bluuebunny/crossref_metadata_2025 huggingface dataset:
Current and experimental therapeutics for Fabry disease
Authors: Castelli Vanessa , Stamerra Cosimo Andrea , d'Angelo Michele , Cimini Annamaria , Ferri Claudio
Published: May 2021

Fabry (or Anderson‐Fabry) is a rare pan‐ethnic disease affecting males and females. Fabry is an X‐linked lysosomal storage disease, affecting glycosphingolipid metabolism, that is caused by mutations of theGLAgene that codes for α‐galactosidase A. Fabry disease (FD) can be classified into a severe, classical phenotype, most often seen in men with no residual enzyme activity, that usually appear before 18 years and a usually milder, nonclassical (later‐onset) phenotype that usually appear above 18 years. Affected patients show multifactorial complications, including renal failure, cardiovascular problems, and neuropathy. In this review, we briefly report the clinical trials so far performed with the available therapies, and then we focus on the in vitro and the in vivo experimental models of the disease, to highlight the relevance in improving the existing therapeutics and understand the mechanism of this rare disorder. Current available in vivo and in vitro models can assist in better comprehension of the pathogenesis and underlying mechanisms of FD, thus the existing therapeutic approaches can be optimized, and new options can be developed.
Patient factors related to early implant failures in the edentulous jaw: A large retrospectivecase–controlstudy
Authors: Malm Malin Olsson , Jemt Torsten , Stenport Victoria Franke
Published: May 2021

Background

Dental implants provide anchorage for dental prostheses to restore functions for individuals with edentulous jaws. During the healing phase, proper osseointegration is required to prevent early implant failure. More knowledge is needed regarding factors related to early failure of dental implants.

Purpose

The aim of the present study was to identify possible risk factors for early implant failure, with respect to anamnestic and clinical parameters.

Materials and Methods

All patients with edentulous jaws with early implant failure (n = 408) from one referral clinic were compared with a matched control group (n = 408) with no implant failure.

Early implant failure was identified during the first year of prosthetic function. Matching was performed on age, gender, year of surgery, type of jaw, and type of implant surface. In addition, data on anamnestic and clinical parameters were collected. The data were analyzed with a multivariable logistic regression model using early implant failure as the binary outcome.

Results

Five anamnestic factors were statistically significant with respect to higher probability for early implant failure: systemic disease, allergies in general, food allergies, smoking, and intake of analgesic medication. Four clinical conditions (i.e., implants in the opposing jaw, low primary stability, reduced bone volume, and healing complications) were also related to higher probability for early implant failure.

Conclusions

This study identified nine factors associated with early implant failure, several related to patient's general health. Further investigations are needed to fully understand the causality between the obtained variables and early implant failure.
Assessment of bone density and stability with immediately loaded dental implants with the All‐on‐Four technique in free vascularized fibular grafts used for mandibular reconstruction
Authors: Shawky Mohamed , Elbeialy Ramy R. , Khashaba Mohammed M. , Zedan Mohamed H.
Published: May 2021

Background

Following free fibula flaps (FFF) reconstruction of mandibular defects the patients need an early dental rehabilitation to regain their masticatory function and enhance their feeding and nutrition.

Methods

This study included 10 patients, with mandibular defects previously reconstructed with FFF that span the area between the two mandibular angles. They received a full arch fixed restoration supported by four implants using a pilot drilling guide to perform a flapless operation. The stability of the placed dental implants was assessed along with the changes in bone density.

Results

There was a statistically significant increase in stability after 3 and 6 months, and there was a decrease in density after 6 months. The patient satisfaction improved over the follow‐up period.

Conclusion

The All‐on‐Four technique is reliable and economic for early functional rehabilitation of resected jaws reconstructed with FFF; however, further studies are needed to investigate the changes in fibula bone density over time and with function.
Extended duration of faecal diversion is associated with increased ileus upon loop ileostomy reversal
Authors: Guidolin Keegan , Jung Flora , Spence Richard , Quereshy Fayez , Chadi Sami A.
Published: May 2021

Aim

The timing of ileostomy reversal has been the subject of controversy, with researchers investigating the safety of early versus late stoma closure. Anecdotally, a longer duration of faecal diversion is associated with a greater incidence of postoperative ileus. We sought to investigate the association between duration of diversion and postoperative ileus.

Method

We conducted an institutional retrospective cohort study on 173 patients undergoing ileostomy closure between 2012 and 2018. Our primary outcome was ileus; secondary outcomes included postoperative complications and descriptive factors. We investigated the association between duration of diversion and ileus using several analyses to ensure that time was treated appropriately as a continuous, nonlinear variable.

Results

In all, 20.2% of patients had an ileus. Multivariate analysis did not identify a significant association between any independent predictors and ileus, although there was a trend towards increased risk of ileus with increasing duration of diversion. When treated as a categorical variable, a duration of diversion >328 days independently increased the odds of ileus (OR = 3.25, P = 0.033). Duration of diversion was associated with days to first flatus and to first diet (P = 0.025 and P = 0.004, respectively). When patients received nasogastric intubation, the mean duration of intubation was 3.2 days.

Conclusion

Greater duration of diversion was associated with a trend towards increased risk of ileus; this risk tripled when diversion lasted more than 328 days.
Vigilant or avoidant? Children's temperamental shyness, patterns of gaze, and physiology during social threat
Authors: Poole Kristie L. , Schmidt Louis A.
Published: May 2021

Temperamental shyness is characterized by fear, wariness, and the perception of threat in response to social novelty. Previous work has been inconsistent regarding attentional patterns to social threat among shy children, with evidence for both avoidance and vigilance. We examined relations between children's shyness and gaze aversion during the approach of a stranger (i.e., a context of social novelty), and tested whether these patterns of gaze moderated relations between shyness and autonomic reactivity and recovery. Participants included 152 typically‐developing children (Mage = 7.82 years, SD = 0.44 years) who had their respiratory sinus arrhythmia (RSA) recorded during baseline, social novelty, and recovery. Children's shyness correlated with increases in self‐reported nervousness from baseline to social novelty, providing support for perceived threat. Results revealed that children's proportion of gaze aversion from social novelty was related to shyness in a U‐shape pattern such that both low levels of gaze aversion (i.e., attentional vigilance) and high levels of gaze aversion (i.e., attentional avoidance) were related to higher levels of shyness. Further, we found that children's shyness was directly related to decreases in RSA from baseline to social novelty, whereas quadratic gaze to social novelty moderated the relation between shyness and RSA recovery. Specifically, shyness was related to greater RSA recovery among children who exhibited attentional vigilance during the novel social interaction. Our findings provide support for both avoidance of, and vigilance to, social threat among different shy children, and these gaze strategies may be differentially related to physiological regulation during novel social encounters.
A real‐world study of user characteristics, safety and efficacy of open‐source closed‐loop systems and Medtronic 670G
Authors: Jeyaventhan Roshell , Gallen Geraldine , Choudhary Pratik , Hussain Sufyan
Published: May 2021

We report a real‐world evaluation of the first commercially approved automated insulin delivery (AID) system, MiniMed 670G (670G), and open source‐automated insulin delivery (OS‐AID) systems. This was undertaken as a retrospective observational study in adults with type 1 diabetes using AID systems for 6 months or longer in a publicly funded health service using clinically validated data. Sixty‐eight adults (38 670G, 30 OS‐AID systems) were included. OS‐AID system users were younger, had a shorter diabetes duration and a higher education status. OS‐AID systems displayed a significantly better change in HbA1c (median −0.9% [−0.4%, −1.1%] vs. −0.1% [IQR −0.7%, 0.2%], P = .004) and time in range 3.9‐10 mmol/L (mean 78.5%, SD ± 12.0% vs. 68.2% ± 14.7%, P = .024) compared with 670G. Both systems showed minimal hypoglycaemia, with OS‐AID systems revealing significantly improved secondary outcomes of mean glucose and percentage of time more than 10 mmol/L, with a higher percentage of time of less than 3 mmol/L. OS‐AID system users displayed improved glycaemic outcomes with no clinical safety concerns compared with 670G, although higher weight‐adjusted insulin dose and weight gain were noted. The study highlights key differences in OS‐AID system user characteristics that are important for interpreting real‐world findings from recent OS‐AID system studies.
Impact of age on the cumulative risk of transformation in patients with chronic myelomonocytic leukaemia
Authors: Machherndl‐Spandl Sigrid , Jäger Eva , Barna Agnes , Gurbisz Michael , Marschon Renate , Graf Temeida , Graf Elmir , Geissler Christoph , Hoermann Gregor , Nösslinger Thomas , Pfeilstöcker Michael , Bettelheim Peter , Zach Otto , Weltermann Ansgar , Heibl Sonja , Thaler Josef , Zebisch Armin , Sill Heinz , Stauder Reinhard , Webersinke Gerald , Kusec Rajko , Ulsperger Ernst , Schneeweiss Bruno , Öhler Leopold , Germing Ulrich , Valent Peter , Tüchler Heinz , Geissler Klaus
Published: May 2021

In older patients with chronic myelomonocytic leukaemia (CMML) and limited life expectancy due to age and or comorbidities, it is particularly important to consider the risk of transformation for individualised treatment decisions. There is limited information on potential differences between younger and older CMML patients regarding the cumulative risk of transformation as well as haematological, molecular and biologic characteristics. We analysed data from the Austrian Biodatabase for CMML (ABCMML) to compare these parameters in 518 CMML patients. Categorisation of patients into 3 age‐related groups: <60 years, 60‐79 years and ≥80 years, showed a significantly lower risk of transformation at higher age by competing risk analysis, with a 4‐year risk of 39%, 23% and 13%, respectively (P < .0001). The lower probability of transformation was associated with a lower percentage of blast cells in the peripheral blood (PB) of older patients. Furthermore, we provide a simple score based on age, PB blasts and platelet counts that allowed us to define subgroups of CMML patients with a different cumulative transformation risk, including a low‐risk group with a transformation risk of only 5%. Our findings may facilitate reasonable treatment decisions in elderly patients with CMML.
Parasite management in aquaculture exerts selection on salmon louse behaviour
Authors: Coates Andrew , Johnsen Ingrid A. , Dempster Tim , Phillips Ben L.
Published: May 2021

The evolution of pest resistance to management strategies is a major challenge for farmed systems. Mitigating the effects of pest adaptation requires identifying the selective pressures imposed by these strategies. In Atlantic salmon (Salmo salar) aquaculture, barriers are used to prevent salmon louse (Lepeophtheirus salmonis) larvae (copepodids) from entering salmon cages. These barriers are effective against shallow‐swimming copepodids, but those swimming deeper can pass underneath and infest salmon. Laboratory experiments suggest that depth regulation in copepodids is a variable behavioural trait with a genetic basis. We used biological–hydrodynamic dispersal models to assess how this trait variation alters the dispersion of lice through the ocean environment and into farms. The dispersal of copepodids with 3 behavioural phenotypes (deep, mean or shallow) was modelled over winter–spring and spring–summer periods in a Norwegian fjord system with intensive aquaculture. The infestation pressure of each phenotype on barrier cages was estimated from their modelled depth distributions: copepodids deeper than 10 m were predicted to successfully pass underneath barriers. The deep phenotype was the most abundant below 10 m and reached infestation pressures 3 times higher than that of the mean phenotype. In contrast, the shallow phenotype infestation pressure reached less than half that of the mean phenotype. These differences in relative fitness indicate that barriers can impose strong directional selection on the swimming behaviour of copepodids. The strength of this selection varied seasonally and geographically, with selection for the deep phenotype stronger in winter–spring and at coastal locations than in spring–summer and within fjords. These findings can be applied across farms to slow louse adaptation, by limiting barriers during situations of strong selection, although this must be balanced against trade‐offs to short‐term efficacy. More broadly, our study highlights new ways in which dispersal models can address evolutionary questions crucial for sustainable parasite management in aquaculture.
Use of the French national health insurance information system for research in the field of mental health: Systematic review and perspectives
Authors: Revet Alexis , Moulis Guillaume , Raynaud Jean‐Philippe , Bui Eric , Lapeyre‐Mestre Maryse
Published: May 2021

Purpose

This systematic review registered in PROSPERO (CRD42021225296) aimed to describe the use of the French national health insurance information system, which covers the entire French population (67 million inhabitants), for research in the field of mental health.

Methods

Three electronic databases and a journal hand‐search identified 15 265 articles from January 1, 2003 (year of creation of the database) to October 31, 2020. Studies of any design were eligible for inclusion provided that they (i) made use of at least one component of the French health insurance database and (ii) focused on a topic in near and far connection with the field of mental health in France. Database used, design and methods, study period, population, key findings, and type of use for medical research were described.

Results

A total of 152 studies were included in the review analysis. There was an increase in the number of published articles over time throughout the studied period. Studies focusing on adults (n = 139) largely outnumbered those focusing on children and adolescents (n = 11). Pharmacoepidemiological studies were by far the most frequent (n = 123), followed by methodological studies (n = 23), epidemiological studies (n = 17), and health economics studies (n = 3). The most studied psychotropic drugs were antidepressants (n = 27), anxiolytics (n = 27), and opioids (n = 25) while fewer studies focused on methylphenidate (n = 6) and on mood stabilizers (n = 5). Few studies specifically focused on psychiatric disorders, mainly depression (n = 4), suicide (n = 4), and psychotic disorders (n = 3).

Conclusion

This systematic review highlighted a relatively poor exploitation of the Système national des données de santé database in the field of psychiatric research with regard to the great possibilities it offers, with a clear lag in certain fields such as epidemiological or health economics studies and in specific populations, in particular children and adolescents.
Epithelial‐to‐mesenchymal‐like transition events in melanoma
Authors: Pedri Dennis , Karras Panagiotis , Landeloos Ewout , Marine Jean‐Christophe , Rambow Florian
Published: May 2021

Epithelial‐to‐mesenchymal transition (EMT), a process through which epithelial tumor cells acquire mesenchymal phenotypic properties, contributes to both metastatic dissemination and therapy resistance in cancer. Accumulating evidence indicates that nonepithelial tumors, including melanoma, can also gain mesenchymal‐like properties that increase their metastatic propensity and decrease their sensitivity to therapy. In this review, we discuss recent findings, illustrating the striking similarities—but also knowledge gaps—between the biology of mesenchymal‐like state(s) in melanoma and mesenchymal state(s) from epithelial cancers. Based on this comparative analysis, we suggest hypothesis‐driven experimental approaches to further deepen our understanding of the EMT‐like process in melanoma and how such investigations may pave the way towards the identification of clinically relevant biomarkers for prognosis and new therapeutic strategies.
Bottom‐up reconstitution of focal adhesion complexes
Authors: Schumacher Stephanie , Vazquez Nunez Roberto , Biertümpfel Christian , Mizuno Naoko
Published: May 2021

Focal adhesions (FA) are large macromolecular assemblies relevant for various cellular and pathological events such as migration, polarization, and metastatic cancer formation. At FA sites at the migrating periphery of a cell, hundreds of players gather and form a network to respond to extra cellular stimuli transmitted by the integrin receptor, the most upstream component within a cell, initiating the FA signaling pathway. Numerous cellular experiments have been performed to understand the FA architecture and functions; however, their intricate network formation hampers unraveling the precise molecular actions of individual players. Here, in vitro bottom‐up reconstitution presents an advantageous approach for elucidating the FA machinery and the hierarchical crosstalk of involved cellular players.
Fossils explained 80
Authors: Donovan Stephen K.
Published: May 2021

Consider the humble fossilized length of crinoid column, possibly one of the least desired of all fossils, yet locally extremely common, particularly in certain Palaeozoic sequences. While disregarded by the uninformed collector, a well‐preserved pluricolumnal can yield unexpected data on crinoid palaeoecology and taphonomy. A puzzle of crinoid preservation has now been solved by reference to a crinoid preserving a unique suite of features.
Do liberals want curbside pickup more than conservatives? Contactless shopping as protectionary action against the COVID‐19 pandemic
Authors: Kim Naeun Lauren , Im Hyunjoo
Published: May 2021

Consumers showed a dramatically increased interest in contactless shopping in reaction to the COVID‐19 pandemic. Based on the protection motivation theory, this study investigated how contactless shopping grew as a protectionary action against COVID‐19. Findings from a nationwide online survey (n = 311) confirmed the impact of politicization of the pandemic on consumer responses for contactless shopping intention and the significance of threat and coping appraisals in taking protectionary actions. This study adds knowledge to the existing literature on contactless shopping and protection motivation theory. Results imply that retailers must invest in contactless shopping and provide an in‐store shopping environment that prioritizes the health and safety of shoppers and employees to decrease the threat of virus infection during shopping. However, in doing so, retailers are recommended to develop different marketing strategies regarding contactless shopping based on consumers' political orientations.
Are we born and do we die without nevi? A cross‐sectional study
Authors: Di Brizzi Eugenia Veronica , Pampena Riccardo , Licata Gaetano , Calabrese Giulia , Longo Caterina , Argenziano Giuseppe
Published: May 2021

Background

It is well known that the number of nevi varies with age. However, there are a few data in the literature concerning total nevus count at different ages. The aim of this study was to assess and compare the total nevus count among different age groups.

Methods

The total nevus count was assessed in consecutive patients belonging to nine age groups. Median nevus count was calculated and compared for each age group. Multivariate logistic regression analysis was used to define the influence of sex and phototype on the association between nevus count and age.

Results

We enrolled 900 patients (461, 51.2% females), with a median age of 46 years and a total of 18,136 nevi. Significant differences were found in the median total nevus count among all age groups (P < 0.001), with a significant increase in the first two decades and a significant decrease after the age of 50 years. A similar trend was also observed in subgroups. The differences observed in the total body nevus count among age groups were independent of sex and phototype.

Conclusions

We demonstrate that the total nevus count significantly increases during childhood and gradually decreases in the elderly.
The effects of external supervision on social workers’ engagement and perceived self‐efficacy: A quasi‐experimental study
Authors: Põder Kaire , Merkuljeva Tiina
Published: May 2021

External supervision is an expanding practice among social workers noted by many authors. However, the empirical evidence of its impact on work efficiency is mixed at best. In the current study, we empirically test the effect of external supervision on social workers’ work engagement and perceived self‐efficacy. Our treatment consists of five external supervision sessions. The survey instrument is designed to test the theoretical premises, allowing us to collect before and after data from the treatment and control group and construct a structural equation model for latent constructs such as engagement and self‐efficacy. Our sample consists of 73 social workers. We estimate treatment effects using differences‐in‐differences technique. After controlling for observable self‐selection, we show that external supervision has a weak positive effect on engagement but no effect on self‐efficacy. The mechanism—whether the content and length of the treatment are important—is under discussion. A weak positive effect of supervision on engagement is present only in the case of those who continued treatment in all five sessions.
A capacity index to replace flawed incident‐based metrics for worker safety
Authors: DEKKER Sidney W.A. , TOOMA Michael
Published: May 2021

The shortcomings of incident‐based metrics for worker safety such as total recordable incident frequency rate (TRIFR) are well documented. In particular, a low TRIFR is no assurance against legal liability. There is considerable overlap between the literature on safety as the presence of capacities to make things go well, and jurisprudence in labour and workplace safety law on employer due diligence. In this article, the authors propose an index that merges the two, measuring the capacities to acquire and maintain safety knowledge, to understand the nature of operations, to resource for safety, to respond to risks, to demonstrate engagement and compliance, and for assurance.
Identity, nationhood and migrations to Turkey from the Balkans, 1950–1960
Authors: Erken Ali
Published: May 2021

The article examines identity politics in Turkey through migrations from the Balkans in the early years of Cold War. Despite secularisation reforms in the 1920s and 1930s, Muslim identity remained a central component in the formation of Turkish nationhood. In the wake of WW II, Turkey chose to be a part of Western world whereas her two regional neighbours, Bulgaria and Yugoslavia, remained in the Socialist bloc. Nearly 500,000 Turks, Bosnians, Albanians and Pomaks in Yugoslavia and Bulgaria were either forced, or "encouraged," to leave their lands after 1950. Despite ideological barriers and ethnic differences, Turkey welcomed these migrants to the country. Official records, recently available biographies and oral sources shed light on the discourses of identity politics through this period.
After the transnational turn: Looking across borders to see the hard face of the nation‐state
Authors: Waldinger Roger
Published: May 2021

This paper leverages the repressive turn in U.S. migration policy to understand how a cross‐border perspective can illuminate the experiences of two different, but contemporaneous second‐generation populations: Those whose lives have unfurled in the United States, all the while growing up in internationalized families with ongoing homeland ties; and those whose childhoods began in the United States, but were disrupted as part of the ‘Great Expulsion’, and thus migrated to Mexico, albeit often with U.S. citizenship and almost always with cross‐border ties to family members still living in the United States. As the paper demonstrates, looking across borders highlights the importance of the territorial frontier and the continuing power of the national to undermine the forces that produce cross‐border connections.
Induction of the apoptosis, degranulation and IL‐13 production of human basophils by butyrate and propionate via suppression of histone deacetylation
Authors: Shi Yanbiao , Xu Meizhen , Pan Shuai , Gao Sijia , Ren Jinfeng , Bai Ruixue , Li Hui , He Cheng , Zhao Shuli , Shi Zhixu , Yu Fang , Xiang Zou , Wang Hui
Published: May 2021

Allergic diseases are caused by dysregulated Th2 immune responses involving multiple effector cells including basophils. Short chain fatty acids (SCFAs), mainly acetate, propionate and butyrate, exert immunomodulatory functions via activation of its receptors GPR41 and GPR43, and inhibition of the histone deacetylases (HDACs) activity. In allergic diseases, SCFAs suppress the activity of mast cells, eosinophils and type 2 innate lymphoid cells (ILC2) but enhance the function of Th2 cells. Here, we aimed to elucidate the function of SCFAs on human basophils. Human basophils were purified from healthy donors by flow cytometric sorting. The surface proteins, apoptosis and degranulation of basophils were analyzed by flow cytometric analysis. The mRNA expression was assayed using real‐time PCR. Interleukin 4 (IL‐4) and IL‐13 were measured by ELISA. Histone acetylation was examined by western blot. GPR41 was expressed by basophils and was enhanced by IL‐3. Acetate induced intracellular calcium influx in basophils which was suppressed by blocking GPR41. Propionate and butyrate, but not acetate, induced the expression of CD69 and IL‐13. In addition, propionate and butyrate enhanced IgE‐mediated basophil degranulation but inhibited basophil survival and IL‐4 secretion. Propionate and butyrate induced histone acetylation of basophils and suppression of HDACs activity mimicked the effects of propionate and butyrate on human basophils. Our findings demonstrate that propionate and butyrate may play a complex role in regulating basophil apoptosis, activation and degranulation via inhibiting HDACs activity. The in vivo effects of SCFAs on the regulation of basophil‐associated allergic diseases need to be further explored.
Thermal stability and performance of optimized ZrCx diffusion barriers in ceramic coating systems for ATF applications
Authors: Chen Lina , Lei Yiming , Li Wenli , Zhang Jie , Wang Jingyang
Published: May 2021

Surface‐modified Zr alloy claddings with advanced ceramic coatings are promising materials for accident‐tolerant fuel (ATF) systems to meet stringent safety regulations concerning light water reactors. The applications of ceramic coatings are, however, limited as a result of inferior thermal stability when used in conjunction with Zircaloy‐4 (Zry‐4) substrates. Herein, the thermal stability of sub‐stoichiometric zirconium carbide barrier layers as a function of composition was studied. Integrated ceramic coatings comprising ZrC0.55 diffusion barriers and a Cr2AlC top layer were synthesized via a magnetron sputtering method. After rapid thermal annealing, the ZrC0.55 barrier layer having a thickness of 0.5 μm effectively prevented the inter‐diffusion between Cr2AlC and the Zry‐4 substrate, thereby ensuring retention of the structural integrity of the integrated ceramic coating system for ATF applications.
Examining the relation between empowerment and civic engagement among parents of individuals with intellectual and developmental disabilities
Authors: Burke Meghan M. , Rossetti Zach , Aleman‐Tovar Janeth , Rios Kristina
Published: May 2021

Internationally, parents of children with intellectual and developmental disabilities have historically engaged in advocacy leading to compulsory education for their children. However, few parents have reported civic engagement. Although empowerment is related to parent advocacy, it is unclear whether empowerment relates to civic engagement. Thus, our study examined parent and child correlates of empowerment and civic engagement, and the relation between empowerment and civic engagement among 235 parents of children with intellectual and developmental disabilities across five states in the United States. Gender and special education knowledge were significant correlates of empowerment and civic engagement. There was a significant positive correlation between empowerment and civic engagement. Implications regarding future research and ways to promote parent empowerment and civic engagement are discussed.
Diagnostic accuracy of self‐reported measures of periodontal disease: A clinical validation study using the 2017 case definitions
Authors: Deng Ke , Pelekos George , Jin Lijian , Tonetti Maurizio S.
Published: May 2021

Aim

To clinically validate a self‐reported questionnaire for periodontal disease and assess its accuracy for differentiating periodontal health and different stages of periodontitis.

Methods

A Chinese (Cantonese) version of a self‐reported questionnaire was prepared by translating and validating the original English questions proposed by the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). The utility of the CDC/AAP questionnaire and its individual questions was assessed against a full‐mouth periodontal examination. Periodontal case definition was based on the 2017 World Workshop classification of periodontal diseases. Multivariable logistic regression and the area under the receiver operating characteristic curve (AUROC) analysis were performed to assess the accuracy of the questionnaire.

Results

408 subjects enrolled in this study, including those with periodontal health (16.2%), gingivitis (15.2%), Stages I/II periodontitis (31.8%) and Stages III/IV periodontitis (36.8%). Overall, the questionnaire had poor accuracy in detecting the presence of Stages I/II periodontitis with an AUROC 0.608. While it showed moderate to high accuracy for identifying periodontal disease (gingivitis and periodontitis), periodontitis and Stages III/IV periodontitis with an AUROC of 0.837, 0.803 and 0.870, respectively. Self‐reported measures in combination with age and tobacco smoking showed excellent performance for identifying Stages III/IV periodontitis with a high AUROC of 0.953, a sensitivity of 95.7%, and a specificity of 89.0%. Specific questions and combinations provided greater utility to discriminate the various periodontal case definitions.

Conclusions

The self‐reported CDC/AAP questionnaire may be a feasible tool for detecting periodontitis, and its combination with demographic and lifestyle factors is useful for the identification of individuals with Stages III/IV periodontitis. This questionnaire seems less helpful in screening of Stages I/II periodontitis. Further studies are needed to test the validity in larger community‐based populations.
Predictors of tooth loss during long‐term periodontal maintenance: An updated systematic review
Authors: Carvalho Rui , Botelho João , Machado Vanessa , Mascarenhas Paulo , Alcoforado Gil , Mendes José João , Chambrone Leandro
Published: May 2021

Aim

To evaluate the risk factors / predictors of tooth loss in patients with periodontitis who underwent periodontal therapy and long‐term periodontal maintenance (PM).

Material and Methods

PubMed, CENTRAL, EMBASE, Web of Science, LILACS and Scholar were searched up to and including September 2020. Studies limited to periodontitis patients who underwent active periodontal therapy (APT) and followed a regular PM programme with 5 years follow‐up minimum were eligible for inclusion in this review. Studies were included if they reported data on tooth loss during PM. Random effects meta‐analyses of number of tooth loss per patient per year were conducted.

Results

Thirty‐six papers regarding thirty‐three studies were included in this review, with three prospective 30 retrospective trials. Subgroup meta‐analysis showed no differences between prospective and retrospective studies, with an average of 0.1 tooth loss per year per patient (p < 0.001). Maxillary and molar teeth were more susceptible to be extracted during long‐term PM. Baseline characteristics (smoking, diabetes mellitus, cardiovascular disease, being male and teeth with furcation lesions) showed no significance as predictor of tooth loss through meta‐regression. The percentage of tooth loss due to periodontal reasons ranged from 0.45% to 14.4%. The individual outcomes in each study evidenced different patient‐related factors (age and smoking) and tooth‐related factors (i.e. tooth type and location) were associated with tooth loss during PM.

Conclusion

The majority of patients undergoing long‐term PM have not lost teeth. On average, long‐term PM effectively causes the loss of 1 tooth per patient every 10 years. Additional prospective trials may confirm these results.
Genetic susceptibility, family history of diabetes and healthy lifestyle factors in relation to diabetes: A gene–environment interaction analysis in Chinese adults
Authors: Ye Chaojie , Niu Jingya , Zhao Zhiyun , Li Mian , Xu Yu , Lu Jieli , Chen Yuhong , Wang Weiqing , Ning Guang , Bi Yufang , Xu Min , Wang Tiange
Published: May 2021

Aims/Introduction

To analyze the associations and interactions of the genetic susceptibility and family history of diabetes with lifestyle factors in relation to diabetes among Chinese adults.

Materials and Methods

We constructed a genetic risk score of 34 single‐nucleotide polymorphisms in 11,596 participants from Songnan and Youyi communities, Baoshan District, Shanghai, China. We determined a healthy lifestyle by a normal body mass index (<24 kg/m2), adequate fruit and vegetable intake (≥4.5 cups/day), never smoked or quit smoking >1 year prior, sufficient physical activity (≥600 metabolic equivalent minutes per week), and a sleep duration of ≥6 to ≤8 h/day. Logistic regression models were used to examine the associations and interactions between heritability and lifestyle on diabetes.

Results

A healthier lifestyle was associated with a lower prevalence of diabetes within any heritable risk groups categorized by the genetic risk score and family history of diabetes. In the combined communities, the odds ratio (95% confidence interval) for diabetes associated with each additional healthy lifestyle factor was 0.83 (0.77–0.89) among participants with a low genetic risk score and 0.86 (0.81–0.91) among participants with a high genetic risk score (Pinteraction = 0.66). Similar interaction patterns of family history (Pinteraction = 0.15) and the combination of family history and the genetic risk score with healthy lifestyle (Pinteraction = 0.55) on diabetes were observed.

Conclusions

A healthier lifestyle was associated with a significantly lower prevalence of diabetes regardless of heritable risk groups, highlighting the importance of adhering to a healthy lifestyle for diabetes prevention among the entire population.
Model‐Based Treatment of Rapid Guessing
Authors: Deribo Tobias , Kroehne Ulf , Goldhammer Frank
Published: May 2021

The increased availability of time‐related information as a result of computer‐based assessment has enabled new ways to measure test‐taking engagement. One of these ways is to distinguish between solution and rapid guessing behavior. Prior research has recommended response‐level filtering to deal with rapid guessing. Response‐level filtering can lead to parameter bias if rapid guessing depends on the measured trait or (un‐)observed covariates. Therefore, a model based on Mislevy and Wu (1996) was applied to investigate the assumption of ignorable missing data underlying response‐level filtering. The model allowed us to investigate different approaches to treating response‐level filtered responses in a single framework through model parameterization. The study found that lower‐ability test‐takers tend to rapidly guess more frequently and are more likely to be unable to solve an item they guessed on, indicating a violation of the assumption of ignorable missing data underlying response‐level filtering. Further ability estimation seemed sensitive to different approaches to treating response‐level filtered responses. Moreover, model‐based approaches exhibited better model fit and higher convergent validity evidence compared to more naïve treatments of rapid guessing. The results illustrate the need to thoroughly investigate the assumptions underlying specific treatments of rapid guessing as well as the need for robust methods.
Power, autonomy and interprofessional practice in dietitian clinical decision making: An interpretive study in acute hospitals
Authors: Vo Ruth , Smith Megan , Patton Narelle
Published: May 2021

Dietitians learn clinical decision making (CDM) predominantly as an autonomous cognitive process that considers the needs and preferences of the patient. Although interprofessional education is increasing in tertiary dietetic programmes, a paucity of research exists that explores the nature of how practising dietitians make decisions, independent or otherwise. This qualitative interpretative study explored the nature of experienced dietitian CDM in the acute care setting. Philosophical hermeneutic principles guided text construction and interpretation via in‐depth, semi‐structured interviews with practising dietitians with at least 3 years of experience. A reference focus group commented on the emerging findings, increasing the rigour of the research. Ten dietitians participated in the interviews and there were five dietitians in the reference focus group. CDM was found to be a highly social phenomenon with varying degrees of autonomy involving complex power relations with various other health professionals, in particular, medical practitioners. Dietitians respond to existing power relations in key ways, including building and maintaining relationships, advocating on behalf of the patient and negotiating decisions with other healthcare staff when in pursuit of improved health and nutrition related outcomes for patients. Strategic interprofessional communication skills are foundational to effective patient care and advancing the role of the dietitian. Power and autonomy in dietitian CDM are important concepts that could inform interprofessional education when seeking to promote both effective dietetic and interprofessional practice.
Smoke or smokeless moxibustion treatment for breech presentation: A three‐arm pilot trial
Authors: Higashihara Akiko , Horiuchi Shigeko
Published: May 2021

Aims

We conducted a pilot trial to compare the effects of smoke and smokeless moxibustion with a control as a possible supplement to external cephalic version (ECV) for converting breech to cephalic presentation and increasing adherence to cephalic position, and to assess their effects on the well‐being of the mother and child.

Methods

We used a quasi‐experimental design with 3 arms: a smoke moxibustion (SM) (n = 20) and smokeless moxibustion (SLM) (n = 20) groups (20‐min acupoint BL67 stimulation once or twice daily for 10–14 days), and a control group (n = 20). The participants had singleton breech presentations between 33 and 35 gestation weeks. The primary outcome was cephalic presentation at the conclusion of intervention. The secondary outcomes were cephalic presentation at birth and effects on mother and child well‐being.

Results

At the conclusion of intervention, cephalic presentation was higher in the SLM (60.0%) than the control groups (25.0%), Relative Risk 2.40, 95% Confidence Interval [1.04–5.56]; there was no significant difference for SM. At birth, there were no significant differences in cephalic presentation or well‐being.

Conclusion

SLM treatment showed an increasing trend towards cephalic presentation at the conclusion of intervention. Although significant differences were not observed at birth possibly due to the small samples and non‐randomization, moxibustion was safe, and not associated with perinatal morbidity and mortality. A randomized controlled trial with a larger sample is warranted to ascertain SLM treatment as a possible ECV supplement for converting and increasing adherence to cephalic position.
Risk factors for recurrence of deep infiltrating endometriosis after surgical treatment
Authors: Yela Daniela Angerame , Vitale Salvatore Giovanni , Vizotto Marina Perencin , Benetti‐Pinto Cristina Laguna
Published: May 2021

Aim

To evaluate the frequency of complications and factors associated with the recurrence of endometriosis in women with deep infiltrating endometriosis (DIE) undergoing surgical treatment.

Methods

A retrospective observational cohort study with 72 women who underwent surgery and followed up by DIE at the University of Campinas from 2007 to 2017. The variables analyzed were clinical characteristics, use and type of drug treatment before and after surgery, operative time and complications inherent to the procedure, as well as the recurrence of lesions on imaging.

Results

The mean age of women was 39.7 ± 6.3 years and the mean follow‐up was 4.56 ± 2.60 years. Complications were reported in 16.6% of surgeries and recurrence of lesions in 34.7%. The risk of intraoperative complications was higher in the presence of lesions of the bowel and in those who used intramuscular progestin before surgery. A higher risk of recurrence was observed among those who did not use hormonal treatment or used a levonorgestrel‐releasing intrauterine device (LNG‐IUD) in the postoperative period.

Conclusion

Women with DIE have a high rate of complications during surgical treatment and a higher risk of recurrence when they did not receive hormonal treatment or when treated with LNG‐IUD after surgery.
Role of systematic pelvic and para‐aortic lymphadenectomy in delayed debulking surgery after six neoadjuvant chemotherapy cycles for high‐grade serous ovarian carcinoma
Authors: Lopes Andre , Genta Maria L. N. D. , da Costa Miranda Vanessa , Aranha Andrea , Lopez Rossana V. M. , Piato Dariane S. A. M. , Anton Cristina , Carvalho Filomena M. , del Pilar Esteves Diz Maria , Carvalho Jesus P.
Published: May 2021

Introduction

We analyzed the role of systematic pelvic and para‐aortic lymphadenectomy in delayed debulking surgery after six neoadjuvant chemotherapy (NACT) cycles for advanced high‐grade serous ovarian carcinoma.

Materials and Methods

We retrospectively reviewed patients with advanced ovarian carcinoma who underwent NACT with carboplatin‐paclitaxel between 2008 and 2016. Patients were included only if they had FIGO IIIC‐IVB high‐grade serous carcinoma with clinically negative lymph nodes after six NACT cycles (carboplatin‐paclitaxel) and underwent complete or near complete cytoreduction. Patients with partial lymphadenectomy or bulky nodes were excluded. Patients who underwent systematic pelvic and aortic lymphadenectomy and those who did not undergo lymph node dissection were compared. Progression‐free and overall survivals were analyzed using the Kaplan–Meier method.

Results

Totally, 132 patients with FIGO IIIC‐IVB epithelial ovarian carcinoma were surgically treated after NACT. Sixty patients were included (39 and 21 in the lymphadenectomy and nonlymphadenectomy group, respectively); 40% had suspicious lymph nodes before NACT. Patient characteristics, blood transfusion numbers, and complication incidence were similar between the groups. In the lymphadenectomy group, 12 patients (30.8%) had histologically positive lymph nodes and the surgical time was longer (229 vs. 164 min). The median overall survival in the lymphadenectomy and nonlymphadenectomy groups, respectively, was 56.7 (95% CI 43.4–70.1) and 61.2 (21.4–101.0) months (p = 0.934); the corresponding disease‐free survival was 8.1 (6.2–10.1) and 8.3 (5.1–11.6) months (p = 0.878). Six patients exclusively presented with lymph node recurrence.

Conclusions

Systematic lymphadenectomy after six NACT cycles may have no influence on survival.
The Impact of Competition on Investment: Evidence From California Hospitals*
Authors: Wilson Nathan E.
Published: May 2021

I examine the relationship between bargaining leverage and capital investment using data on California’s hospital markets. I find evidence that investment increases with bargaining leverage; a hospital whose bargaining position improves by one standard deviation will increase its investment rate by 16 percentage points. A positive causal relationship between bargaining leverage and investment fits the institutional details of the health care sector, where many firms have non‐profit tax status, making it difficult to return monopoly rents to shareholders. Consistent with this explanation, I find that non‐profit hospitals with bargaining leverage invest more than for‐profit ones, all else equal. I do not find strong evidence that financing constraints matter disproportionately for hospitals operating in more competitive markets, supporting the hypothesis that the incremental investment may not be socially efficient.
Safety and outcomes of routine endovascular thrombectomy in large artery occlusion recorded in the SITS Register: An observational study
Authors: Ahmed N. , Mazya M. , Nunes A. P. , Moreira T. , Ollikainen J. P. , Escudero‐Martinez I. , Bigliardi G. , Dorado L. , Dávalos A. , Egido J. A. , Tassi R. , Strbian D. , Zini A. , Nichelli P. , Herzig R. , Jurák L. , Hurtikova E. , Tsivgoulis G. , Peeters A. , Nevšímalová M. , Brozman M. , Cavallo R. , Lees K. R , Mikulik R. , Toni D. , Holmin S.
Published: May 2021

Background and objective

We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS–International Stroke Thrombectomy Register (SITS‐ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies.

Methods

We identified centres recording ≥10 consecutive patients in the SITS‐ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014–2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0‐2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS‐MOST.

Results

Results are presented in the following order: SITS‐ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44–47), 46.0% (42–50), 38% (35–41) and 37% (35–41), respectively; death was 19.2% (19–21), 15.3% (12.7–18.4), 29.2% (27–32) and 28.6% (27–31); and SICH was 3.6% (3–4), 4.4% (3.0–6.4), 5.8% (4.7–7.1) and not available.

Conclusion

Thrombectomy in routine clinical use registered in the SITS‐ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies.