. , Rhodes Leslie , Sorabella Robert A. , Hurst Daniel J. , Cleveland David C. , Dabal Robert J. , Cooper David K. , Paris Wayne , Carlo Waldemar F.
Published: October 2020

Background

Scientific advancements are occurring in cardiac xenotransplantation (XTx). However, there have been religious and social concerns surrounding this allotransplantation alternative. The purpose of this study was to explore the acceptance of XTx among stakeholders of the congenital heart disease (CHD) community.

Methods

A Likert‐scale anonymous survey was distributed to physicians and nurses who care for children with CHD and parents of children with CHD. Psychosocial and clinical attitudes were compared across all groups to identify differences, and regression analysis was performed to identify factors associated with XTx acceptance.

Results

A total of 297 responded to the survey: 134 physicians, 62 nurses, and 101 parents. Potential acceptance of XTx if outcomes were similar to allotransplantation was high overall (75.3%), but different between the groups (physicians 86%; nurses 71%, parents 64%; P < .0001). Regression analysis showed respondents who reported religion would influence medical decision making (OR 0.48; 95%CI 0.24‐0.97) and those who would not use a pig heart transplant as a bridge until a human heart became available were less likely to accept XTx (OR 0.09; 95%CI 0.04‐0.21). Psychosocial concerns to XTx were minimal but were also associated with XTx acceptance particularly among parents (OR 0.17; 95%CI 0.03‐0.80).

Conclusions

Potential acceptance of XTx is high, assuming results are similar to allotransplantation. Religious beliefs and attitudes toward the use of XTx as a bridge to allotransplant may present barriers to XTx acceptance. Future research is needed to assess potential attitude differences in light of ethical, psychosocial, and religious objections to XTx.