bluuebunny/crossref_metadata_2025 huggingface dataset:
Maxillary implant overdentures on two or four implants. A prospective randomized cross‐over clinical trial of implant and denture success and survival
Authors: Kappel Stefanie , Klotz Anna‐Luisa , Eberhard Lydia , Lorenzo Bermejo Justo , Rammelsberg Peter , Giannakopoulos Nikolaos Nikitas
Published: June 2021

Objectives

To determine implant survival and success of four conventionally but initially asynchronously loaded implants in implant‐supported overdentures for the edentulous maxilla, in participants with opposing mandibular two‐implant overdentures.

Material and methods

Twenty‐six participants received four implants in the region of the maxillary canines and molars. After healing, 24 of these participants (mean age: 68.3 years) were randomly allocated to one of two treatment groups, and the adapted overdenture was attached to two unsplinted cylindrical attachments. The other two matrixes remained unattached to the implants for 3 months. After this period, the other two implants were loaded for 3 months (cross‐over design). Then, all four implants were loaded for another 3 months. Kaplan–Meier curves were used to evaluate survival and success of implants and dentures.

Results

During the active prosthetic study phase, three participants lost one implant. Two participants lost three implants during the recall period. Implant survival after loading was 93.8% after a mean observation period of 3.1 years. Denture survival was 100%, but denture success was 95.8%, due to major prosthetic complications. Most participants preferred four implants to two.

Conclusions

Within the limitations of the study, it can be concluded that maxillary implant overdentures on two or four implants are both recommendable treatment options. Two posterior implants are not superior to two anterior implants under overdentures retained by unsplinted cylindrical attachments. Implant and prosthetic complications and aftercare measures are common but are mostly easy to handle. However, 23 of the 24 participants preferred the 4‐implant maxillary overdenture.
4,5‐Dinitrosulfonefluorescein and related dyes: Kinetics of reversible rupture of the pyran ring and their interaction with lysozyme
Authors: Kriklya Nika N. , Gromovoy Taras Yu. , Mchedlov‐Petrossyan Nikolay O.
Published: June 2021

Fluorescein and sulfonefluorescein dyes are stable in solution within a wide pH range. Nucleophilic addition of the hydroxide (HO–) group to the nodal carbon atom is not typical of these compounds. They are also not prone to rupture of the pyran cycle under the action of alkali. However, the last‐named heterocycle readily opens at high pH values in the case of derivatives containing nitro groups in the xanthene moiety. Moreover, while in the case of nitrofluoresceins, for example, 4,5‐dinitrofluorescein, this reaction is irreversible, with 4,5‐dinitrosulfonefluorescein acidification of the alkaline solution immediately returns the visible absorption spectrum to that of the original hydroxyxanthene dye. We present a quantitative study of the kinetics of the pyran cycle rupture in aqueous alkali without and with micelles of a cationic surfactant. Also, both initial dye and reaction product were studied via the matrix‐assisted laser desorption/ionisation time‐of‐flight (MALDI‐ToF) technique. The second part of the article is devoted to the interaction of 4,5‐dinitrosulfonefluorescein and other dyes of similar structure with lysozyme basing on the MALDI‐ToF mass spectrometry. This made it possible to arrange the dyes according to their affinity for the protein and draw some conclusions about the nature of the association of the dye with lysozyme.
Nodakenin represses obesity and its complications via the inhibition of the VLDLR signalling pathway in vivo and in vitro
Authors: Jin Bo‐Ram , Lee Minho , An Hyo‐Jin
Published: June 2021

Objectives

Nodakenin (NK) is a coumarin glucoside that is found in the roots of Angelicae gigas. A limited number of studies have been conducted on the pharmacological activities of NK. Although NK is an important natural resource having anti‐inflammatory and antioxidant effects, no investigation has been conducted to examine the effects of NK on obesity and obesity‐induced inflammation.

Materials and Methods

The present study investigated the therapeutic effects of NK treatment on obesity and its complications, and its mechanism of action using differentiated 3T3‐L1 adipocytes and high‐fat diet (HFD)‐induced obese mice. Oil red O staining, western blot assay, qRT‐PCR assay, siRNA transfection, enzyme‐linked immunosorbent assay, H&E staining, immunohistochemistry, molecular docking and immunofluorescence staining were utilized.

Results

Treatment with NK demonstrated anti‐adipogenesis effects via the regulation of adipogenic transcription factors and genes associated with triglyceride synthesis in differentiated 3T3‐L1 adipocytes. Compared with the control group, the group administered NK showed a suppression in weight gain, dyslipidaemia and the development of fatty liver in HFD‐induced obese mice. In addition, NK administration inhibited adipogenic differentiation and obesity‐induced inflammation and oxidative stress via the suppression of the VLDLR and MEK/ERK1/2 pathways. This is the first study that has documented the interaction between NK and VLDLR structure.

Conclusion

These results demonstrate the potential of NK as a natural product‐based therapeutic candidate for the treatment of obesity and its complications by targeting adipogenesis and adipose tissue inflammation‐associated markers.
Functional divergence of three glutathione transferases in two biotypes of the English grain aphid, Sitobion avenae
Authors: Zhang Na , Liu Deguang , Zhai Yingting , Li Xiaosai , Simon Jean‐Christophe
Published: June 2021

The English grain aphid, Sitobion avenae (Fabricius) (Hemiptera: Aphididae), is a significant pest of cereal crops, but molecular factors and mechanisms that underpin its ability to develop differential biotypes on variable host plants are still not well understood. In this study, we investigated the interactions between two plant secondary metabolites (i.e., gramine and gallic acid) and three glutathione S‐transferases (GSTs) of S. avenae. Using artificial diets complemented or not with one of these two plant compounds, we found that gramine had relatively stronger negative effects on fitness of S. avenae biotype 3 (adapted to barley), and gallic acid on that of biotype 4 (adapted to wheat). Gramine significantly induced overexpression of SaveGST1 and SaveGST2 in biotype 4, but not in biotype 3. Gramine also reduced SaveGST3 expression in biotype 4, but not in biotype 3, suggesting biotype‐specific effect of GSTs’ regulation. In the treatments with gallic acid, the overexpression of SaveGST1, but not SaveGST2 or SaveGST3, was significantly induced in both biotypes, suggesting a critical role of SaveGST1 in detoxification of phenolic compounds such as gallic acid. The total constitutive GST activity was much higher in biotype 4 than in biotype 3. Significant increase in GST activity was obtained by the addition of both secondary metabolites in biotype 4, but not in biotype 3, showing significantly higher expression plasticity of GSTs in biotype 4. Thus, both constitutive and induced expression of GSTs could affect the adaptability of S. avenae on plants with variable secondary compounds, and thus contribute to the divergence of biotypes in this aphid species.
The UK experience of stereoelectroencephalography in children: An analysis of factors predicting the identification of a seizure‐onset zone and subsequent seizure freedom
Authors:   UK Children’s Epilepsy Surgery Collaboration
Published: June 2021

Objective

Stereoelectroencephalography (SEEG) is being used more frequently in the pre‐surgical evaluation of children with focal epilepsy. It has been shown to be safe in children, but there are no multicenter studies assessing the rates and factors associated with the identification of a putative seizure‐onset zone (SOZ) and subsequent seizure freedom following SEEG‐guided epilepsy surgery.

Methods

Multicenter retrospective cohort study of all children undergoing SEEG at six of seven UK Children's Epilepsy Surgery Service centers from 2014 to 2019. Demographics, noninvasive evaluation, SEEG, and operative factors were analyzed to identify variables associated with the identification of a putative SOZ and subsequent seizure freedom following SEEG‐guided epilepsy surgery.

Results

One hundred thirty‐five patients underwent 139 SEEG explorations using a total of 1767 electrodes. A putative SOZ was identified in 117 patients (85.7%); odds of successfully finding an SOZ were 6.4 times greater for non‐motor seizures compared to motor seizures (p = 0.02) and 3.6 times more if four or more seizures were recorded during SEEG (p = 0.03). Of 100 patients undergoing surgical treatment, 47 (47.0%) had an Engel class I outcome at a median follow‐up of 1.3 years; the only factor associated with outcome was indication for SEEG (p = 0.03); an indication of “recurrence following surgery/treatment” had a 5.9 times lower odds of achieving seizure freedom (p = 0.002) compared to the “lesion negative” cohort, whereas other indications (“lesion positive, define extent,” “lesion positive, discordant noninvasive investigations” and “multiple lesions”) were not statistically significantly different.

Significance

This large nationally representative cohort illustrates that SEEG‐guided surgery can still achieve high rates of seizure freedom. Seizure semiology and the number of seizures recorded during SEEG are important factors in the identification of a putative SOZ, and the indication for SEEG is an important factor in postoperative outcomes.
Public sector audit in uncertain times
Authors: Cordery Carolyn J. , Hay David C.
Published: June 2021

In the future, environmental disasters and resource constraints will continue to impact the public sector audit environment. Governments will be held responsible for their responses and the corresponding financial impacts, particularly rising levels of public debt. Supreme Audit Institutions (SAIs) are vital in keeping governments accountable. Yet, they also need legitimacy and they are subject to isomorphic pressures to gain this. Mimetic isomorphism explains SAIs’ structures, although they remain diverse, worldwide. Our analysis of extensive data about SAIs together with statistical measures about countries, an international survey and document analysis enables us to make projections about what isomorphic pressures will shape SAIs and enable them to deal with an uncertain future. Examining public debt and the United Nation's Sustainable Development Goals as case studies, we show how isomorphism will shape SAIs’ responses to an uncertain future.
Clinical features of 65‐year‐old individuals in Japan diagnosed with possible sarcopenia based on the Asian Working Group for Sarcopenia 2019 criteria
Authors: Miura Hiroshi , Sakaguchi Kazuhiko , Ogawa Wataru , Tamori Yoshikazu
Published: June 2021

Aim

The prevalence of sarcopenia and the health status of affected individuals, particularly among the young elderly, are unclear in Japan. We determined the prevalence of possible sarcopenia, a concept proposed by the Asian Working Group for Sarcopenia (AWGS) in 2019, and then investigated its clinical features in community‐dwelling young elderly individuals in Kobe, a representative large city in Japan.

Methods

This retrospective cross‐sectional study examined 1768 residents of Kobe aged 65 years who underwent health and frailty checkups implemented by Kobe City between April 2017 and March 2019. Possible sarcopenia was diagnosed by the AWGS 2019 algorithm. Frailty status was assessed with the use of the Kihon Checklist, which was developed to identify senior citizens requiring nursing care in Japan.

Results

Fifty‐one of the 1768 subjects were diagnosed with possible sarcopenia (overall prevalence of 2.9% [confidence interval: 2.1–3.7%]), with the prevalence being higher in women than in men. Individuals with possible sarcopenia had a lower body mass index, abdominal circumference, diastolic blood pressure and percentage of taking lipid‐lowering drugs as well as a higher high‐density lipoprotein cholesterol level and estimated glomerular filtration rate. They also showed a higher degree of frailty. A low body mass index and physical inactivity were significantly associated with possible sarcopenia.

Conclusions

The prevalence of possible sarcopenia based on the AWGS 2019 criteria was 2.9% among 65‐year‐olds in Japan, with affected individuals more likely to be frail compared with those without this condition. Geriatr Gerontol Int 2021; 21: 689–696.
The impact of MYC gene amplification on the clinicopathological features and prognosis of radiation‐associated angiosarcomas of the breast
Authors: Kuba Maria Gabriela , Xu Bin , D’Angelo Sandra P , Rosenbaum Evan , Plitas George , Ross Dara S , Brogi Edi , Antonescu Cristina R
Published: June 2021

Aims

Radiation‐associated angiosarcomas (RT‐ASs) of the breast are rare tumours with a poor prognosis. MYC gene amplification is considered to be the hallmark of RT‐AS, and is sometimes used as a diagnostic tool to distinguish it from other radiation‐associated vascular lesions. However, a small subset of RT‐ASs lacks MYC amplification, and this may be associated with better outcome. Loss of trimethylation at lysine 27 of histone 3 (H3K27me3) expression by immunohistochemistry (IHC) has been recently postulated as an additional diagnostic marker for RT‐AS. The aims of this study were to evaluate the impact of MYC amplification as detected by fluorescence in‐situ hybridisation and/or next‐generation sequencing on clinicopathological features and outcome in a large cohort of RT‐ASs, compare outcome with those of radiation‐associated sarcomas (RT‐Ss) of the breast other than angiosarcoma, and evaluate expression of H3K27me3 IHC in these groups.

Methods and results

Eighty‐one RT‐ASs were identified, including 73 that were MYC‐amplified and 8 (10%) that were MYC‐non‐amplified. MYC‐amplified RT‐ASs were diagnosed in older patients (median age, 69 years versus 61 years). The 5‐year disease‐specific survival and 5‐year overall survival rates were 56% and 47%, respectively. Older age, larger tumour size, positive margin and MYC amplification were associated with worse prognosis. None of the RT‐ASs showed complete loss of H3K27me3 IHC expression. All 18 RT‐Ss were MYC‐non‐amplified, and complete loss of H3K27me3 expression was seen in 2 cases. We found no difference in prognosis between RT‐AS and RT‐S.

Conclusions

RT‐AS of the breast is associated with a poor prognosis. Older age at diagnosis, larger tumour size, positive margin at excision and MYC amplification are associated with worse prognosis.
Concentrated MTA Repair HP reduced biofilm and can cause reparative action at a distance
Authors: Silva Poliana Amanda Oliveira , Lima Stella Maris de Freitas , Martins Danilo César Mota , Amorim Ingrid Aquino , Lacorte Cristiano , de Almeida Jeesser Alves , Franco Octávio Luiz , Rezende Taia Maria Berto
Published: June 2021

Aim

To evaluate in vitro whether MTA Repair HP can induce repair processes at a distance, including its effects on biofilm, cell viability, migration, production of TGF‐β, phosphate and ALP, evaluated through MTA diluted extracts.

Methodology

Initially, antibacterial tests were performed with the bacterium Streptococcus mutans (ATCC 25175) in the presence of MTA extracts (dilutions of 1:1, 1:2 and 1:4). Growth inhibition assay by microdilution in broth, antibiofilm plate assay of young biofilm and antibiofilm assay in confocal microscopy of mature biofilm were carried out. Then, pulp cells were stimulated in the presence of several MTA dilutions, and cell viability (MTT assay), proliferation and migration capacity (scratch assay) were evaluated. To evaluate the capacity of 1:1, 1:2 and 1:4 dilutions of MTA Repair HP to promote the production of important agents of odontogenic differentiation and mineralization, ALP activity, TGF‐β secretion and phosphate quantification were measured. Statistical differences were verified using one‐way and two‐way anova and Tukey's post‐tests.

Results

The test dilutions of MTA Repair HP did not inhibit planktonic S. mutans growth but were able to reduce young and mature S. mutans biofilm (p < 0.001). In addition, none of the MTA Repair HP dilutions was cytotoxic for pulp cells. The 1:2 and 1:4 dilutions of MTA Repair HP induced migration and proliferation of pulp cells (p < 0.05). ALP activity and TGF‐β secretion were independent of the tested dilution (p < 0.001). Diluted 1:4 MTA Repair HP produced less phosphate than the more concentrated 1:1 and 1:2 MTA dilutions (p < 0.001).

Conclusions

Undiluted MTA Repair HP reduced S. mutans biofilm, when compared to 1:2 and 1:4 MTA dilutions. Furthermore, none of the tested dilutions was cytotoxic to pulp cells. MTA Repair HP promoted cell migration and proliferation at a distance, assessed through the dilution of the MTA. Even from a distance, MTA Repair HP has the ability to participate in some events related to repair, such as migration, proliferation and TGF production.
Structural and optical properties in Tm3+/Tm3+–Yb3+ doped NaLuF4 glass‐ceramics
Authors: Velázquez Jose J. , Balda Rolindes , Fernández Joaquin , Gorni Giulio , Sedano Mercedes , Durán Alicia , Galusek Dušan , Pascual Maria J.
Published: June 2021

Transparent NaLuF4 glass‐ceramics (GCs) doped with Tm3+ and Tm3+/Yb3+ have been prepared by melting‐quenching followed by thermal treatment at temperatures near the glass transition temperature. The crystallization process has been studied using X‐ray diffraction (XRD) and high‐resolution transmission electron microscopy (HRTEM). NaLuF4 nanocrystals (NCs) ranging 9–30 nm in size are the only crystalline phase, the crystal size increasing with the dopant concentration. Energy dispersive X‐ray (EDX) measurements confirm the Tm3+ and Yb3+ incorporation in the NCs. Optical characterization included the analysis of up‐conversion (UC) as well as the Near‐infrared (NIR) luminescence. NIR emission spectra of Tm3+ and Yb3+ in co‐doped samples confirmed an efficient energy transfer between both ions. No UC emissions are observed in Tm3+ single‐doped glass and GCs. Yb3+ incorporation favors the Tm3+‐Tm3+ UC processes resulting in Tm3+ blue, yellowish‐red and NIR UC emissions after excitation at 975 nm. Blue UC emission is also observed in the codoped samples after Tm3+ excitation at 791 nm. These effects were more evident for the GCs compared to the base glasses, confirming the RE ions incorporation in the NCs. As a result, these GCs can be used to tune the UC emission from NIR to blue by selective excitation.
Atrial fibrillation recurrence and spontaneous conversion to sinus rhythm after cardiac surgery: Insights from 426 patients with continuous rhythm monitoring
Authors: Charitos Efstratios I. , Herrmann Florian E. M. , Ziegler Paul D.
Published: June 2021

Introduction

Cardiac surgery may influence occurrence and persistence of atrial fibrillation (AF). In patients with a history of cardiac surgery and postoperative pacemaker or implantable cardioverter defibrillator implantation we attempted to quantify AF characteristics and investigate factors that influence AF recurrence.

Methods

In 426 patients (319 male; age: 73 SD: 9 years) with a history of cardiac surgery (364 CABG; 69 mitral valve; 57 aortic valve and 59 combination procedures) the heart rhythm history (mean: 351 days SD: 54 days) was reconstructed and investigated for AF recurrence patterns.

Results

AF developed and subsequently recurred in 75% of patients (n = 320). The mean AF burden in these patients was 0.21 (21% of the total observed time spent in AF) and 4085 episodes of AF were observed and analyzed. AF episodes spontaneously terminated within 24 h (n = 2509), 48 h (n = 700), 72 h (n = 279), and 1 week (n = 31). The probability of spontaneous conversion to sinus rhythm (SR) decreased with time spent in AF and plateaued after approximately 7 days. Patient age, LVEF and presence of coronary artery disease significantly influenced the probability of spontaneous conversion to SR. Type of cardiac surgery also significantly influenced AF episode characteristics.

Conclusion

AF episodes are common in patients with a history of cardiac surgery. Spontaneous conversion to SR diminishes with increasing time spent in AF and is influenced by AF characteristics and several patient‐related factors. Continuous monitoring can provide detailed information about AF recurrence that may immensely improve our understanding and influence the clinical management of AF.
Transforming a pre‐existing MRI environment into an interventional cardiac MRI suite
Authors: Bijvoet Geertruida P. , Holtackers Robert J. , Smink Jouke , Lloyd Tom , van den Hombergh Cristy L. M. , Debie Luuk J. B. M. , Wildberger Joachim E. , Vernooy Kevin , Mihl Casper , Chaldoupi Sevasti‐Maria
Published: June 2021

Aims

To illustrate the practical and technical challenges along with the safety aspects when performing MRI‐guided electrophysiological procedures in a pre‐existing diagnostic magnetic resonance imaging (MRI) environment.

Methods and Results

A dedicated, well‐trained multidisciplinary interventional cardiac MRI team (iCMR team), consisting of electrophysiologists, imaging cardiologists, radiologists, anaesthesiologists, MRI physicists, electrophysiological (EP) and MRI technicians, biomedical engineers, and medical instrumentation technologists is a prerequisite for a safe and feasible implementation of CMR‐guided electrophysiological procedures (iCMR) in a pre‐existing MRI environment. A formal dry run “mock‐up” to address the entire spectrum of technical, logistic, and safety issues was performed before obtaining final approval of the Board of Directors. With this process we showed feasibility of our workflow, safety protocol, and bailout procedures during iCMR outside the conventional EP lab. The practical aspects of performing iCMR procedures in a pre‐existing MRI environment were addressed and solidified. Finally, the influence on neighbouring MRI scanners was evaluated, showing no interference.

Conclusion

Transforming a pre‐existing diagnostic MRI environment into an iCMR suite is feasible and safe. However, performing iCMR procedures outside the conventional fluoroscopic lab, poses challenges with technical, practical, and safety aspects that need to be addressed by a dedicated multi‐disciplinary iCMR team.
Pseudo‐elevation of conduction system pacing threshold through parallel connection of an intracardiac electrogram recording system
Authors: Yokota Jun , Fujiu Katsuhito , Oshima Tsukasa , Matsubara Takumi J , Matsuda Jun , Shimizu Yu , Hasumi Eriko , Kojima Toshiya , Doi Kent , Komuro Issei
Published: June 2021

Parallel connection of an electrophysiology recording system (EP system) to equipment for conduction system pacing (CSP) has been widely used for fine monitoring of intracardiac electrograms and pacing evaluation. We experienced a case showing unexpected pacing threshold exacerbation under specific conditions when the EP system was connected in parallel. We evaluated the underlying mechanism using an ex vivo model. An ex vivo pacing and intracardiac electrogram monitoring model was generated using an oscilloscope, pacing system analyzer (PSA), EP system, and simulated heart. The discrepancy between expected output at the PSA and the actual measured output value at the simulated heart was measured under various conditions and using various combinations of pacing equipment. Parallel connection of the EP system was associated with reduced electrical output from the PSA as recorded at the simulated heart. The unexpected adverse effects were particularly noticeable when using an RMC‐5000 EP system with the pacing function on. The trouble is completely resolved by simply turning off the pacing function of the system. There is a possibility that the EP system might increase the pacing threshold in CSP when the PSA and EP system is are deployed in parallel. The issue may provoke pseudo failure of CSP due to the high pacing threshold. When the RMC‐5000 is used for conduction system pacing in parallel with a PSA for the pacing test, the pacing function of RMC‐5000 should be turned off.
Safety and efficacy of left atrial appendage closure using an epicardial suture snaring device: Systematic review and current status
Authors: Sabzwari Syed Rafay Ali , Mehta Nikhil A. , Garg Lohit , Racharla Lekha , Kurtz Emilee , Afzal Muhammad R. , Turagam Mohit K. , Lakkireddy Dhanunjaya
Published: June 2021

Introduction

The LARIAT epicardial suture snaring device has been fraught with technical challenges and procedural complications. Over time, technique modification and improved operator experience have helped overcome many of these challenges.

Methods and Results

Studies reporting left atrial appendage epicardial closure over a 12‐year period from 2009 to 2020 were evaluated. The primary efficacy outcome evaluated was left atrial appendage closure with residual flow ≤1 mm. Safety outcomes evaluated were periprocedural and long term complications after device placement. Nine studies consisting of 1430 patients were included in this analysis, of which 1386 (97%) underwent successful device placement. The mean age was 69.3 years, with a mean CHADS2‐VASC score of 3.78. Primary efficacy end point was achieved in 95.8% patients immediately after device placement, and in 92.8% patients on long term follow‐up. Early procedural complications consisted of pericardial effusion 5.6%, cardiac perforation 2.7%, pericarditis 2.6%, and need for open heart surgery 1.5%. Long term complications consisted of all‐cause mortality 2.3%, stroke 1.5%, and left atrial appendage thrombus 2.3%. Reduced complications were noted using micropuncture needles (2.20% vs. 10.14%; p < .0001), a longer duration pericardial drainage, and use of anti‐inflammatory medications (1.58% vs. 8.4%). Oral anticoagulation use decreased from 44.7% to 22.9% post device implantation, and to 8.5% on last clinical follow up.

Conclusions

The LARIAT device is effective in epicardial closure of the left atrial appendage. Improvement in device techniques such as use of micropuncture needle, prophylactic colchicine, and maintenance of a pericardial drain have helped improve safety over time.
Personalized at‐home neurofeedback compared to long‐acting methylphenidate in children with ADHD: NEWROFEED, a European randomized noninferiority trial
Authors: Purper‐Ouakil Diane , Blasco‐Fontecilla Hilario , Ros Tomas , Acquaviva Eric , Banaschewski Tobias , Baumeister Sarah , Bousquet Elisa , Bussalb Aurore , Delhaye Marie , Delorme Richard , Drechsler Renate , Goujon Allison , Häge Alexander , Kaiser Anna , Mayaud Louis , Mechler Konstantin , Menache Caroline , Revol Olivier , Tagwerker Friederike , Walitza Susanne , Werling Anna Maria , Bioulac Stephanie , Brandeis Daniel
Published: June 2021

Background

Neurofeedback is considered a promising intervention for the treatment of attention‐deficit hyperactivity disorder (ADHD). NEWROFEED is a prospective, multicentre, randomized (3:2), reference drug‐controlled trial in children with ADHD aged between 7 and 13 years. The main objective of NEWROFEED was to demonstrate the noninferiority of personalized at‐home neurofeedback (NF) training versus methylphenidate in the treatment of children with ADHD.

Methods

The NF group (n = 111) underwent eight visits and two treatment phases of 16 to 20 at‐home sessions with down‐training of the theta/beta ratio (TBR) for children with high TBR and enhancing the sensorimotor rhythm (SMR) for the others. The control group (n = 67) received optimally titrated long‐acting methylphenidate. The primary endpoint was the change between baseline and endpoint in the Clinician ADHD‐RS‐IV total score in the per‐protocol population (90 NF/59 controls). Trial registration: US National Institute of Health, ClinicalTrials.gov #NCT02778360.

Results

Our study failed to demonstrate noninferiority of NF versus methylphenidate (mean between‐group difference 8.09 90% CI [8.09; 10.56]). However, both treatment groups showed significant pre–post improvements in core ADHD symptoms and in a broader range of problems. Reduction in the Clinician ADHD‐RS‐IV total score between baseline and final visit (D90) was 26.7% (SMD = 0.89) in the NF and 46.9% (SMD = 2.03) in the control group. NF effects increased whereas those of methylphenidate were stable between intermediate and final visit.

Conclusions

Based on clinicians’ reports, the effects of at‐home NF were inferior to those of methylphenidate as a stand‐alone treatment.
Banks as Potentially Crooked Secret Keepers
Authors: JACKSON TIMOTHY , KOTLIKOFF LAURENCE J.
Published: June 2021

Bank failures are generally liquidity as well as solvency events. Whether it is households running on banks or banks running on banks, defunding episodes are full of drama. This theater has, arguably, lured economists into placing liquidity at the epicenter of financial collapse and liquidity provision as opposed to improved intermediation as the rationale for banks. But loss of liquidity describes how banks fail . Bad news about banks explains why they fail. This paper models banks as arising from asymmetric information. Banks have superior knowledge of investment opportunities. But bankers, or at least a subset, also know how to steal. Hence, we model banking crises as triggered by news that the degree (share) of banking malfeasance is likely to be particularly high. The malfeasance share follows a Markov process. When this period's share is high, agents rationally raise their probability that next period's share will be high as well. Whether or not this proves true, agents invest less in banks, reducing intermediation and output. Worse, bad bankers can infect good bankers. When bad bankers are thought to abound, good bankers have less incentive to secure a high return on their investment. Deposit insurance prevents defunding runs and stabilizes the economy. But it sustains bad banking, lowering welfare. Private monitoring helps, but is no panacea. It partially limits banking malfeasance. But it does so inefficiently as households needlessly replicate each other's costly information acquisition. Moreover, if private audits become public, private monitoring breaks down due to free‐riding. Redistribution between generations that do and do not confront the highest share of banking malfeasance does not relieve the problem. What does improve matters is government real‐time disclosure of banking malfeasance. This mitigates, if not eliminates, the asymmetric information problem leading to potentially large gains in both nonstolen output and welfare.
Quantifying Stock and Flow Effects of QE
Authors: SUDO NAO , TANAKA MASAKI
Published: June 2021

In this paper, we focus on the transmission mechanism of quantitative‐easing (QE) policy and address which matters most: the size of the bond purchases in each period (flow effects) or the total amount of bonds taken away from the private sectors (stock effects). To this end, we estimate a dynamic stochastic general equilibrium (DSGE) model in which short‐ and long‐term bonds are imperfect substitutes due to market segmentation and preferred habitats, using Japan's data from the 1980s to 2017. We find that (i) Japan's data support imperfect substitutability between short‐ and long‐term bonds, which implies that government bond purchases by the Bank of Japan (BOJ) reduce the term premium, exerting an expansionary effect on economic activity and prices; (ii) government bond purchases by BOJ have compressed the 10‐year yields by 50–100 basis points as of the end of 2017; and (iii) the compression of the term premium has been mainly driven by stock effects, which underscores the importance of the size of BOJ's government bond holdings in determining the term premium.
Malaria in Pregnancy: Considerations for Health Care Providers in Nonendemic Countries
Authors: Mills Michelle , Holley Sharon L. , Coly Paul , DeJoy Susan
Published: June 2021

Malaria is a common infection world‐wide, which carries significant risk of morbidity and mortality. Health care providers in the United States may lack experience in recognizing and treating this disease. The pathophysiology of malaria differs during pregnancy, resulting in increased risk for serious morbidity and mortality for the woman and her fetus. Screening for risk factors, especially immigration from and travel to endemic countries, is critical. Symptoms of malaria can mimic influenza‐type illnesses, causing delay in diagnosis. Consultation with an infectious disease specialist and hospitalization may be required for appropriate testing and treatment. Chemoprophylaxis and counseling regarding methods to reduce risk are important components of prevention. The US Centers for Disease Control and Prevention and the World Health Organization have established protocols for treatment and are helpful resources for clinicians. A team approach to care based on the woman's stage of illness and recovery, can involve midwives, physicians, specialists and others.
Centric relation critically revisited—What are the clinical implications?
Authors: Zonnenberg Adriaan J. J. , Türp Jens Christoph , Greene Charles S.
Published: June 2021

Purpose of the article

Centric relation is a dental term that has undergone many alterations over the years, which in turn have led to significant clinical controversies. These continuing changes in the meaning of the term CR have not only led to confusion, but they also have resulted in a variety of unnecessary diagnostic and therapeutic procedures. Analysis of the dental literature reveals ongoing misunderstanding and disagreement regarding that term among both clinicians and academic dentists.

Materials and methods

A search of the PubMed database was performed with the following search terms: “centric relation”, “masticatory muscles”, “maxillomandibular relationship” and “condylar position.” Relevant literature from the past 70 years until the present day was meticulously scrutinised.

Results

As expected, the literature review on the topic of CR revealed a problematic pattern of changing definitions and clinical disagreements, all of which have had a significant impact on the practice of dentistry.

Conclusion

There are semantic, conceptual and practical reasons for concluding that the term ‘centric relation’ is flawed. Those flaws have a significant impact on dental practice. Based on our analysis, argumentation is provided to conclude that the term ‘centric relation’ should be abandoned. Instead, it appears that every individual has a unique temporomandibular joint relationship which cannot be described by any singular term. In healthy dentate patients, this relationship is determined by the maximum intercuspation of the teeth and should therefore be considered as biologically acceptable.
Medical confidentiality in underage consent sex in Brazil
Authors: Soares Leila Cristina , Monteiro Denise Leite Maia , Brollo Jorge Luiz Alves
Published: June 2021

This paper is a theoretical discussion that explores medical confidentiality within the context of Brazilian law about underage consent sex. Brazilian law determines that the age of consent for sexual intercourse is 14 years. Before this limit, physicians should report the sexual activity of adolescents, breaking the confidentiality of the consultation. The medical code of ethics prohibits the breach of professional confidentiality of a minor patient, including their parents or legal representatives, unless a lack of disclosure may cause harm to the patient. The legal issue seems to go beyond the ethical issue; however, the breach of confidentiality can cause more risks than benefits by removing these adolescents from health services. The law aims to protect the sexual dignity of teenagers under 14 years old, but the particularities of each case must be considered, and flexibility concerning medical confidentiality should be included.
Substrate usage determines carbon flux via the citrate cycle in Helicobacter pylori
Authors: Steiner Thomas M. , Lettl Clara , Schindele Franziska , Goebel Werner , Haas Rainer , Fischer Wolfgang , Eisenreich Wolfgang
Published: June 2021

Helicobacter pylori displays a worldwide infection rate of about 50%. The Gram‐negative bacterium is the main reason for gastric cancer and other severe diseases. Despite considerable knowledge about the metabolic inventory of H. pylori, carbon fluxes through the citrate cycle (TCA cycle) remained enigmatic. In this study, different 13C‐labeled substrates were supplied as carbon sources to H. pylori during microaerophilic growth in a complex medium. After growth, 13C‐excess and 13C‐distribution were determined in multiple metabolites using GC–MS analysis. [U‐13C6]Glucose was efficiently converted into glyceraldehyde but only less into TCA cycle‐related metabolites. In contrast, [U‐13C5]glutamate, [U‐13C4]succinate, and [U‐13C4]aspartate were incorporated at high levels into intermediates of the TCA cycle. The comparative analysis of the 13C‐distributions indicated an adaptive TCA cycle fully operating in the closed oxidative direction with rapid equilibrium fluxes between oxaloacetate—succinate and α‐ketoglutarate—citrate. 13C‐Profiles of the four‐carbon intermediates in the TCA cycle, especially of malate, together with the observation of an isocitrate lyase activity by in vitro assays, suggested carbon fluxes via a glyoxylate bypass. In conjunction with the lack of enzymes for anaplerotic CO2 fixation, the glyoxylate bypass could be relevant to fill up the TCA cycle with carbon atoms derived from acetyl‐CoA.
What to do with unusual TDP‐43 proteinopathy cases?
Authors: Nelson Peter T.
Published: June 2021

LATE‐NC is a diagnostic term developed by a large, multidisciplinary, international team of experts, after months of discussion and a NIH‐funded 2 day in‐person meeting in late 2018. This group was tasked with generating suitable terminology for common TDP‐43 proteinopathy in aging. When diagnosing an unusual case of TDP‐43 proteinopathy at autopsy, a diagnostic approach is recommended that is analogous to unusual tauopathy or α‐synucleinopathy cases: render a descriptive neuropathologic diagnosis, rather than label such cases as LATE‐NC.
Size‐mediated priority effects are trait‐dependent and consistent across latitudes in a damselfly
Authors: Raczyński Mateusz , Stoks Robby , Johansson Frank , Sniegula Szymon
Published: June 2021

Variation in hatching time (phenology) might cause size differences within populations resulting in size‐mediated priority effects (SMPEs) shaping intraspecific interactions. These phenology‐driven effects potentially can be strengthened by seasonal time constraints caused by a short growth season, and depend on latitude. Here the single and combined effects of phenology and latitude‐associated time constraints on SMPEs in larvae of an aquatic insect, the damselfly Lestes sponsa, are studied. We did so by rearing larvae in groups of 16 individuals with different phenology (hatching date) thereby imposing strong intraspecific competition, resulting in cannibalism. We thereby manipulated in a fully crossed way time constraints (combination of temperature and photoperiod: thermo‐photoperiod) in larvae from low‐latitude and more time constrained high‐latitude populations, and examined effects on life history (survival, development, growth) and physiology (fat and protein contents, and phenoloxidase activity as a measure of immune function). Phenology, time constraints and latitude of origin had strong effects on life history, but only the time constraint affected the physiology. We detected a SMPE for survival that, however, was not stronger under time constraints and was consistent in strength between latitudes. Phenology and time constraints interacted for development and growth in a direction suggesting adaptive responses to time constraints but these life history traits did not show SMPEs. We provided important insights in the study of SMPEs thereby showing these to be trait‐dependent and not more pronounced under experimentally manipulated or latitude‐associated time constraints. Our study thereby makes an important addition to geographic variation in SMPEs, a largely neglected topic.
Trimmed central venous catheters in pediatric cardiac surgery: Does height or weight correlate with the amount trimmed?
Authors: Glenski Todd A. , Taylor Christian M. , Doyle Nichole M. , Erkmann John J. , Huffman Joseph C. , Anyaso Jessica C.
Published: June 2021

Background

Due to excess catheter length, pediatric patients undergoing cardiac surgery frequently have the tip of the central venous catheter trimmed while on bypass to obtain optimal catheter positioning.

Aims

We sought to determine if there is a correlation between the patient's height or weight and the length of catheter removed. Our secondary aim compared the instances of central line‐associated bloodstream infections and venous thromboembolisms between the trimmed and untrimmed catheters.

Methods

This retrospective study included patients having undergone cardiac surgery over a 3‐year period who had an 8 cm central venous catheter placed in the right internal jugular vein. Hospital lists of central line‐associated bloodstream infections and venous thromboembolisms that occurred were cross referenced with our study patients.

Results

There were 147 cases where the 8 cm central venous catheter was trimmed, which represents 35% of the cases. Of the catheters that were cut, on average 2.17 cm was removed.

There is negligible correlation between the length of catheter removed and patient height (r = −.19, p = .021). There is negligible correlation between the length of catheter removed and patient weight (r = −.17, p = .039).

There were no instances of central line‐associated bloodstream infections or venous thromboembolisms attributed to the trimmed catheters. Of the 273 untrimmed catheters, there were no instances of an infection and one instance of a venous thromboembolism.

Conclusion

Right internal jugular 8 cm central venous catheters are trimmed during pediatric cardiac surgery, and there is minimal correlation between the length removed and the patient height or weight. Due to the difficulty in estimating the proper length of a central venous catheter in smaller pediatric patients, placing an 8 cm long catheter in these patients and then trimming the distal tip while on bypass may be the most accurate way to properly position a catheter.
Long noncoding RNA lncRNA354 functions as a competing endogenous RNA of miR160b to regulate ARF genes in response to salt stress in upland cotton
Authors: Zhang Xiaopei , Shen Jian , Xu Qingjiang , Dong Jie , Song Lirong , Wang Wei , Shen Fafu
Published: June 2021

Long non‐coding RNAs (lncRNAs) play important roles in response to biotic and abiotic stress through acting as competing endogenous RNAs (ceRNAs) to decoy mature miRNAs. However, whether this mechanism is involved in cotton salt stress response remains unknown. We report the characterization of an endogenous lncRNA, lncRNA354, whose expression was reduced in salt‐treated cotton and was localized at the nucleus and cytoplasm. Using endogenous target mimic (eTM) analysis, we predicted that lncRNA354 had a potential binding site for miR160b. Transient expression in tobacco demonstrated that lncRNA354 was a miR160b eTM and attenuated miR160b suppression of its target genes, including auxin response factors (ARFs). Silencing or overexpressing lncRNA354 affected the expression of miR160b and target ARFs. Silencing lncRNA354 and targets GhARF17/18 resulted in taller cotton plants and enhanced the resistant to salt stress. Overexpression of lncRNA354 and targets GhARF17/18 in Arabidopsis led to dwarf plants, decreased root dry weight and reduced salt tolerance. Our results show that the lncRNA354‐miR160b effect on GhARF17/18 expression may modulate auxin signalling and thus affect growth. These results also shed new light on a mechanism of lncRNA‐associated responses to salt stress.
A Class II CPD Photolyase and a 6‐4 Photolyase with Photorepair Activity from the Antarctic Moss Pohlia nutans M211
Authors: An Meiling , Qu Changfeng , Miao Jinlai , Sha Zhenxia
Published: June 2021

Antarctic mosses are the dominant vegetation in the Antarctic continent. Because of stratospheric ozone depletion, they can withstand physiological extreme UV. The formation of CPD and 6‐4PP is one of the most harmful damages of UV to DNA. DNA damage can interfere with replication and transcription, resulting in mutation and death. Two types of photolyase, CPD photolyase and 6‐4 photolyase, are capable of specific binding CPD or 6‐4PP and repairing these lesions. However, there is little research on photolyase in Antarctic moss. Here, we isolated a gene encoding class II CPD photolyase (PnCPDPhr) and a gene encoding 6‐4 photolyase (Pn6‐4Phr) from Antarctic moss P. nutans M211. When exposed to UVB, CPDs accumulated in gametophytes and the gene expressions of PnCPDPhr and Pn6‐4Phr were both up‐regulated. In addition, the in vitro expression and photoreactivation assays of PnCPDPhr and Pn6‐4Phr were performed. Our results demonstrated that PnCPDPhr and Pn6‐4Phr have an effective activity of DNA repair. This is the first study to determine the CPD accumulation in Antarctic moss as well as the first report isolating CPD photolyase and 6‐4 photolyase from Antarctic moss. These results will enrich the knowledge of photolyase family and benefit the exploitation of functioning gene in Antarctic moss.
Intention Persistence
Authors: Brunero John
Published: June 2021

There are two well‐known formulations of the diachronic rational requirement of intention persistence, due to Michael Bratman and John Broome. I argue in this paper that both formulations face serious difficulties. Bratman’s formulation is unable to accommodate two different kinds of examples in which it is permissible to drop an intention even though one’s assessment of the adequacy of its reasons remains constant. Broome’s formulation is both too weak and too strong, unable to rule out the unlicensed reconsideration of intentions, while at the same time disallowing valuable spontaneous shifts in intentions. I propose a new formulation, Intention Persistence, that avoids these difficulties and has other advantages.
Effect of preschool childcare on school‐aged children’s adiposity in Quebec, Canada
Authors: Murphy Tanya J. , Kaufman Jay S. , Li Patricia , Steele Russell , Yang Seungmi
Published: June 2021

Background

Regulated public childcare must follow nutrition and physical activity guidelines, but the impact of public childcare on childhood adiposity is unclear.

Objectives

To estimate the effects of universal preschool childcare on children's BMI in elementary school in Quebec, Canada, and whether the effects differed in children from more or less advantaged families.

Methods

For 1657 children enrolled in the Quebec Longitudinal Study of Child Development (1998–2010), BMI z‐scores (BMIz) from 6 to 13 years were regressed on the childcare used from 2 to 5 years, adjusted for pre‐childcare variables. Average treatment effects were estimated using the Bayesian multilevel linear regression and g‐computation for four childcare profiles: 1) parental care or full‐time care (35 hours/week) in a 2) centre‐based, 3) regulated home‐based or 4) unregulated home‐based arrangement.

Results

Had all participants attended centre‐based care, mean BMIz in kindergarten would have been 0.38 (95% credible interval [CrI] 0.23, 0.52), which was 0.40 (95% CrI 0.14, 0.65) SD higher than regulated home‐based, 0.20 (95% CrI −0.04, 0.43) SD higher than unregulated home‐based and 0.36 (95% CrI 0.11, 0.60) SD higher than parental care. By 12 years, mean BMIz had increased for all childcare profiles, but differences between childcare profiles had diminished.

Conclusions

Although centre‐based childcare was associated with an earlier rise in BMI, compared with informal care, it had no large, enduring effect, overall, or for less advantaged children, in particular.