bluuebunny/crossref_metadata_2025 huggingface dataset:
Corticosteroid, oseltamivir and delayed admission are independent risk factors for prolonged viral shedding in patients with Coronavirus Disease 2019
Authors: Hu Fuying , Yin Gang , Chen Youping , Song Jiangqin , Ye Maosong , Liu Jie , Chen Cuicui , Song Yuanlin , Tang Xinjun , Zhang Yong
Published: August 2020

Introduction

Coronavirus Disease 2019 (COVID‐19) has spread worldwide, and it has reached to more than 14.5 million cases. Although Hubei province is the epicenter of China, little is known about epidemiological and clinical features of COVID‐19 in other areas in Hubei province around Wuhan. In addition, the virological data, particularly the factors associated with viral shedding of COVID‐19 has not been well described.

Objective

To describe the epidemiological and clinical features of patients with COVID‐19 in Tianmen city, and identify risk factors associated with prolonged viral shedding of COVID‐19.

Methods

Inpatients with COVID‐19 admitted before February 9, 2020 were included. Characteristics were compared between patients with early and late viral RNA shedding. Multivariate cox regression model was used to investigate variables associated with prolonged viral shedding.

Results

One hundred and eighty‐three patients were included. About 8.2% patients were categorized as critical degree of severity. All patients received antiviral therapy, with arbidol and interferon being the commonest. About 38.3% and 16.9% patients were treated with corticosteroid and immunoglobulin, respectively. Time from onset to admission (HR = 0.829, P < 0.001), and administration of corticosteroid (HR = 0.496, P = 0.002), arbidol (HR = 2.605, P = 0.008) and oseltamivir (HR = 0.416, P < 0.001) were independently associated with duration of viral shedding.

Conclusion

Symptoms of patients from Tianmen are relatively mild. Treatment should be started as early as possible, but corticosteroid and oseltamivir should be initiated with caution. In addition, clinical trials on arbidol should be conducted to demonstrate its effectiveness.
Gradually progressive increasing left thigh swelling in a young woman
Authors: Rani Deepa , Gupta Anurag , Singh Pradyumn
Published: August 2020

Synovial sarcoma is a malignant mesenchymal neoplasm of uncertain type with a specific translocation, t(X;18). Key cytological features and specific immunohistochemistry on cell block can help to establish a definite diagnosis.
Using a multidimensional model of attention to predict low‐income preschoolers’ early academic skills across time
Authors: Shannon Katherine A. , Scerif Gaia , Raver C. Cybele
Published: August 2020

The current study examines the organization of attention skills across the preschool year before kindergarten, and tests how distinct attention subcomponents predict early academic skills in a sample of low‐income children (n = 99). Children completed well‐validated attention tasks in fall at 4.5 years old and spring at 5 years old, capturing the abilities to selectively focus, sustain attention, and employ executive control. Exploratory factor analyses at both time points support a 2‐factor model differentiating selective and sustained attention from attention processing speed and executive attention, suggesting that attention in low‐income preschoolers may have a simpler organization than the 3‐factor structure found in adulthood. Multiple regression models find children's ability to selectively focus and sustain attention serves as a robust concurrent and longitudinal predictor of academic skills. These results highlight the role of selective and sustained attention processes in supporting school readiness for economically vulnerable children.
Psychosocial impact of paediatric demyelinating disorders: a scoping review
Authors: Duncan Morvwen , Carroll Susan , Cockburn Rebecca , Johnston Claudia , Bullock Hayley , Mitchell Sophie , Hemingway Cheryl
Published: August 2020

Aim

To: (1) provide greater insight into the psychological and social impact of a range of demyelinating disorders, (2) explore differences between disorders, and (3) provide direction for future research.

Method

Studies were identified by searching online databases. Studies that explored the psychological, emotional, or social impact of a range of demyelinating disorders in childhood, including acute disseminated encephalomyelitis (ADEM), optic neuritis, transverse myelitis, and multiple sclerosis, were included and screened independently by three authors. Data on the design, sample characteristics, psychosocial measures, key findings, and methodological strengths and limitations were extracted. Twenty‐five studies were included in the narrative synthesis.

Results

Demyelinating disorders are associated with lower quality of life, affecting young people's emotional, social, school, and behavioural functioning. There is a high prevalence of psychiatric disorders and fatigue, particularly in multiple sclerosis. Subtle differences exist in the psychological presentation between different demyelinating disorders, with clear gaps in the research for the long‐term psychosocial impact of monophasic conditions.

Interpretation

The difference between the impact of monophasic and relapsing demyelinating disorders on psychosocial functioning is unclear. Future research should aim to identify the psychosocial impact across disorders and over time, ensure that services are capturing those patients who may benefit from tailored interventions.

What this paper adds

Prevalence of psychiatric diagnoses in paediatric demyelinating disorders is higher than controls.

Depression and emotional concerns are elevated in paediatric demyelinating disorders.

Demyelinating disorders impact children's quality of life across school, social, and physical functioning
Relationship between coronary microvascular dysfunction and left ventricular diastolic function in patients with chest pain and unobstructed coronary arteries
Authors: Lam Jeng Hwan , Quah Jing Xian , Davies Thomas , Boos Christopher John , Nel Karen , Anstey Christopher M. , Stanton Tony , Greaves Kim
Published: August 2020

Backgroud

Diastolic dysfunction (DD) is reported to affect up to 35% of the adult general population. The consequence of progressive DD is heart failure with preserved ejection fraction (HFpEF). Coronary microvascular dysfunction (CMD) has been suggested as one of the pathologic mechanisms leading to HFpEF. We investigated whether there was an association between coronary microvascular function and echocardiographic indices of left ventricular diastolic function at rest in patients with chest pain and unobstructed coronary arteries (CPUCA).

Methods

This retrospective observational study recruited patients referred to cardiology clinics assessment of chest pain who subsequently underwent assessment via CT coronary angiogram (CTA). Coronary microvascular dysfunction was determined by myocardial blood flow reserve (MBFR; <2.0) using myocardial contrast echocardiography. Echocardiographic indices of diastolic function (septal mitral annular e′; septal mitral annular E/e′, E/A ratio) were measured from baseline transthoracic echocardiogram.

Results

149 patients (52% men) with a mean age 59.7(9.5) years were recruited. Mean (standard deviation) MBFR was 2.2 (0.51). 37% (55/149) had MBFR < 2.0. Median [interquartile range] septal mitral annular e′ velocity and septal mitral annular E/e′ were 7.6 cm/s [6.2, 8.9] and 9.5 [7.5, 10.8], respectively. Univariate regression analysis showed only age was a significant predictor of increasing septal mitral annular E/e′ (β = +0.20 95% CI 0.13, +0.28, P < .001) but not MBFR. Multivariable analysis also showed no association between these septal mitral annular E/e′ and MBFR after adjustment for cardiovascular risk factors.

Conclusion

There was no relationship found between echocardiographic indices of left ventricular diastolic function and coronary microvascular function at rest.
A cross‐scale framework to support a mechanistic understanding and modelling of marine climate‐driven species redistribution, from individuals to communities
Authors: Twiname Samantha , Audzijonyte Asta , Blanchard Julia L. , Champion Curtis , de la Chesnais Thibaut , Fitzgibbon Quinn P. , Fogarty Hannah E. , Hobday Alistair J. , Kelly Rachel , Murphy Kieran J. , Oellermann Michael , Peinado Patricia , Tracey Sean , Villanueva Cecilia , Wolfe Barrett , Pecl Gretta T.
Published: August 2020

Climate‐driven species redistribution is pervasive and accelerating, yet the complex mechanisms at play remain poorly understood. The implications of large‐scale species redistribution for natural systems and human societies have resulted in a large number of studies exploring the effects on individual species and ecological communities worldwide. Whilst many studies have investigated discrete components of species redistribution, the integration required for a more complete mechanistic understanding is lacking. In this paper, we provide a framework for synthesising approaches to more robustly understand and predict marine species redistributions. We conceptualise the stages and processes involved in climate‐driven species redistribution at increasing levels of biological organisation, and synthesize the laboratory, field and modelling approaches used to study redistribution related processes at individual, population and community levels. We then summarise links between scales of biological organisation and methodological approaches in a hierarchical framework that represents an integrated mechanistic assessment of climate‐driven species redistributions. In a rapidly expanding field of research, this framework provides direction for: 1) guiding future research, 2) highlighting key knowledge gaps, 3) fostering data exchange and collaboration between disciplines and 4) improving shared capacity to predict and therefore, inform the proactive management of climate impacts on natural systems.
Gregariousness affects performance and defensive reactions in swallowtail caterpillars
Authors: Cisternas Mónica F. , Escobedo Victor M. , Rios Rodrigo S. , Gianoli Ernesto
Published: August 2020

1. Group living in caterpillars may enhance individual performance due to sharing of costs associated with individual tasks when dealing with biotic or abiotic ecological factors.

2. In the gregarious caterpillar Battus polydamas archidamas (Papilionidae) egg clusters and caterpillar groups vary in size. We hypothesized that individual survival would be higher in larger groups and that group living would enhance individual performance: shorter development time and/or reduced frequency of (presumably costly) defensive reactions in larvae and larger adult size. We also tested whether the group size conferring the highest survival to laboratory‐reared caterpillars matched the most frequent egg clutch size in the field.

3. We collected egg clutches in the field and reared caterpillars in groups of 1, 6, 10, and 14 individuals. We quantified larval survival and stage duration as well as adult mass under laboratory conditions, excluding natural enemies. We also recorded the frequency of larval defensive reactions (thrashing and osmeterium display) against a tactile stimulus of first‐instar larvae.

4. Group living enhanced caterpillar survival, particularly during the first instars, when caterpillars are 100% gregarious. Groups of intermediate size reduced larval development time but group living did not affect adult mass. Individual caterpillars in groups showed defensive reactions less frequently than solitary individuals, revealing a cost‐saving feature of gregariousness for this swallowtail species. The most frequent clutch size in the field (9–10 eggs) did not match the larval group with highest survival (14 individuals), but did match the group with shortest development time.
Land, ladies, and the law: a case study on women's land rights and welfare in Southeast Asia in the nineteenth century†
Authors: Chankrajang Thanyaporn , Vechbanyongratana Jessica
Published: August 2020

This study evaluates women's de jure and de facto land rights and their implications for household welfare in nineteenth‐century Bangkok. Women constituted a significant share of agricultural landowners holding government‐issued land deeds in central Siam (now Thailand)—a pattern that stands in contrast to both historical and contemporary developing economy contexts where the structure of land rights often favours men. The findings show, through both direct and indirect evidence, that women's de jure rights were upheld in practice. Women made significantly more agricultural investments than male or mixed‐gender owners, which supports the assertion that women perceived their land rights as secure under Siam's traditional usufruct land rights system. An assessment of land‐related court cases directly supports our claim, showing that women in Siam had access to legal representation and were protected when their land rights were challenged by investors and local elites in the context of high demand for both agricultural and urban land. Such secure land rights helped preserve women's livelihoods as agriculturists and household well‐being. We estimate that the median female‐owned orchard could support 10 adults annually, achieving a standard of living comparable to unskilled labourer households in Beijing and Milan during the same period.
Translation and validation of the ageism scale for dental students in Romanian (ASDS‐Rom)
Authors: Veenstra Luke , Barlow Patrick , Kossioni Anastassia , Popescu Sanda Mihaela , Mercut Veronica , Tuculina Mihaela Jana , Scrieciu Monica , Stanusi Andreea , Marchini Leonardo
Published: August 2020

Aims

The aim of this paper was to validate the Romanian version of an ageism scale for dental students.

Materials and Methods

The initial 27‐item ageism scale was translated into Romanian and administered to 210 dental students in Craiova. The data were analysed using principal components analysis (PCA) with an orthogonal, Varimax rotation. The answers were then compared across several demographic variables using a combination of independent samples t tests and one‐way between‐subjects analysis of variance (ANOVA).

Results

Adequate factorability was confirmed with a Kaiser‐Meyer‐Olkin (KMO) of 0.676 and a Bartlett's Test of Sphericity yielding P < 0.001. PCA revealed a 10‐item scale distributed into three components that accounted for 58% of the overall variance. The first component contained 4 items related to the cost‐benefit of providing care to older patients (α = 0.80). The second contained 3 items that revolved around the perceptions about older people and their value in the society (α = 0.59). The third contained 3 items related to gerodontology training (α = 0.46). Discriminant validity showed differences in the first component based on whether a student had an older family member.

Conclusions

The 10‐item, three components scale demonstrated acceptable validity and reliability.
COVID‐19 coagulopathy: An in‐depth analysis of the coagulation system
Authors: Martín‐Rojas Reyes María , Pérez‐Rus Gloria , Delgado‐Pinos Valeria Estefania , Domingo‐González Amalia , Regalado‐Artamendi Isabel , Alba‐Urdiales Natalia , Demelo‐Rodríguez Pablo , Monsalvo Silvia , Rodríguez‐Macías Gabriela , Ballesteros Monica , Osorio‐Prendes Santiago , Díez‐Martín José Luis , Pascual Izquierdo Cristina
Published: August 2020

Background

Abnormal coagulation parameters have been reported in COVID‐19‐infected patients. Although the underlying mechanism of COVID‐19 coagulopathy remains unknown, it has been suggested to be a form of disseminated intravascular coagulation (DIC).

Objectives

The aim of our study was to analyze the coagulation parameters of patients with COVID‐19, determine whether coagulation factors consumption occurs and identify potential prognostic biomarkers of the disease.

Patients/Methods

Blood samples from hospitalized patients with COVID‐19 pneumonia were collected. We performed basic coagulation tests and quantification of coagulation factors and physiological inhibitor proteins. Laboratory data were compared with clinical data and outcomes.

Results

The study involved 206 patients (63.6% male). D‐dimer was particularly elevated (median 450 ng/mL; IQR 222.5‐957.3). Free protein S levels were below the normal range (median 56.6%; IQR: 43.6‐68.9), and factor VIII showed an increasing trend (median 173.4%; IQR: 144.1‐214.9). However, all coagulation factors were within normal limits. We found no correlation between abnormal coagulation parameters and thrombosis, except for higher D‐dimer (HR 1.99; 95% CI 1.3‐3.1; P = .002).

Conclusions

COVID‐19 is associated with coagulopathy that correlates with poor prognosis. However, we did not demonstrate a consumption of coagulation factors, as seen in DIC.
Entrepreneurial Process Studies Using Insider Action Research: Opportunities & Challenges for Entrepreneurship Scholarship
Authors: Futonge Nzembayie Kisito , Buckley Anthony Paul
Published: August 2020

This paper examines the opportunities and challenges of adopting insider action research (IAR) in entrepreneurial process studies. It employs a critical reflexive and narrative approach in examining our own lived experience in a real‐time digital entrepreneurial journey spanning three years while triangulating it with experiential knowledge in another role as dissertation supervisors. Our live case illustrates that IAR, when it combines reflective practice, cooperative inquiry and design science, represents a suitable but under‐exploited methodology for entrepreneurship scholarship. We build on this knowledge to offer a model for incorporating this methodology in entrepreneurship research and education. Consequently, we contribute towards responding to the need for phenomenon‐methodology fit in the discipline. Ultimately, the paper's value lies in its effort towards resolving the seemingly perennial question regarding the legitimacy of entrepreneurship as a distinctive domain of scholarship.
Influence of selective caries excavation on marginal penetration of class II composite restorations in vitro
Authors: Scholz Konstantin J. , Hinderberger Michael , Widbiller Matthias , Federlin Marianne , Hiller Karl‐Anton , Buchalla Wolfgang
Published: August 2020

Selective caries excavation may support pulp preservation. This in vitro study investigated the influence of selective removal of demineralized dentin on marginal integrity of composite restorations as determined by dye penetration. Dentinal caries‐like lesions were produced in the approximal surfaces of 40 extracted human molars (ethylenediaminetetraacetate, 0.5 M, 96 h). The following test procedures were established: complete excavation, selective excavation, and caries‐free control. Two class II cavities with enamel at the cervical margins were prepared per tooth and demineralization volume was determined by micro‐computed tomography for the purpose of a stratified distribution to receive complete excavation or selective excavation. After complete or selective excavation (30 cavities each), adhesive composite restorations were placed. Cavities without demineralized dentin (20 cavities) served as control. The marginal integrity of restorations was evaluated by dye penetration with and without thermocycling or mechanical loading. Results were analyzed by non‐parametrical statistical tests (Mann‐Whitney U Test) with an α = 0.05 level of significance. Dye penetration did not differ significantly among completely excavated, selectively excavated, or undemineralized teeth, but was increased by thermocycling and mechanical loading in all experimental groups. Selective caries removal did not increase marginal penetration in class II restorations. The presence of remaining demineralized dentin surrounded by sound dentin did not impair marginal integrity of restorations with margins placed in sound enamel.
In vivo confocal microscopy: The role of comparative approach in patients with multiple atypical nevi
Authors: Longhitano Sabrina , Pampena Riccardo , Guida Stefania , De Pace Barbara , Ciardo Silvana , Chester Johanna , Longo Caterina , Farnetani Francesca , Pellacani Giovanni
Published: August 2020

Background

In vivo reflectance confocal microscopy (RCM) increases diagnostic accuracy for melanoma diagnosis when combined with dermoscopy. In patients with multiple atypical nevi, a comparative dermoscopic approach improves melanoma recognition and saves unnecessary excision. The performance of a comparative approach combining dermoscopy and RCM has not been yet investigated.

Objective

To validate a comparative dermoscopic + RCM approach according to melanoma diagnostic accuracy in patients with multiple atypical nevi.

Methods

Consecutive patients undergoing RCM examination for ≥3 atypical melanocytic lesions, assessed with a dermoscopic + RCM comparative approach in a real‐life setting, from July 2012 to April 2018 at a single centre, were enrolled. Dermoscopic and dermoscopic + RCM morphologic approaches were retrospectively applied by evaluating revisited 7‐point checklist, RCM and Delphi scores for each enrolled lesion. Comparative dermoscopic and dermoscopic + RCM approaches were subsequently used. For each approach, lesions were classified as non‐suspicious (long‐term follow‐up) or suspicious (short‐term follow‐up or excision) and diagnostic accuracy for melanoma diagnosis was assessed.

Results

Diagnostic accuracy progressively increased comparing morphologic to comparative approaches, and comparing dermoscopic to dermoscopic + RCM approaches. The retrospective comparative dermoscopic + RCM approach revealed the largest area under the curve (0.84; 95%CI:0.79‐0.89; P < .001) and the lowest number needed to excise (5.7). Furthermore, this approach had the highest specificity (67.6%) and sensitivity (100%) levels, which were similar to those verified in the real‐life setting. The main study limitations are the retrospective design and high‐risk patient inclusion only.

Conclusions

Comparative dermoscopic + RCM approach increases melanoma diagnostic accuracy, reducing unnecessary excision without missing melanomas.
Oral drug delivery with nanoparticles into the gastrointestinal mucosa
Authors: Liu Jiao , Leng Ping , Liu Yujun
Published: August 2020

The oral route of protein and peptide drugs has been a popular method of drug delivery in recent years, although it is often a challenge to achieve effective drug release and minimize the barrier functions of the gastrointestinal tract. Gastrointestinal mucosa can capture and remove harmful substances; similarly, it can limit the absorption of drugs. Many drugs are effectively captured by the mucus and rapidly removed, making it difficult to control the release of drugs in the gastrointestinal tract. The use of drug carrier systems can overcome the mucosal barrier and significantly improve bioavailability. Nanoparticle drug carriers can protect the drug from degradation, transporting it to a predetermined location in the gastrointestinal tract to achieve more efficient and sustained drug delivery. It is becoming clearer that the characteristics of nanoparticles, such as particle size, charge, and hydrophobicity, are related to permeability of the mucosal barrier. This review focuses on the latest research progress of nanoparticles to penetrate the mucosal barrier, including the delivery methods of nanoparticles on the surface of gastrointestinal mucosa, and aims to summarize how successful oral nanoparticle delivery systems can overcome this biological barrier in the human body. In addition, the in vitro model based on gastrointestinal mucus is an important tool for drug research and development. Here, we discuss different types of drug delivery systems and their advantages and disadvantages in design and potential applications. Similarly, we reviewed and summarized various methods for evaluating oral nanoparticles in in vitro and in vivo models.
Migration and Neighborhood Change in Sweden: The Interaction of Ethnic Choice and Income Constraints
Authors: Malmberg Bo , Clark William A. V.
Published: August 2020

The majority of segregation studies focus on ethnic concentration but there is growing research that also documents high and increasing status segregation. While empirical studies have documented the existence of both ethnic concentration and status segregation, there is only limited research on the two complexly related distributions. In this article, we examine the conjoint relationship of ethnic and economic segregation in bespoke neighborhoods in Sweden and estimate how the interaction of ethnic choice and economic constraint effects segregation outcomes. Empirically, we examine the finding that the large‐scale foreign‐born flows into Swedish cities have created migrant/ethnic concentrations which are also areas of concentrated poverty. We provide evaluations of how the combination of ethnicity and status are factors in migrant concentration, and evaluate the conjoint relationship of ethnic concentration and economic segregation. We demonstrate that residential sorting by income in large cities in Sweden is strongly associated with ethnic concentration. We conclude that preferences modified by budget constraints combine to create continuing immigrant clustering.
The provision of mobile dental services to dependent elderly people in Switzerland
Authors: Borg‐Bartolo Roberta , Amberg Helen , Bieri Oliver , Schirrmann Eric , Essig Stefan
Published: August 2020

Objective

This work aimed at describing mobile dental services provided by both the private sector and the universities in Switzerland to dependent elderly people. It also aimed at presenting the views of both sectors on the current status of these services.

Background

As people age and become more care‐dependent, their oral health requirements increase, as access to dental care decreases.

Method

A survey was sent to practitioners who potentially provided a mobile dental service (n = 253). Five interviews were conducted with six individuals who have a leading role in Geriatric dentistry in the four universities in Switzerland that provide dental training.

Results

The private sector provides a mobile dental service to the elderly mainly through the use of portable equipment, while university services are provided by different models. The interviewees discussed the reasons as to why these services were set up. They discussed the challenges associated with treating dependent elderly patients, which often makes work in this field hard and unattractive. Both sectors see the need for better collaboration with other professionals.

Conclusion

The private sector in Switzerland provides a mobile dental service to elderly people mostly through the use of portable equipment, while university services are provided in a variable configuration of models. Better collaboration is required to improve dental care and service delivery to dependent elders. There is a potential for improvement of these services, in order to meet the demand of an ageing population, catering for both the institutionalised elders and those living at home.
Surveying purine biosynthesis across the domains of life unveils promising drug targets in pathogens
Authors: Chua Sheena MH , Fraser James A
Published: August 2020

Purines play an integral role in cellular processes such as energy metabolism, cell signaling and encoding the genetic makeup of all living organisms—ensuring that the purine metabolic pathway is maintained across all domains of life. To gain a deeper understanding of purine biosynthesis via the de novo biosynthetic pathway, the genes encoding purine metabolic enzymes from 35 archaean, 69 bacterial and 99 eukaryotic species were investigated. While the classic elements of the canonical purine metabolic pathway were utilized in all domains, a subset of familiar biochemical roles was found to be performed by unrelated proteins in some members of the Archaea and Bacteria. In the Bacteria, a major differentiating feature of de novo purine biosynthesis is the increasing prevalence of gene fusions, where two or more purine biosynthesis enzymes that perform consecutive biochemical functions in the pathway are encoded by a single gene. All species in the Eukaryota exhibited the most common fusions seen in the Bacteria, in addition to new gene fusions to potentially increase metabolic flux. This complexity is taken further in humans, where a reversible biomolecular assembly of enzymes known as the purinosome has been identified, allowing short‐term regulation in response to metabolic cues while expanding on the benefits that can come from gene fusion. By surveying purine metabolism across all domains of life, we have identified important features of the purine biosynthetic pathway that can potentially be exploited as prospective drug targets.
Contagion risk in african sovereign debt markets: A spatial econometrics approach
Authors: Muteba Mwamba J. W. , Manguzvane Mathias
Published: August 2020

This study applies the spatial Durbin model to analyse the extent to which international trade and geographical proximity affect the stability of African sovereign‐debt markets. Using sovereign credit default swap spreads, our empirical findings show that it is not only a country's macroeconomic fundamentals that influence its likelihood of default but also contagion from other countries. Trade linkages are found to be a strong transmission channel for contagion risk, especially among countries that trade heavily. A decomposition of the results demonstrates that at least 60% of the variation in credit default swap spread changes is attributed to spillovers through the trading channel. A change in the weighting matrix to geographical proximity confirms the baseline findings that an African country's debt market is susceptible to macroeconomic events in other countries.
Photoluminescence property of inexpensive flexible SiC nanowires membrane by electrospinning and carbothermal reduction
Authors: Wei Jian , Li Xueting , Wang Yuan , Chen Bing , Zhang Mengjie , Qin Congmin
Published: August 2020

Silicon carbide nanowire (SiC NW), as a typical wide band gap semiconductor was used as light‐emitting materials and devices in high‐temperature and harsh environments due to its excellent properties. In this paper, flexible ultra‐long SiC NWs membrane was successfully synthesized by electrospinning and subsequently high‐temperature sintering using phenolic resin and silica sol as precursors. Results of system characterization reveal that SiC NWs possess a smooth and uniform surface with diameter distribution mainly between 50‐300 nm and a length of more than tens of micrometers, forming a network structure. The growth mechanism of synthesized nanowires was mainly carbothermal reduction in situ and was accompanied by vapor‐solid (V‐S) reaction. The present work provides a simple and cost‐effective way for controllable fabrication of SiC NWs membrane. The photoluminescence spectrum of SiC NWs membrane emerged a clear blue shift, indicating a potential application in optoelectronic devices and discussed the potential applications of SiC NWs membrane in other fields.
Periodontal and peri‐implant diseases in centenarians
Authors: Sekundo Caroline , Langowski Eva , Kilian Samuel , Frese Cornelia
Published: August 2020

Aims

To report the prevalence of periodontal and peri‐implant diseases in centenarians in South‐Western Germany, examine associations with sociodemographic factors and explore age‐related trends.

Material and methods

Eligible persons born before 1920 were identified from population registries in South‐Western Germany. A total of 55 centenarians were visited at home or in nursing care facilities. Of them, 35 were dentate, 33 of which underwent periodontal examination. Implants in 2 edentulous patients were also registered.

Results

The mean number of teeth was 9.5 ± 7.1; centenarians in need of nursing care had considerably less teeth than others (8.5 versus. 17.0 teeth, p = .03). Mean probing depth was 2.7 ± 0.8mm; mean clinical attachment loss was 4.2 ± 1.7 mm. Severe tooth mobility (degree 2 or 3) and furcation involvement were present in approximately 3% of eligible teeth. According to CDC/AAP classification, 25.8% of centenarians had no or mild periodontitis, 54.8% of centenarians had moderate periodontitis, and only 19.4% were severely affected. Of 27 implants examined in 5 centenarians, 59.3% were classified as healthy, 29.6% had peri‐implant mucositis, and 11.1% had peri‐implantitis.

Conclusions

This study reveals the predominance of moderately severe disease in centenarians. While there were high levels of moderate periodontitis and peri‐implant mucositis, signs of severe periodontitis, severe furcation involvement, tooth mobility or peri‐implantitis were less frequent.
Self‐reported bleeding on brushing as a predictor of bleeding on probing: Early observations from the deployment of an internet of things network of intelligent power‐driven toothbrushes in a supportive periodontal care population
Authors: Tonetti Maurizio S. , Deng Ke , Christiansen Allis , Bogetti Katja , Nicora Chiara , Thurnay Susanne , Cortellini Pierpaolo
Published: August 2020

Background

Bleeding on brushing (BoB) is an important sign of gingival inflammation. Recently, the use of intelligent toothbrushes and oral health Apps has shown potential to improve oral and periodontal health. In the context of the introduction of an Internet of things network of intelligent power‐driven toothbrushes in a supportive periodontal care programme, the aim of this study was (a) to audit the adoption and retention of this new technology; and (b) to preliminarily assess the feasibility to gather data on BoB and associate them with clinical periodontal parameters.

Methods

100 subjects with different periodontal case diagnoses participating in supportive periodontal care (SPC) were provided with and instructed on the use of an intelligent power‐driven toothbrush connected with an App (I‐Brush). Brushing sessions and occurrence of BoB were recorded through the App and stored in a data protection compliant backend. Subject retention was audited over time. BoB recorded in the two weeks before the SPC appointment was associated with clinical parameters observed by the clinician blind to App data.

Results

75% of subjects provided data from using the power toothbrush and the App for a minimum of 10 brushing sessions over an average period of 362 days. Compared with baseline, subjects’ oral hygiene, bleeding on probing and prevalence of residual pockets improved gradually while using the I‐Brush. The number of BoB episodes in the two weeks leading to the SPC appointment and the number of residual pockets predicted BOP (p < .001) detected during the examination. App use in the previous two weeks was associated with lower plaque scores at SPC.

Conclusions

These preliminary observations indicate good adoption and retention of a mobile health system built around an intelligent power toothbrush in a SPC population. The App was able to gather clinically relevant information predicting the observed degree of gingival inflammation. Deployment of mHealth systems seems feasible in dental practice and may bring significant oral health benefits. More investigations are needed in this area.
“I Don't Have Time to Sit and Talk with Them”: Hospitalists’ Perspectives on Palliative Care Consultation for Patients with Dementia
Authors: Courtright Katherine R. , Srinivasan Trishya L. , Madden Vanessa L. , Karlawish Jason , Szymanski Stephanie , Hill Sarah H. , Halpern Scott D. , Ersek Mary
Published: August 2020

BACKGROUND/OBJECTIVES

Specialty palliative care for hospitalized patients with dementia is widely recommended and may improve outcomes, yet rates of consultation remain low. We sought to describe hospitalists' decision‐making regarding palliative care consultation for patients with dementia.

DESIGN

Descriptive qualitative study.

SETTING

Seven hospitals within a national nonprofit health system.

PARTICIPANTS

Hospitalist physicians.

MEASUREMENTS

Individual semistructured interviews. We used thematic analysis to explore factors that influence hospitalists' decision to consult palliative care for patients with dementia.

RESULTS

A total of 171 hospitalists were eligible to participate, and 28 (16%) were interviewed; 17 (61%) were male, 16 (57%) were white, and 18 (64%) were in practice less than 10 years. Overall, hospitalists' decisions to consult palliative care for patients with dementia were influenced by multiple factors across four themes: patient, family caregiver, hospitalist, and organization. Consultation was typically only considered for patients with advanced disease, particularly those receiving aggressive care or with family communication needs (navigating conflicts around goals of care and improving disease and prognostic understanding). Hospitalists' limited time and, for some, a lack of confidence in palliative care skills were strong drivers of consultation. Palliative care needs notwithstanding, most hospitalists would not request consultation if they perceived families would be resistant to it or had limited availability or involvement in caregiving. Additional barriers to referral at the organization level included a hospital culture that conflated palliative and end‐of‐life care and busy palliative care teams at some hospitals.

CONCLUSION

Hospitalists described a complex consultation decision process for involving palliative care specialists in the care of patients with dementia. Systematic identification of hospitalized patients with dementia most likely to benefit from palliative care consultation and strategies to overcome modifiable family and organization barriers are needed. J Am Geriatr Soc 68:2365–2372, 2020.
Sex‐dependent pronociceptive role of spinal α5‐GABAA receptor and its epigenetic regulation in neuropathic rodents
Authors: Franco‐Enzástiga Úrzula , García Guadalupe , Murbartián Janet , González‐Barrios Rodrigo , Salinas‐Abarca Ana B. , Sánchez‐Hernández Beatriz , Tavares‐Ferreira Diana , Herrera Luis A. , Barragán‐Iglesias Paulino , Delgado‐Lezama Rodolfo , Price Theodore J. , Granados‐Soto Vinicio
Published: August 2020

Extrasynaptic α5‐subunit containing GABAA (α5‐GABAA) receptors participate in chronic pain. Previously, we reported a sex difference in the action of α5‐GABAA receptors in dysfunctional pain. However, the underlying mechanisms remain unknown. The aim of this study was to examine this sexual dimorphism in neuropathic rodents and the mechanisms involved. Female and male Wistar rats or ICR mice were subjected to nerve injury followed by α5‐GABAA receptor inverse agonist intrathecal administration, L‐655,708. The drug produced an antiallodynic effect in nerve‐injured female rats and mice, and a lower effect in males. We hypothesized that changes in α5‐GABAA receptor, probably influenced by hormonal and epigenetic status, might underlie this sex difference. Thus, we performed qPCR and western blot. Nerve injury increased α5‐GABAA mRNA and protein in female dorsal root ganglia (DRG) and decreased them in DRG and spinal cord of males. To investigate the hormonal influence over α5‐GABAA receptor actions, we performed nerve injury to ovariectomized rats and reconstituted them with 17β‐estradiol (E2). Ovariectomy abrogated L‐655,708 antiallodynic effect and E2 restored it. Ovariectomy decreased α5‐GABAA receptor and estrogen receptor α protein in DRG of neuropathic female rats, while E2 enhanced them. Since DNA methylation might contribute to α5‐GABAA receptor down‐regulation in males, we examined CpG island DNA methylation of α5‐GABAA receptor coding gene through pyrosequencing. Nerve injury increased methylation in male, but not female rats. Pharmacological inhibition of DNA methyltransferases increased α5‐GABAA receptor and enabled L‐655,708 antinociceptive effect in male rats. These results suggest that α5‐GABAA receptor is a suitable target to treat chronic pain in females.

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Noninvasive evaluation of the influence of aucubin‐containing cosmetic macroemulsion on selected skin parameters
Authors: Dąbrowska Marta , Nowak Izabela
Published: August 2020

Background

Objective evaluation of skin condition on the basis of noninvasive methods has become obligatory and may be a good strategy for verifying the efficiency of new cosmetic active ingredients.

Aim

The aim of this study was to assess the influence of aucubin‐containing cosmetic macroemulsion on skin parameters using the skin testing equipment.

Patients/Methods

The study was carried out on the group of 25 female volunteers of the mean age 27 ± 2 years. The skin parameters were measured using the following devices: Tewameter® TM 300 (transepidermal water loss, TEWL), Corneometer® CM 825 (skin hydration), Cutometer® MPA 580 (skin elasticity), Visioscan® VC 98 (skin topography), and Visioline® VL 650 (skin macrorelief). All measurements were performed on the inner part of the left forearm.

Results

The skin parameters measured revealed the beneficial influence of aucubin on TEWL and skin hydration level. The application of aucubin‐enriched cream caused more significant improvements of all determined SELS parameters, in comparison with cream without it. An analogous tendency was noticed in the case of skin macrorelief parameters; the addiction of the active ingredient led to a decrease in the value of total wrinkle area and diminished the mean length and depth of single wrinkles.

Conclusions

Noninvasive methods of skin testing have provided a possibility of objective evaluation of the action of new active ingredients in cosmetic formulations. The study has proved the positive influence of aucubin on effectiveness of cosmetic macroemulsions, diminishing TEWL, increasing skin hydration level, and improving the values of SELS and skin macrorelief parameters.
Effects of N6‐(4‐hydroxybenzyl) adenine riboside in stress‐induced insomnia in rodents
Authors: Jou Shuo‐Bin , Tsai Chung‐Jen , Fang Chun‐Ying , Yi Pei‐Lu , Chang Fang‐Chia
Published: August 2020

Adenosine exhibits a somnogenic effect; however, there is no adenosinergic hypnotic because of cardiovascular effects. This study investigated whether N6‐(4‐hydroxybenzyl) adenine riboside (T1‐11), extracted from Gastrodia elata, produces somnogenic effects in rodents. We determined the involvement of adenosine 2A receptors (A2ARs) in GABAergic neurons of the ventrolateral preoptic area (VLPO) and the cardiovascular effects. Change of cage bedding is employed as a stressor to induce insomnia in rodents, and electroencephalograms and electromyograms were used to acquire and analyse sleep–wake activity. We found that intracerebroventricular administration of T1‐11 before a dark period increased non‐rapid eye movement (NREM) and rapid eye movement (REM) sleep during a dark period, and T1‐11‐induced sleep increases were blocked by the A2AR antagonist, SCH58261, in naïve rats. Oral administration of T1‐11 increased NREM sleep during both dark and light periods. Microinjection of the A2AR antagonist, SCH58261, into the VLPO blocked sleep effects of T1‐11. In addition to the somnogenic effect in naïve mice, T1‐11 suppressed the stress‐induced insomnia and this suppressive effect was blocked by SCH58261. C‐fos expression in GABAergic neurons of VLPO was increased after administration of T1‐11 in Gad2‐Cre::Ai14 mice, suggesting the activation of GABAergic neurons in the VLPO. T1‐11 exhibited no effects on heart rate and the low frequency/high frequency ratio of heart rate variability. We concluded that T1‐11 elicited somnogenic effects and effectively ameliorated acute stress‐induced insomnia. The somnogenic effect is mediated by A2ARs to activate GABAergic neurons in the VLPO. This adenosine analogue could be a potential hypnotic because of no sympathetic and parasympathetic effects on the cardiovascular system.
Cost‐effectiveness of strategies to improve HCV screening, linkage‐to‐care and treatment in remand prison settings in England
Authors: Mohamed Zameer , Scott Nick , Al‐Kurdi Deyaa , Selvapatt Nowlan , Thursz Mark R. , Lemoine Maud , Brown Ashley S. , Nayagam Shevanthi
Published: August 2020

Background

A simplified cascade‐of‐care may improve screening and treatment uptake among incarcerated individuals. We assessed the cost‐effectiveness of traditional and simplified screening and treatment in a London remand prison.

Methods

Using empirical data from Her Majesty's Prison (HMP) Wormwood Scrubs, London, we designed a decision tree and Markov transition state model using national average data for HCV screening and treatment for the base‐case scenario. This compared two alternative strategies; (a) general prison population screening and treatment and (b) prioritising screening and treatment among people who inject drugs (PWID) combined with general prison population screening and treatment. Strategies varied the rates of screening (47%‐90%), linkage‐to‐care (60%‐86%) and treatment (21%‐85%). Cost, utility and disease transition rates were obtained from existing literature. Outcome measures were as follows: screening, treatment and disease‐related costs per admitted individual, quality‐adjusted life years (QALYs). Incremental cost‐effectiveness ratios (ICERs) were calculated for each intervention. All costs and utilities were discounted at a rate of 3.5% per annum. Both univariate and probabilistic sensitivity analyses have been conducted.

Results

In our cohort of 5239 incarcerated individuals with an estimated chronic HCV prevalence of 2.6%, all strategy ICER values (£3565‐10 300) fell below the national willingness to pay threshold (£30 000). Increased successful treatment (7%‐54%) was observed by an optimising cascade‐of‐care. A robust sensitivity analysis identified treatment cost of, QALY for mild liver disease and probability of completing treatment as important factors that impact the ICER value.

Conclusion

In our remand setting, optimising adherence to the cascade‐of‐care is cost‐effective. Where universal screening is not practical, a stratified approach focused on intensive screening and treatment of PWID also results in increased treatment uptake and is highly cost‐effective.
Prognosis predictability of serum and urine renal markers in patients with decompensated cirrhosis: A multicentre prospective study
Authors: Kim Tae Hyung , Seo Yeon Seok , Kang Seong Hee , Kim Moon Young , Kim Sang Gyune , Lee Hyo Young , Lee Jeong‐Hoon , Lee Young‐Sun , Kim Ji Hoon , Jeong Soung Won , Jang Jae Young , Suk Ki Tae , Jung Young Kul , An Hyonggin , Yim Hyung Joon , Kim Young Seok , Um Soon Ho ,   The Korean Study Group of Portal Hypertension
Published: August 2020

Background and Aims

This prospective observational study aimed to evaluate the best serum and urine markers to assess predictability for the prognosis of patients with decompensated cirrhosis.

Methods

Serum creatinine and cystatin C (CysC), and urinary N‐acetyl‐beta‐D glucosaminidase (uNAG) and neutrophil gelatinase‐associated lipocalin (uNGAL) levels were measured from hospitalized patients with decompensated cirrhosis.

Results

In total, 328 patients (mean age, 57.2 ± 12.0 years; 237 men) with decompensated cirrhosis were included. Alcoholic liver disease was the most frequent underlying liver disease (68.0%). Acute kidney injury (AKI) was concomitantly present in 41 patients (12.5%) at baseline. INR, serum creatinine and CysC levels, and uNAG and uNGAL levels were significantly higher in patients with AKI. During hospitalization, AKI had progressed in 37 patients (11.3%). In 287 patients without AKI, the incidence of AKI at 3, 6, 9 and 12 months was 15.4%, 22.2%, 28.6% and 32.5% respectively. On multivariate analysis, serum CysC and uNAG levels were independent predictors of AKI, and their optimal cut‐off values were 1.055 mg/L and 23.1 U/g urinary Cr respectively. When patients were classified into three groups with these cut‐off values of serum CysC and uNAG levels (group 1, both low; group 2, one of two high; and group 3, both high), progression of AKI during hospitalization (P = .001), incidence of AKI in patients without AKI at baseline (P = .001) and mortality rate (P < .001) differed significantly according to serum CysC and uNAG levels.

Conclusion

Serum CysC and uNAG levels are useful prognostic markers for renal outcomes and mortality in patients with decompensated cirrhosis.