bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of functional placental magnetic resonance imaging for assessment of the placenta after prolonged preterm rupture of the membranes in vivo: A pilot study
Authors: Hutter Jana , Jackson Laurence , Ho Alison , Avena Zampieri Carla , Hajnal Joseph V. , Al‐Adnani Mudher , Nanda Surabhi , Shennan Andrew H. , Tribe Rachel M. , Gibbons Deena , Rutherford Mary A. , Story Lisa
Published: September 2021

Introduction

Preterm prelabor rupture of membranes (PPROM) complicates 3% of pregnancies in the UK. Where delivery does not occur spontaneously, expectant management until 37 weeks of gestation is advocated, unless signs of maternal infection develop. However, clinical presentation of maternal infection can be a late sign and injurious fetal inflammatory responses may already have been activated. There is therefore a need for more sensitive markers to aid optimal timing of interventions. At present there is no non‐invasive test in clinical practice to assess for infection in the fetal compartment and definitive diagnosis of chorioamnionitis is by histological assessment of the placenta after delivery. This study presents comprehensive functional placental magnetic resonance imaging (MRI) quantification, already used in other organ systems, to assess for infection/inflammation, in women with and without PPROM aiming to explore its use as a biomarker for inflammation within the feto‐placental compartment in vivo.

Material and methods

Placental MRI scans were performed in a cohort of 12 women (with one having two scans) with PPROM before 34 weeks of gestation (selected because of their high risk of infection), and in a control group of 87 women. Functional placental assessment was performed with magnetic resonance techniques sensitive to changes in the microstructure (diffusion) and tissue composition (relaxometry), with quantification performed both over the entire organ and in regions of interest between the basal and chorionic plate. Placental histology was analyzed after delivery where available.

Results

Normative evolution of functional magnetic resonance biomarkers over gestation was studied. Cases of inflammation, as assessed by histological presence of chorioamnionitis, and umbilical cord vasculitis with or without funisitis, were associated with lower T2* (mean T2* at 30 weeks 50 ms compared with 58 ms in controls) and higher fractional anisotropy (mean at 30 weeks 0.55 compared with 0.45 in controls). These differences did not reach significance and there was substantial heterogeneity both in T2* and Apparent Diffusivitiy across the cohort.

Conclusions

This first exploration of functional placental assessment in a cohort of women with PPROM demonstrates that functional placental MRI can reveal a range of placental changes associated with inflammatory processes. It is a promising tool to gain information and in the future to identify inflammation in vivo, and could therefore assist in improving optimal timing for interventions designed to prevent fetal injury.
Longitudinal asthma and allergy study showed that childhood symptoms frequently persisted into adulthood
Authors: Stefánsdóttir Arndís Rós , Lúdvíksson Björn Rúnar , Árdal Björn , Haraldsson Ásgeir
Published: September 2021

Aims

The prevalence of allergic diseases is high and increasing in many countries. The aim of this study was to describe the prevalence of allergic diseases and changes in clinical expression in a birth cohort followed for three decades.

Methods

We followed Icelandic citizens born in 1987 for allergic diseases when they were 2, 4, 8, 15, 21 and 29 years of age. These were diagnosed using standardised questionnaires, physical examinations and skin‐prick tests.

Results

Just under half (46%) of the 112 who took part at 29 years of age had one or more allergic diseases, usually mild. Eczema was confirmed in 14% and was highest at the age of 2 years (31%). The prevalence of asthma was 23% and was highest at the age of 4 years (28%). Allergic rhinitis affected 30% at 29 years of age but was not found before the age of 2 years. In addition, 34% had a positive skin‐prick test at 29 years of age.

Conclusion

The results show that 46% of Icelandic adults diagnosed with allergic diseases during childhood still had symptoms at the age of 29, usually mild, developing from eczema in infancy to asthma and allergic rhinitis in adulthood.
Identification of IGF2BP1‐related lncRNA‐miRNA‐mRNA network in goat skeletal muscle satellite cells
Authors: Xu Xiaoli , Leng Junchen , Zhang Xiao , Capellini Terence D. , Chen Yuan , Yang Liu , Chen Zitong , Zheng Shuailong , Zhang Xujia , Zhan Siyuan , Wang Linjie , Zhong Tao , Guo Jiazhong , Niu Lili , Wang Yan , Dai Dinghui , Zhang Hongping , Li Li , Cao Jiaxue
Published: September 2021

Insulin‐like growth factor 2 mRNA‐binding protein 1 (IGF2BP1) plays essential roles in the proliferation of skeletal muscle satellite cells (MuSCs). Increasing evidence has shown that IGF2BP1 regulates the expression of noncoding RNAs and mRNAs. However, the related molecular network remains to be fully understood. Therefore, we performed RNA sequencing and analyzed the microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and mRNAs differentially expressed in goat MuSCs treated with IGF2BP1 overexpressing and empty vectors. A total of 36 miRNAs, 59 lncRNAs, and 44 mRNAs were differentially expressed caused by IGF2BP1. Expectedly, they were enriched in muscle development‐related Rap1, PI3K‐AKT, and FoxO signaling pathways. Finally, we constructed a lncRNA‐miRNA‐mRNA interaction network containing 30 lncRNAs, 15 miRNAs, and 34 mRNAs, in which several miRNAs, including miR‐133a‐3p, miR‐204‐5p, miR‐125a‐3p, miR‐145‐3p, and miR‐423‐5p, relate with cell growth and participate in muscle development. Overall, we constructed an IGF2BP1‐related network, which provides new insight into the myogenic proliferation of goat.
Saliva testing as a means to monitor therapeutic lithium levels in patients with psychiatric disorders: Identification of clinical and environmental covariates, and their incorporation into a prediction model
Authors: Parkin Georgia M. , McCarthy Michael J. , Thein Soe H. , Piccerillo Hillary L. , Warikoo Nisha , Granger Douglas A. , Thomas Elizabeth A.
Published: September 2021

Objective

The narrow therapeutic window of lithium medications necessitates frequent serum monitoring, which can be expensive and inconvenient for the patient. Compared to blood, saliva collection is easier, non‐invasive, requires less processing, and can be done without the need for trained personnel. This study investigated the utility of longitudinal salivary lithium level monitoring.

Methods

We measured salivary lithium levels using ICP‐OES in n = 169 passive drool samples, collected both as single observations and longitudinally for up to 18 months, from a multi‐center cohort of n = 75 patients with bipolar disorder or other psychiatric conditions.

Results

Saliva and serum lithium levels were highly correlated. Adjustment for daily lithium dose, diabetes, and smoking improved this relationship (r = 0.77). Using the adjusted intersubject equation and a patient's salivary lithium value, we observed a strong correlation between the predicted vs. observed serum lithium levels (r = 0.70). Most patients had highly stable saliva/serum ratios across multiple visits, with longitudinal variability significantly greater with age. Use of the intrasubject saliva/serum ratio from a single prior observation had similar predictive power to the use of the adjusted intersubject equation. However, the use of the mean intrasubject ratio from three prior observations could robustly predict serum lithium levels (predicted vs. observed r = 0.90).

Conclusions

These findings strongly suggest that saliva could be used for lithium monitoring, and open the door for the development and implementation of a point‐of‐care salivary lithium device for use at home or the clinic. We propose that the use of saliva will dramatically improve treatment opportunities for patients with mood disorders.
To drink or not to drink: When drinking intentions predict alcohol consumption and consequences
Authors: Hamilton Hannah R. , Armeli Stephen , Tennen Howard
Published: September 2021

Objectives

We examined daily associations between drinking intentions and drinking behaviour and tested past drinking behaviour and current social environment as potential moderators of the daily intention‐behaviour association. We expected both more frequent past drinking and being in a high drinking environment to weaken the intention‐behaviour association. We also tested intentionality as a moderator of the association between alcohol consumption and next‐day negative outcomes, expecting that less intentional alcohol consumption would be related to greater stress and regret.

Design

We tested these hypotheses using two separate micro‐longitudinal studies of college students (Ns = 1,641, 540).

Methods

In two samples, participants completed bursts of data collection in which they indicated their previous alcohol consumption and then completed 30 days of diary surveys in which they reported their alcohol consumption and social environment the previous evening and their levels of stress, regret, and drinking intentions that day.

Result

Consistent with our predictions, drinking intentions more strongly predicted drinking behaviour among individuals with less frequent past drinking behaviour, and, in Sample 1, drinking intentions more strongly predicted drinking behaviour among individuals in a low drinking environment. Contrary to hypotheses, results indicated that individuals with low drinking intentions were more likely to experience stress the next day, particularly if they consumed less alcohol. Greater consumption, however, was related to greater odds of experiencing regret, but this was stronger among individuals with higher drinking intentions.

Conclusions

Findings are discussed in terms of the complex interplay between intentions and both social environment and contextual factors with respect to predicting drinking level and related problems.
Improving intraoral implant scanning with a novel auxiliary device: An in‐vitro study
Authors: Pan Yu , Tsoi James Kit Hon , Lam Walter YH , Zhao Ke , Pow Edmond HN
Published: September 2021

Objectives

To develop a novel auxiliary device for improving the accuracy of intraoral implant scanning in the complete‐edentulous arch.

Materials and methods

A standard model of edentulous maxilla with six dummy implants was prepared. Scan bodies were attached to the model, which was scanned by a laboratory scanner. A simulated mucosa (Group 0), a resin base (Group 1), a resin base with a cuboidal reference block and 4 fiduciary spheres (Group 2) or artificial teeth (Group 3) in between the implants were mounted on the model, respectively. Each group were consecutively scanned using an intraoral scanner (n = 10). The scans were analysed for trueness and precision in inter‐implant distances and angles by inspection software. Effects of the auxiliary device and different quadrants on the accuracy of complete‐arch intraoral scanning were analysed by two‐way ANOVA.

Results

Significant effects of the auxiliary device and quadrant were found on both linear and angular accuracies. The lowest linear accuracy was found in group 0. Group 1 and group 3 showed the best linear accuracy in quadrant 1 and quadrant 2, respectively. Group 2 showed the least angular precision among the three groups.

Conclusions

The three designs of auxiliary devices significantly improved the accuracy of complete‐arch intraoral implant scanning. The base‐only design showed good scanning accuracy in a single quadrant, while the base with tooth‐shaped landmarks design showed better accuracy in cross‐arch. The fiduciary spheres might compromise the precision of scanning.
Excising or preserving perforation margins in endoscopic transtympanic cartilage myringoplasty does not affect surgical success
Authors: Lou Zhengcai , Lou Zihan , Jin Kangfeng , Sun Junzhi , Chen Zhengnong
Published: September 2021

Objective

To compare the outcome of endoscopic transtympanic cartilage myringoplasty with and without removal of perforation edges for repairing chronic perforations with mucosal chronic otitis media (COM).

Study design

Quasi‐randomised clinical trial.

Setting

Tertiary referral centre.

Materials and Methods

Patients with chronic perforations and mucosal COM undergoing endoscopic transtympanic cartilage myringoplasty were allocated to a control group for whom the perforation edges were preserved (n = 40) and an intervention group for whom the edges were removed (n = 39). Mean operation time, graft success rate, mean scores of graft neovascularisation and epithelialisation, and hearing were compared between the groups at 4 weeks and/or 6 months postoperatively.

Results

Graft success rate was 95% (38/40) in the control group and 97% (38/39) in the intervention group at 6 months postoperatively; the difference was not significant. Mean graft neovascularisation scores 4 weeks postoperatively were 2.52 ± 0.59 in the control group and 2.58 ± 0.55 in the intervention group; the difference was not significant. Mean graft epithelisation scores 4 weeks postoperatively were 1.48 ± 0.57 in the control group and 1.68 ± 0.51 in the intervention group; the difference was not significant and remained nonsignificant 6 months postoperatively (2.5 ± 0.55 vs. 2.76 ± 0.36). Audiological outcomes at 6 months did not differ between the groups.

Conclusion

Endoscopic, transtympanic cartilage underlay myringoplasty with preservation of the perforation margins did not affect graft neovascularisation, epithelialisation or success. Longer‐term outcomes and risk of cholesteatoma require further study.
Sotagliflozin for patients with type 2 diabetes: A systematic review and meta‐analysis
Authors: Avgerinos Ioannis , Karagiannis Thomas , Kakotrichi Panagiota , Michailidis Theodoros , Liakos Aris , Matthews David R. , Tsapas Apostolos , Bekiari Eleni
Published: September 2021

Aim

To assess the efficacy and safety of sotagliflozin in patients with type 2 diabetes.

Methods

We searched Medline, Embase, the Cochrane Library, and grey literature sources up to August 2021 for randomized controlled trials (RCTs) that compared sotagliflozin with placebo or other antidiabetic agents in patients with type 2 diabetes. Our primary outcome was change in HbA1c from baseline. We additionally assessed three secondary efficacy and 15 safety outcomes. We synthesized data using weighted mean differences (WMDs) and odds ratios (ORs), along with 95% confidence intervals (CIs).

Results

We included 11 RCTs comprising 16 411 subjects in the meta‐analysis. Compared with placebo, sotagliflozin reduced HbA1c (WMD −0.42%, 95% CI −0.56 to −0.29), body weight (WMD −1.33 kg, 95% CI −1.57 to −1.09), and systolic blood pressure (WMD −2.44 mmHg, 95% CI −2.81 to −2.07). No difference was evident against other active comparators. Sotagliflozin reduced myocardial infarction (OR 0.72, 95% CI 0.54 to 0.97) and heart failure (OR 0.68, 95% CI 0.58 to 0.79) compared with placebo, and had a neutral effect on all‐cause mortality, cardiovascular mortality, and stroke. Treatment with sotagliflozin was safe regarding the incidence of serious adverse events, hypoglycaemia, and diabetic ketoacidosis. Nevertheless, it was associated with an increased incidence of diarrhoea, genital infections, and volume depletion events.

Conclusions

Sotagliflozin reduces blood glucose, body weight, and systolic blood pressure, and demonstrates a beneficial effect on heart failure and myocardial infarction. Its overall safety profile is comparable with other sodium‐glucose co‐transporter‐2 inhibitors.
Local canopy disturbance as an explanation for long‐term increases in liana abundance
Authors: Schnitzer Stefan A. , DeFilippis David M. , Visser Marco , Estrada‐Villegas Sergio , Rivera‐Camaña Rigoberto , Bernal Boris , Peréz Salomé , Valdéz Abelino , Valdéz Seberino , Aguilar Antonio , Dalling James W. , Broadbent Eben N. , Almeyda Zambrano Angelica M. , Hubbell Stephen P. , Garcia‐Leon Maria
Published: September 2021

Canopy disturbance explains liana abundance and distribution within tropical forests and thus may also explain the widespread pattern of increasing liana abundance; however, this hypothesis remains untested. We used a 10‐year study (2007–2017) of 117,100 rooted lianas in an old‐growth Panamanian forest to test whether local canopy disturbance explains increasing liana abundance. We found that liana density increased 29.2% and basal area 12.5%. The vast majority of these increases were associated with clonal stem proliferation following canopy disturbance, particularly in liana‐dense, low‐canopy gaps, which had far greater liana increases than did undisturbed forest. Lianas may be ecological niche constructors, arresting tree regeneration in gaps and thus creating a high‐light environment that favours sustained liana proliferation. Our findings demonstrate that liana abundance is increasing rapidly and their ability to proliferate via copious clonal stem production in canopy gaps explains much of their increase in this and possibly other tropical forests.
Retinoids are not linked to risk of multiple sclerosis: A Danish nationwide cohort study
Authors: Cortes‐Figueiredo Filipe , Nielsen Nete Munk , Stenager Egon , Paul Friedemann , Hallas Jesper , Kristensen Kasper Bruun
Published: September 2021

Background and purpose

Multiple sclerosis (MS) is a chronic immune‐mediated disease of the central nervous system with an undetermined etiology. Retinoids may have immunomodulatory effects that favorably influence MS progression. We aimed to explore the yet unknown relationship between exposure to retinoids and the risk of acquiring MS.

Methods

We performed a nationwide cohort study in the Danish population in the period 1998–2016, comparing MS incidence in three groups: users of systemic retinoids; users of topical retinoids (negative control group); and users of non‐retinoid acne drugs (control group). We used data from the Danish Multiple Sclerosis Registry (DMSR), the Danish National Prescription Registry and the Danish National Patient Registry. Linkage was obtained through the personal identification number (CPR number). We addressed confounding by three‐way propensity score (PS)‐matching weights. Additionally, to evaluate a cumulative dose–response effect for systemic retinoids on MS incidence, we conducted a case–control study, nested within the cohort.

Results

A total of 257,193 users of non‐retinoid acne drugs, 130,560 users of topical retinoids, and 75,610 users of systemic retinoids were included. Systemic retinoid use was not associated with a reduced risk of MS compared to non‐retinoid acne drug use in crude (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.61 to 1.05]) and weighted analyses (HR 0.89, 95% CI 0.67 to 1.20). There was no evidence of a cumulative dose–response association between systemic retinoids and MS incidence.

Conclusions

Use of systemic retinoids was not associated with a reduced incidence of MS compared to use of non‐retinoid acne drugs in this study.
Revisiting the steps of Salmonella gut infection with a focus on antagonistic interbacterial interactions
Authors: Sibinelli‐Sousa Stephanie , de Araújo‐Silva André Luiz , Hespanhol Julia Takuno , Bayer‐Santos Ethel
Published: September 2021

A commensal microbial community is established in the mammalian gut during its development, and these organisms protect the host against pathogenic invaders. The hallmark of noninvasive Salmonella gut infection is the induction of inflammation via effector proteins secreted by the type III secretion system, which modulate host responses to create a new niche in which the pathogen can overcome the colonization resistance imposed by the microbiota. Several studies have shown that endogenous microbes are important to control Salmonella infection by competing for resources. However, there is limited information about antimicrobial mechanisms used by commensals and pathogens during these in vivo disputes for niche control. This review aims to revisit the steps that Salmonella needs to overcome during gut colonization—before and after the induction of inflammation—to achieve an effective infection. We focus on a series of reported and hypothetical antagonistic interbacterial interactions in which both contact‐independent and contact‐dependent mechanisms might define the outcome of the infection.
Horizontal movements, utilization distributions, and mixing rates of yellowfin tuna (Thunnus albacares) tagged and released with archival tags in six discrete areas of the eastern and central Pacific Ocean
Authors: Schaefer Kurt M. , Fuller Daniel W.
Published: September 2021

A total of 1522 yellowfin tuna, Thunnus albacares, were captured, tagged, and released with surgically implanted archival tags (ATs), in six discrete areas of the eastern and central Pacific Ocean, during 2002 through 2019. Of 483 ATs returned (31.7%), 227 ATs from yellowfin (48–147 cm in fork length) at liberty from 32 to 1846 d (
 = 300.1 d) provided suitable data sets which were processed using an unscented Kalman filter model with sea‐surface temperature measurements integrated (UKFsst) in order to obtain most probable tracks and movement parameters. Although some differences were observed in the movement patterns for fish from within and among the six release areas, 99% of the 227 fish remained within 1000 M of their release locations, indicating limited dispersion and fidelity to release locations. The median movement parameter D, which defines dispersion from the UKFsst model, for the fish released in the offshore equatorial areas showed much greater dispersion rates compared to those for the fish released along the coast or around islands. The rates of mixing of yellowfin among the release areas were found to be dependent on the distances between release areas, with, in general, the greatest mixing occurring among areas in closest proximity, whereas for the two areas offshore Mexico and the two offshore equatorial areas, the rates of mixing were nonexistent or negligible.
What structures diurnal visitation rates to flowering trees in an Afrotropical lowland rainforest understory?
Authors: Drager Andrea P. , Chuyong George B. , Kenfack David , Nkomo Wilfried Asset , Thomas Duncan W. , Wandji Ruth Tchana , Dunham Amy E.
Published: September 2021

As environmental change and degradation accelerate, perturbing insect populations, we need to better understand the resource use dynamics of diverse wild pollinators. Most tropical trees are adapted for biotic pollination, yet we still know little about plant–pollinator interactions in African rainforests.

We addressed this gap from a community perspective, identifying what floral traits – colour, scent, reward accessibility and visibility – structure visitation patterns among insect functional groups to tree species flowering in the understory of Korup National Park, Cameroon. To understand how visitor groups share resources, we used joint modelling that explicitly considers zero‐inflation in visitation rates and correlation among visitor groups.

Most tree species had exposed floral rewards, and all were visited by multiple insect groups among which ants, bees, beetles, and flies were most abundant. Visitation rates varied more among tree species than among individual trees. Floral scent differences were important for structuring visits, particularly for flies, bees, and ants. Ant and bee visitation rates decreased while fly visits increased marginally throughout the season, correlated with the dry to wet season transition.

Comparison with other lowland tropical understories suggests flies may be uniquely diverse and important to this system, and differences in seasonality and forest structure may be drivers of community differences. Floral scent is likely a key functional trait structuring flower–insect interactions in tropical forest environments and should be emphasised in future studies. Lastly, a joint modelling approach can elucidate community structure, particularly in communities with ecologically generalised interactions.
Towards a non‐dichotomous view of motivators and demotivators in language learning
Authors: Pack Austin , Kiss Tamas , Barrett Alex , Chen Chen
Published: September 2021

This study explores the motivational dynamics and motivational factors of 60 first‐year English for Academic Purposes learners. Data were collected over a 10‐week period by means of motivation journals and focus group discussions. The findings indicate that students’ motivation levels changed frequently from day to day and that motivational factors can serve as both motivators and demotivators as their strength and polarity change according to initial conditioning and the complex interactions of factors within and outside of the classroom context. We argue that the practice of categorizing contextual factors as motivators or demotivators be abandoned, and in its place a non‐dichotomous view of motivators and demotivators in language learning be adopted.
Our evolving view of neutrophils in defining the pathology of chronic lung disease
Authors: Mincham Kyle T. , Bruno Nicoletta , Singanayagam Aran , Snelgrove Robert J.
Published: September 2021

Neutrophils are critical components of the body's immune response to infection, being loaded with a potent arsenal of toxic mediators and displaying immense destructive capacity. Given the potential of neutrophils to impart extensive tissue damage, it is perhaps not surprising that when augmented these cells are also implicated in the pathology of inflammatory diseases. Prominent neutrophilic inflammation is a hallmark feature of patients with chronic lung diseases such as chronic obstructive pulmonary disease, severe asthma, bronchiectasis and cystic fibrosis, with their numbers frequently associating with worse prognosis. Accordingly, it is anticipated that neutrophils are central to the pathology of these diseases and represent an attractive therapeutic target. However, in many instances, evidence directly linking neutrophils to the pathology of disease has remained somewhat circumstantial and strategies that have looked to reduce neutrophilic inflammation in the clinic have proved largely disappointing. We have classically viewed neutrophils as somewhat crude, terminally differentiated, insular and homogeneous protagonists of pathology. However, it is now clear that this does not do the neutrophil justice, and we now recognize that these cells exhibit heterogeneity, a pronounced awareness of the localized environment and a remarkable capacity to interact with and modulate the behaviour of a multitude of cells, even exhibiting anti‐inflammatory, pro‐resolving and pro‐repair functions. In this review, we discuss evidence for the role of neutrophils in chronic lung disease and how our evolving view of these cells may impact upon our perceived assessment of their contribution to disease pathology and efforts to target them therapeutically.
Poverty and health inequalities: Perceptions of social work students and nursing students
Authors: Demirtas Basak , Polat Gonca , Özalp Ateş Funda Seher , Ka‘opua Lana Sue
Published: September 2021

Aim

This study describes student perceptions on health inequalities and causes of poverty.

Background

As frontline providers, social workers and nurses are expected to engage with patients from socioeconomically diverse backgrounds.

Methods

In this cross‐sectional study, a socio‐demographic questionnaire, a questionnaire on health inequalities and the Perceived Causes of Poverty Scale were administered using a convenience sample of 155 students in social work and 266 students in nursing undergraduate programmes at a state university in Turkey. Mann–Whitney U test and Spearman correlation coefficient were used in the analysis of the data.

Findings

Social work students were more likely to attribute the cause of poverty to social injustice and a lack of opportunities, whereas nursing students had more fatalistic explanations or beliefs, maintaining that outcomes are pre‐determined and therefore cannot be changed. In both groups, those who agreed that there were problems and deficiencies in health service provision and that there was ill‐health among poor groups were more likely to associate poverty with social injustice and lack of opportunities. Those without a systemic understanding of poverty and health inequalities showed a tendency to hold more individualistic/fate‐related perspectives.

Conclusion and implications for nursing and education policy

The nursing students, as compared to the social work students, tended to explain poverty more on the basis of individual responsibility and fatalism and were less likely to link poverty with health inequalities and to advocate for policies to end health inequalities. The students’ perceptions on the causes of poverty affected their views on health inequalities. These findings suggest the need to develop curricula that equip nursing students with an understanding of poverty as a systemic cause of health inequality. Health inequality and poverty need to be positioned at the centre of training curricula by professional accreditation bodies. Interdisciplinary collaboration is recommended to foster advocacy skills in students. Furthermore, transformative changes are needed in nursing and social work education to prepare students to adequately address the Social Determinants of Health. Curricula should incorporate leadership and political activism within courses to facilitate structural change.
Effect of Ta5+ doping on the thermal physical properties of defective fluorite Y3NbO7 ceramics
Authors: Song Dowon , Pyeon Janghyeok , Ryu Myeungwoo , Jeon Hak‐Beom , Oh Yoon‐Suk , Song Taeseup , Paik Ungyu , Yang SeungCheol , Jung Yeon‐Gil
Published: September 2021

The effects of substituting the B cation in A3BO7 ceramics on their thermal physical properties were investigated by applying a large mass difference. Y3(Nb1‐xTax)O7 (x = 0, 0.1, 0.2, 0.3, 0.4, and 0.5) ceramics were synthesized, and their structural characteristics were determined. All the fabricated Y3(Nb1‐xTax)O7 ceramics showed defective fluorite structures and glass‐like low thermal conductivity (1.18−2.04 W/m∙K at 25°C) because of the highly distorted crystal structure and significant mass difference. Substitution with Ta5+ enhanced the sintering resistance, leading to superior thermal‐insulating performance via grain boundary scattering. Furthermore, the ceramics exhibited excellent coefficients of thermal expansion, implying the promising applicability of Y3(Nb1‐xTax)O7 as new thermal barrier materials. The effect of mass difference on the thermomechanical properties of the ceramics was examined, suggesting a simple strategy for engineering the chemical composition of new thermal barrier materials.
Resistance to antihypertensive treatment and long‐term risk: The Atherosclerosis Risk in Communities study
Authors: Wijkman Magnus O. , Malachias Marcus V.B. , Claggett Brian L. , Cheng Susan , Matsushita Kunihiro , Shah Amil M. , Jhund Pardeep S. , Coresh Josef , Solomon Scott D. , Vardeny Orly
Published: September 2021

More stringent blood pressure (BP) goals have led to greater prevalence of apparent resistant hypertension (ARH), yet the long‐term prognostic impact of ARH diagnosed according to these goals in the general population remains unknown. We assessed the prognostic impact of ARH according to contemporary BP goals in 9612 participants of the Atherosclerosis Risk in Communities (ARIC) study without previous cardiovascular disease. ARH, defined as BP above goal (traditional goal <140/90 mmHg, more stringent goal <130/80 mmHg) despite the use of ≥3 antihypertensive drug classes or any BP with ≥4 antihypertensive drug classes (one of which was required to be a diuretic) was compared with controlled hypertension (BP at goal with 1‐3 antihypertensive drug classes). Cox regression models were adjusted for age, sex, race, study center, BMI, heart rate, smoking, eGFR, LDL, HDL, triglycerides, and diabetes. Using the traditional BP goal, 133 participants (3.8% of the treated) had ARH. If the more stringent BP goal was instead applied, 785 participants (22.6% of the treated) were reclassified from controlled hypertension to uncontrolled hypertension (n = 725) or to ARH (n = 60). Over a median follow‐up time of 19 years, ARH was associated with increased risk for a composite end point (all‐cause mortality, hospitalization for myocardial infarction, stroke, or heart failure) regardless of whether traditional (adjusted HR 1.50, 95% CI: 1.23‐1.82) or more stringent (adjusted HR 1.43, 95% CI: 1.20‐1.70) blood pressure goals were applied. We conclude that in patients free from cardiovascular disease, ARH predicted long‐term risk regardless of whether traditional or more stringent BP criteria were applied.
Dose‐dependent effect of mesenchymal stromal cells co‐grafted with dopaminergic neurons in a Parkinson's disease rat model
Authors: Rodriguez‐Pallares Jannette , Garcia‐Garrote Maria , Parga Juan A. , Labandeira‐Garcia Jose Luis
Published: September 2021

A major limiting factor for cell therapy in Parkinson's disease is the poor survival and reinnervation capacity of grafted dopaminergic neurons, independently of the cell source. Mesenchymal stromal cells (MSCs) have high capability to regulate the local environment through the release of trophic, antiapoptotic and immunomodulatory factors. In this work, we investigated whether co‐grafting of MSCs could improve the survival and reinnervation ability of dopaminergic precursors transplanted in animal models of Parkinson's disease. Rats with total unilateral dopaminergic denervation were grafted with a cell suspension of rat dopaminergic precursors (500,000 cells) with or without a high (200,000 cells) or low (25,000 cells) number of MSCs. Eight weeks after grafting, rats were tested for motor behaviour and sacrificed for histological analysis. Our results showed that the survival of dopaminergic neurons and graft‐derived striatal dopaminergic innervation was higher in rats that received co‐grafts containing a low number of MSCs than in non‐co‐grafted controls. However, the survival of dopaminergic neurons and graft‐derived dopaminergic reinnervation was lower in rats receiving co‐grafts with high number of MSCs than in non‐co‐grafted controls. In conclusion, co‐grafting with MSCs or MSCs‐derived products may constitute a useful strategy to improve dopaminergic graft survival and function. However, a tight control of MSCs density or levels of MSCs‐derived products is necessary.
Non‐carious cervical lesions (NCCLs) and associated factors: A multilevel analysis in a cohort study in southern Brazil
Authors: Demarco Flávio Fernando , Cademartori Mariana Gonzalez , Hartwig Andréia Drawanz , Lund Rafael Guerra , Azevedo Marina Sousa , Horta Bernardo Lessa , Corrêa Marcos Britto , Huysmans Marie‐Charlotte D. N. J. M.
Published: September 2021

Aim

To investigate the prevalence of non‐carious cervical lesions (NCCLs) and their association with individual and tooth‐related factors in adults from the 1982 Pelotas Birth Cohort.

Materials and methods

Participants were interviewed and clinically examined at the age of 31. NCCL was defined as loss of dental tissue without bacterial involvement in the cervical region. Independent variables were the socioeconomic, demographic, behavioural, and clinical characteristics. Associations were tested using a multilevel Poisson regression model.

Results

Five‐hundred and thirty‐nine participants were clinically examined, with a 26% prevalence of NCCLs, which were more prevalent in the maxilla (56.5%) and in premolars (72.9%). In the multilevel analysis, women presented lower prevalence than men [prevalence ratio (PR) 0.59 (0.48–0.73)]; those who reported smoking at both 22 and 30 years of age had more NCCLs than those who never smoked [PR 1.65 (1.31–2.07)]; and high‐frequency brushers presented higher prevalence than low‐frequency brushers [PR 1.26 (1.03–1.55)]. Gingival recession increased 10 times the prevalence of NCCLs [PR 10.03 (8.15–12.35)], while the presence of periodontal pockets (≥4 mm) reduced the prevalence of NCCLs [PR 0.43 (0.28–0.66)].

Conclusions

NCCLs were more prevalent in males, smokers, and those with higher frequency of toothbrushing. While the presence of periodontal pockets was associated with a lower prevalence of NCCLs, gingival recession was a strong clinical indicator for the presence of NCCLs.
Serum antibody response against periodontal bacteria and coronary heart disease: Systematic review and meta‐analysis
Authors: Joshi Chaitanya , Bapat Ranjeet , Anderson William , Dawson Dana , Cherukara George , Hijazi Karolin
Published: September 2021

Aim

The present systematic review and meta‐analysis assessed the strength of a reported association between elevated serum anti‐periodontal bacterial antibody responses and coronary heart disease (CHD).

Materials and methods

Twenty original studies were identified after systematically searching five databases. The majority (n = 11) compared serum anti‐Porphyromonas gingivalis (Pg) and/or anti‐Aggregatibacter actinomycetemcomitans (Aa) IgG antibody responses between CHD patients and control participants. The strength of the association between serum anti‐Pg antibodies and CHD (n = 10) and serum anti‐Aa antibodies and CHD (n = 6) was investigated using a meta‐analysis approach separately.

Results

Most studies (61%) reported that the serum IgG antibody responses were elevated in CHD patients than in controls. The meta‐analyses showed a significant association between elevated serum IgG antibody responses (anti‐Pg and anti‐Aa) and CHD, with pooled odds ratios of 1.23 [95% confidence interval (CI): 1.09–1.38, p = .001] and 1.25 (95% CI: 1.04–1.47, p = .0004), respectively.

Conclusions

A modest increase of CHD events in individuals with higher serum anti‐Pg and anti‐Aa IgG antibody responses may support their use as potential biomarkers to detect and monitor at‐risk populations. However, the observed inconsistencies with the design and interpretation of immunoassays warrant standardization of the immunoassays assessing antibody responses against periodontal bacteria.
Life expectancy estimates based on comorbidities and frailty to inform preventive care
Authors: Schoenborn Nancy L. , Blackford Amanda L. , Joshu Corinne E. , Boyd Cynthia M. , Varadhan Ravi
Published: September 2021

Background

Long‐term prognostication is important to inform preventive care in older adults. Existing prediction indices incorporate age and comorbidities. Frailty is another important factor in prognostication. In this project, we aimed at developing life expectancy estimates that incorporate both comorbidities and frailty.

Methods

In this retrospective cohort study, we used data from a 5% sample of Medicare beneficiaries with and without history of cancer from Surveillance, Epidemiology, and End Results (SEER) cancer registry areas. We included adults aged 66–95 years who were continuously enrolled in fee‐for‐service Medicare for ≥1 year from 1998 to 2014. Participants were followed for survival until 12/31/2015, death, or disenrollment. Comorbidity (none, low/medium, high) and frailty categories (low, high) were defined using established methods for claims. We estimated 5‐ and 10‐year survival probabilities and median life expectancies by age, sex, comorbidities, and frailty.

Results

The study included 479,646 individuals (4,128,316 person‐years), of whom most were women (58.7%). Frailty scores varied widely among participants in the same comorbidity category. In Cox models, both comorbidities and frailty were independent predictors of mortality. Individuals with high comorbidities (HR, 3.24; 95% CI, 3.20–3.28) and low/medium comorbidities (HR, 1.36; 95% CI, 1.34–1.39) had higher risks of death than those with no comorbidities. Compared to low frailty, high frailty was associated with higher risk of death (HR, 1.55; 95% CI, 1.52–1.58). Frailty affected life expectancy estimates in ways relevant to preventive care (i.e., distinguishing <10‐year versus >10‐year life expectancy) in multiple subgroups.

Conclusion

Incorporating both comorbidities and frailty may be important in estimating long‐term life expectancies of older adults. Our life expectancy tables can aid clinicians' prognostication and inform simulation models and population health management.
Test–retest reliability of the Epworth Sleepiness Scale in clinical trial settings
Authors: Rosenberg Russell , Babson Kimberly , Menno Diane , Morris Susan , Baladi Michelle , Hyman Danielle , Black Jed
Published: September 2021

The present analysis examined the test–retest reliability of the Epworth Sleepiness Scale in participants with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea in three clinical trials. Intraclass correlation coefficient estimates for Epworth Sleepiness Scale scores from two solriamfetol 12‐week placebo‐controlled trials (one narcolepsy, one obstructive sleep apnea) and one long‐term open‐label extension trial (narcolepsy or obstructive sleep apnea) were calculated using postbaseline time‐point pairs for the overall population in each trial, by treatment, and by primary obstructive sleep apnea therapy adherence. In the 12‐week narcolepsy trial, intraclass correlation coefficients (95% confidence intervals) were 0.83 (0.79, 0.87) for weeks 4 and 8 (n = 199), 0.87 (0.83, 0.90) for weeks 8 and 12 (n = 196), and 0.81 (0.76, 0.85) for weeks 4 and 12 (n = 196). In the 12‐week obstructive sleep apnea trial, intraclass correlation coefficients (95% confidence intervals) were 0.74 (0.69, 0.78) (n = 416), 0.80 (0.76, 0.83) (n = 405), and 0.74 (0.69, 0.78) (n = 405), respectively. In the open‐label extension trial, intraclass correlation coefficients (95% confidence intervals) were 0.82 (0.79, 0.85) for weeks 14 and 26/27 (n = 495), 0.85 (0.82, 0.87) for weeks 26/27 and 39/40 (n = 463), and 0.78 (0.74, 0.81) for weeks 14 and 39/40 (n = 463). Placebo/solriamfetol treatment or adherence to primary obstructive sleep apnea therapy did not affect reliability. In conclusion, across three large clinical trials of participants with narcolepsy or obstructive sleep apnea, Epworth Sleepiness Scale scores demonstrated a robust acceptable level of test–retest reliability in evaluating treatment response over time.
Smartphone‐based virtual agents and insomnia management: A proof‐of‐concept study for new methods of autonomous screening and management of insomnia symptoms in the general population
Authors: Dupuy Lucile , Morin Charles M. , de Sevin Etienne , Taillard Jacques , Salles Nathalie , Bioulac Stéphanie , Auriacombe Marc , Micoulaud‐Franchi Jean‐Arthur , Philip Pierre
Published: September 2021

Insomnia is the most frequent sleep disorder, and the COVID‐19 crisis has massively increased its prevalence in the population, due to psychosocial stress or direct viral contamination. KANOPEE_2 is a smartphone‐based application that provides interactions with a virtual agent to autonomously screen and alleviate insomnia symptoms through an intervention programme giving personalized advices regarding sleep hygiene, relaxation techniques and stimulus‐control. In this proof‐of‐concept study, we tested the effects of KANOPEE_2 among users from all over the country (France) who downloaded the app between 1 June and 26 October 2020 (to focus on effects after the end of COVID‐19 confinement). Outcome measures include insomnia severity (Insomnia Severity Index) and sleep/wake schedules measured by a sleep diary. One‐thousand and thirty‐four users answered the screening interview (Mage = 43.76 years; SD = 13.14), and 108 completed the two‐step programme (Mage = 46.64 years; SD = 13.63). Of those who answered the screening, 42.8% did not report sleep complaints, while 57.2% presented mild‐to‐severe insomnia symptoms. At the end of the intervention, users reported significantly fewer sleep complaints compared with the beginning of the intervention (Insomnia Severity Indexbeginning = 13.58; Insomnia Severity Indexend = 11.30; p < 0.001), and significantly increased their sleep efficiency (sleep efficiencybeginning = 76.46%; sleep efficiencyend = 80.17%; p = 0.013). KANOPEE_2 is a promising solution both to provide autonomous evaluation of individuals’ sleep hygiene and reduce insomnia symptoms over a brief and simple intervention. These results are very encouraging for addressing the issue of insomnia management in people exposed to major psychosocial stress and the consequences of COVID‐19 infection.
Using spatial patterns of seeds and saplings to assess the prevalence of heterospecific replacements among cloud forest canopy tree species
Authors: Mejía‐Domínguez Nancy R. , Meave Jorge A. , Díaz‐Ávalos Carlos , Gómez‐Aparicio Lorena
Published: September 2021

Questions

To gain insights into the role of species‐by‐species replacements in cloud forest community structuring, we asked: (1) What are the effects of the spatial distribution of standing individuals on the seed rain, soil seed bank, and sapling density and survival in this cloud forest?; and (2) What is the prevalence of conspecific vs heterospecific replacements in the regeneration of this forest?

Location

Santo Tomás Teipan, Oaxaca State, southern Mexico.

Methods

In a 1‐ha cloud forest plot, we assessed seed rain, seed bank, and sapling density and survival of four canopy tree species (Chiranthodendron pentadactylon, Cornus disciflora, Quercus laurina and Oreopanax xalapensis). All standing individuals of these and other tree species (diameter at breast height [DBH] ≥ 2.5 cm) were mapped. We used neighbourhood models to examine the spatial patterns of the three life cycle stages relative to the spatial distribution of adults. The neighbourhood effect was assessed through the Neighbourhood Index, which integrates information on size (DBH) and distance to adults. Data analysis was based on maximum likelihood and model selection procedures.

Results

We found large between‐species differences regarding the spatial patterns of seeds and saplings. Three species showed evidence for the Janzen–Connell effect operating at the seed (Chiranthodendron pentadactylon and Quercus laurina) or sapling (Oreopanax xalapensis) stage. We also found support for a critical role of specific microsite factors (i.e. niche differentiation) in the regeneration of two species (Chiranthodendron pentadactylon and Cornus disciflora).

Conclusions

Seed and sapling distribution patterns suggest the prevalence of heterospecific replacements and that both Janzen–Connell and niche differentiation effects contribute to this pattern. Our results largely support the notion that the prevalence of heterospecific replacements among canopy species promotes species co‐existence in cloud forests.