bluuebunny/crossref_metadata_2025 huggingface dataset:
S1‐Leitlinie Atypisches Fibroxanthom (AFX) und pleomorphes dermales Sarkom (PDS)
Authors: Helbig Doris , Ziemer Mirjana , Dippel Edgar , Erdmann Michael , Hillen Uwe , Leiter Ulrike , Mentzel Thomas , Osterhoff Georg , Ugurel Selma , Utikal Jochen , von Bubnoff Dagmar , Weishaupt Carsten , Grabbe Stephan
Published: February 2022

Das atypische Fibroxanthom (AFX) und das pleomorphe dermale Sarkom (PDS) sind seltene Neoplasien der Haut und histomorphologisch, genetisch sowie epigenetisch Varianten eines Tumorspektrums. Die Tumoren treten typischerweise bei hochbetagten Männern in chronisch lichtexponierter Haut als unspezifische, haut‐ bis fleischfarbene, häufig ulzerierte Knoten auf. Das AFX imponiert meist als gut umschriebener Tumor, während das PDS häufiger unscharf abgegrenzt und infiltrativ wachsend ist. Die Wachstumsdynamik beider Tumorarten ist variabel. Histologisch sind sie charakterisiert durch spindelförmige und epitheloide Tumorzellen mit pleomorphen Kernen sowie atypische mehrkernige Tumorriesenzellen und häufig atypische Mitosen. Im Unterschied zum AFX erfasst das PDS relevante Anteile der Subkutis und/oder weist nekrotische Tumoranteile und/oder eine perineurale Infiltration auf. Aufgrund der regelhaften Entdifferenzierung von AFX/PDS (Grad 3) erfolgt die Sicherung der Diagnose durch eine immunhistologische Ausschlussdiagnostik, insbesondere anderer kutaner Sarkome, undifferenzierter Karzinome und Melanome.

Die Therapie der Wahl ist die mikroskopisch kontrollierte Chirurgie. Beim AFX kann nach vollständiger Exzision von einer Heilung ausgegangen werden. Soweit PDS mit einem Sicherheitsabstand von 2 cm operiert wurden, ist die Lokalrezidivrate ebenfalls gering. Lokoregionäre Metastasen können bei sehr dicken oder unvollständig exzidierten Tumoren auftreten, selten kommt es zu Fernmetastasen. Eine zugelassene wirksame medikamentöse Therapie ist nicht bekannt.
Characteristics and age‐related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study
Authors: Segura‐Palleres Ignasi , Sobrero Federica , Roccia Fabio , de Oliveira Gorla Luis Fernando , Pereira‐Filho Valfrido Antonio , Gallafassi Daniel , Faverani Leonardo Perez , Romeo Irene , Bojino Alessandro , Copelli Chiara , Duran‐Valles Francesc , Bescos Coro , Ganasouli Dimitra , Zanakis Stelios N. , Hassanein Ahmed Gaber , Alalawy Haider , Kamel Mohammed , Samieirad Sahand , Jaisani Mehul Rajesh , Rahman Sajjad Abdur , Rahman Tabishur , Aladelusi Timothy , Carlaw Kirsten , Aquilina Peter , Rae Euan , Laverick Sean , Goetzinger Maximilian , Bottini Gian Battista
Published: February 2022

Background/Aims

Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1‐year period.

Methods

The following data were collected: age (preschool [0–6 years], school age [7–12 years], and adolescent [13–18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.

Results

Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0–18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001).

Conclusion

The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0–6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.
In vivo electrophysiological study of the targeting of 5‐HT3 receptor‐expressing cortical interneurons by the multimodal antidepressant, vortioxetine
Authors: Schweimer Judith V. , Brouard Julia T. , Li Yan , Sánchez Connie , Sharp Trevor
Published: February 2022

The antidepressant vortioxetine has high affinity for the ionotropic 5‐HT3 receptor (5‐HT3R) as well as other targets including the 5‐HT transporter. The procognitive effects of vortioxetine have been linked to altered excitatory:inhibitory balance in cortex. Thus, vortioxetine purportedly inhibits cortical 5‐HT3R‐expressing interneurons (5‐HT3R‐INs) to disinhibit excitatory pyramidal neurons. The current study determined for the first time the effect of vortioxetine on the in vivo firing of putative 5‐HT3R‐INs whilst simultaneously recording pyramidal neuron activity using cortical slow‐wave oscillations as a readout. Extracellular single unit and local field potential recordings were made in superficial layers of the prefrontal cortex of urethane‐anaesthetised rats. 5‐HT3R‐INs were identified by a short‐latency excitation evoked by electrical stimulation of the dorsal raphe nucleus (DRN). Juxtacellular‐labelling found such neurons had the morphological and immunohistochemical properties of 5‐HT3R‐INs: basket cell or bipolar cell morphology, expression of 5‐HT3R‐IN markers and parvalbumin‐immunonegative. Vortioxetine inhibited the short‐latency DRN‐evoked excitation of 5‐HT3R‐INs and simultaneously decreased cortical slow wave oscillations, indicative of pyramidal neuron activation. Likewise, the 5‐HT3R antagonist ondansetron inhibited the short‐latency DRN‐evoked excitation of 5‐HT3R‐INs. However unlike vortioxetine, ondansetron did not decrease cortical slow‐wave oscillations, suggesting a dissociation between this effect and inhibition of 5‐HT3R‐INs. The 5‐HT reuptake inhibitor escitalopram had no consistent effect on any electrophysiological parameter measured. Overall, the current findings suggest that vortioxetine simultaneously inhibits (DRN‐evoked) 5‐HT3R‐INs and excites pyramidal neurons, thereby changing the excitatory:inhibitory balance in cortex. However, under the current experimental conditions, these two effects were dissociable with only the former likely involving a 5‐HT3R‐mediated mechanism.
The role of NOTCH2NLC in Parkinson's disease: A clinical, neuroimaging, and pathological study
Authors: Liu Peng , Yang Dehao , Zhang Fan , Chen Shuqi , Xie Fei , Luo Yong , Wang Haotian , Chen Yueting , Lin Zhiru , Wang Lebo , Chen Xinhui , Wang Bo , Wu Sheng , Ouyang Zhiyuan , Cen Zhidong , Luo Wei
Published: February 2022

Background and purpose

Recently, the pathogenic and intermediate GGC repeat expansion in NOTCH2NLC was detected in Parkinson's disease (PD). However, detailed clinical, neuroimaging, and pathological information of clinically diagnosed PD patients with pathogenic GGC repeat expansion in NOTCH2NLC remains scarce. Thus, we aimed to elucidate the clinical, neuroimaging, and pathological characteristics of PD patients carrying the pathogenic GGC repeat expansion in NOTCH2NLC.

Methods

The NOTCH2NLC GGC repeat expansion was screened in 941 sporadic PD patients and 244 unrelated probands. Comprehensive assessments were performed in three PD patients with pathogenic GGC repeat expansion in NOTCH2NLC. The repeat expansion length was estimated using CRISPR/Cas9‐based targeted long‐read sequencing.

Results

The three patients (two PD patients from Family 1 and one sporadic PD) carrying the pathogenic NOTCH2NLC expansion were reconfirmed with a diagnosis of clinically established PD. Although they lacked the typical neuronal intranuclear inclusion disease (NIID) magnetic resonance imaging (MRI) feature, the typical PD pattern of striatal dopamine transporter loss was detected. Notably, all three patients presented with systemic areflexia, and other secondary causes of polyneuropathy were excluded. Skin biopsy showed intranuclear inclusions and an absence of phosphorylated alpha‐synuclein deposition in the skin nerve fibers of all three patients.

Conclusions

Although these clinically diagnosed PD patients with pathogenic GGC repeat expansion in NOTCH2NLC were hardly distinguishable from idiopathic PD based on clinical course and neuroimaging features, the pathological findings indicated that their phenotype was a PD phenocopy of NIID. Systemic areflexia may be an important and unique clinical clue suggesting further genetic testing and skin biopsy examination to confirm the diagnosis of NIID in patients presenting with a PD phenocopy.
A tale of two cohorts: Differing outcomes in infantile‐onset focal epilepsy
Authors: Triplet Erin M. , Nickels Katherine , Wong‐Kisiel Lily , Fine Anthony , Wirrell Elaine C.
Published: February 2022

Objective

Infants with focal‐onset epilepsy are an understudied population, requiring additional evaluation for clinical assessment and prognostication. Our goal was to characterize the etiology and natural history of infantile‐onset focal epilepsy.

Methods

We retrospectively identified all infants (0–24 months) with onset of focal epilepsy while resident in Olmsted County, Minnesota, between 1980 and 2018, using the Rochester Epidemiology Project Database. We assessed the impact of etiology on both seizure and neurodevelopmental outcome, and mortality.

Results

Of 686 children with epilepsy onset <18 years, 125 (18.2%) presented with focal‐onset seizures in infancy. Median follow‐up for this group was 10.9 years (interquartile range [IQR] 6.2, 19.3). Etiology was identified in 65.6% (structural N = 62, genetic N = 13, both structural and genetic N = 3, metabolic N = 4). Of 107 patients followed >2 years, 38 (35.5%) developed drug‐resistant epilepsy (DRE). DRE was more likely with younger age at onset, known etiology, and presence of epileptic spasms. Sixty‐eight (63.0% of those with follow‐up) were developmentally delayed at last follow‐up, and known etiology, DRE, and presence of epileptic spasms were significantly associated with delay (p < .001 for all). Fifteen patients (12.0%) died at a median age of 7.1 years (IQR 1.7, 21.7), but only one death was seizure related (suspected sudden unexpected death in epilepsy [SUDEP]). Of 20 infants with normal development at onset and no known etiology with >2 years follow‐up, none developed DRE, all were seizure‐free at last follow‐up (95% off antiseizure medications [ASMs]), and all remained developmentally normal.

Significance

Infantile‐onset focal epilepsy accounts for 18% of all epilepsy in childhood, is frequently due to known etiologies, and has a high rate of DRE. However, developmentally normal infants without a known cause appear to have a very favorable course.
Relationship education for women during pregnancy: The impact of MotherWise on birth outcomes
Authors: Rhoades Galena K. , Allen Maggie O. T. , Peña Rachel , Hyer Jennifer , Mazzoni Sara E.
Published: February 2022

The field of relationship science has called for more research on the impact of relationship education on child outcomes, yet studies in this area remain sparse, particularly regarding maternal and infant health at birth. Research on group prenatal care demonstrates that individual‐oriented group interventions have a positive impact on infant birth outcomes, suggesting the need to consider the impacts of other forms of group programming for women. The current study examined the impact of MotherWise, an individual‐oriented relationship education and brief case management/coaching program for minority and low‐income pregnant women, on birth outcomes. The study sample included 136 women who enrolled in a larger randomized controlled trial of MotherWise during early pregnancy. Although statistical power was limited due to the sample size and the effects were not outright significant at p < 0.05, results indicated that the effects of MotherWise on birth outcomes were small to moderate in size (0.23 for birthweight, 0.46 for preterm birth) and suggest important avenues for future tests of relationship education programs and their impacts on maternal and infant health. The current study suggests that relationship education during pregnancy could directly impact women's and infant's health.
Reactive air brazing of 3YSZ ceramic to aluminized Crofer22H stainless steel using Ag–CuO fillers
Authors: Zhou Wen Long , Hu Sheng Peng , Yang Meng Juan , Luo Yun , Fu Wei , Song Xiao Guo
Published: February 2022

In this work, an effective protected Al2O3layer was fabricated first on the surface of Crofer22H by reactive air aluminization to suppress cathodic poisoning in solid oxide fuel cells. Then, the reactive air brazing of aluminized Crofer22H to 3YSZ ceramics was carried out by using Ag–CuO fillers. The effects of CuO content and brazing temperature on the interfacial microstructure and mechanical properties of the joints were studied in detail. The results indicated that maintaining a continuous Al2O3layer was the prerequisite for achieving a reliable joint. And the interfacial reaction gradually became intense with the increase of CuO content, and the continuity of the Al2O3layer was disrupted as it was increased to 6 mol%. The well‐connected joints could be achieved when brazing at 970–1100°C with Ag–2CuO filler. The interfacial microstructure did not obviously change with increasing temperature, and the joint strength was stable at ∼35 MPa. While the interfacial reaction gradually weakened with increasing temperature as brazing with Ag–4CuO filler, the well‐connected joints were obtained when brazing above 1000°C, and the maximum shear strength of ∼44.3 MPa was obtained when brazing at 1050°C for 30 min.
Sibling absence and body mass index: From adolescence to adulthood
Authors: Lin Shengjie , Falbo Toni
Published: February 2022

Objectives

To examine if sibling absence is associated with higher BMI and to identify potential lifestyle factors underlying this effect; to determine if sibling effects on BMI persist into adulthood.

Methods

We used data from all five waves of the National Longitudinal Study of Adolescent to Adult Health to study the sibling factors and BMI of 3,563 participants who were in grades 7‐12 at first wave (1994‐95). These participants were measured again in the second wave (1996), the third wave (2001‐2002), the fourth wave (2008‐2009), and most recently, the fifth wave (2016‐2018). We identified categories of siblings, comparing the BMI of those without siblings either to birth order or sibship size. BMI was calculated based on direct measurements of height and weight; underlying mechanisms were self‐reported.

Results

Participants without siblings had significantly higher BMI than those with siblings, across waves, regardless of sibship size. Those without siblings had consistently higher BMI than middle‐born, but not last‐born participants. Adolescents without siblings reported eating fast food more frequently and spending more screen time.

Conclusions

Sibling absence is associated with higher BMI in adolescence and this difference persists into adulthood.
Clinical features and urodynamic findings in elderly men with chronic prostatitis
Authors: Matsukawa Yoshihisa , Funahashi Yasuhito , Ishida Shohei , Naito Yushi , Yuba Takuma , Matsuo Kazuna , Gotoh Momokazu
Published: February 2022

Objectives

To investigate the complication rate of chronic prostatitis/chronic pelvic pain syndrome in men with lower urinary tract symptoms, and to clarify their clinical features and urodynamic findings.

Methods

We retrospectively reviewed the clinical data of treatment‐naïve men with lower urinary tract symptoms. Patients were divided into two groups (chronic prostatitis/chronic pelvic pain syndrome + lower urinary tract symptoms and lower urinary tract symptoms only) according to the presence or absence of chronic prostatitis/chronic pelvic pain syndrome, and the patient characteristics as well as the parameters of lower urinary tract symptoms and lower urinary tract function assessed by urodynamics were compared. The diagnostic criteria for chronic prostatitis/chronic pelvic pain syndrome included a complaint of pelvic pain for ≥3 months, National Institutes of Health Chronic Prostatitis Symptom Index pain subscore ≥4, and negative culture of a urine specimen collected after prostate massage.

Results

Out of 386 men, 123 (31.9%) had chronic prostatitis/chronic pelvic pain syndrome. Parameters of lower urinary tract symptoms and National Institutes of Health Chronic Prostatitis Symptom Index scores were significantly higher in the chronic prostatitis/chronic pelvic pain syndrome + lower urinary tract symptoms group. Although there were no significant intergroup differences in voiding parameters such as maximum flow rate and bladder outlet obstruction index, storage functions such as the incidence of detrusor overactivity and bladder compliance were significantly reduced in the chronic prostatitis/chronic pelvic pain syndrome + lower urinary tract symptoms group. The multivariable regression analysis revealed that a low serum total testosterone level (<3.5 ng/mL), complications of hyperlipidemia, and presence of overactive bladder and detrusor overactivity were significantly associated with the development of chronic prostatitis/chronic pelvic pain syndrome.

Conclusions

Chronic prostatitis causes a significant decrease in storage function, such as an increase in detrusor overactivity. Additionally, low serum testosterone levels and hyperlipidemia were found to be significantly associated with the development of chronic prostatitis/chronic pelvic pain syndrome in men with lower urinary tract symptoms.
The relationship between peripheral immune response and disease severity in SARS‐CoV‐2‐infected subjects: A cross‐sectional study
Authors: Walter Laura Otto , Cardoso Chandra Chiappin , Santos‐Pirath Íris Mattos , Costa Heloisa Zorzi , Gartner Rafaela , Werle Isabel , Mohr Eduarda Talita Bramorski , da Rosa Julia Salvan , Felisberto Mariano , Kretzer Iara Fabricia , Masukawa Ivete Ioshiko , Vanny Patrícia de Almeida , Luiz Magali Chaves , de Moraes Ana Carolina Rabello , Dalmarco Eduardo Monguilhott , Santos‐Silva Maria Cláudia
Published: February 2022

Coronavirus disease 2019 (COVID‐19) is a respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and marked by an intense inflammatory response and immune dysregulation in the most severe cases. In order to better clarify the relationship between peripheral immune system changes and the severity of COVID‐19, this study aimed to evaluate the frequencies and absolute numbers of peripheral subsets of neutrophils, monocytes, and dendritic cells (DCs), in addition to quantifying the levels of inflammatory mediators. One hundred fifty‐seven COVID‐19 patients were stratified into mild, moderate, severe, and critical disease categories. The cellular components and circulating cytokines were assessed by flow cytometry. Nitric oxide (NOx) and myeloperoxidase (MPO) levels were measured by colourimetric tests. COVID‐19 patients presented neutrophilia, with signs of emergency myelopoiesis. Alterations in the monocytic component were observed in patients with moderate to critical illness, with an increase in classical monocytes and a reduction in nonclassical monocytes, in addition to a reduction in the expression of HLA‐DR in all subtypes of monocytes, indicating immunosuppression. DCs, especially plasmacytoid DCs, also showed a large reduction in moderate to critical patients. COVID‐19 patients showed an increase in MPO, interleukin (IL)‐12, IL‐6, IL‐10, and IL‐8, accompanied by a reduction in IL‐17A and NOx. IL‐10 levels ≥14 pg/ml were strongly related to the worst outcome, with a sensitivity of 78·3% and a specificity of 79·1%. The results of this study indicate the presence of systemic effects induced by COVID‐19, which appear to be related to the pathophysiology of the disease, highlighting the potential of IL‐10 as a possible prognostic biomarker for COVID‐19.
Increasing empathy for children in dental students using virtual reality
Authors: Hu Shijia , Lai Bien Wen Pui
Published: February 2022

Background

Virtual reality (VR) can be used to simulate the viewpoint of a child to allow dental students to experience what a child experiences during a dental visit.

Aim

The aim of this study was to evaluate the effect of VR simulation on the empathy and comfort managing children among dental students.

Design

Sixty dental students experienced a VR scenario created for the study. Empathy levels were examined using the Jefferson Scale of Empathy (JSE). A self‐administered questionnaire was used to collect information on self‐perceived ability, comfort and impact of the intervention.

Results

There was a significant (p = .004) increase (indicating greater empathy) in JSE scores between pre‐intervention (112.35 ± 9.34) and post‐intervention (117.64 ± 10.03), which returned to baseline 3 months later (112.72 ± 10.36). Dental students perceived themselves to be more confident at communicating (6.45 ± 1.64 vs. 5.75 ± 1.71, p = .011) and interacting (6.63 ± 1.44 vs. 6.00 ± 1.78, p = .046) with children after the intervention. All (100%) felt that the VR scenarios helped them better empathize with children. Only 30% revisited the scenario after the intervention, and they were significantly more likely (p < .001) to find it helpful for actual clinical sessions.

Conclusion

Virtual reality could be used to improve empathy, self‐perceived comfort and ability at managing children in dental students. Yet, they should be encouraged to revise using it to maintain this effect.
CD44/ERM/F‐actin complex mediates targeted nuclear degranulation and excessive neutrophil extracellular trap formation during sepsis
Authors: Shao Yiming , Li Linbin , Liu Lu , Yang Yunxi , Huang Jiamin , Ji Dongdong , Zhou Yuying , Chen Yi , Zhu Zhechen , Sun Bingwei
Published: February 2022

Neutrophils release neutrophil extracellular traps (NETs) to capture and kill pathogens, but excessive NET release can damage the surrounding tissues. Myeloperoxidase (MPO) and neutrophil elastase (NE) are thought to be important in promoting histone depolymerization and DNA breakage in the nucleus. However, the detailed path by which MPO and NE enter the nucleus is unknown. In the present study, we observed that delayed fusion of azurophilic granules with the nuclear membrane 15–20 min after extracellular degranulation in activated neutrophils. In a subsequent experiment, we further demonstrated that this fusion leads to MPO entry into the nucleus and promotes nuclear histone depolymerization and DNA breakage, a process called ‘targeted nuclear degranulation’. This process can be effectively inhibited by dexamethasone and accompanied by the continuous low levels of MPO in the nucleus after PMA stimulation. Meanwhile, we found that ‘targeted nuclear degranulation’ is dependent on the CD44 translocation and subsequent redistribution of CD44 / ERM (Ezrin/Radixin/Moesin) / F‐actin complexes, which guides the movement of azurophilic granules towards the nucleus. Application of ERM phosphorylation inhibitors and importin activity inhibitors significantly reduced the complexes formation and redistribution. Taken together, these findings indicate for the first time that delayed ‘targeted nuclear degranulation’ after neutrophil activation is a key mechanism of NET formation. CD44/ERM/F‐actin complex mediates this process, which providing targets with promising prospects for the precise regulation of NET formation.
Body size and sexual selection shaped the evolution of parrot calls
Authors: Marcolin Fabio , Cardoso Gonçalo C. , Bento Daniel , Reino Luís , Santana Joana
Published: February 2022

Morphology, habitat and various selective pressures (e.g. social and sexual selection) can influence the evolution of acoustic signals, but the relative importance of their effects is not well understood. The order Psittaciformes (parrots, sensu lato) is a large clade of very vocal and often gregarious species for which large‐scale comparative studies of vocalizations are lacking. We measured acoustic traits (duration, sound frequency, frequency bandwidth and sound entropy) of the predominant call type for >200 parrot species to test: (1) for associations with body size; (2) the acoustic adaptation hypothesis (AAH) (predicting differences between forest and open‐habitat species); (3) the social complexity hypothesis (predicting more complex calls in gregarious species) and (4) influences of sexual selection (predicting correlated evolution with colour ornamentation). Larger species had on average longer calls, lower sound frequency and wider frequency bandwidth. These associations with body size are all predicted by physical principles of sound production. We found no evidence for the acoustic adaptation and social complexity hypotheses, but perhaps social complexity is associated with vocal traits not studied here, such as call repertoire sizes. More sexually dichromatic species had on average simpler calls (shorter, with lower entropy and narrower frequency bandwidth) indicating an influence of sexual selection, namely an evolutionary negative correlation between colour ornamentation and elaborate acoustic signals, as predicted by the transference hypothesis. Our study is the first large‐scale attempt at understanding acoustic diversity across the Psittaciformes, and indicates that body size and sexual selection influenced the evolution of species differences in vocal signals.
Systematic review of clinical studies assessing the needling for treatment of melasma: Focusing on efficacy, safety, and recurrence rate
Authors: Sadeghzadeh‐Bazargan Afsaneh , Behrangi Elham , Najar Nobari Niloufar , Ghassemi Mohammadreza , Roohaninasab Masoumeh , Goodarzi Azadeh
Published: February 2022

Background and objective

Melasma is common, chronic and treatment‐challenging cosmetic concern and the aim of this study was to systematically evaluate clinical studies assessing the treatment of melasma through needling while focusing on efficiency, safety, and recurrence.

Method

After e‐search a total of 54 articles were reviewed and 12 published articles (February 2011‐September 2020) in terms of content, topic, and purpose, were finalized. Articles were open pilot trials, case reports, case series, retrospective studies, quasi‐experimental trials, randomized clinical trials, and split face comparative studies.

Results

The highest decrease in MASI score was 85.71% and allocated to microneedling method following only 3 sessions with an interval of 30 days. On the other hand, the lowest decrease in this score was 3.7% and allocated to microneedling treatment and its use for vitamin C delivery at the end of the fourth week of treatment. No side effects were reported in included studies, and the various needling methods used were safe. Recurrence after treatment was reported in none of these articles, and only one of them reported a 4% recurrence in the second phase of treatment, but no recurrence was reported in the last phase of that study.

Conclusion

Non‐aggressive microneedling with topical depigmenting agents was more effective than topical depigmenting agents alone, so that the mean MASI score was significantly higher than those who used lightening serum alone. So needling can be suggested as an effective and safe method with low recurrence rate for the treatment of melasma.
The snakes and ladders of legal participation: litigants in person and the right to a fair trial under Article 6 of the European Convention on Human Rights
Authors: MCKEEVER GRÁINNE , ROYAL‐DAWSON LUCY , KIRK ELEANOR , MCCORD JOHN
Published: February 2022

This article reviews the right to a fair trial under Article 6 of the European Convention on Human Rights for litigants in person (LIPs). LIPs operate in a system that was not designed for them and so challenge the norm of fully represented parties that the system has evolved to expect, creating potential risks for their Article 6 rights. The jurisprudence on Article 6 reveals the centrality of effective participation as a requirement for fulfilling the right to a fair trial. The article views the jurisprudential interpretation against original and significant empirical research data on how LIPs participate in civil and family court processes. It applies a conceptual analysis of legal participation to consider what might constitute effective participation in court proceedings and, through the empirical evidence, categorizes the intellectual, practical, emotional, and attitudinal barriers that LIPs face in their legal proceedings, which can constitute risks to their rights under Article 6.
Child welfare, Indigenous parents, and judicial mediation
Authors: LECKEY ROBERT
Published: February 2022

Can judicial mediation within a settler state's justice system improve the experience of dealing with child welfare services for Indigenous parents? Interviews with social workers, lawyers, and judges in the Canadian province of Quebec yield little basis for optimism. Adapting judicial mediation will not suffice to decolonize dispute resolution between Indigenous individuals and the state. Mediation fits uneasily with the severe power disparity in this setting. Moreover, the cautious nature of participants’ recommendations signals the limited adaptive capacity of the settler state's system of civil justice. The recommendations exemplify relatively superficial accommodation, rather than deep engagement with legal pluralism and Indigenous difference. Constraints on the state system's ability to adapt are both legal and cultural. This study contributes to literatures on Indigenous and colonial legal cultures in relation to child welfare, on access to justice for Indigenous peoples, and on mediation in Canada and elsewhere.
Evaluation of the effectiveness of a mobile application in the management of dental anxiety: A randomised controlled trial
Authors: Nalci Gamze , Alaçam Tayfun , Altunkaynak Bülent
Published: February 2022

Background

The software, which was developed according to the principle of perceived control, can be installed on tablets and smartphones and used by patients to help them control their anxiety.

Objective

The aim of this study was to evaluate the effectiveness of a specially designed mobile application developed to provide patients with a sense of anxiety control during the various stages of endodontic treatment. The patients' anxiety was assessed by measuring their salivary cortisol levels.

Methods

A total of 46 patients requiring endodontic treatment were recruited. The patients were randomly assigned to two groups. The experimental group used the special communication application, while the control group did not. Salivary samples were collected from all patients preoperatively, postanaesthesia, and postoperatively. The samples were analysed with an enzyme‐linked immunosorbent assay to measure the cortisol levels.

Results

A significant difference in cortisol levels was observed between the experimental and the control group (Mann–Whitney U‐test, p < .05). This difference was significant in the experimental group in each step (p < .01). No difference was found in the control group steps (p > .05).

Conclusions

Perceived control of anxiety using the specially designed software was effective in reducing salivary cortisol levels.
Supporting the needs of people with intellectual and developmental disabilities 1 year into the COVID‐19 pandemic: An international, mixed methods study of nurses' perspectives
Authors: Desroches Melissa L. , Fisher Kathleen , Ailey Sarah , Stych Judith , McMillan Shirley , Horan Paul , Marsden Daniel , Trip Henrietta , Wilson Nathan
Published: February 2022

As the largest public health crisis within a century, the COVID‐19 pandemic has caused long‐term disruption in the support systems of people with intellectual and developmental disabilities (IDD) across the globe. The purpose of this study was to investigate challenges and ameliorative strategies to supporting the basic care needs of people with IDD 1 year into the pandemic, as experienced by nurses who specialize in IDD nursing. We surveyed a convenience sample of 369 nurses from across North America, Europe, and Australasia using a 52‐item online questionnaire. Descriptive statistics were used to rank the greatest challenges and the degree of support available to nurses, and manifest content analysis was used to analyze open‐ended responses related to ongoing challenges and ameliorative strategies. Results of descriptive analyses revealed consistent findings across global regions in terms of the challenges faced by nurses; the greatest challenges related to supporting or enabling socialization with family/friends, ensuring adequate day programming or educational services, identifying/planning alternative entertainment activities, ensuring adequate staffing of familiar support workers and caregivers, and managing challenging behaviors related to change in daily routine and activities. Nurses described a considerable degree of support offered by their organizations in terms of flexibility in scheduling related to family obligations and paid time off for COVID‐19‐related isolation and quarantine. Content analysis of open‐ended survey responses revealed numerous challenges related to: (1) client socialization, meaningful activity, and mental/behavioral health; (2) interpreting, keeping up with, and helping others to understand COVID‐19 guidelines; (3) access to, quality of, and continuity of care; and (4) COVID‐19 fatigue and the influence of time. Overall, our study highlights ongoing issues with access to care and support, exacerbated by the pandemic, and the importance of having meaningful activity and socialization for overall well‐being of people with IDD during a long‐term public health crisis.
Variations in host surfaces morphology and biology of ciliate epibionts explaining distribution pattern of epibionts in the invasive signal crayfish Pacifastacus leniusculus (Dana, 1852)
Authors: Dobrzycka‐Krahel A. , Rolbiecki L. , Karczewski J. , Skóra M. E.
Published: February 2022

The present paper reports the distribution of Epistylididae (Sessilida) epibiotic ciliates on the signal crayfish Pacifastacus leniusculus in relation to specialized structures of the host's exoskeleton for the first time. This species is known to maintain a relatively clean carapace, but it is sometimes overgrown by other organisms. Epibionts cover different parts of the signal crayfish body, mainly antennae, antennules, maxillipedes III and pereiopods with inner edges of chelae; however, some parts of the signal crayfish are not fouled. e.g. dorsal surfaces of the carapace and dorsal surfaces of chelae. Using scanning electron microscopy (SEM), topographies of different parts of the crayfish's exoskeleton were examined. Our investigations revealed that the epibiosis in the signal crayfish was determined by morphology of body surfaces. No epibionts were found on smooth surfaces with regular single setae (a known design that prevents fouling in aquatic environments). The dimpled surfaces with regular single micro‐papillae may be considered as a newly described example of self‐cleaning surfaces. Bio‐inspired surface patterning presents promising approaches to the design of novel functional surfaces that can prevent biofouling. The new self‐cleaning design may be used in further technological applications.
Factors influencing intention to stay of male nurses: A descriptive predictive study
Authors: Lyu Xiaochen , Akkadechanunt Thitinut , Soivong Pratum , Juntasopeepun Phanida
Published: February 2022

Nurse shortages and nurse attrition are high in many countries, and there is also a dearth of male nurses in the profession. This study aimed to examine the level of intention to stay and ten predictors of this among male nurses in China. A descriptive, predictive study was administered to 480 registered male nurses. Eight research instruments were used to collect data. Descriptive statistics and binary logistic regression were employed to analyze the data. The overall intention to stay in the nursing profession as perceived by male nurses was at a moderate level. Binary logistic regression demonstrated that work group cohesion, transformational leadership, career growth, and job satisfaction were significant predictors, explaining 32.2% of the total variance for intention to stay. The findings of this study provide suggestions for nursing administrators and policymakers to develop appropriate strategies or interventions to increase the intention to stay for male nurses to stay in the profession, based on the four predictors.
Monetary volatility and the dynamics of economic growth: An empirical analysis of an oil‐based economy, 1970–2018
Authors: Algaeed Abdulaziz Hamad , Algethami Basmah S.
Published: February 2022

Over the past decades, and since the first development plan in 1970, Saudi Arabia has controlled the stability of its economy through prudent fiscal policy and tight monetary policy. This study examines the impact of monetary volatility on real gross domestic product (GDP) growth in an oil‐based economy from 1970 to 2018, using the Hodrick–Prescott filtering approach. Although standard methods such as GARCH are used to test volatility, the uniqueness of this study is that it tests the volatility of monetary policy using ordinary least squares (OLS), autoregressive distributed lag (ARDL) and IRF methods. We find that the standard deviation of the broad money supply and the real interest rate business cycle tends to have a negative impact on real growth in the short and long run, supporting the proposition that a high interest rate negatively affects real growth. We also document that the standard deviation of the real exchange rate business cycle has a positive (negative) effect on real growth in the short and long run and is not statistically significant. This suggests that the volatility of the real exchange rate does not affect real growth. Moreover, the magnitude of the volatility of the coefficients is lower in the long run than in the short run. To achieve sustainable economic growth, policy makers need to plan how to manage the volatility of the money supply and the interest rate in the short run and develop long‐run strategies to manage volatility in the long run. To control monetary volatility, policymakers should also control government spending by dampening the volatility of oil prices, which ultimately affect the money supply and thus stable economic growth.
Witnessing Intimate Partner Violence Impacts Schooling and Labor Market Outcomes for Young Women in India
Authors: Ludwick Teralynn , Ishida Marie , Desai Sapna , Mahal Ajay
Published: February 2022

Intimate partner violence (IPV) is a major health and social issue that affects around 30 percent of women globally. This study investigates the relationships through which witnessing IPV in adolescence may impact the labor force participation and employment prospects of women in early adulthood, using a unique dataset from Bihar (India), which surveyed youth (primarily girls) in adolescence and again nine years later. The study examined the relationship between exposure to IPV and labor market outcomes among young women, including intermediate factors likely to influence their employment prospects, such as educational attainment, self‐efficacy, mental health, and soft skills. Witnessing IPV as an adolescent had a negative effect on educational attainment, mental health, and social and behavioral aspects of young women almost nine years later. IPV was not associated with the likelihood of paid employment or participation in skilled work among women, although it was associated with higher levels of labor force participation. These findings suggest that witnessing IPV should be considered one of multiple forms of violence that may expose young women to longer term vulnerability related to poorer educational and employment prospects, mental health, and social networks, with implications for economic and social development far beyond the family.
Mitigation of recurrent perturbation mortality is an important goal for river restoration and conservation of freshwater fish species
Authors: Hatch Michael D. , Abadi Fitsum , Porter Michael D. , Cowley David E.
Published: February 2022

Human perturbations affect many aquatic ecosystems globally. We use age‐structured matrix population models to explore how population growth rates in short‐lived freshwater fish are affected by recurrent environmental perturbations to river ecosystems. Simulations are summarized to reveal how species‐specific fitness characteristics contribute to population sustainability in habitats subject to recurrent perturbation. Deterministic calculations are used to estimate time to population recovery with successive years of intermittence disturbance, followed by post‐perturbation equilibrium conditions. Perturbation that reduces only juvenile survival has a shorter recovery time to initial population size and greater resilience of population growth than when adult survival is reduced. Consecutive occurrences of perturbation lengthen recovery time nonlinearly, more notably when adults experience perturbation mortality. We illustrate with an example how managers could identify multiple options to mitigate recurrent ecosystem perturbations by reducing perturbation frequency and/or mitigating perturbation mortality. Our simulations suggest parameter approximations for a hypothetical species provide a useful frame of reference for river restoration and conservation when life history data are lacking for a specific species of concern.
The HUNT study: Association of comorbidity clusters with long‐term survival and incidence of exacerbation in a population‐based Norwegian COPD cohort
Authors: Vikjord Sigrid Anna Aalberg , Brumpton Ben Michael , Mai Xiao‐Mei , Romundstad Solfrid , Langhammer Arnulf , Vanfleteren Lowie
Published: February 2022

Background and objective

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease often viewed as part of a multimorbidity complex. There is a need for better phenotyping of the disease, characterization of its interplay with other comorbidities and its association with long‐term outcomes. This study aims to examine how clusters of comorbidities are associated with severe exacerbations and mortality in COPD.

Methods

Participants with potential COPD were recruited from the second (1995–1997) and third (2006–2008) survey of the HUNT Study and followed up until April 2020. Ten objectively identified comorbidities were clustered using self‐organizing maps. Severe COPD exacerbations requiring hospitalization were assessed using hospital data. All‐cause mortality was collected from national registries. Multivariable Cox regression was used to calculate hazard ratios (HRs) with 95% CIs for the association between comorbidity clusters and all‐cause mortality. Poisson regression was used to calculate incidence rate ratios (IRRs) with 95% CI for the cumulative number of severe exacerbations for each cluster.

Results

Five distinct clusters were identified, including ‘less comorbidity’, ‘psychological’, ‘cardiovascular’, ‘metabolic’ and ‘cachectic’ clusters. Using the less comorbidity cluster as reference, the psychological and cachectic clusters were associated with all‐cause mortality (HR 1.23 [1.04–1.45] and HR 1.83 [1.52–2.20], adjusted for age and sex). The same clusters also had increased risk of exacerbations (unadjusted IRR of 1.24 [95% CI 1.04–1.48] and 1.50 [95% CI 1.23–1.83], respectively).

Conclusion

During 25 years of follow‐up, individuals in the psychological and cachectic clusters had increased mortality. Furthermore, these clusters were associated with increased risk of severe COPD exacerbations.
Progressive fibrosing hypersensitivity pneumonitis: Why wait?
Authors: Barnes Hayley , Glaspole Ian N.
Published: February 2022

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Markups, inequality and monetary‐fiscal policies
Authors: Chu Shiou‐Yen
Published: February 2022

This paper reexamines the cyclical behaviors of price markup, profits, and labor share when responding to monetary and fiscal policy shocks in a two‐agent, two‐branch, and two‐sector model. We show that this framework is able to generate procyclical price markup and profits, and countercyclical labor share conditional on expansionary policy shocks. These results are in line with empirical evidences but at odds with the prediction of canonical New Keynesian models. As the share of nondurables in total production decreases, the results reverse. This finding implies expansionary monetary and fiscal policies widen the income inequality between Ricardian households and collateral‐constrained households.
Measuring Knee Joint Laxity in Three Degrees-of-Freedom In Vivo Using a Robotics- and Image-Based Technology
Authors: Kümmerlin Jana , Fabro Hannah Katharina , Pedersen Peter Heide , Jensen Kenneth Krogh , Pedersen Dennis , Andersen Michael Skipper
Published: February 2022

Accurate and reliable information about three-dimensional (3D) knee joint laxity can prevent misdiagnosis and avoid incorrect treatments. Nevertheless, knee laxity assessments presented in the literature suffer from significant drawbacks such as soft tissue artifacts, restricting the knee within the measurement, and the absence of quantitative knee ligament property information. In this study, we demonstrated the applicability of a novel methodology for measuring 3D knee laxity, combining robotics- and image-based technology. As such technology has never been applied to healthy living subjects, the aims of this study were to develop novel technology to measure 3D knee laxity in vivo and to provide proof-of-concept 3D knee laxity measurements. To measure tibiofemoral movements, four healthy subjects were placed on a custom-built arthrometer located inside a low dose biplanar X-ray system with an approximately 60 deg knee flexion angle. Anteroposterior and mediolateral translation as well as internal and external rotation loads were subsequently applied to the unconstrained leg, which was placed inside a pneumatic cast boot. Bone contours were segmented in the obtained X-rays, to which subject-specific bone geometries from magnetic resonance imaging (MRI) scans were registered. Afterward, tibiofemoral poses were computed. Measurements of primary and secondary laxity revealed considerable interpersonal differences. The method differs from those available by the ability to accurately track secondary laxity of the unrestricted knee and to apply coupled forces in multiple planes. Our methodology can provide reliable information for academic knee ligament research as well as for clinical diagnostics in the future.