bluuebunny/crossref_metadata_2025 huggingface dataset:
Al‐Ghoryeen: An Early Bronze Age settlement in central Oman peninsula
Authors: Al‐Jahwari Nasser S. , Douglas Khaled A. , Hesein Mohamad A.
Published: June 2020

Al‐Ghoryeen, located 95 km southwest of Muscat, is a unique settlement dating to the Umm an‐Nar period and is built upon a Late Hafit period settlement. It was found in 2004 and excavation began in 2018. Preliminary analysis of the results revealed two major occupation phases with an occupational gap in between. A change occurred between the earlier and later phases of the settlement system reflected mainly in the difference in building sizes and plan. We excavated either partially or completely a stone round tower and more than 10 domestic structures. The distribution of the architectural features including the round tower, domestic structures and burials showed some kind of organised settlement structure. The Hafit period settlement was tested in two trenches where 14C analysis dated the earliest occupation to the late Hafit period.
Reply to Linnenluecke, Shen, Smith, Zhu, and Liang (2020)
Authors: Johnstone David
Published: June 2020

When the firm changes its operating leverage it becomes a different firm with a different payoff distribution from its operations. Its CAPM market value can therefore be higher or lower, as can its cost of capital. Its market value is not independent of its operating leverage in the way that its firm value is independent (under MM) of its debt to equity financing ratio. Changes in debt to equity do not affect the firm's operations, whereas changes in operating leverage are designed to do exactly that.
Etomidate Use Is Associated With Less Hypotension Than Ketamine for Emergency Department Sepsis Intubations: A NEAR Cohort Study
Authors: Mohr Nicholas M. , Pape Stephen G. , Runde Dan , Kaji Amy H. , Walls Ron M. , Brown Calvin A.
Published: June 2020

Objective

The objectives of this study were 1) to describe the current use of etomidate and other induction agents in patients with sepsis and 2) to compare adverse events between etomidate and ketamine in sepsis.

Methods

This was an observational cohort study of the prospective National Emergency Airway Registry (NEAR) data set. Descriptive statistics were used to report the distribution of induction agents used in patients with sepsis. Adverse events were compared using bivariate analysis, and a sensitivity analysis was conducted using a propensity score–adjusted analysis of etomidate versus ketamine.

Results

A total of 531 patients were intubated for sepsis, and the majority (71%) were intubated with etomidate as the initial induction agent. Etomidate was less frequently used in sepsis patients than nonsepsis patients (71% vs. 85%, odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.4 to 0.5). Sepsis patients had a greater risk of adverse events, and vasopressor therapy was required for 25% of patients after intubation. Postprocedure hypotension was higher between those intubated for sepsis with ketamine versus etomidate (74% vs. 50%, OR = 2.9, 95% CI = 1.9 to 4.5). After confounding by indication in the propensity score–adjusted analysis was accounted for, ketamine was associated with more postprocedure hypotension (OR = 2.7, 95% CI = 1.1 to 6.7). No difference in emergency department deaths was observed.

Conclusions

Etomidate is used less frequently in sepsis patients than nonsepsis patients, with ketamine being the most frequently used alternative. Ketamine was associated with more postprocedural hypotension than etomidate. Future clinical trials are needed to determine the optimal induction agent in patients with sepsis.
Surgery as a safe and effective treatment option for spheno‐orbital meningioma: a systematic review and meta‐analysis of surgical techniques and outcomes
Authors: Fisher Fleur L. , Zamanipoor Najafabadi Amir H. , Schoones Jan W. , Genders Stijn W. , van Furth Wouter R.
Published: June 2020

Purpose

The effectiveness and safety of surgery for spheno‐orbital meningiomas remains subject of debate, as studies often describe different surgical approaches and reconstruction techniques with very heterogeneous outcomes. We aimed to systematically summarize and analyse the literature on spheno‐orbital meningiomas regarding presenting symptoms, surgical techniques, outcomes and complications.

Methods

Studies were retrieved from eight databases. Original articles were included if in ≥5 patients presenting symptoms, surgical treatment and outcomes were described. Fixed‐ and random‐effects meta‐analysis was performed to estimate weighted percentages with 95%CIs of presenting symptoms, outcomes and complications.

Results

Thirty‐eight articles were included describing 1486 patients. Proptosis was the most common presenting symptom (84%; 95%CI 76–91%), followed by unilateral visual acuity deficits (46%; 95%CI 40–51%) and visual field deficits (31%; 95%CI 20–43%). In 35/38 studies (92%), a pterional craniotomy was used. Decompression of the optic canal (82%) and the superior orbital fissure (66%) was most often performed, and usually dural (47%) and bony defects (76%) were reconstructed. In almost all patients, visual acuity (91%; 95%CI 86–96%), visual fields (87%; 95%CI 70–99%) and proptosis (96%; 95%CI 90–100%) improved. Furthermore, surgery showed improvement in 96% (95%CI 78–100%) for both diplopia and ophthalmoplegia. The most common surgical complications were hypesthesia (19%; 95%CI 10–30%), ptosis and diplopia (both 17%; 95%CI, respectively, 10–26% and 5–33%) and ophthalmoplegia (16%; 95%CI 10–24).

Conclusion

Patients with spheno‐orbital meningioma usually present with proptosis or unilateral decreased visual acuity. Surgery shows to be effective in improving visual acuity and visual field deficits with mostly minor and well‐tolerated complications.
Outcomes of pattern scanning laser trabeculoplasty and selective laser trabeculoplasty: Results from the lausanne laser trabeculoplasty registry
Authors: Elahi Sina , Rao Harsha L. , Paillard Archibald , Mansouri Kaweh
Published: June 2020

Purpose

To compare the long‐term safety and efficacy of pattern scanning laser trabeculoplasty (PSLT) and selective laser trabeculoplasty (SLT).

Methods

This was a retrospective database analysis (Lausanne Laser Trabeculoplasty Registry) of patients having had laser trabeculoplasty (LT) prior to 2017 with a minimum follow‐up of 1 year. Inclusion criteria were age ≥40 years and diagnosis of ocular hypertension (OHT) and open‐angle glaucoma (OAG). Selective laser trabeculoplasty (SLT) eyes were matched to PSLT eyes according to baseline intraocular pressure (IOP), baseline number of ocular hypotensive medications (OHM) and glaucoma diagnosis. Success was defined as an IOP ≤ 20% from baseline or an IOP equal or lower than baseline accompanied by a reduction in OHM. Multivariate regression models were used to study associations between success and baseline clinical parameters.

Results

From 280 eyes in the database, 81 eyes had PSLT and were matched with 81 SLT eyes (162 patients). Mean age was 69.4 ± 12.1 years, and 56.2% were female. Mean IOP was 18.6 ± 5.3 and 18.2 ± 4.1 mmHg at baseline and 15.9 ± 3.0 and 16.0 ± 3.4 mmHg at 12 months and 15.2 ± 2.7 and 16.2 ± 3.4 mmHg at 24 months, for PSLT and SLT, respectively. 60.5% of PSLT and 65.4% of SLT eyes achieved treatment success (p = 0.20). Number of OHM was 1.0 ± 1.0 and 1.4 ± 1.2, respectively (p = 0.052). Baseline IOP (OR = 1.23, p < 0.01) and number of OHM (OR = 1.67, p < 0.01) were associated with success in both PSLT and SLT, while LT modality was not [OR = 0.81 (0.43–1.53), p = 0.52], and a diagnosis of primary OAG was negatively associated (OR = 0.42, p = 0.04).

Conclusion

Our study did not find any significant differences between PSLT and SLT in terms of safety and efficacy in patients with OHT and glaucoma. Baseline IOP was associated with higher success rates in both procedures. Additional studies are needed to evaluate the outcomes of PSLT in non‐Caucasian populations and the ability of repeat PSLT to achieve additional IOP reduction.
Mechanisms coupling sodium and magnesium reabsorption in the distal convoluted tubule of the kidney
Authors: Franken Gijs A. C. , Adella Anastasia , Bindels René J. M. , de Baaij Jeroen H. F.
Published: June 2020

Hypomagnesaemia is a common feature of renal Na+ wasting disorders such as Gitelman and EAST/SeSAME syndrome. These genetic defects specifically affect Na+ reabsorption in the distal convoluted tubule, where Mg2+ reabsorption is tightly regulated. Apical uptake via TRPM6 Mg2+ channels and basolateral Mg2+ extrusion via a putative Na+‐Mg2+ exchanger determines Mg2+ reabsorption in the distal convoluted tubule. However, the mechanisms that explain the high incidence of hypomagnesaemia in patients with Na+ wasting disorders of the distal convoluted tubule are largely unknown. In this review, we describe three potential mechanisms by which Mg2+ reabsorption in the distal convoluted tubule is linked to Na+ reabsorption. First, decreased activity of the thiazide‐sensitive Na+/Cl− cotransporter (NCC) results in shortening of the segment, reducing the Mg2+ reabsorption capacity. Second, the activity of TRPM6 and NCC are determined by common regulatory pathways. Secondary effects of NCC dysregulation such as hormonal imbalance, therefore, might disturb TRPM6 expression. Third, the basolateral membrane potential, maintained by the K+ permeability and Na+‐K+‐ATPase activity, provides the driving force for Na+ and Mg2+ extrusion. Depolarisation of the basolateral membrane potential in Na+ wasting disorders of the distal convoluted tubule may therefore lead to reduced activity of the putative Na+‐Mg2+ exchanger SLC41A1. Elucidating the interconnections between Mg2+ and Na+ transport in the distal convoluted tubule is hampered by the currently available models. Our analysis indicates that the coupling of Na+ and Mg2+ reabsorption may be multifactorial and that advanced experimental models are required to study the molecular mechanisms.
Mutations in the Drosophila rough deal gene affecting RZZ kinetochore function
Authors: Menant Alexandra , Karess Roger E.
Published: June 2020

Background

The RZZ complex, composed of the proteins Rough‐Deal (Rod), Zw10 and Zwilch, plays a central role in the spindle assembly checkpoint (SAC), which assures proper sister chromatid segregation during mitosis. RZZ contributes to the regulation of the spindle assembly checkpoint by helping to recruit Mad1–Mad2 and the microtubule motor dynein to unattached kinetochores. It is an important component of the outer kinetochore and specifically the fibrous corona whose expansion is believed to facilitate microtubule capture. How RZZ carries out its diverse activities is only poorly understood. The C‐terminal region of the Rod subunit is relatively well‐conserved across metazoan phylogeny, but no function has been attributed to it.

Results

To explore the importance of the Rod_C domain in RZZ function in Drosophila, we generated a series of point mutations in a stretch of 200 residues within this domain and we report here their phenotypes. Several of the mutations profoundly disrupt recruitment of RZZ to kinetochores, including one in a temperature‐sensitive manner, while still retaining the capacity to assemble into a complex with Zw10 and Zwilch. Others affect aspects of dynein activity or recruitment at the kinetochore.

Conclusions and Significance

These results suggest that the Rod_C domain participates in the protein interactions necessary for RZZ recruitment and functionality at kinetochores.
Retracted: Allopregnanolone restores the tyrosine hydroxylase‐positive neurons and motor performance in a 6‐OHDA‐injected mouse model
Authors: Chen Zhi‐Chi , Wang Tong‐Tong , Bian Wei , Ye Xin , Li Meng‐Yi , Du Juan‐Juan , Zhou Peng , Cui Huai‐Rui , Ding Yu‐Qiang , Ren Yan‐hua , Qi Shuang‐Shuang , Yuan Yuan‐Yuan , Liao Min , Sun Chen‐You
Published: June 2020

Aims

It has been reported that allopregnanolone (APα) promotes the neurogenesis of the neural progenitor cells (NPCs) in the subventricular zone (SVZ) and prevents the decrease of dopaminergic neurons in 6‐hydroxydopamine (6‐OHDA)‐treated mice by binding to γ‐aminobutyric acid A receptor (GABAAR) and then opening voltage‐gated L‐type Ca2+ channel, but the underlying mechanisms remain elusive. The aim of this study was to explore the possible involvement of GABAAR and calcium/calmodulin‐dependent protein kinase II delta 3 (CaMKIIδ3) in this process.

Methods

6‐OHDA‐treated mice and primary cultured midbrain cells were administrated with APα and GABAAR antagonist bicuculline (Bic), and the proliferation and differentiation of NPCs, the tyrosine hydroxylase (TH)‐positive neurons and their fibers, the expression levels of CaMKIIδ3 and brain‐derived neurotrophic factor (BDNF), and motor functions were measured using ELISA, immunohistochemical staining, real‐time RT‐PCR, Western blot, and behavioral test.

Results

Allopregnanolone significantly promoted the phosphorylation of cytoplasmic CaMKIIδ3 and its nuclear translocation by binding to GABAAR, which, in turn, increased the expression levels of BDNF. This may account for the findings that the exogenous APα enhanced the proliferation and differentiation of NPCs, and ameliorated the nigrostriatal system and behavioral performance in 6‐OHDA‐treated mice.

Conclusions

Allopregnanolone may directly activate GABAAR, which, in turn, enhance the proliferation and differentiation of NPCs via upregulating the expression levels of CaMKIIδ3, and finally contribute to the restoration of dopaminergic neurons in 6‐OHDA‐treated mice.
Rubber Dam Isolation Survey (RDIS) for adhesive restorative treatments
Authors: Abreu‐Placeres Ninoska , Yunes Fragoso Paula , Cruz Aponte Paola , Garrido Luis Eduardo
Published: June 2020

Introduction

Rubber dam isolation is considered as an essential component of modern adhesive dentistry. However, dental students do not always use it due to several barriers they face on their clinical practice. The aim of this study was to design and validate a questionnaire based on the COM‐B model to measure students' implementation of rubber dam isolation in restorative treatments with adhesive materials.

Materials and methods

A 7‐item questionnaire was developed based on the COM‐B model, with questions measuring the Capability, Opportunity (Relevance and Resources), and Motivation to perform rubber dam isolation (Behaviour). Content validation of the questionnaire was conducted by experts in aesthetic/restorative dentistry that assessed the clarity, coherence and relevance of the questions. The final survey was administered to a dental student population from three large private universities in the Dominican Republic. Descriptive analysis, t tests, polychoric correlations and a path analysis were carried out to establish the validity of the instrument.

Results

A total of 382 students from three universities completed the questionnaire. According to the COM‐B path model, the significant predictors of the implementation of rubber dam isolation were Capability and Motivation for University A, Motivation and Opportunity‐Resources for University B, and Opportunity‐Relevance and Capability for University C.

Conclusions

The RDIS is a very short, easy to administer and valid questionnaire that can be applied by the universities to determine where they need to focus their interventions to achieve better rubber dam isolation implementation by their students.
How to improve reliability of cut‐off scores in dental competency exam: A comparison of rating methods in standard setting
Authors: Kim Jooah , Yang Ji Seung
Published: June 2020

Aim

The aim of this study was to find ways to improve reliability of cut‐off scores that are typically used to make high‐stake decisions in dental education by empirically comparing two different rating methods, Yes/No and Percentage methods.

Material and Methods

The two rating methods are commonly used when the Angoff's method is applied to determine a cut‐off score that divides the examinees into minimally competent group (pass) and incompetent group (fail). The expert panel data were collected using both methods from 11 to 13 panel members in two consecutive years, respectively; The data were analysed within the generalisability theory framework to quantify relative influences of each factor (eg panel, item, rating rounds) on the variability of cut‐off scores, standard error of measurement and panel agreement.

Results

The results suggest that (a) the two methods can make a substantial difference in overall success rates for college senior students, (b) item‐related variance components are generally large and whilst rater‐related variance components are small, (c) standard errors of measurement for the cut‐off scores decreased from Cohort 1 to Cohort 2 as the number of items are increased and as the expert panel members are more trained and (d) the Percentage method yielded higher agreement amongst the panel in both years. The results provide practical guidelines for dental educators who make efforts to control the quality of final competency exams and cut‐off scores with respect to standard setting practices and panel data analysis.

Conclusion

It can be concluded that evaluations with Percentage method results in more reliable outcomes compared to those with Yes/No method when criterion‐referenced assessment is applied to determine the cut‐off scores of competency tests at schools.
Between a rock and a hard place: adaptive sensing and site‐specific dispersal
Authors: Nichols Bethany S. , Leubner‐Metzger Gerhard , Jansen Vincent A. A.
Published: June 2020

Environmental variability can lead to dispersal: why stay put if it is better elsewhere? Without clues about local conditions, the optimal strategy is often to disperse a set fraction of offspring. Many habitats contain environmentally differing sub‐habitats. Is it adaptive for individuals to sense in which sub‐habitat they find themselves, using environmental clues, and respond plastically by altering the dispersal rates? This appears to be done by some plants which produce dimorphic seeds with differential dispersal properties in response to ambient temperature. Here we develop a mathematical model to show, that in highly variable environments, not only does sensing promote plasticity of dispersal morph ratio, individuals who can sense their sub‐habitat and respond in this way have an adaptive advantage over those who cannot. With a rise in environmental variability due to climate change, our understanding of how natural populations persist and respond to changes has become crucially important.
Evaluation of the neuroprotective effect of donepezil in type 2 diabetic rats
Authors: Gomaa Adel A. , Makboul Rania M. , El‐Mokhtar Mohamed A. , Abdel‐Rahman Engy A. , Ahmed Esraa A. , Nicola Mariam A.
Published: June 2020

Recent studies raise the possibility that donepezil can delay the progression of Alzheimer’s disease (AD). This research evaluated the efficacy of donepezil in an animal model with brain insulin resistance and AD‐like alterations. Rats were fed with high‐fat/high‐fructose (HF/Hfr) diet during the study period (17 weeks) and received one injection of streptozotocin (STZ) (25 mg/kg) after 8 weeks of starting the study. Diabetic (T2D) rats were treated with donepezil (4 mg/kg; p.o.) or vehicle for 8 weeks after STZ injection. The influence of donepezil on AD‐related behavioral, biochemical, and neuropathological changes was investigated in T2D rats. Treatment of diabetic rats with donepezil led to a significant decrease in both amyloid‐β deposition and the raised hippocampal activity of cholinesterase (ChE). It significantly increased the suppressed glutamate receptor expression (AMPA GluR1 subunit and NMDA receptor subunits NR1, NR2A, NR2B). It also improved cognitive dysfunction in the passive avoidance and the Morris water maze tests. However, donepezil treatment did not significantly decrease the elevated levels of P‐tau, caspase‐3, GSK‐3β, MDA, TNF‐α, and IL‐1β in the hippocampus of diabetic rats. Also, it did not restore the suppressed levels of glutathione and superoxide dismutase in the brain of these rats. Moreover, donepezil did not alter the elevated serum level of glucose, insulin, and total cholesterol. These findings suggest that donepezil treatment could ameliorate learning and memory impairment in T2D rats through reversal of some of the AD‐related alterations, including reduction of amyloid‐β burden and ChE activity as well as restoration of glutamate receptor expression. However, lack of any significant effect on P‐tau load, oxidative stress, neuroinflammation, and insulin resistance raises the question about the ability of donepezil to delay the development or arrest the progression of T2D‐induced AD and it is still a matter of debate that requires further studies.
Impacts of co‐occurring environmental changes on Alaskan stream fishes
Authors: Murdoch Alyssa , Mantyka‐Pringle Chrystal , Sharma Sapna
Published: June 2020

Freshwater fishes are now facing unprecedented environmental changes across their northern ranges, especially due to rapid warming occurring at higher latitudes. However, empirical research that examines co‐occurring environmental effects on northern fish communities remains limited.

We used fish community data from 1587 Alaskan stream sites to examine the potential combined and interacting effects of climate change, current weather, habitat, land use, and fire on two community‐level metrics (species richness, relative abundance), and on the distributions of three Alaskan fish species.

Our models were 71–76% accurate in predicting the distribution of Alaskan stream fishes using a combination of climate and habitat variables. In contrast to other freshwater ecosystems that are most threatened by land use pressures, we did not detect any evidence for the potential stress of anthropogenic land use or fire on stream fishes.

Warming temperatures increased overall community richness and abundance but produced differing responses at the species level. Juvenile salmon presence was positively associated with several climate variables including warmer spring and autumn temperatures and wetter summers. In comparison, warmer seasonal temperatures contributed to declines for northern‐adapted species such as Arctic grayling and Dolly Varden.

This study highlights the overarching role of current and changing climate in regulating northern stream fish biodiversity. Although many fish species may benefit from climate change across their northern ranges, localised declines are likely to occur and may prove detrimental for communities with limited fishing portfolios. Climate change adaptation and mitigation strategies customised for rapidly changing northern ecosystems will play an essential role in preserving ecologically unique northern species.
Estimation of vital population rates to assess the relative health of mussel assemblages in the Upper Mississippi River
Authors: Newton Teresa J. , Zigler Steve J. , Schrank Patricia R. , Davis Mike , Smith David R.
Published: June 2020

Native freshwater mussels are a guild of benthic, filter feeding invertebrates that perform important ecological functions in rivers. Because of their long lifespans (30–50 years or longer), mussels are slow to respond to human‐induced alterations. Thus, development of sensitive indicators of mussel population responses to river conditions and management would be beneficial. Compared to marine species, estimation of vital rates (e.g. survival, growth) in freshwater mussels has received little attention.

We placed passively integrated transponder tags on 578 mussels of four species (Amblema plicata, Cyclonaias pustulosa, Obliquaria reflexa, and Pleurobema sintoxia) in a well‐studied mussel assemblage in a side channel of the upper Mississippi River. Growth and survival of tagged mussels were assessed annually for 4 years across core (high density) and peripheral (low density) areas of the assemblage.

Overall survival was highly variable, ranging from c. 15 to 90%, and was related to life history, habitat quality, and hydrologic events. Survival, which varied significantly among species and over time, was consistently higher in the dense and species‐rich core of the mussel assemblage, relative to the periphery because substrates were consistently more stable in the core of the mussel bed relative to the periphery. Substrate movement during low flows was an order of magnitude lower in the core relative to the periphery, and survival was inversely related to stability of river substrates. Patterns in habitat‐specific survival indicate source–sink population dynamics such that mussels in the core habitat provide recruitment to the periphery, but mussels in the periphery are subject to unsustainably low survival; additional studies to track the source of recruitment in the periphery are needed to test this hypothesis.

Growth rate did not vary significantly between core and peripheral areas but did vary by species. Growth rate (proportional change per year) declined with age, and was similar at mean age for A. plicata (0.016 per year), P. sintoxia (0.015 per year), and C. pustulosa (0.013 per year), but much lower for O. reflexa (0.008 per year).

Effective management decisions for mussels requires a better understanding of how vital rates govern populations and how they vary across a suite of physical and biological factors. Information on how population vital rates vary among species and over time gives managers another tool to understand how mussels may respond to management actions such as habitat restoration projects. Given the importance of substrate stability inferred from this study, management actions that maintain or increase substrate stability are likely to result in high quality mussel assemblages and may restore a valuable component of ecosystem function in this region.
Efficacy and safety of a new rifabutin‐based triple therapy with vonoprazan for refractoryHelicobacter pyloriinfection: A prospective single‐arm study
Authors: Hirata Yoshihiro , Yamada Atsuo , Niikura Ryota , Shichijo Satoki , Hayakawa Yoku , Koike Kazuhiko
Published: June 2020

Background

A small proportion ofHelicobacter pylori‐infected individuals in Japan suffer failure of eradication therapy with third‐line regimens containing the potent acid suppressor, vonoprazan, and a quinolone.

Objectives

This prospective study evaluated the efficacy and safety of rifabutin‐based triple therapy with vonoprazan for refractoryH pyloriinfection.

Methods

Patients who failedH pylorieradication by clarithromycin‐based first‐line, metronidazole‐based second‐line, and sitafloxacin‐based third‐line therapies were recruited. After obtaining informed consent, patients received eradication therapy with vonoprazan (20 mg), amoxicillin (750 mg), and rifabutin (150 mg) twice daily for 10 days. Eradication was confirmed by a negativeH pyloristool antigen or urea breath test at least 8 weeks after the end of therapy.

Results

Nineteen patients were included in the study. All of the patients completed the course of medication. Eradication ofH pyloriwas confirmed in all of the patients (19/19; 100%, 95% confidence interval; 83‐100%). The most common adverse event was soft stool/diarrhea (4/19, 21%). No severe adverse event was observed.

Conclusions

Ten‐day rifabutin with amoxicillin and vonoprazan triple therapy appears to be effective and safe for refractoryH pyloriinfections. However, considering the recent publications showing high eradication rates with vonoprazan amoxicillin dual therapy, confirmation will require future studies comparing our new therapy with vonoprazan‐amoxicillin dual with similar doses and duration and with vonoprazan‐rifabutin dual therapy.
Patient enablement after a consultation with a general practitioner—Explaining variation between countries, practices and patients
Authors: Tolvanen Elina , Groenewegen Peter P. , Koskela Tuomas H. , Bjerve Eide Torunn , Cohidon Christine , Kosunen Elise
Published: June 2020

Background

Patient enablement is a concept developed to measure quality in primary health care. The comparative analysis of patient enablement in an international context is lacking.

Objective

To explain variation in patient enablement between patients, general practitioners (GPs) and countries. To find independent variables associated with enablement.

Design

We constructed multi‐level logistic regression models encompassing variables from patient, GP and country levels. The proportions of explained variances at each level and odds ratios for independent variables were calculated.

Setting and Participants

A total of 7210 GPs and 58 930 patients in 31 countries were recruited through the Quality and Costs of Primary Care in Europe (QUALICOPC) study framework. In addition, data from the Primary Health Care Activity Monitor for Europe (PHAMEU) study and Hofstede's national cultural dimensions were combined with QUALICOPC data.

Results

In the final model, 50.6% of the country variance and 18.4% of the practice variance could be explained. Cultural dimensions explained a major part of the variation between countries. Several patient‐level and only a few practice‐level variables showed statistically significant associations with patient enablement. Structural elements of the relevant health‐care system showed no associations. From the 20 study hypotheses, eight were supported and four were partly supported.

Discussion and Conclusions

There are large differences in patient enablement between GPs and countries. Patient characteristics and patients’ perceptions of consultation seem to have the strongest associations with patient enablement. When comparing patient‐reported measures as an indicator of health‐care system performance, researchers should be aware of the influence of cultural elements.
Instantanés de la situation des jeunes générations sur le marché du travail aux Pays‐Bas
Authors: BEKKER Sonja , POP Ioana
Published: June 2020

La relation de travail Ṣtypiqueṣ perd du terrain aujourd'hui. Les jeunes sont particulièrement touchés par cette évolution. Dans ce contexte, les auteures examinent dans le détail le parcours d'insertion des générations arrivées sur le marché du travail des Pays‐Bas entre 1985 et 2014, en procédant sur le modèle de l'analyse séquentielle des parcours de vie. Avec deux indicateurs spécifiques (niveau d'entropie et de turbulence), elles montrent que la trajectoire des cohortes qui s'insèrent après 2000, notamment en 2008, est effectivement plus accidentée, et ce malgré la politique de flexisécurité à l'honneur dans le pays. Les transitions vers l'emploi stable sont l'exception plutôt que la règle.
Defect chemistry of A site nonstoichiometry and the resulting dielectric behaviors in SrxTi0.985(Nb2/3Zn1/3)0.015O3 ceramics
Authors: Pan Wengao , Cao Minghe , Hao Hua , Yao Zhonghua , Yu Zhiyong , Liu Hanxing
Published: June 2020

Defect chemistry of Sr site nonstoichiometry in SrxTi0.985(Nb2/3Zn1/3)0.015O3 ceramics and the resulting effects on the structure and dielectric behavior are systematically investigated by experiment and density functional theory (DFT) methods. The results indicate that, appropriate Sr deficiency benefits the dielectric properties and grain growth due to the creation of Sr vacancy. While Sr excess deteriorates the dielectric properties and inhibits the grain growth by forming a Ruddlesden‐Popper structure. In Sr‐deficient sample, more point defects arise and aggregate into defect clusters, resulting in great changes in local structures and the enhancement of dielectric properties. The Sr vacancy benefits the generation of oxygen vacancy, thus facilitating the localization of electrons and the decrease in dielectric loss. Besides, the electronic polarization and structural polarization are also improved by Sr vacancy and the resultant oxygen vacancy, leading to the further enhanced dielectric properties. These findings may facilitate the development of defect engineering towards novel multifunctional electronic materials.
Grain size engineered Ba0.9Sr0.1Ti0.9Hf0.1O3‐Na0.5Bi0.5TiO3 relaxor ceramics with improved energy storage performance
Authors: Jain Aditya , Wang Yingang , Guo Hao , Wang Neng
Published: June 2020

Novel lead‐free diphasic (1‐x)Ba0.9Sr0.1Ti0.9Hf0.1O3‐xNa0.5Bi0.5TiO3 (BSTH‐NBT) ceramic nanocomposites were synthesized via an economically viable modified mechano‐chemical activation technique. In the present investigation, we have developed an energy storage composite material by systematically optimizing the charge transport behavior and charge storage characteristics between the ferroelectric BSTH and piezoelectric NBT phase. The composite with x = 0.09 NBT concentration has shown the best energy storage properties with 1.61 J/cm3 discharge energy density along with 80.1% energy efficiency. The BSTH and NBT had a synergetic effect on the ferroelectric properties of the composites. The improvement in ferroelectric and piezoelectric properties along with excellent aging characteristics in composite materials is mainly attributed to enhancement in microstructural density, grain boundary interface, and stress effects. The improved dispersibility and excellent compatibility between BSTH and NBT phase have resulted in approximately 20% enhancement in breakdown strength of composite compared to pure BSTH ceramic.
Comparison of a 1064‐nm neodymium‐doped yttrium aluminum garnet picosecond laser using a diffractive optical element vs. a nonablative 1550‐nm erbium‐glass laser for the treatment of facial acne scarring in Asian patients: a 17‐week prospective, randomized, split‐face, controlled trial
Authors: Kwon H.H. , Yang S.H. , Cho Y.J. , Shin E. , Choi M. , Bae Y. , Jung J.Y. , Park G.‐H.
Published: June 2020

Background

Novel picosecond lasers using a diffractive optical element (P‐DOE) have been available for skin resurfacing with distinct mechanisms. However, there are limited data directly comparing P‐DOE and conventional fractional lasers for the treatment of atrophic acne scarring.

Objectives

We sought to compare the efficacy and safety of a 1064‐nm neodymium‐doped yttrium aluminium garnet P‐DOE and a non‐ablative fractional laser (NAFL) in the treatment of acne scarring.

Methods

A prospective, randomized, split‐face, controlled trial was performed. One randomly assigned half‐side of each patient’s face (n = 25) was treated with four consecutive sessions of P‐DOE at 3‐week intervals and the other side with NAFL, with subsequent follow‐up for 8 weeks after the final sessions. The efficacy and safety of the two lasers were determined by the Echelle d'Evaluation Clinique des Cicatrices d'acné (Scale of Clinical Evaluation of Acne Scars; ECCA) grading scale, Investigator’s Global Assessment (IGA) score and patients’ reports at the final visit. Histologic analysis was also performed.

Results

The P‐DOE‐treated side achieved a significantly better improvement in acne appearance (ECCA per cent reduction: 55% vs. 42%) with less severe pain (4.3 vs. 5.6) (P < 0.05). The IGA score and subjective satisfaction were consistent with ECCA score results. Occurrences of treatment‐related side‐effects were also lower in the group treated with P‐DOE (P < 0.05). Histologic analysis revealed elongation and increased density of neocollagen fibres, elastic fibres and mucin throughout the dermis from both sides.

Conclusions

Compared with NAFL, P‐DOE afforded better clinical outcomes and fewer side‐effects in the treatment of acne scarring in Asian patients.
Change in sexual signalling traits outruns morphological divergence across an ecological gradient in the post‐glacial radiation of the songbird genusJunco
Authors: Friis Guillermo , Milá Borja
Published: June 2020

The relative roles of natural and sexual selection in promoting evolutionary lineage divergence remains controversial and difficult to assess in natural systems. Local adaptation through natural selection is known to play a central role in promoting evolutionary divergence, yet secondary sexual traits can vary widely among species in recent radiations, suggesting that sexual selection may also be important in the early stages of speciation. Here, we compare rates of divergence in ecologically relevant traits (morphology) and sexually selected signalling traits (coloration) relative to neutral structure in genome‐wide molecular markers and examine patterns of variation in sexual dichromatism to explore the roles of natural and sexual selection in the diversification of the songbird genusJunco(Aves: Passerellidae). Juncos include divergent lineages in Central America and several dark‐eyed junco (J. hyemalis) lineages that diversified recently as the group recolonized North America following the last glacial maximum (ca. 18,000 years ago). We found an accelerated rate of divergence in sexually selected characters relative to ecologically relevant traits. Moreover, sexual dichromatism measurements suggested a positive relationship between the degree of colour divergence and the strength of sexual selection when controlling for neutral genetic distance. We also found a positive correlation between dichromatism and latitude, which coincides with the geographic axis of decreasing lineage age in juncos but also with a steep ecological gradient. Finally, we found significant associations between genome‐wide variants linked to functional genes and proxies of both sexual and natural selection. These results suggest that the joint effects of sexual and ecological selection have played a prominent role in the junco radiation.
Post‐orthodontic recontouring of anterior teeth using composite injection technique with a digital workflow
Authors: Hosaka Keiichi , Tichy Antonin , Motoyama Yasuji , Mizutani Koji , Lai Wei‐Jen , Kanno Zuisei , Tagami Junji , Nakajima Masatoshi
Published: June 2020

Objective

Restorative treatment of anterior teeth is often required as the final step of orthodontic therapy to optimize the esthetics and function. This case report presents a direct minimally invasive approach for post‐orthodontic recontouring of anterior teeth using the composite injection technique with a digital workflow.

Clinical considerations

The extraction of central incisors with short roots was indicated to resolve maxillary anterior crowding. The gained space was closed with lateral incisors, and it was necessary to recontour them and canines to resemble central and lateral incisors, respectively. The restorations were digitally designed, and a transparent silicone index was fabricated from a 3D‐printed cast of the digital wax‐up. After lateral incisors and canines were bonded with a universal adhesive in the etch‐and‐rinse mode, a highly filled injectable composite resin was applied into the index. The restorative treatment was preceded by gingivectomy using an Er:YAG laser and home bleaching.

Conclusions

In cases where more complex recontouring of anterior teeth is necessary, the composite injection technique could be a suitable alternative to indirect restorations, because it is straightforward, cost‐effective, and does not require any preparation. The digital workflow simplified and expedited the treatment while contributing to its precision.

Clinical Significance

Post‐orthodontic recontouring using direct composite restorations is well accepted by patients due to low cost and non‐invasiveness. However, in complicated cases, the free‐hand technique is time‐consuming and technique‐sensitive. The presented composite injection technique with a digital workflow significantly simplifies and expedites the composite placement while predictably enhancing the treatment outcome.
First observations of intersex development in paddlefish Polyodon spathula
Authors: Schooley Jason D. , Geik Adam , Scarnecchia Dennis L.
Published: June 2020

This study reports the first cases of intersex (abnormal development of both male and female reproductive tissues in a gonad) paddlefish Polyodon spathula, an Acipenseriform species of large rivers in the central U.S. and in aquaculture worldwide. Despite a large, multi‐decadal data set in Oklahoma, Montana, and North Dakota, intersex development was not observed until 2019, when two individuals were harvested from the Grand Lake/Neosho River stock in Oklahoma. This suggests that intersex development in mid‐water, zooplanktivorous paddlefish is rarer than in bottom‐dwelling sturgeons for which intersex development is regularly observed. Although contaminants are implicated in causing intersex development in other Acipenseriformes, more investigation is needed.
Rising prevalence of colonic diverticulosis in a westernized multi‐ethnic Asian community
Authors: Soh Yu Sen Alex , Ooi Shu Qin Delicia , Chan Yiong Huak , Siah Tien‐Ho Kewin , Lee Soh‐Ee , Lee Wei Jie Jonathan , Zhu Feng , Yeoh Khay Guan , Gwee Kok‐Ann
Published: June 2020

Background and Aim

Singapore is a multi‐ethnic country that has undergone rapid development over the last few decades, with increasing influence of western culture, and faces an aging population. Previously, a varying prevalence of colonic diverticulosis (CD) was reported by a few small studies. This study aims to evaluate the prevalence of CD in Singapore and identify associations with common gastrointestinal symptoms and risk factors.

Methods

We reviewed retrospective data of 20 395 consecutive colonoscopies performed from 2006 to 2016 for presence of CD and indications of screening, diarrhea, constipation, and abdominal pain.

Results

The prevalence of CD progressively increased from 2006 to 2016 (14.9% vs 23.9%, adjusted trend < 0.001), with an overall prevalence of 19.6%. Patients with CD were older and had higher body mass index (BMI). CD was significantly more prevalent in Chinese compared with Malay and Indian races (20.5% vs 18.9% vs 15.5%, P < 0.05), and in male patients compared with female patients (21.5% vs 17.6%, P < 0.05). Right‐sided CD was more common than left‐sided or pan diverticulosis (16.2% vs 8.3% vs 4.8%, P < 0.05). Age [odds ratio (OR), 1.060; 95% confidence interval (CI), 1.052–1.068], BMI (OR, 1.051; 95% CI, 1.028–1.075), male gender (OR, 1.317; 95% CI, 1.084–1.600), and abdominal pain (OR, 1.409; 95% CI, 1.168–1.699) were positively associated, while constipation (OR, 0.566; 95% CI, 0.452–0.709) was negatively associated with CD.

Conclusion

The prevalence of CD in Singapore has progressively increased over the last decade and is associated with older age, higher BMI, and abdominal pain. These findings may provide insights for healthcare resource planning in the region.
Endoscopic ultrasound‐guided cyanoacrylate injection to prevent rebleeding in hepatocellular carcinoma patients with variceal hemorrhage
Authors: Tang Raymond S Y , Kyaw Moe H , Teoh Anthony Y B , Lui Rashid N S , Tse Yee‐Kit , Lam Thomas Y T , Chan Stephen L , Wong Vincent W S , Wu Justin C Y , Lau James Y W , Sung Joseph J Y
Published: June 2020

Background and Aim

Secondary prophylaxis (SP) of variceal rebleeding was reported to improve outcomes of hepatocellular carcinoma (HCC) patients, but the optimal endoscopic approach is not well defined. We compared outcomes in HCC patients who underwent SP by endoscopic ultrasound‐guided cyanoacrylate obturation (EUS‐CYA) versus no SP.

Methods

Between 2014 and 2018, 30 consecutive patients with inoperable HCC and recent endoscopically controlled variceal bleeding were prospectively recruited. Twenty‐seven patients with persistent varices ≥ 3 mm on endoscopic ultrasound underwent EUS‐CYA for SP. Thirty‐three HCC patients treated by esophagogastroduodenoscopy‐guided CYA obturation (EGD‐CYA) alone for acute variceal bleeding between 2009 and 2013 were identified from a prospective gastrointestinal bleed registry as standard of care controls for comparison. Outcome measures were death‐adjusted cumulative incidence of rebleeding, bleeding‐free survival, technical success, and procedure‐related adverse events of EUS‐CYA.

Results

The majority of patients in both groups had advanced HCC, portal vein thrombosis, and Child–Pugh B cirrhosis. EUS‐CYA was successful in all 27 patients with no radiographic evidence of cyanoacrylate–lipiodol embolization. Significantly lower 30‐ and 90‐day death‐adjusted cumulative incidence of rebleeding (14.8% vs 42.4%, P = 0.023 and 18.5% vs 60.6%, P = 0.002, respectively) and significantly higher variceal bleeding‐free survival at 3 and 6 months (51.9% vs 21.2%, P = 0.009, 40.7% vs 15.2%, P = 0.010, respectively) were observed in the EUS‐CYA group when compared with standard of care group.

Conclusions

Secondary prophylaxis by EUS‐CYA reduced rebleeding rate and improved variceal bleeding‐free survival in patients with inoperable HCC and variceal bleeding when compared with no SP. Randomized studies are needed to confirm the benefits of EUS‐CYA for this difficult‐to‐treat population.
Metabolic functions of prolactin: Physiological and pathological aspects
Authors: Lopez‐Vicchi Felicitas , De Winne Catalina , Brie Belen , Sorianello Eleonora , Ladyman Sharon R. , Becu‐Villalobos Damasia
Published: June 2020

Prolactin is named after its vital role of promoting milk production during lactation, although it has been implicated in multiple functions within the body, including metabolism and energy homeostasis. Prolactin has been hypothesised to play a key role in driving many of the adaptations of the maternal body to allow the mother to meet the physiological demands of both pregnancy and lactation, including the high energetic demands of the growing foetus followed by milk production to support the offspring after birth. Prolactin receptors are found in many tissues involved in metabolism and food intake, such as the pancreas, liver, hypothalamus, small intestine and adipose tissue. We review the literature examining the effects of prolactin in these various tissues and how they relate to changes in function in physiological states of high prolactin, such as pregnancy and lactation, and in pathological states of hyperprolactinaemia in the adult. In many cases, whether prolactin promotes healthy metabolism or leads to dysregulation of metabolic functions is highly dependent on the situation. Overall, although prolactin may not play a major role in regulating metabolism and body weight outside of pregnancy and lactation, it definitely has the ability to contribute to metabolic function.
Morphological plasticity in the kelpNereocystis luetkeana(Phaeophyceae) is sensitive to the magnitude, direction, and location of mechanical loading
Authors: Coleman Liam J. M. , Martone Patrick T.
Published: June 2020

Nereocystis luetkeanais a canopy‐forming kelp that exhibits morphological plasticity across hydrodynamic gradients, producing broad, undulate blades in slow flow and narrow, flattened blades in fast flow, enabling thalli to reduce drag while optimizing photosynthesis. While the functional significance of this phenomenon has been well studied, the developmental and physiological mechanisms that facilitate the plasticity remain poorly understood. In this study, we conducted three experiments to characterize how the (1) magnitude, (2) direction, and (3) location of plasticity‐inducing mechanical stimuli affect the morphology ofNereocystisblades. We found that applying a gradient of tensile force caused blades to grow progressively longer, narrower, less ruffled, and heavier in a linear fashion, suggesting thatNereocystisis equally well adapted for all conditions within its hydrodynamic niche. We also found that applying tension transversely across blades caused the growth response to rotate 90°, indicating that there is no substantial separation between the sites of stimulus perception and response and suggesting that a long‐distance signaling mechanism, such as a hormone, is unlikely to mediate this phenomenon. Meristoderm cells showed morphological changes that paralleled those of their respective blades in this experiment, implying that tissue‐level morphology is influenced by cell growth. Finally, we found that plasticity was only induced when tension was applied directly to the growing tissue, reinforcing that long‐distance signaling is probably not involved and possibly indicating that the mechanism on display generally requires an intercalary meristem to facilitate mechanoperception.