bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of dental services among middle‐aged adults: predisposing, enabling and need variables
Authors: Singh KA , Brennan DS
Published: February 2021

Objectives

To examine if making a visit, number of visits and services varied by predisposing (gender, perceived health competence, education, previous relief of pain visit), enabling (dental anxiety, income, social support) and need (perceived need, number of teeth and oral pain) characteristics.

Methods

Dental visiting and services data from a sample of middle‐aged South Australian adults were collected from 61% of participants at 12‐months (n = 603) and 59% after 24‐months (n = 583). Visiting over 2‐years, mean visits and mean services were analysed by log binomial and Poison regression using the Andersen and Newman model.

Results

The percentage having a dental visit over 2‐years was lower for males than females, prevalence ratio (PR, 95% CI) 0.91 (0.84, 0.99), and for higher than lower dental anxiety, PR = 0.78 (0.62, 0.98). Number of visits was associated with higher than lower income, rate ratio (RR, 95%CI) 1.20 (1.02, 1.41) but lower for those with higher social support, RR = 0.86 (0.74, 0.99). Services were lower for those with higher perceived health competence, RR = 0.72 (0.56, 0.92) but higher for those with perceived needs, RR = 1.22 (1.01, 1.46).

Conclusions

While need and cost factors predict dental service use, psychosocial variables such as health competence and social support also need to be considered.
Do Campaign Contribution Limits Curb the Influence of Money in Politics?
Authors: Gulzar Saad , Rueda Miguel R. , Ruiz Nelson A.
Published: February 2021

Over 40% of countries around the world have adopted limits on campaign contributions to curb the influence of money in politics. Yet, we have limited knowledge of whether and how these limits achieve this goal. Using a regression discontinuity design that exploits institutional rules on contribution limits in Colombian municipalities, we show that looser limits increase the number of public contracts assigned to donors to the elected candidate. This is explained by looser limits increasing the influence of top donors over the elected candidate, rather than reducing electoral competition or changing who is elected to office. We further show that looser limits worsen the quality of public contracts given to the winner's donors: These contracts are more likely to run over their stipulated costs. Overall, this article links looser campaign contribution limits, donor kickbacks, and worse performance of contracts awarded to donors.
Periprosthetic fractures of the femur in primary total hip arthroplasty: a New Zealand Joint Registry analysis
Authors: Stringer Mark R. , Hooper Gary J. , Frampton Christopher , Kieser David C. , Deng Yi
Published: February 2021

Background

Periprosthetic femoral fractures around total hip arthroplasty (THA) are increasing annually, and are a major cause for revision surgery in the New Zealand Joint Registry (NZJR). The aim of this study was to determine the timing and risk factors for periprosthetic femoral fractures in THA requiring revision surgery in the NZJR.

Methods

All patients with a primary THA who sustained a periprosthetic femoral fracture requiring revision THA recorded in the NZJR were reviewed to determine age, gender, body mass index, American Society of Anesthesiologists (ASA) rating and femoral stem fixation (cemented or uncemented). Revision rates were calculated per 100 component years (cy), and risk factors determined in the first 90 days, and beyond.

Results

Between 1999 and 2017, there were 713 revision THA for periprosthetic femoral fractures. Early revision THA was significantly associated with ASA score and body mass index ≥40. There was no gender difference (P = 0.274). The revision rate in uncemented femoral stems (1.12/100 cy) was significantly higher (p < 0.001) than cemented stems (0.16/100 cy). After 90 days, the revision rate was significantly higher with increasing age (P < 0.001), males (P < 0.001) and higher ASA score (P < 0.001). The difference between cemented (0.07/100 cy) and uncemented (0.05/100 cy) stems did not reach statistical significance (P = 0.108).

Conclusion

The rate of revision THA for periprosthetic femoral fracture is higher in uncemented femoral stems in the first 90 days, and is significantly associated with ASA score and morbid obesity. After 90 days, the rate is lower for uncemented femoral stems, but did not reach statistical significance.
Strategic approach to minimally invasive necrosectomy for necrotizing pancreatitis: technique, complications and predictors of outcome
Authors: Mohapatra Nihar , Sasturkar Shridhar V. , Falari Sanyam , Sandhyav Rommel , Kumar Niteen , Agrawal Nikhil , Arora Asit , Pamecha Viniyendra , Chattopadhyay Tushar K.
Published: February 2021

Background

Minimally invasive retroperitoneal necrosectomy has been an integral component of ‘step‐up’ approach for infected pancreatic necrosis. Even though the clinical outcome of nephroscopic necrosectomy has been studied earlier, its predictor and morbidities following surgery have not been extensively evaluated. We aimed to evaluate the clinical outcome and early and late complications after percutaneous nephroscopic necrosectomy (PCNN).

Methods

The pre‐ and intra‐operative as well as post‐operative and follow‐up data of severe pancreatitis patients undergoing PCNN were collected prospectively.

Results

Out of 115 patients requiring intervention, 40 patients (34.78%) improved with percutaneous drain alone and another 40 proceeded for PCNN. After exclusion, 37 patients successfully underwent 48 sessions of PCNN. Median number of PCNN session was 1 (1–4). Early complications were seen in 21 (56.75%) patients and mortality was experienced in eight (21.62%) patients. On median follow‐up of 36 months, 12 (32.43%) patients experienced late complications. Persistent post‐operative pancreatic fistula was observed in six (16.21%) patients. Of these, three developed late‐onset pseudocyst, whereas one patient had disconnected duct syndrome. Seven patients experienced new‐onset diabetes. Age, severity of pancreatitis, preoperative organ failure and multiorgan failure were significant predictors of mortality on univariate analysis (P ≤ 0.05 for each). The logistic regression analysis revealed presence of multiorgan failure before surgery as the sole predictor (P = 0.007; odds ratio 10.417; 95% confidence interval 1.759–61.672).

Conclusion

Preoperative multiorgan failure was the most important predictor of mortality following PCNN. Late complications were seen in nearly one‐third of patients emphasizing the need for long‐term follow‐up.
Examining prosecutorial decision‐making in plea bargaining: An experimental paradigm in a community sample
Authors: Votruba Ashley M. , Tisdale Casey N.
Published: February 2021

Scholars estimate that 90–95% of guilty pleas are the result of plea bargaining and there is a growing body of empirical research on plea bargain decision‐making. We use a new experimental paradigm that mimics prosecutors’ actual decision‐making processes to examine factors that influence plea bargaining decisions. Participants received a casefile detailing a theft from an electronics store. This casefile—fabricated to reflect one a prosecutor would actually receive—included a police report, witness statements, and a criminal history report. In these materials, we manipulated the defendant's motive, the severity of the crime, and the defendant's criminal history and measured the impact of these factors on participants’ decisions to offer a plea and the severity of the plea offers—operationalized as sentence offer length. The results indicated that the vast majority of the participants initially decided to offer a plea. The severity of the crime (operationalized as value of the theft) and defendant's criminal history impacted plea decisions, such that higher severity and a criminal history of theft increased the length of the sentence offer. Contrary to our hypothesis, the defendant's motive had no effect on plea offers. These results parallel current sentencing practices codified in law. Policy implications are discussed.
Astaxanthin Z‐isomer‐rich diets enhance egg yolk pigmentation in laying hens compared to that in all‐E‐isomer‐rich diets
Authors: Honda Masaki , Kawashima Yuki , Hirasawa Kazuaki , Uemura Takeshi , Sun Jinkun , Hayashi Yoshiaki
Published: February 2021

The effects of feeding diets containing astaxanthin with different Z‐isomer ratios to laying hens on egg qualities, such as astaxanthin concentration in egg yolk and yolk color, were investigated. As the astaxanthin source, a natural microorganism Paracoccus carotinifaciens was used. Astaxanthin with different Z‐isomer ratios was prepared by thermal treatment with different conditions and then added to the basal diet at a final astaxanthin concentration of 8 mg/kg. We found that, as the Z‐isomer ratios of astaxanthin in the diet increased, the astaxanthin concentration in egg yolk and the yolk color fan score also increased significantly. Importantly, feeding a 50.6% Z‐isomer ratio diet increased astaxanthin concentration in egg yolk by approximately fivefold and the color fan score by approximately 2 compared to that in hens fed an all‐E‐isomer‐rich diet. Moreover, we showed that feeding Z‐isomer‐rich astaxanthin to laying hens increased plasma astaxanthin concentration by more than five times in comparison to that in hens fed an all‐E‐isomer‐rich diet. These results indicate that Z‐isomers of astaxanthin have higher bioavailability than that of the all‐E‐isomer and thus they exhibit greater egg yolk‐accumulation efficiency.
Fatty acid profile as affected by fat depot and the sex category of Polish Holstein‐Friesian × Limousin fattening cattle fed silage ad libitum
Authors: Sobczuk‐Szul Monika , Mochol Magdalena , Nogalski Zenon , Pogorzelska‐Przybyłek Paulina
Published: February 2021

This study was designed to compare the fatty acid profiles of four types of fat depots from bulls, steers, and heifers. All animals were Polish Holstein‐Friesian and Limousin crossbreds fattened semi‐intensively—silage at libitum and concentrate in the amount corresponding to 30% of their net energy requirements. The fatty acid profile in intramuscular, intermuscular, and external and internal fat was determined. The intramuscular fat of bulls was most abundant in total PUFAs and n‐6 PUFAs, and functional fatty acids C 18:2, C 20:4, and C 22:5 in comparison with steers and heifers. Regardless of sex category, intramuscular and external fat were characterized by higher levels of UFAs and a more desirable MUFA/SFA ratio than the remaining fat types. It should also be noted that external fat was more abundant in CLA than other fat types, and that the highest CLA content was found in bull fat, compared with the remaining sex categories of cattle.
Effect of weaning method on body weight, testicular growth, sexual behavior, age of puberty, and testosterone concentration of Beetal bucks
Authors: Amjad Muhammad , Hameed Nasir , Khan Muhammad Irfan‐ur‐Rehman , Ullah Farid , Sattar Abdul
Published: February 2021

The current study evaluates the effects of early (8th week) and late (16th week of age) weaning of male goat kids on their body growth, testicular growth, sexual behavior, plasma testosterone concentration, and pubertal age. Early (n = 6) and late (n = 7) weaned Beetal bucks were weekly monitored from 18th to 38th week for their body weight, scrotal circumference, testicular volume, testicular echogenicity (via ultrasonography), sexual activities, and plasma testosterone concentration. In comparison to early‐weaned, late‐weaned bucks showed a marked increase (p < .05) in body weight (11.4 ± 0.8 vs. 13.7 ± 0.6kg), testicular volume (44.1 ± 7.2 vs. 79.8 ± 18.7cm3), scrotal circumference (10.7 ± 0.6 vs. 12.8 ± 0.7cm), and testicular echogenicity (28.3 ± 2.7 vs. 38.3 ± 2.1) from 18th, 28th, 21st, and 24th week onward, respectively. Sexual activities started earlier in late‐ than early‐weaned bucks (22nd vs. 25th week, respectively). Moreover, the sexual behavior index was better (p < .05) after the 34th week in late than early‐weaned bucks. The plasma concentration of testosterone (at 39 weeks of age) was relatively more and the onset of puberty was 2–3 weeks earlier (p < .05) in late than early‐weaned bucks. In conclusion, age‐based early weaning of male kids impairs their testicular growth, sexual behavior, and age at puberty compared to conventional weaning.
Deferasirox induces cyclin D1 degradation and apoptosis in mantle cell lymphoma in a reactive oxygen species‐ and GSK3β‐dependent mechanism
Authors: Samara Aladin , Shapira Saar , Lubin Ido , Shpilberg Ofer , Avigad Smadar , Granot Galit , Raanani Pia
Published: February 2021

Mantle cell lymphoma (MCL) is a difficult‐to‐treat B‐cell malignancy characterized by cyclin D1 (CD1) overexpression. Targeting CD1 in MCL has been shown to be of therapeutic significance. However, treatment of MCL remains challenging since patients are still subject to early and frequent relapse of the disease. To ensure their high proliferation rate, tumour cells have increased iron needs, making them more susceptible to iron deprivation. Indeed, several iron chelators proved to be effective anti‐cancer agents. In this study, we demonstrate that the clinically approved iron chelator deferasirox (DFX) exerts an anti‐tumoural effect in MCL cell lines and patient cells. The exposure of MCL cells to clinically feasible concentrations of DFX resulted in growth inhibition, cell cycle arrest and induction of apoptosis. We show that DFX unfolds its cytotoxic effect by a rapid induction of reactive oxygen species (ROS) that leads to oxidative stress and severe DNA damage and by triggering CD1 proteolysis in a mechanism that requires its phosphorylation on T286 by glycogen synthase kinase‐3β (GSK3β). Moreover, we demonstrate that DFX mediates CD1 proteolysis by repressing the phosphatidylinositol 3‐kinase (PI3K)/AKT/GSK3β pathway via ROS generation. Our data suggest DFX as a potential therapeutic option for MCL and paves the way for more treatment options for these patients.
Linking Quality and Quantity of Parental Linguistic Input to Child Language Skills: A Meta‐Analysis
Authors: Anderson Nina J. , Graham Susan A. , Prime Heather , Jenkins Jennifer M. , Madigan Sheri
Published: February 2021

This meta‐analysis examined associations between the quantity and quality of parental linguistic input and children’s language. Pooled effect size for quality (i.e., vocabulary diversity and syntactic complexity; k = 35; N = 1,958; r = .33) was more robust than for quantity (i.e., number of words/tokens/utterances; k = 33; N = 1,411; r = .20) of linguistic input. For quality and quantity of parental linguistic input, effect sizes were stronger when input was observed in naturalistic contexts compared to free play tasks. For quality of parental linguistic input, effect sizes also increased as child age and observation length increased. Effect sizes were not moderated by socioeconomic status or child gender. Findings highlight parental linguistic input as a key environmental factor in children’s language skills.
Causal Explanations for Weight Influence Children’s Social Preferences: Biological‐Essentialist Explanations Reduce, and Behavioral Explanations Promote, Preferences for Thin Friends
Authors: Carvalho Keri , Peretz‐Lange Rebecca , Muentener Paul
Published: February 2021

The current study experimentally investigated the impact of causal‐explanatory information on weight bias over development. Participants (n = 395, children ages 4–11 years and adults) received either a biological or behavioral explanation for body size, or neither, in three between‐subjects conditions. Participants then made preference judgments for characters with smaller versus larger body sizes. Results showed that both behavioral and biological explanations impacted children’s preferences. Relative to children’s baseline preferences, behavioral explanations enhanced preferences for smaller characters, and biological explanations reduced these preferences—unlike the typical facilitative impact of biological‐essentialist explanations on other biases. The explanations did not affect adults’ preferences. In contrast to previous findings, we demonstrate that causal knowledge can impact weight bias early in development.
Use of dental services by disability status in Brazil in 2013
Authors: Macarevich Condessa Aline , Pilotto Luciane Maria , Celeste Roger Keller , Hilgert Juliana Balbinot
Published: February 2021

Objective

To describe the prevalence and factors associated with the use of oral health services in people with and without disabilities in Brazil.

Methods

A cross‐sectional study was used with the secondary data of 60,202 individuals from the Brazilian National Health Survey of 2013. The main exposure variable was ‘Disability’, and the main outcome was ‘Dental service use’. Independent variables were selected using the modified Andersen and Davidson model, according to four groups: exogenous variables, primary determinants of oral health, health behaviours and oral health conditions. The analysis was based on a hierarchical approach stratified by ‘disability (yes/no)’, with multiple logistic regression incorporating sampling design. Interaction terms between the disability variable and covariates were tested in logistic regression models.

Results

A total of 45.5% of the people without disabilities and 34.1% of those with disabilities visited the dentist in the last year. In the crude model, the nondisabled group used dental services more (OR = 1.61, 95%CI = 1.45‐1.79), but the difference was no longer significant (OR = 1.18, 95%CI = 0.93‐1.51) when adjusted by the health behaviour and oral health condition blocks. Determinants of dental use were similar among people with and without a disability.

Conclusions

No difference in dental service use according to disability status was found after adjusting for oral health conditions. Although edentulism is more prevalent among disabled people, they do not go to the dentist as regularly as nondisabled people. Health services should actively schedule maintenance visits to ensure that the needs of disabled individuals are fully addressed.
Sirtuin 1 ameliorates defenestration in hepatic sinusoidal endothelial cells during liver fibrosis via inhibiting stress‐induced premature senescence
Authors: Luo Xiaoying , Bai Yangqiu , He Shuli , Sun Suofeng , Jiang Xiaoke , Yang Zhiyu , Lu Di , Wei Peiru , Liang Yuan , Peng Cong , Wang Yaru , Sheng Ruli , Han Shuangyin , Li Xiuling , Zhang Bingyong
Published: February 2021

Objective

Premature senescence is related to progerin and involves in endothelial dysfunction and liver diseases. Activating sirtuin 1 (SIRT1) ameliorates liver fibrosis. However, the mechanisms of premature senescence in defenestration of hepatic sinusoidal endothelial cells (HSECs) and how SIRT1 affects HSECs fenestrae remain elusive.

Methods

We employed the CCl4‐induced liver fibrogenesis rat models and cultured primary HSECs in vitro, administered with the SIRT1‐adenovirus vector, the activator of SIRT1 and knockdown NOX2. We measured the activity of senescence‐associated β‐galactosidase (SA‐β‐gal) in HSECs. Meanwhile, the protein expression of SIRT1, NOX2, progerin, Lamin A/C, Ac p53 K381 and total p53 was detected by Western blot, co‐immunoprecipitation and immunofluorescence.

Results

In vivo, premature senescence was triggered by oxidative stress during CCl4‐induced HSECs defenestration and liver fibrogenesis, whereas overexpressing SIRT1 with adenovirus vector lessened premature senescence to relieve CCl4‐induced HSECs defenestration and liver fibrosis. In vitro, HSECs fenestrae disappeared, with emerging progerin‐associated premature senescence; these effects were aggravated by H2O2. Nevertheless, knockdown of NOX2, activation of SIRT1 with resveratrol and SIRT1‐adenovirus vector inhibited progerin‐associated premature senescence to maintain fenestrae through deacetylating p53. Furthermore, more Ac p53 K381 and progerin co‐localized with the abnormal accumulation of actin filament (F‐actin) in the nuclear envelope of H2O2‐treated HSECs; in contrast, these effects were rescued by overexpressing SIRT1.

Conclusion

SIRT1‐mediated deacetylation maintains HSECs fenestrae and attenuates liver fibrogenesis through inhibiting oxidative stress‐induced premature senescence.
CTGF facilitates cell‐cell communication in chondrocytes via PI3K/Akt signalling pathway
Authors: Wu Zuping , Zhou Chenchen , Yuan Quan , Zhang Demao , Xie Jing , Zou Shujuan
Published: February 2021

Purposes

Gap junction intercellular communication (GJIC) is essential for articular cartilage to respond appropriately to physical or biological stimuli and maintain homeostasis. Connective tissue growth factor (CTGF), identified as an endochondral ossification genetic factor, plays a vital role in cell proliferation, migration and adhesion. However, how CTGF regulates GJIC in chondrocytes is still unknown. This study aims to explore the effects of CTGF on GJIC in chondrocytes and its potential biomechanism.

Materials and methods

qPCR was performed to determine the expression of gene profile in the CCN family in chondrocytes. After CTGF treatment, CCK‐8 assay and scratch assay were performed to explore cell proliferation and migration. A scrape loading/dye transfer assay was adopted to visualize GJIC in living chondrocytes. Western blot analysis was done to detect the expression of Cx43 and PI3K/Akt signalling. Immunofluorescence staining was used to show protein distribution. siRNA targeting CTGF was used to detect the influence on cell‐cell communication.

Results

The CTGF (CCN2) was shown to be the highest expressed member of the CCN family in chondrocytes. CTGF facilitated functional gap junction intercellular communication in chondrocytes through up‐regulation of Cx43 expressions. CTGF activated PI3K/Akt signalling to promote Akt phosphorylation and translocation. Suppressing CTGF also reduced the expression of Cx43. The inhibition of PI3K/Akt signalling decreased the expressions of Cx43 and thus impaired gap junction intercellular communication enhanced by CTGF.

Conclusions

For the first time, we provide evidence to show CTGF facilitates cell communication in chondrocytes via PI3K/Akt signalling pathway.
Extrinsically reinforced hybrid speciation within Holarctic ermine (Mustelaspp.) produces an insular endemic
Authors: Colella Jocelyn P. , Frederick Lindsey M. , Talbot Sandra L. , Cook Joseph A.
Published: February 2021

Aim

Refugial isolation during glaciation is an established driver of speciation; however, the opposing role of interglacial population expansion, secondary contact, and gene flow on the diversification process remains less understood. The consequences of glacial cycling on diversity are complex and especially so for archipelago species, which experience dramatic fluctuations in connectivity in response to both lower sea levels during glacial events and increased fragmentation during glacial recession. We test whether extended refugial isolation has led to the divergence of genetically and morphologically distinct species within Holarctic ermine (Mustela erminea), a small cosmopolitan carnivore species that harbours 34 extant subspecies, 14 of which are insular endemics.

Location

Holarctic.

Methods

We use genetic sequences (complete mitochondrial genomes, four nuclear genes) from >100 ermine (stoats) and geometric morphometric data for >200 individuals (27 of the 34 extant subspecies) from across their Holarctic range to provide an integrative perspective on diversification and endemism across this complex landscape. Multiple species delimitation methods (iBPP,bPTP) assessed congruence between morphometric and genetic data.

Results

Our results support the recognition of at least three species within theM. ermineacomplex, coincident with three of four genetic clades, tied to diversification in separate glacial refugia. We found substantial geographic variation within each species, with geometric morphometric results largely consistent with historical infraspecific taxonomy.

Main conclusions

Phylogeographic structure mirrors patterns of diversification in other Holarctic species, with a major Nearctic‐Palearctic split, but with greater intraspecific morphological diversity. Recognition of insular endemic speciesM. haidarumis consistent with a deep history of refugial persistence and highlights the urgency of mindful management of island populations along North America's North Pacific Coast. Significant environmental modification (e.g. industrial‐scale logging, mining) has been proposed for a number of these islands, which may elevate the risk of extinction of insular palaeoendemics.
Cerebrospinal fluid, neuroinflammation, and electrospray ionization mass spectrometry
Authors: Turner Charles
Published: February 2021

This commentary is on the original article by Yan et al. on pages 552–559 of this issue.
Turnover rates for muscle, mucus and ovary tissues of ayu fish (Plecoglossus altivelis altivelis) in multiple stages determined through carbon and nitrogen stable isotope analyses
Authors: Sawada Hayato , Fujiwara Sohei , Tanaka Ryusei , Yonekura Ryuji , Maruyama Atsushi
Published: February 2021

Stable isotope ratios are powerful indicators that facilitate the understanding of the diet shifts and between‐habitat migration of aquatic animals. However, isotopic change rate can be variable even between the life stages of a single species, which affects field data interpretation. We conducted diet‐switch experiments to compare the δ13C and δ15N changes in multiple tissues between the growing and reproductive stages of ayu fish (Plecoglossus altivelis altivelis). Isotopic changes in the muscle and mucus tissues were faster in the growing stage than in the reproductive stage. Isotopic change in the muscle tissue during the reproductive stage was caused mainly by whole‐body growth, whereas allometric growth and/or catabolic turnover rather than whole‐body growth accounted more for the isotopic changes in mucus tissue during both stages. Isotopic change was slower in muscle, mucus and ovary tissues, in that order, probably according to the allometric growth and/or catabolic turnover of each tissue. Our investigation showed that the timing of drastic changes differed between the δ13C and δ15N values, as the first report of the isotopic change in the fish ovary tissue, which suggests that the δ13C and δ15N values in the ovary tissue may reflect diets and/or habitats of different time scales. Trophic discrimination factors varied between tissues examined. Our results allowed for accurate applications of multiple‐tissue isotope analysis to our target fish over all stages. Such approaches to any fish species are more accurate when considering the variability of isotopic changes between and within stages.
Differential contribution of CB1, CB2, 5‐HT1A, and PPAR‐γ receptors to cannabidiol effects on ischemia‐induced emotional and cognitive impairments
Authors: Mori Marco Aurélio , Meyer Erika , da Silva Francielly F. , Milani Humberto , Guimarães Francisco Silveira , Oliveira Rúbia Maria Weffort
Published: February 2021

An ever‐increasing body of preclinical studies has shown the multifaceted neuroprotective profile of cannabidiol (CBD) against impairments caused by cerebral ischemia. In this study, we have explored the neuropharmacological mechanisms of CBD action and its impact on functional recovery using a model of transient global cerebral ischemia in mice. C57BL/6J mice were subjected to bilateral common carotid artery occlusion (BCCAO) for 20 min and received vehicle or CBD (10 mg/Kg) 0.5 hr before and 3, 24, and 48 hr after reperfusion. To investigate the neuropharmacological mechanisms of CBD, the animals were injected with CB1 (AM251, 1 mg/kg), CB2 (AM630, 1 mg/kg), 5‐HT1A (WAY‐100635, 10 mg/kg), or PPAR‐γ (GW9662, 3 mg/kg) receptor antagonists 0.5 hr prior to each injection of CBD. The animals were evaluated using a multi‐task testing battery that included the open field, elevated zero maze, Y‐maze (YM), and forced swim test. CBD prevented anxiety‐like behavior, memory impairments, and despair‐like behaviors induced by BCCAO in mice. The anxiolytic‐like effects of CBD in BCCAO mice were attenuated by CB1, CB2, 5‐HT1A, and PPAR‐γ receptor antagonists. In the YM, both CBD and the CB1 receptor antagonist AM251 increased the exploration of the novel arm in ischemic animals, indicating beneficial effects of these treatments in the spatial memory performance. Together, these findings indicate the involvement of CB1, CB2, 5‐HT1A, and PPAR‐γ receptors in the functional recovery induced by CBD in BCCAO mice.
Approximation of emicizumab plasma levels in emergency situations. A practical approach
Authors: Pekrul Isabell , Pfrepper Christian , Calatzis Geli , Giebl Andreas , Siegemund Annelie , Grützner Stefanie , Spannagl Michael
Published: February 2021

Introduction

A dedicated emicizumab assay based on the modified one‐stage factor VIII (FVIII) assay (mOSA) is mainly available in haemophilia treatment centres (HTC). A method to estimate emicizumab plasma levels based on a widely available assay would be desirable, especially for emergency situations.

Aim

A method for emicizumab plasma level approximation (ELA) using a routine FVIII activity measurement with standard one‐stage assay (sOSA) was developed and evaluated.

Method

Within this pilot study, 59 samples from patients with severe haemophilia A with (n = 8) and without (n = 8) inhibitors under emicizumab treatment were analysed using sOSA following a manual 1:8 sample pre‐test dilution with saline. The sOSA was determined in two different laboratories, using two different analyser platforms each.

Results

The results demonstrated an excellent correlation of approximated emicizumab plasma levels (ELA) with the emicizumab plasma concentration determined with mOSA (r > .9; p < .05). The ELA showed a sensitivity of 93.3% and a specificity of 89.6% to predict a pre‐defined cut‐off‐value of ≤30 µg/ml for the discrimination between subtherapeutic and therapeutic emicizumab plasma levels.

Conclusion

Approximation of emicizumab levels by standard one‐stage FVIII assay discriminates between subtherapeutic and therapeutic emicizumab levels and might facilitate clinical decision‐making in emergency situations, such as bleeding, trauma or urgent surgery in case that dedicated emicizumab assays are not available.
An audit of disseminated intravascular coagulation screen requests at an academic hospital laboratory in central South Africa
Authors: Haupt Leriska , Vieira Mario , Brits Hanti , de Beer Jaco , Erasmus Etienne , Esterhuyse Wian , Fraser Ruben , Joubert Gina
Published: February 2021

Introduction

Disseminated intravascular coagulation (DIC) is a feared complication of various systemic illnesses. We aimed to evaluate the laboratory requesting practices of clinicians, especially concerning the laboratory parameters, included in the International Society of Thrombosis and Haemostasis (ISTH) DIC score.

Methods

A retrospective descriptive study was performed and included data from DIC screen requests analysed at Universitas National Health Laboratory Service (NHLS) laboratory, Bloemfontein, South Africa, for one calendar year. Laboratory request forms were analysed, recording the pretest diagnosis and whether the diagnosis was associated with DIC. Parameters of the DIC screen, prothrombin time, activated partial thromboplastin time, thrombin time, d‐dimer and fibrinogen were used to calculate the ITSH DIC score and diagnose heparin contamination. The platelet count, currently not part of the DIC screen test set, was also recorded.

Results

A total of 778 DIC screen requests were processed. One hundred and eighty‐three requests were excluded due to laboratory‐defined rejection criteria, heparin contamination or for lacking an ISTH score parameter. Of the remaining 595 complete requests, 283 (47.7%) were laboratory‐defined overt DIC. The pretest diagnosis was not predictive of either a positive or negative finding of overt DIC. The contribution of fibrinogen to assigning overt DIC was questionable.

Conclusion

The number of DIC screen requests received highlights the need for laboratory evidence of DIC. To improve laboratory DIC testing, the authors suggest critical evaluation of the contribution of the pretest diagnosis and fibrinogen in a prospective study and adding the platelet count in our local DIC test set.
Cow‐calf Relationships in Giraffe (Giraffa camelopardalis giraffa)
Authors: Langman V. A.
Published: February 2021

The duration and intensity of the cow‐calf bond during lying out, calving pools and nursery herds has been analysed in a wild population of giraffe (Giraffa camelopardalis giraffa). Field behaviour observations were made on naturally marked and radio‐collared giraffe. Radio‐tracking was used to follow and observe giraffe of a known age for up to 1½ years. The giraffe calf participates in various calf sub‐groups while the cow travels to browse and water. A strong maternal bond exists between the giraffe cow and calf until the cow's next calving.

Die Entwicklung der Mutter‐Kind‐Beziehung bei Giraffen (Giraffa camelopardalis giraffa) von der Geburt bis zur Trennung von Mutter und Kind wurde beobachtet und in 3 Entwicklungsabschnitte unterteilt: 1. Absonderung des ruhenden Kalbes während der ersten bis dritten Woche nach der Geburt; 2. Säugegruppen, Geburtsgruppen und Gruppen abgesondert ruhender Kälber; 3. Trennung von Mutter und Kalb vor der nächsten Geburt. Entwöhnt werden Giraffen mit 6–8 Monaten; die Kuh‐Kalb‐Beziehungen dauern 14–16 Monate. Der durchschnittliche Anteil von Liegen (78%), Fressen (19%) und Säugen (2%) an der Gesamtaktivität ganz junger Giraffen unterschied diese von halbwüchsigen Giraffen, welche 80% ihrer täglichen Aktivität mit Fressen, 19% mit Liegen und 1% mit Säugen verbrachten.
Feasibility of combining heart rate variability and electrochemical skin conductance as screening and severity evaluation of cardiovascular autonomic neuropathy in type 2 diabetes
Authors: Lai Yun‐Ru , Huang Chih‐Cheng , Cheng Ben‐Chung , Tsai Nai‐Wen , Chiu Wen‐Chan , Chang Hsueh‐Wen , Chen Jung‐Fu , Lu Cheng‐Hsien
Published: February 2021

Aims/Introduction

Clinical studies show that either heart rate variability (HRV) or electrochemical skin conductance (ESC) alone can serve as a simple and objective method for screening cardiovascular autonomic neuropathy (CAN). We tested the hypothesis that combining these two quantitative approaches can not only reinforce accuracy in CAN screening but also provide a better estimate of CAN severity in patients with type 2 diabetes (T2DM) who had already had CAN in outpatient clinics.

Materials and Methods

Each patient received a complete battery of cardiovascular autonomic reflex tests (CARTs), with ESC measured by SUDOSCAN, time domain of HRV measured by standard deviation of all normal RR intervals (SDNN) and frequency domain of HRV (low frequency [LF], high frequency [HF], and LF/HF ratio), and peripheral blood studies for vascular risk factors. Severity of CAN was measured by CAN score.

Results

The 90 T2DM patients included 50 males and 40 females. Those with more severe CAN had lower values in feet ESC (P = 0.023) and SDNN (P < 0.0001). Multiple linear regression analysis also showed that feet ESC and SDNN value (P = 0.003 and P < 0.0001) were significantly associated with CAN score. Combining SDNN and feet ESC also can increase the diagnostic accuracy of CAN with respective to sensitivity and specificity by using receiver operating characteristic analysis.

Conclusions

Combining the results of SDNN and feet ESC can not only assess, but also quantitatively reflect the progress or improvement of autonomic nerve function (including sympathetic and parasympathetic activity) in patients with T2DM.
COVID 19: Ethical dilemmas in human lives
Authors: Bustan Smadar , Nacoti Mirco , Botbol‐Baum Mylene , Fischkoff Katherine , Charon Rita , Madé Laure , Simon Jeremy R. , Kritzinger Meinhard
Published: February 2021

On 7 May 2020, Columbia University Global Centers hosted an online international symposium on ethical dilemmas during the COVID‐19 pandemic. This interdisciplinary engagement between philosophers and Covid medical professionals reports the challenges as well as the discrepancies between ethical guidelines and reality. This collection of presentations identifies four key ethical dilemmas regarding responsibility, fairness, dignity and honouring death. In looking into accountability and consistency in medical humanities, it examines whether the contextuality of coronavirus across countries and cultures affected the ethical decision‐making processes. This work aims to provide a seminal resource for the development of a high‐quality roadmap in medical ethics for future health crises.
Aerosol and spatter mitigation in dentistry: Analysis of the effectiveness of 13 setups
Authors: Comisi John C. , Ravenel Theodore D. , Kelly Abigail , Teich Sorin T. , Renne Walter
Published: February 2021

Objectives

The current study aims to investigate the aerosol and spatter mitigation quality of 13 dry‐field isolation methods in a simulated setup that replicates real‐life work scenarios encountered in dental practices.

Methods

A crown preparation on a manikin was performed on tooth number 30 and repeated five times for each setup to simulate a patient under care. Aerosol, environmental, and operator face shield spatter, and sound intensity was measured. Generalized linear mixed models were used, and posthoc pairwise comparisons were performed to compare least‐squares means when appropriate using a Tukey adjustment.

Results

All tested setups showed some environmental spatter formation; however, these were able to control most (and in some cases all) spatter on the operator face shield. All methods resulted in excellent aerosol mitigation when a second line of high‐volume evacuation (HVE) was added to the device setup. However, in most setups, total sound levels exceeded 85 dB, posing a concern for prolonged noise exposure.

Conclusions

The Prototype device and four other tested setups with secondary HVE addition completely eliminated aerosol creation as tested. Spatter of the Face Shield was best eliminated using the Prototype device.

Clinical Significance

Within the limitations of this study, it can be concluded that the dental community has at its disposal equipment that can effectively mitigate aerosol and spatter.
Feasibility of a syndrome‐informed micro‐intervention for infants with Down syndrome
Authors: Fidler D. J. , Schworer E. K. , Needham A. , Prince M. A. , Patel L. , Will E. A. , Daunhauer L. A.
Published: February 2021

Background

Infants with Down syndrome (DS) are at risk for a range of phenotypic outcomes, including delays in the onset of reaching behaviour, a critical skill that facilitates early learning. This parallel‐group feasibility and pilot study presents findings from a parent‐mediated micro‐intervention that aimed to support the development of reaching behaviour in a sample of infants with DS.

Methods

Participants were 73 infants with DS and their caregivers. Infants who qualified for the home‐based intervention (based on manual skill performance on Bayley Scales of Infant and Toddler Development, Third Edition items) were randomly assigned individually or by geographical region to a treatment or an alternative treatment condition that involved toy‐based interactions with caregivers. Infants in the treatment condition experienced facilitated reaching during the toy‐based interactions through the use of Velcro‐affixed mittens and toys.

Results

Forty‐two infants met criteria to participate in the intervention, and 37 participated in both baseline and post‐treatment visits. At post‐treatment, infants in the treatment condition demonstrated shorter latencies to make contact with objects and showed higher frequencies of reach attempts and swats at objects than infants in the alternative treatment group. These findings were more pronounced when examining a chronological age‐restricted subgroup of infants 5 to 10 months.

Conclusions

Findings suggest that a syndrome‐informed approach to targeted intervention may be a promising application of phenotyping science in DS and other neurogenetic conditions associated with intellectual disability.
Mediating Effects of Anger Expression in the Relationship of Work Stress with Burnout among Hospital Nurses Depending on Career Experience
Authors: Lee Hye Yeong , Jang Mi Heui , Jeong Yoo Mi , Sok Sohyune R. , Kim Ae Sil
Published: February 2021

Objectives

This study examined the mediating effects of anger expression in the relationship between work stress and burnout among nurses with more than or less than 3 years of career experience.

Methods

A cross‐sectional study was conducted with 454 nurses working at three university hospitals in South Korea. Nurses completed a survey consisting of demographic questions, the Maslach Burnout Inventory, the Work Stress Scale, and the Korean version of the Anger Expression Inventory. A multiple‐group mediation analysis was performed using structural equation modeling. Results: In total (N = 454), work stress directly affected burnout, and all anger expressions indirectly affected the relationship of work stress with burnout. Different mediating effects of anger expression style according to career experience were shown; anger‐out and anger‐in in nurses with less experience (n = 184) and only anger‐in in those with more experience (n = 270) partially mediated the relationship of work stress with burnout.

Conclusions and Clinical Relevance

The indirect effect of anger‐in style was higher than other anger expression styles in all nurses; suppression of anger caused by work stress can increase burnout. Anger‐out played a functional role in the relationship of work stress with burnout among nurses who had less career experience. Therefore, to reduce burnout, creating a work environment with collaborative culture including authentic leadership and providing anger management programs will help to manage nurses’ anger properly. For new nurses, promoting work and life balance, and creating a culturally empowering work environment to help them use anger‐out expression constructively, are important to reduce burnout.
Behavioural strategies to self‐manage low‐potassium diets in chronic kidney disease
Authors: Morris Andrew , Lycett Deborah
Published: February 2021

Background

Dietary potassium restrictions may be challenging to follow, due in part to the restrictive nature of recommendations on foods people enjoy. Little is known how people incorporate low‐potassium diets into their lifestyles.

Objective

To examine the self‐directed behavioural strategies people employ to follow low‐potassium advice.

Design

Qualitative methodology.

Participants

Thirty‐four adults with chronic kidney disease.

Approach

Semistructured interviews were undertaken in an outpatient department. Thematic analysis was undertaken on transcribed interviews.

Findings

Analysis identified three themes: 'Differing opinions of food'; 'Food generates positive emotions'; and 'Doing what works'. Participants described foods providing different levels of enjoyment. Favourite foods in their habitual diet held either a physiological or a psychological value to them. Five subthemes underpinned the 'Doing what works' theme that described the self‐management behaviours used by participants to follow low‐potassium dietary advice. These were positive reframing; reflection; self‐talk; social support; decisional balance; paradoxical instruction; and knowledge shaping. These techniques helped overcome the conflict between favourite food preferences and dietary restrictions. Dietary restrictions proved more challenging where an emotional connection to a favourite food existed. Restrictions on less preferred foods did not present participants with the same self‐management challenges.

Conclusions

Promoting behavioural change techniques such as decisional balance, and social support may be a useful strategy to empower people following dietary restrictions. Practitioners should understand whether suggested dietary restrictions include an individual's favourite food; the value attached to it, and explore specific ways to include favourite foods in some way when discussing a low‐potassium diet.
Rational conjectures and evolutionary beliefs in public goods games
Authors: McGinty Matthew
Published: February 2021

This paper applies conjectural variations (CVs) to a model of public good provision and shows that CVs are superior to Nash beliefs. In addition to imposing consistency, as Bresnahan, I show that consistent conjectures (CCs) are obtained from individual payoff maximization. CCs emerge as the unique subgame perfect Nash equilibrium (NE) in a two‐stage game in which beliefs are chosen in Stage 1 and quantities in Stage 2. There is an individual payoff advantage to non‐Nash behavior, generating a Prisoner's Dilemma in conjectures in addition to the usual free‐rider problem associated with public goods. The correct and payoff maximizing conjecture is the unique equilibrium in an evolutionary framework against a player with Nash conjectures. The consistent conjecture equilibrium is the unique evolutionary equilibrium when both players conjectures evolve. Hence, the NE prediction is too optimistic when players have rational conjectures.
Survival rate and potential risk indicators of implant loss in non‐smokers and systemically healthy periodontitis patients: An up to 9‐year retrospective study
Authors: Wang Yiwei , Fan Yadan , Lin Zhikai , Song Zhongchen , Shu Rong , Xie Yufeng
Published: February 2021

Background

An increasing number of patients with chronic periodontitis (CP) have received implant restoration. However, very few studies have evaluated the probable risk indicators of implant loss in patients with CP.

Objective

The aim of this study is to evaluate implant long‐term survival rates in patients with CP. The results are analyzed to discern potential risk indicators of implant loss.

Methods

A total of 1549 implants were inserted in 827 non‐smokers and systemically healthy CP patients between March 2011 and March 2019. Clinical variables (age; sex; implant location; implant diameter; implant length; implant type; bone quality; bone graft, periodontal disease status, and insertion torque) were recorded. Kaplan‐Meier survival curves illustrated the cumulative survival rate. The relationship between variables and implant loss was discerned by univariate analysis. Further multivariate Cox proportional hazard regression analysis was carried out for the variables with P < 0.2.

Results

The cumulative survival rates were 98.8% after 3 months, 97.9% after 6 months, 97.7% after 1 year, and 97.4% after 2 to 9 years. After adjusting possible confounders, the multivariable Cox regression model revealed statistically significant influences of implant location, history of bone graft, and insertion torque on implant loss. Implants with history of bone graft were more likely to loss. Implants inserted in the anterior area had a higher implant loss risk; insertion torque of <15 Newton‐centimeter (Ncm) showed a relatively high risk of being lost.

Conclusions

The study represented public hospital insight into long‐term implant results of patients with CP. Under the premise of strict periodontal control, patients with the history of CP exhibited relatively high implant survival rate. Anterior implant location, history of bone graft, and insertion torque <15 Ncm are associated with a lower implant survival rate and could be considered at a higher risk of implant failure in patients with CP.