bluuebunny/crossref_metadata_2025 huggingface dataset:
Cephalic marks and well‐being in newborns after operative vaginal delivery
Authors: Gachon Bertrand , Daressy Elisa , Vanhecke Johanne , Juinier Louarn Christine , Papin Sonia , Pierre Fabrice , Fritel Xavier
Published: September 2021

Objectives

To compare the incidence of cephalic marks in newborns exposed to operative vaginal delivery and those who are not. We examined the factors associated with alterations in neonatal well‐being and with cephalic mark occurrence.

Methods

Prospective study involving singleton term newborns delivered in a cephalic presentation. Newborns in the operative group were matched with newborns born on the same day without instruments required. A cephalic mark was defined as any mark or edema on the newborn's skin between 12 and 72 hours of life. Neonatal well‐being was assessed by analgesic consumption, neonatal discomfort (EDIN score of 1 or more), and prolonged hospitalization (4 days or more). We compared the operative and spontaneous groups and determined the relative risk (RR) for cephalic marks. We investigated the factors associated with alterations in neonatal well‐being and factors associated with cephalic mark occurrence in the case of operative delivery using multivariate logistic regression analysis.

Results

A total of 135 newborns were included in each group. The incidence of cephalic marks was higher in the operative group (RR = 13.3 [6.0–29.5]). In case of operative delivery, cephalic marks were associated with neonatal discomfort (adjusted odds ratios [aOR] = 8.2 [2.2–30.6]) and analgesic consumption (aOR = 3.0 [1.2–7.1]). The number of cephalic marks was higher in cases with sequential use of vacuum and forceps (aOR = 3.5 [1.1–11.7]) and forceps only deliveries (aOR = 3.0 [1.1–8.1]) relative to vacuum only deliveries.

Conclusions

Operative delivery increases the risk of neonatal cephalic marks, which can negatively affect neonatal well‐being.
Control of hippocampal prothrombin kringle‐2 (pKr‐2) expression reduces neurotoxic symptoms in five familial Alzheimer's disease mice
Authors: Kim Sehwan , Moon Gyeong Joon , Kim Hyung Jun , Kim Do‐Geun , Kim Jaekwang , Nam Youngpyo , Sharma Chanchal , Leem Eunju , Lee Shinrye , Kim Kyu‐Sung , Ha Chang Man , McLean Catriona , Jin Byung Kwan , Shin Won‐Ho , Kim Dong Woon , Oh Yong‐Seok , Hong Chang‐Won , Kim Sang Ryong
Published: September 2021

Background and Purpose

There is a scarcity of information regarding the role of prothrombin kringle‐2 (pKr‐2), which can be generated by active thrombin, in hippocampal neurodegeneration and Alzheimer's disease (AD).

Experimental Approach

To assess the role of pKr‐2 in association with the neurotoxic symptoms of AD, we determined pKr‐2 protein levels in post‐mortem hippocampal tissues of patients with AD and the hippocampi of five familial AD (5XFAD) mice compared with those of age‐matched controls and wild‐type (WT) mice, respectively. In addition, we investigated whether the hippocampal neurodegeneration and object memory impairments shown in 5XFAD mice were mediated by changes to pKr‐2 up‐regulation.

Key Results

Our results demonstrated that pKr‐2 was up‐regulated in the hippocampi of patients with AD and 5XFAD mice, but was not associated with amyloid‐β aggregation in 5XFAD mice. The up‐regulation of pKr‐2 expression was inhibited by preservation of the blood–brain barrier (BBB) via addition of caffeine to their water supply or by treatment with rivaroxaban, an inhibitor of factor Xa that is associated with thrombin production. Moreover, the prevention of up‐regulation of pKr‐2 expression reduced neurotoxic symptoms, such as hippocampal neurodegeneration and object recognition decline due to neurotoxic inflammatory responses in 5XFAD mice.

Conclusion and Implications

We identified a novel pathological mechanism of AD mediated by abnormal accumulation of pKr‐2, which functions as an important pathogenic factor in the adult brain via blood brain barrier (BBB) breakdown. Thus, pKr‐2 represents a novel target for AD therapeutic strategies and those for related conditions.
Les grappes industrielles en régions périphériques: le cas des biotechnologies marines à Rimouski (Québec)
Authors: Doloreux David , Shearmur Richard , Poulin‐Houle Sophianne
Published: September 2021

Figurant comme un élément important des politiques de développement économique, les grappes régionales ont été souvent présentées, à tort ou à raison, comme étant l'environnement le mieux adapté pour stimuler l'innovation et la compétitivité des entreprises et des régions. L'objectif de cet article est d'étudier le phénomène des grappes industrielles en région périphérique à partir du cas des biotechnologies marines à Rimouski. Pour ce faire, nous décrivons la structure et le fonctionnement de la grappe et nous analysons comment les dynamiques d'innovation résultent de processus et d'interactions qui se déroulent à différentes échelles spatiales. De plus, nous discutons en quoi le cas des biotechnologies marines à Rimouski illustre la difficulté de faire émerger une grappe dans un contexte périphérique.
Liquid biopsy of cerebrospinal fluid for MYD88 L265P mutation is useful for diagnosis of central nervous system lymphoma
Authors: Yamagishi Yuki , Sasaki Nobuyoshi , Nakano Yoshiko , Matushita Yuko , Omura Takaki , Shimizu Saki , Saito Kuniaki , Kobayashi Keiichi , Narita Yoshitaka , Kondo Akihide , Shiokawa Yoshiaki , Nagane Motoo , Ichimura Koichi
Published: September 2021

The current standard of diagnosing central nervous system (CNS) lymphoma is stereotactic biopsy, however the procedure has a risk of surgical complication. Liquid biopsy of the CSF is a less invasive, non‐surgical method that can be used for diagnosing CNS lymphoma. In this study, we established a clinically applicable protocol for determining mutations in MYD88 in the CSF of patients with CNS lymphoma. CSF was collected prior to the start of chemotherapy from 42 patients with CNS lymphoma and matched tumor specimens. Mutations in MYD88 in 33 tumor samples were identified using pyrosequencing. Using 10 ng each of cellular DNA and cell‐free DNA (cfDNA) extracted from the CSF, the MYD88 L265P mutation was detected using digital PCR. The conditions to judge mutation were rigorously determined. The median Target/Total value of cases with MYD88 mutations in the tumors was 5.1% in cellular DNA and 22.0% in cfDNA. The criteria to judge mutation were then determined, with a Target/Total value of 0.25% as the cutoff. When MYD88 mutations were determined based on these criteria, the sensitivity and specificity were 92.2% and 100%, respectively, with cellular DNA; and the sensitivity and specificity were 100% with cfDNA. Therefore, the DNA yield, mutated allele fraction, and accuracy were significantly higher in cfDNA compared with that in cellular DNA. Taken together, this study highlights the importance of detecting the MYD88 L265P mutation in cfDNA of the CSF for diagnosing CNS lymphoma using digital PCR, a highly accurate and clinically applicable method.
Quantifying the road‐effect zone for a critically endangered primate
Authors: Andrasi Balint , Jaeger Jochen A.G. , Heinicke Stefanie , Metcalfe Kristian , Hockings Kimberley J.
Published: September 2021

The global road network is expanding at an unprecedented rate, threatening the persistence of many species. Yet, even for the most endangered wildlife, crucial information on the distance up to which roads impact species abundance is lacking. Here we use ecological threshold analysis to quantify the road‐effect zone (REZ) for the critically endangered western chimpanzee (Pan troglodytes verus). We found: (1) the REZ extends 5.4 km (95% CI [4.9–5.8 km]) from minor roads and 17.2 km (95% CI [15.8–18.6]) from major roads, the latter being more than three times wider than a previous estimate of the average REZ for mammals; and (2) only 4.3% of the chimpanzees’ range is not impacted by existing roads. These findings reveal the high sensitivity and susceptibility of nonhuman primates to roads across West Africa, a region undergoing rapid development, and can inform the implementation of more effective guidelines to mitigate road impacts.
Safety and clinical efficacy of the double switch from originator infliximab to biosimilars CT‐P13 and SB2 in patients with inflammatory bowel diseases (SCESICS): A multicenter cohort study
Authors: Mazza Stefano , Piazza O. Sed Nicole , Conforti Francesco Simone , Fascì Alberto , Rimondi Alessandro , Marinoni Beatrice , Casini Valentina , Ricci Chiara , Munari Francesca , Pirola Lorena , Invernizzi Pietro , Girelli Carlo , Lupinacci Guido , Pastorelli Luca , Cavallaro Flaminia , Ferraris Luca , Colucci Alice , Amato Arnaldo , Eugenio Tontini Gian , Vecchi Maurizio , Fiorino Gionata , Caprioli Flavio
Published: September 2021

Data regarding double switching from originator infliximab (IFX) to IFX biosimilars in inflammatory bowel diseases (IBDs) are lacking. The purpose of this study was to evaluate the safety and efficacy of switching from originator IFX to CT‐P13 and subsequently to SB2 (double switch) in patients with IBD. Patients undergoing IFX‐double switch in eight Centers in Lombardy (Italy) from November 2018 to May 2019 were retrospectively analyzed. The IFX discontinuation rate, incidence and type of adverse events (AEs), and clinical remission rate were recorded. A comparison with a control group of patients with IBD single‐switched from originator IFX to CT‐P13 was performed, before and after an inverse probability of treatment weighting (IPTW)‐based propensity score analysis. Fifty‐two double‐switched patients with IBD were enrolled. The 24‐ and 52‐week proportions of patients continuing on IFX therapy following the second switch (CTP13 → SB2) were 98% (95% confidence interval [CI] 94%–100%) and 90% (95% CI 81%–99%), respectively. Four patients experienced a total of five AEs, all graded 1–3 according to Common Terminology Criteria for Adverse Events (CTCAE). No infusion reactions were observed. The 24‐week and follow‐up end clinical remission rates following the second switch were 94% and 88%, respectively. No differences were observed in the safety and efficacy outcomes by comparing the double‐switch group with a single‐switch group of 66 patients with IBD; all these results were confirmed by IPTW‐adjusted analysis. The study suggests both the safety and efficacy of the double switch from originator IFX to CT‐P13 and SB2 in patients with IBD is maintained. This strategy may be associated with potential cost implications.
Pharmacokinetics and pharmacodynamics of itepekimab in healthy adults and patients with asthma: Phase I first‐in‐human and first‐in‐patient trials
Authors: Kosloski Matthew P. , Kalliolias George D. , Xu Christine R. , Harel Sivan , Lai Ching‐Ha , Zheng Wenjun , Davis John D. , Kamal Mohamed A.
Published: September 2021

Itepekimab is a monoclonal antibody that targets interleukin (IL‐33) and has been shown to reduce airway inflammation and associated tissue damage in preclinical studies. We assessed the safety, tolerability, pharmacokinetics (PKs), and pharmacodynamic profiles of single‐ascending and multiple‐ascending doses of itepekimab in two randomized, double‐blind, placebo‐controlled phase I studies. Healthy adults (N = 40) were randomized to the single‐dose study and patients with moderate asthma (N = 23) to the multiple‐dose study. Itepekimab was administered intravenously (0.3, 1, 3, or 10 mg/kg infusion) or subcutaneously (150 mg) in the single‐dose study and subcutaneously (75 or 150 mg weekly for 4 weeks) in the multiple‐dose study. Itepekimab exhibited linear PKs across studies and dose‐proportional increases in mean maximum concentration in serum and area under the concentration–time curve following single intravenous or multiple subcutaneous doses. Itepekimab demonstrated mean subcutaneous bioavailability of 59–73% and a long terminal half‐life (30.0–31.6 days). IL‐33 concentrations in most healthy participants and patients with asthma were undetectable at baseline. Following administration of itepekimab in both studies, total IL‐33 concentrations increased and blood eosinophils decreased, both with durable effect. Itepekimab was well‐tolerated in both studies with no detection of treatment‐emergent anti‐drug antibody responses.
Urticarial vasculitis: A potential signpost for multisystem inflammatory syndrome in children
Authors: Gosnell Hailey L. , Grider Douglas J.
Published: September 2021

Multisystem inflammatory syndrome in children (MIS‐C) is a rare and serious complication of Sars‐Cov‐2 infection. Dermatologic manifestations are present in the majority of patients. Skin lesions found in children with MIS‐C are classified into four categories: morbilliform, reticulated, scarlatiniform, and urticarial lesions. Clinicopathologic characterization within these categories is limited. Thus, we present a clear example of an urticarial lesion in the context of MIS‐C with well‐documented clinicopathologic phenomena. A previously healthy 16‐year‐old female presented with 3 weeks of an itchy, burning rash initially presenting on her right forearm (and lasting greater than 24 hours without migration) before spreading diffusely. She also reported fever, cough, myalgias, nausea, and vomiting of 4 weeks' duration. Physical examination revealed an edematous, maculopapular, nonblanching, erythematous rash covering the patient's upper extremities, abdomen, back, anterior thighs, and face. The patient tested positive for COVID‐19. A low‐grade leukocytoclastic vasculitis was noted along with intraluminal fibrin and rare microthrombi in vessels of the mid to deep dermis. The patient was diagnosed with MIS‐C and urticarial vasculitis. She was treated with steroids and naproxen for subsequent MIS‐C flares. Dapsone treatment was started for the urticarial vasculitis.
Gradients of genetic diversity and differentiation across the distribution range of a Mediterranean coral: Patterns, processes and conservation implications
Authors: Ledoux Jean‐Baptiste , Ghanem Raouia , Horaud Mathilde , López‐Sendino Paula , Romero‐Soriano Valèria , Antunes Agostinho , Bensoussan Nathaniel , Gómez‐Gras Daniel , Linares Cristina , Machordom Annie , Ocaña Oscar , Templado José , Leblois Raphaêl , Ben Souissi Jamila , Garrabou Joaquim
Published: September 2021

Aim

How historical and contemporary eco‐evolutionary processes shape the patterns of genetic diversity and differentiation across species’ distribution range remains an open question with strong conservation implications. Focusing on the orange stony coral, Astroides calycularis, we (a) characterized the pattern of neutral genetic diversity across the distribution range; (b) gave insights into the underlying processes; and (c) discussed conservation implications with emphasis on a national park located on a hotspot of genetic diversity.

Location

South Mediterranean Sea and Zembra National Park.

Methods

We combined new data from 12 microsatellites in 13 populations located in the Centre and in the Western Periphery of the distribution range with a published dataset including 16 populations from the Western and Eastern Peripheries. We analysed the relationship among parameters of genetic diversity (He, Ar(g)) and structure (population‐specific FST) and two measures of geographic peripherality. We compared two estimators of pairwise genetic structure (GST, DEST) across the distribution range. The evolutionary and demographic history of the populations following the Last Glacial Maximum was reconstructed using approximate Bayesian computations and maximum‐likelihood analyses. We inferred the contemporary connectivity among populations from Zembra National Park and with the neighbouring area of Cap Bon.

Results

We demonstrate a decrease in genetic diversity and an increase in genetic differentiation from the Centre to the Eastern and Western Peripheries of the distribution range. Populations from Zembra show the highest genetic diversity reported in the species. We identified a spillover effect towards Cap Bon.

Main conclusions

The patterns of genetic diversity and differentiation are most likely explained by “the postglacial range expansion hypothesis” rather than the “central–peripheral hypothesis.” Enforcement of conservation measures should be considered to protect this genetic diversity pattern, in particular when considering the low effective population size inferred at many sites.
Long‐term outcomes of standardized colonic stenting using WallFlex as a bridge to surgery: Multicenter prospective cohort study
Authors: Kuwai Toshio , Tamaru Yuzuru , Kusunoki Ryusaku , Yoshida Shuntaro , Matsuzawa Takeaki , Isayama Hiroyuki , Maetani Iruru , Shimada Mamoru , Yamada Tomonori , Saito Shuji , Tomita Masafumi , Koizumi Koichi , Shiratori Toshiyasu , Enomoto Toshiyuki , Saida Yoshihisa
Published: September 2021

Objectives

The oncological outcomes, especially high recurrence rate, of bridge‐to‐surgery (BTS) self‐expandable metallic stent (SEMS) placement remain concerning, emphasizing the necessity of standardized SEMS placement. However, its impact on long‐term BTS outcomes is unknown. We investigated the long‐term outcomes of BTS colonic stenting using standardized SEMS placement.

Methods

This prospective, multicenter cohort study conducted at 46 hospitals in Japan (March 2012 to October 2013) included consecutive patients with stage II and III obstructive colorectal cancer managed with BTS SEMS placement. The SEMS placement technique was standardized by information dissemination among the participating hospitals. The primary outcome was overall survival (OS) after SEMS placement, and the secondary outcomes were relapse‐free survival (RFS), recurrence, and short‐term outcomes of SEMS placement and surgery.

Results

The 1‐, 3‐, and 5‐year OS rates were 94.1%, 77.4%, and 67.4% (Kaplan–Meier), respectively, with high technical success (99.0%, 206/208) and low perforation (1.9%, 4/208) rates. The 1‐, 3‐, and 5‐year RFS rates were 81.6%, 65.6%, and 57.9% (Kaplan–Meier), respectively, and the overall recurrence rate was 31.0% (62/200). The RFS rate was significantly poorer in patients with perforation (n = 4) than in those without perforation (n = 196) (log‐rank P = 0.017); moreover, perforation was identified as an independent factor affecting RFS (hazard ratio 3.31; 95% confidence interval 1.03–10.71, multivariate Cox regression).

Conclusion

This large, prospective, multicenter study revealed satisfactory long‐term outcomes of BTS colonic stenting using a standardized SEMS insertion method, which might be specifically due to the reduced perforation rate. (UMIN000007953).
Interactions between the intestinal microbiota and epigenome in individuals with autism spectrum disorder
Authors: Kushak Rafail I , Sengupta Ashok , Winter Harland S
Published: September 2021

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by variable impairment of cognitive function and interpersonal relationships. Furthermore, some individuals with ASD have gastrointestinal disorders that have been correlated with impairments in intestinal microbiota. Gut microbiota are important not only for intestinal health, but also for many other functions including food digestion, energy production, immune system regulation, and, according to current data, behavior. Disruption of the indigenous microbiota, microbial dysbiosis (imbalance between microorganisms present in the gut), overgrowth of potentially pathogenic microorganisms, a less diverse microbiome, or lower levels of beneficial bacteria in children with ASD can affect behavior. Metabolome analysis in children with ASD has identified perturbations in multiple metabolic pathways that might be associated with cognitive functions. Recent studies have shown that the intestinal microbiome provides environmental signals that can modify host response to stimuli by modifying the host epigenome, which affects DNA methylation, histone modification, and non‐coding RNAs. The most studied microbiota‐produced epigenetic modifiers are short‐chain fatty acids, although other products of intestinal microbiota might also cause epigenetic modifications in the host's DNA. Here we review evidence suggesting that epigenetic alterations caused by modification of gene expression play an important role in understanding ASD.
Hyperbaric oxygen via mediating SIRT1‐induced deacetylation of HMGB1 improved cReperfusion inj/reperfusion injury
Authors: Zhao Peng‐Cheng , Xu Shao‐Nian , Huang Zhen‐Shan , Jiang Guo‐Wei , Deng Peng‐Cheng , Zhang Yong‐Ming
Published: September 2021

Ischemic stroke leads to severe neurological dysfunction in adults. Hyperbaric oxygen (HBO) induces tolerance to cReperfusion inj/reperfusion (I/R) injury. Therefore, our aims were to investigate whether SIRT1 participates in regulatingin the neuro‐protective effect of HBO in a cerebral I/R model and its mechanism. Mice N2a cells were used to construct an oxygen deprivation/reperfusion (OGD/R) model to simulate in vitro brain I/R injury and to evaluate the role of HBO in OGD/R stimulated cells. Cell proliferation was detected using MTT, and apoptosis was determined by flow cytometry. ELISA was used to measure the concentration of TNF‐α, IL‐1β and IL‐6 related inflammatory factors. RT‐qPCR and western blot assays were performed to test the expression of SIRT1. Immunoprecipitation was used to detect acetylation of HMGB1. Expression of SIRT1 was obviously reduced after OGD/R treatment in N2a cells, while SIRT1 was obviously enhanced in HBO treated cells. Moreover, knockdown of SIRT1 induced neuro‐inflammation damage in cells and HBO effectively improved the inflammatory response in OGD/R treated cells by affecting SIRT1 levels. Furthermore, HBO induced the deacetylation of HMGB1 via regulating SIRT1. Interestingly, HBO via regulating the SIRT1‐induced HMGB1 deacetylation and suppressing MMP‐9 improved ischemic brain injury. HBO regulated ischemic brain injury via regulation of SIRT1‐induced HMGB1 deacetylation, making it a potential treatment for ischemic brain injury treatment.
Effect of phosphate sorption on soil pH
Authors: Barrow N. J. , Debnath Abhijit , Sen Arup
Published: September 2021

The effect of reaction between soil and phosphate on pH has not previously been explored or explained. We incubated samples of a soil with calcium carbonate to give a range of from 4.2 to 7.2, and then measured the change in pH when these samples were reacted with phosphate solutions. These solutions were at the same pH as the soil to which they were added. We also measured exchangeable cations and cation exchange capacity. At low pH, reaction with phosphate increased pH; at high pH it decreased it. These effects are a consequence of the way that the charge on the phosphate molecules is distributed. Reaction with phosphate conveys negative charge to the soil. This charge may be located partly on the surface side of the adsorbed phosphorus molecule and partly on the solution side; that is either ‘inside’ or ‘outside’. At low pH the electric potential before reaction is less negative than at higher pH and it is easy to increase the negative charge inside the adsorbed phosphate molecules. Changes in charge inside the phosphorus atom have a large effect on potential; a small amount of charge is required to achieve the necessary electric potential. The charge conveyed to the surface is less than the mean charge of the ions in solution and the pH therefore increases. At high pH, because of the more‐negative potential, it is more difficult to increase the negative charge inside the adsorbed phosphorus atom. A larger fraction of the charge is therefore located outside it. A large amount of charge is required to achieve the necessary electric potential. This charge is greater than the mean charge on the ions in solution and the pH therefore decreases. The cation exchange capacity and the exchangeable cations reflect the charge inside the adsorbed phosphate molecule. At low to medium initial pH, reaction with phosphate did not decrease pH. The decreases in pH that are sometimes observed following application of phosphate are due to ancillary effects.

Highlights

The effect of reaction with phosphate on soil pH is not well understood.

At low pH, reaction with phosphate increased soil pH; at high pH, it decreased it.

These effects occur because the distribution of the charge on adsorbed phosphate changes with pH.

These differences occur because of differences in the electrical potential.
Environmental sound classification using convolution neural networks with different integrated loss functions
Authors: Das Joy Krishan , Chakrabarty Amitabha , Piran Md. Jalil
Published: September 2021

The hike in the demand for smart cities has gathered the interest of researchers to work on environmental sound classification. Most researchers' goal is to reach the Bayesian optimal error in the field of audio classification. Nonetheless, it is very baffling to interpret meaning from a three‐dimensional audio and this is where different types of spectrograms become effective. Using benchmark spectral features such as mel frequency cepstral coefficients (MFCCs), chromagram, log‐mel spectrogram (LM), and so on audio can be converted into meaningful 2D spectrograms. In this paper, we propose a convolutional neural network (CNN) model, which is fabricated with additive angular margin loss (AAML), large margin cosine loss (LMCL) and a‐softmax loss. These loss functions proposed for face recognition, hold their value in the other fields of study if they are implemented in a systematic manner. The mentioned loss functions are more dominant than conventional softmax loss when it comes to classification task because of its capability to increase intra‐class compactness and inter‐class discrepancy. Thus, with MCAAM‐Net, MCAS‐Net and MCLCM‐Net models, a classification accuracy of 99.60%, 99.43% and 99.37% is achieved on UrbanSound8K dataset respectively without any augmentation. This paper also demonstrates the benefit of stacking features together and the above‐mentioned validation accuracies are achieved after stacking MFCCs and chromagram on the x‐axis. We also visualized the clusters formed by the embedded vectors of test data for further acknowledgement of our results, after passing it through different proposed models. Finally, we show that the MCAAM‐Net model achieved an accuracy of 99.60% on UrbanSound8K dataset, which outperforms the benchmark models like TSCNN‐DS, ADCNN‐5, ESResNet‐Attention, and so on that are introduced over the recent years.
Scoping review: Facilitators and barriers in the adoption of teledentistry among older adults
Authors: Tan Sharon Hui Xuan , Lee Cheryl Ker Jia , Yong Chee Weng , Ding Yew Yoong
Published: September 2021

Objective/Background

Access to oral health care among older adults is a key issue in society, which has been exacerbated by social distancing measures and lockdowns during the COVID‐19 pandemic. Older adults would greatly benefit from teledentistry, yet little information exists on the enablers and challenges of adopting this technology for use with this group. The aim of this scoping review is to summarise the applications and key factors associated with the adoption of teledentistry among older adults.

Materials and methods

This scoping review was developed in accordance with Arksey and O’Malley's five‐stage framework and the Joanna Briggs Institute scoping review protocol guidelines. Publications on teledentistry involving direct clinical services for older adults aged 60 and above were included. Publications that focused solely on teleeducation were excluded. A systematic search was carried out on major electronic databases until 25 August 2020. Out of 1084 articles screened, 25 articles were included. Facilitators and barriers were categorised using the socio‐ecological model.

Results/Discussion

Teleconsultation and telediagnosis were the most reported applications of teledentistry among older adults. Reported policy‐level factors were data privacy issues (n = 7) and regulations (n = 17). Community‐level facilitators and barriers included the availability of resources (n = 15) and support (n = 3). Familiar care settings (n = 2) and effective administration (n = 20) were key organisational‐level factors. Staff attitudes and education (n = 23) and individual patient knowledge, attitudes and practices (n = 10) can influence teledentistry adoption while complex medical conditions (n = 8) may pose a challenge.

Conclusion

Key factors in the uptake of teledentistry among older adults span across policy, community, organisational, interpersonal and individual factors. Commonly reported barriers included technical issues, lack of funding, consent issues and cognitive impairments.
The actual and ideal roles of haemophilia treatment centre social workers in the United States and the barriers to ideal roles
Authors: Geary Margaret K. , Kachalsky Ellen , Parnes Aric
Published: September 2021

Introduction

Social Workers (SWs) provide valuable services on multidisciplinary teams of Haemophilia Treatment Centres (HTCs). However, their roles have not been defined and standardized. This paper identifies six major SW roles, including counselling, case management, financial/insurance, outreach/programs, administrative, and grants/research. Roles were further classified as ‘actual’ roles, those that SWs were actively practicing, and ‘ideal’ roles, those that SWs felt were most important for their clients.

Aim

The goal of this study was to determine the actual and ideal roles of HTC SWs and the barriers to ideal roles.

Methods

An online survey was tested with a focus group and then e‐mailed to 147 SWs who were working in the 141 HTCs across the United States.

Results

Fifty‐five percent of the SWs completed the survey. Data revealed that SWs’ most prominent actual role was case management in their work with three client sub‐populations: adult patients, paediatric patients and family members. However, SWs identified counselling as the ideal role that was most important for all client groups. Barriers to practicing ideal roles included lack of SW input, insufficient budgeted time and inadequate training. Salaries were found to be stagnant compared to 2010. Twenty‐five percent of SWs reported no supervision.

Conclusions

Survey results gave evidence that although HTC SWs were primarily engaged in case management roles, they wanted to take on larger counselling roles. Efforts should be made to eliminate barriers to ideal SW roles so that SWs can provide additional psychosocial services for HTC patients.
Lessons learnt from MDM2 fluorescence in‐situ hybridisation analysis of 439 mature lipomatous lesions with an emphasis on atypical lipomatous tumour/well‐differentiated liposarcoma lacking cytological atypia
Authors: Vargas Ana Cristina , Joy Christopher , Cheah Alison L , Jones Martin , Bonar Fiona , Brookwell Ross , Garrone Bernadette , Talbot Joel , Harraway James , Gill Anthony J , Maclean Fiona M
Published: September 2021

Aims

Amplification of the murine double minute‐2 (MDM2) gene, which is usually detected with fluorescence in‐situ hybridisation (FISH), is the key driving event for atypical lipomatous tumours (ALTs)/well‐differentiated liposarcomas (WDLs). We sought to determine the concordance between the histopathological findings and MDM2 FISH in the diagnosis of ALT/WDL, and to identify the histological features of MDM2‐amplified tumours lacking classic atypia.

Methods and results

We performed a retrospective analysis of all mature lipomatous lesions subjected to MDM2 FISH analysis at our institution. MDM2 FISH analysis was performed on 439 mature lipomatous lesions: 364 (82.9%) were negative and 75 (17%) were positive. In 17 of 75 (22.6%) ALTs/WDLs, cytological atypia was not identified on initial histological assessment, thus favouring lipoma. On review, these cases shared common histological features, consisting of a very low number of relatively small stromal cells within the tumour lobules, with mildly coarse chromatin and oval nuclei, admixed with unremarkable adipocytes in a tumour background devoid of fibroconnective septa, areas of fibrosis, or blood vessels. These cells matched the cells in which FISH showed MDM2 amplification. In contrast, 13 cases (3.5%) regarded as suspicious for ALT/WDL on the basis of histology lacked MDM2 amplification and were reclassified following the FISH findings.

Conclusions

We conclude that a subset of lipoma‐like ALTs/WDLs are not associated with any of the features typically described in ALT/WDL. Our study also showed that tumours >100 mm are more likely to be ALT/WDL; however, a history of recurrence or concerning clinical/radiological features was not significantly associated with classification as ALT/WDL.
Study on the protective effect of the dense slag layer on converter lining
Authors: Changhai Lv , Jing Li , Wei Yan , Chen Yan , Renxiang Lv
Published: September 2021

In this paper, the protective effect of the dense slag layer on the furnace lining is investigated through comparative sampling of residual bricks. The physical and chemical properties of the residual brick samples were tested, and the result showed that sample NO.1 had 7.9% higher bulk density, 37.6% lower apparent porosity, 41% higher flexural strength, and 14.3% higher compressive strength than sample NO.2. The residual carbon of sample NO.1 was normal, while the residual carbon oxidation loss rate of sample NO.2 was 36%. X‐ray diffractomer (XRD), optical microscope (OM), and EDS: scanning electron microscope‐Energy Dispersive Spectrometer (SEM+EDS) were adopted to study the physical phase composition, microscopic morphology, and mineral phase composition and distribution of the dense slag layer. The slag layer was found to be highly alkaline and oxidizing, with 58–73% RO phase, 17–26% phosphorus‐rich phase, and 6–16% base phase in the mineral phases. The FactSage 8.1 thermodynamic software was used to simulate and calculate the melting temperature of each mineral phase. The presence of the high melting point phase and RO phase in the dense slag layer is an important reason for its ability against high temperature and high oxidation. The formation of the dense slag layer was related to the saturated solubility of MgO. The results indicated that the extremely unstable saturated solubility of magnesia had a greater effect on the dissolution rate of magnesia particles. External temperature and oxidation changes are important factors affecting the saturated solubility of MgO in the slag layer, and reducing the internal‐external heat and mass transfer rate could effectively improve the service life of the furnace lining.
Effect of zircon surface coating on alumina grog and its influences on the properties of low‐cement castables
Authors: Krishnan M. , Manikandan R. , Thenmuhil D.
Published: September 2021

In this investigation, four types of low‐cement castables (LCC) were prepared with sintered mullite, high alumina grog, unfired, and fired zircon coated on alumina grog. These castables were evaluated in terms of their physical, thermal, and thermomechanical properties. The castables prepared using sintered mullite showed good physical and thermal properties with higher TSR than castables with fired zircon coated on alumina grog due to higher mullite with lower anorthite phases. Fired zircon coated on alumina grog castables were superior with lower corrosion and higher TSR of castables to those of castables with unfired zircon coated on alumina grog and high alumina grog due to formation of zircon and zirconia phases and surface coated on alumina grog gave better corrosion resistance. Castables prepared using unfired zircon coated on alumina grog and high alumina grog showed poorer properties than the other castables due to formation of higher porosity of alumina grog.
Peripheral granular lymphocytopenia and dysmorphic leukocytosis as simple prognostic markers in COVID‐19
Authors: Horiuchi Yuki , Hayashi Fumiaki , Iwasaki Yosuke , Matsuzaki Akihiko , Nishibe Kumiko , Kaniyu Kimiko , Marutani Setsuko , Saito Kaori , Matsuoka Sachiko , Uchihashi Kinya , Miida Takashi , Ai Tomohiko , Tabe Yoko
Published: September 2021

Introduction

Developing prognostic markers can be useful for clinical decision‐making. Peripheral blood (PB) examination is simple and basic that can be performed in any facility. We aimed to investigate whether PB examination can predict prognosis in coronavirus disease (COVID‐19).

Methods

Complete blood count (CBC) and PB cell morphology were examined in 38 healthy controls (HCs) and 40 patients with COVID‐19. Patients with COVID‐19, including 26 mild and 14 severe cases, were hospitalized in Juntendo University Hospital (Tokyo, Japan) between April 1 and August 6, 2020. PB examinations were performed using Sysmex XN‐3000 automated hematology analyzer and Sysmex DI‐60 employing the convolutional neural network‐based automatic image‐recognition system.

Results

Compared with mild cases, severe cases showed a significantly higher incidence of anemia, lymphopenia, and leukocytosis (P < .001). Granular lymphocyte counts were normal or higher in mild cases and persistently decreased in fatal cases. Temporary increase in granular lymphocytes was associated with survival of patients with severe infection. Red cell distribution width was significantly higher in severe cases than in mild cases (P < .001). Neutrophil dysplasia was consistently observed in COVID‐19 cases, but not in HCs. Levels of giant neutrophils and toxic granulation/Döhle bodies were increased in severe cases.

Conclusion

Basic PB examination can be useful to predict the prognosis of COVID‐19, by detecting SARS‐CoV‐2 infection‐induced multi‐lineage changes in blood cell counts and morphological anomalies. These changes were dynamically correlated with disease severity and may be associated with disruption of hematopoiesis and the immunological system due to bone marrow stress in severe infection.
Penicillin Allergy Delabeling Program: an exploratory economic evaluation in the Australian context
Authors: Brusco Natasha K. , Bury Susan , Chua Kyra Y. L. , Vogrin Sara , Holmes Natasha E. , Trubiano Jason A.
Published: September 2021

Background

Internationally, clinical and economic advantages of low‐risk penicillin delabelling have been explored, supporting changes to healthcare delivery systems where penicillin delabelling is embedded into inpatient usual care.

Aims

To determine if economic advantages of low‐risk inpatient penicillin delabelling, described in the international literature, are realised in the Australian context.

Methods

This explorative economic evaluation had prospective patient data collection between January and August 2019, across two Australian health services. Part 1: determine the cost per effectively delabelled patient for Penicillin Allergy Delabeling Program inpatients (PADP cohort) compared with Outpatient Antibiotic Allergy Testing Service outpatients (OAATS cohort). Part 2: a cost analysis to compare hospital costs for inpatients with low‐risk penicillin allergy who did (PADP cohort) and did not (usual care cohort) undergo PADP delabelling.

Results

Part 1: the PADP (n = 350) and OAATS (n = 27 patients, n = 36 individual visits) cohorts were comparable. In PADP, costs/proportion delabelled was $20.10/0.98, equating to $20.51 per effectively delabelled patient; in OAATS, it was $181.24/0.50, equating to $362. Compared with OAATS, PADP was associated with savings of $341.97 per effectively delabelled patient, indicating the outpatient testing was the dominated strategy, being more costly and less effective. Part 2: the PADP (n = 218) and usual care (n = 32) cohorts were comparable. Significantly favouring the delabelled PADP cohort, the mean difference per patient was −4.41 days (95% confidence interval: −7.64, −1.18) and −$9467.72 (95% confidence interval: −$15 419.98, −$3515.46).

Conclusions

Consistent with international literature, delabelling low‐risk penicillin allergies in the inpatient setting had economic advantages in the Australian context. Fully powered economic evaluations are urgently required to consolidate these findings.
Prediction accuracy of commonly used pneumonia severity scores in Aboriginal patients with severe community‐acquired pneumonia: a retrospective study
Authors: Tsai Danny , Secombe Paul , Chiong Fabian , Ullah Shahid , Lipman Jeffrey , Hewagama Saliya
Published: September 2021

Background

Severe community‐acquired pneumonia (SCAP) is highly prevalent in the Aboriginal population. Few pneumonia severity scores are validated in this population.

Aims

To assess the prediction accuracy of pneumonia severity scores in Aboriginal patients with SCAP and to identify risk factors for poor prognosis.

Methods

Retrospective cohort study examining Aboriginal patients admitted to the intensive care unit with confirmed SCAP between January 2011 and December 2014. Severity scores were calculated for SMARTCOP (systolic blood pressure, multi‐lobar, albumin, respiratory rate, tachycardia, confusion, oxygenation and arterial pH), SMARTACOP (systolic blood pressure, multi‐lobar, albumin, respiratory rate, tachycardia, Aboriginal status, confusion, oxygenation and arterial pH), CURB‐65 (confusion, urea, respiratory rate, blood pressure and age ≥65 years), pneumonia severity index, Infectious Diseases Society of America and American Thoracic Society SCAP, and Acute Physiology and Chronic Health Evaluation (APACHE) II/III using medical records. Prediction accuracy of 30‐day mortality and requirement for intensive respiratory and/or vasoactive support (IRVS) were assessed using logistic regression and the area under the receiver operating characteristic curve (AUROC). Multivariate analysis was used to test associations between poor prognosis and demographic/clinical variables.

Results

A total of 203 cases (49% women) was identified. Thirty‐day mortality was 6.4% (n = 13), and 53% (n = 107) required IRVS. None of the tested pneumonia severity scores accurately predicted mortality. SMARTCOP and SMARTACOP predicted IRVS requirement with the highest diagnostic accuracy, but only achieved acceptable discrimination (P <0.001 and <0.001; AUROC = 0.74 and 0.75 respectively). APACHE II/III predicted both mortality (P = 0.003 and 0.001; AUROC = 0.74 and 0.73 respectively) and IRVS requirement (P <0.001 and <0.001; AUROC = 0.72 and 0.73 respectively). Multivariate analysis associated mortality with male gender, cirrhosis, immunosuppression and acidaemia, and IRVS requirement with multi‐lobar pneumonia, hypotension and tachypnoea. Multivariate analysis for mortality and IRVS requirement achieved an AUROC of 0.93 and 0.87 respectively.

Conclusion

None of the pneumonia severity scores accurately predicted mortality. We recommend SMARTACOP to predict IRVS requirement in Aboriginal patients with SCAP. Given Aboriginal patients are over‐represented in Australian intensive care units, a new score is warranted for this understudied population.
Low rates of venous thromboembolism in hospitalised COVID‐19 patients: an Australian experience
Authors: Ong Jeremy , Walker Patricia , Singh Kasha P. , Bishop Emma , Htun Kay
Published: September 2021

Background

Venous thromboembolic (VTE) complications appear common in hospitalised COVID‐19 patients, particularly among critically ill patients in intensive care units. However, there is significant heterogeneity in the reported use of thromboprophylaxis.

Aims

The primary objective was to determine rates of symptomatic VTE in hospitalised COVID‐19 patients. Secondary objectives were to assess adherence to an institutional risk‐adapted thromboprophylaxis guideline, and rates of bleeding complications.

Methods

A retrospective, single‐centre, cohort study was performed in consecutive hospitalised COVID‐19 patients over a 6‐month period (March to August 2020). Enoxaparin was used as thromboprophylaxis in all patients without a contraindication, with dose adjusted according to disease severity, weight and renal function.

Results

Among 86 hospitalised COVID‐19 patients, no VTE were identified. Eighty‐one (94%) patients received anticoagulation, with 90% adherence to institutional thromboprophylaxis guidelines. Four bleeding events occurred, with one clinically relevant non‐major bleeding event and three minor bleeding events.

Conclusion

Low rates of VTE were identified in hospitalised COVID‐19 patients using a risk‐adapted thromboprophylaxis protocol.
Do peripheral protein oligomers in neurodegenerative diseases shape T cell responses beyond the brain?
Authors: Ferguson Annabelle , Milling Simon
Published: September 2021

Neurodegenerative diseases place a devastating burden on affected individuals and their families, and new treatments are desperately needed for these common immune‐mediated inflammatory conditions. While large aggregates of abnormal proteins in the brain cause significant damage, it is becoming clear that smaller soluble protein aggregates can also contribute to disease, by both direct and indirect mechanisms. These soluble protein oligomers can be found in patients' serum. Here, we describe recent research that identifies effects of model oligomer molecules on peripheral blood T cells, therefore providing an additional mechanism by which neurodegeneration may be worsened through amplification of peripheral adaptive immune responses.
Synthesis‐condition recommender system discovers novel inorganic oxides
Authors: Hayashi Hiroyuki , Kouzai Keita , Morimitsu Yuta , Tanaka Isao
Published: September 2021

Accurately predicting successful synthesis conditions to prepare new pseudo‐binary oxides remains a challenge despite extensive research. This study presents a synthesis‐condition recommender system to efficiently explore a wide chemistry space composed of 10 206 pseudo‐binary oxide compositions. As a training dataset, we systematically performed 1542 synthesis experiments by a polymerized complex method. The results were organized into a tensor‐type database. Then we scored 66 150 unexperimented synthesis conditions by the tensor‐decomposition method and arranged the results in the order of increasing predicted score. We selected 300 synthesis conditions from the top predictions of unexperimented compositions and verified the predictive performance by conducting additional experiments. The fraction of successful syntheses was approximately proportional to the predicted scores, validating the synthesis‐condition recommender system. Additionally, the synthesis experiments for the high‐scored conditions led to the discovery of two yet‐to‐be‐found pseudo‐binary oxides: La4V2O11 and La7Sb3O18. La4V2O11 and La7Sb3O18 have similar crystal structures to γ‐Bi4V2O11 and La7Ru3O18, respectively. The synthesis‐condition recommender system gave higher predicted scores to the successful synthesis conditions of those materials.
A qualitative content analysis study using electronic medical records to understand youth suicide attempts
Authors: Piper Karen , Young Cara C. , V. Jones Kristian , Lawson Karla A. , Wesson Catherine L. , Barczyk Amanda N.
Published: September 2021

Problem

Suicide is the second leading cause of death for people aged 10–24 in the United States. The purpose of this study was to examine circumstances youth self‐reported when presenting to hospitals due to a suicide attempt.

Methods

A qualitative content analysis of clinicians' notes identified major themes of patients' lived experiences and circumstances leading up to suicide attempt.

Findings

A total of 231 unique patient encounters were included in this study. Mean age of participants was 14.71 (SD = 2.04) the majority being female (75%) and Non‐Hispanic White (48%). Four themes characterized contributing factors: (1) trauma, (2) relationship quality, (3) risky behaviors, and (4) personal emotions and symptoms.

Conclusions

Findings suggest commonalities among these youths' circumstances and experiences which may have precipitated a suicide attempt. These data will aid nurses and other health‐care providers in understanding the complex, and often traumatic, histories of youth who attempt suicide. Improved knowledge in this area has the potential to direct improved screening, treatment, and referral protocols as well as suggest areas to focus prevention efforts.