bluuebunny/crossref_metadata_2025 huggingface dataset:
Caries experience among children born after a complicated pregnancy
Authors: van der Tas Justin T. , Wolvius Eppo B. , Kragt Lea , Rivadeneira Fernando , Moll Henriëtte A. , Steegers Eric A. P. , Schalekamp‐Timmermans Sarah
Published: November 2020

Objectives

Behavioural and lifestyle factors, as oral hygiene and diet, are well‐established risk factors in the pathogenesis of dental caries, though displaying large differences in susceptibility across individuals. Since enamel formation already starts in utero, pregnancy course and outcome may eventually play a role in enamel strength and caries susceptibility. Therefore, we studied the association between history of pregnancy complications and the caries experience in their six‐year‐old children. The pregnancy complications included small for gestational age (SGA), spontaneous preterm birth (sPTB), gestational hypertension (GH), pre‐eclampsia (PE), individually, and a combination of those, designated as placental syndrome.

Methods

This study was embedded in Generation R, a prospective longitudinal Dutch multiethnic pregnancy cohort study. Information about pregnancy complications was obtained from questionnaires completed by midwives and obstetricians with cross‐validation in medical records. These included SGA, sPTB, GH and PE. Caries experience was assessed with the decayed, missing and filled teeth (dmft) index at a mean age of six years. The association between dental caries experience and a history of pregnancy complications was studied by using hurdle negative binomial (HNB) models.

Results

We were able to assess the dmft index in 5323 six‐year‐old children (mean age 6.2 years, SD 0.5). We did not find an association between the different pregnancy complications and dental caries experience in childhood, whether for SGA, sPTB, GH, PE, or for the combined outcome placental syndrome (HNB estimates: OR 1.02, 95%CI 0.87 ‐ 1.19; RR 0.90, 95%CI 0.78 ‐ 1.04). Further adjustment of the models with different confounders did not alter the outcome.

Conclusions

Although it is expected that prenatal stress can be a risk factor for caries development later in life, our findings do not support this hypothesis. Therefore, we believe disparities in caries experience between children are probably not explained by early life events during a critical intrauterine period of development.
Overlap of allergic, eosinophilic and type 2 inflammatory subtypes in moderate‐to‐severe asthma
Authors: Chen Meng , Shepard Kirk , Yang Ming , Raut Pranil , Pazwash Hooman , Holweg Cecile T.J. , Choo Eugene
Published: November 2020

Background

Current biologic therapies target allergic, eosinophilic or type 2 inflammation phenotypic asthma. However, frequency and degree of overlap among these subtypes is unclear.

Objective

To characterize overlap among allergic, eosinophilic and type 2 asthma phenotypes.

Methods

Post hoc analyses of baseline data were performed in two adult populations: (a) not selected for any asthma subtype (N = 935) and (b) selected for allergic asthma (N = 1049). Degree of overlap was examined using commonly accepted phenotypic definitions to guide treatment for allergic asthma (skin prick–positive and/or positive serum–specific immunoglobulin E > 0.35 kU/L) and eosinophilic asthma (blood eosinophil high count ≥ 300 cells/µL; low cut‐off ≥ 150 cells/µL). Consistent with previous studies, fractional exhaled nitric oxide high level of ≥ 35 ppb and low cut‐off of ≥ 25 ppb were selected as local markers of type 2 inflammation and to prevent overlap with the systemic eosinophilic asthma definition.

Results

In the non‐subtype–selected population, 78.0% had allergic asthma; of these, 39.5% had eosinophilic asthma and 29.5% had type 2 asthma. Within patients with eosinophilic asthma (40.6% of total), 75.8% had allergic asthma and 41.3% had type 2 asthma. Within patients with type 2 asthma (28.3% of total), 81.1% had allergic asthma and 59.2% had eosinophilic asthma. In the allergic asthma–selected population, 38.3% had eosinophilic asthma and 29.2% had type 2 asthma. Within patients with eosinophilic asthma, 46.3% had type 2 asthma. Within patients with type 2 asthma, 60.8% had eosinophilic asthma. Overlaps among subtypes increased at low cut‐off values.

Conclusions and clinical relevance

In this post hoc analysis in adults with moderate‐to‐severe asthma, allergic asthma was the most prevalent phenotype, followed by eosinophilic and type 2 asthma. Despite observed overlaps, a considerable proportion of patients had only a predominantly allergic subtype. Understanding the degree of overlap across phenotypes will help patient management and guide treatment options.
Mechanisms that mitigate the effects of child poverty and improve children's cognitive and social–emotional development: A systematic review
Authors: Saitadze Inga , Lalayants Marina
Published: November 2020

The negative effects of poverty on children's development have been examined in many studies. Poverty exerts its influence on children indirectly through mediating pathways, some of which have powerful effects in reducing the impact of early economic deprivation. However, the literature on the mediating mechanisms through which poverty operates and influences children's cognitive and social–emotional development is limited. This review provides a systematic analysis of published and unpublished studies that investigate mediating mechanisms that have been found to be effective in reducing the effects of early childhood poverty and in improving children's cognitive and social–emotional development. The findings of this review suggest that positive parenting and cognitively stimulating home environments have the potential to enhance the developmental outcomes of children living in poverty—in particular, educational materials including books and computers and home learning activities such as reading and counting are salient for the outcomes of children living in poverty. Findings on the effects of early childhood programmes for low‐income children's development and well‐being are also discussed.
Phylogenomics reveals accelerated late Cretaceous diversification of bee flies (Diptera: Bombyliidae)
Authors: Li Xuankun , Teasdale Luisa C. , Bayless Keith M. , Ellis Allan G. , Wiegmann Brian M. , Lamas Carlos José E. , Lambkin Christine L. , Evenhuis Neal L. , Nicholls James A. , Hartley Diana , Shin Seunggwan , Trautwein Michelle , Zwick Andreas , Lessard Bryan D. , Yeates David K.
Published: November 2020

Bombyliidae is a very species‐rich and widespread family of parasitoid flies with more than 250 genera classified into 17 extant subfamilies. However, little is known about their evolutionary history or how their present‐day diversity was shaped. Transcriptomes of 15 species and anchored hybrid enrichment (AHE) sequence captures of 86 species, representing 94 bee fly species and 14 subfamilies, were used to reconstruct the phylogeny of Bombyliidae. We integrated data from transcriptomes across each of the main lineages in our AHE tree to build a data set with more genes (550 loci versus 216 loci) and higher support levels. Our overall results show strong congruence with the current classification of the family, with 11 out of 14 included subfamilies recovered as monophyletic. Heterotropinae and Mythicomyiinae are successive sister groups to the remainder of the family. We examined the evolution of key morphological characters through our phylogenetic hypotheses and show that neither the “sand chamber subfamilies” nor the “Tomophthalmae” are monophyletic in our phylogenomic analyses. Based on our results, we reinstate two tribes at the subfamily level (Phthiriinae stat. rev. and Ecliminae stat. rev.) and we include the genus Sericosoma Macquart (previously incertae sedis) in the subfamily Oniromyiinae, bringing the total number of bee fly subfamilies to 19. Our dating analyses indicate a Jurassic origin of the family (165–194 Ma), with the sand chamber evolving early in bee fly evolution, in the late Jurassic or mid‐Cretaceous (100–165 Ma). We hypothesize that the angiosperm radiation and the hothouse climate established during the late Cretaceous accelerated the diversification of bee flies, by providing an expanded range of resources for the parasitoid larvae and nectarivorous adults.
Public family firms and capital structure: A meta‐analysis
Authors: Hansen Christopher , Block Joern
Published: November 2020

Research Question/Issue

In this study, we examine the impact of family firm status on publicly listed firms' leverage ratios. Furthermore, we investigate the moderating role of a country's institutional setting, especially its shareholder and creditor rights, on this relationship.

Research Findings/Insights

Conducting a meta‐analysis on 869 effect sizes from 613 studies, we find an overall slightly negative but significant relationship between family firm status and leverage. Our results reveal a large amount of heterogeneity and considerable mean effect size differences across the 48 countries included in the study. The results of our meta‐regression analysis reveal significant moderating effects of shareholder and creditor rights on family firms' capital structure decisions. Whereas stronger shareholder rights have a positive impact on family firm leverage, stronger creditor rights have a negative impact.

Theoretical/Academic Implications

Our study combines the two dominating and competing views on family firm leverage. On the one hand, the overall lower leverage ratio of family firms confirms the risk‐aversion view of family firms. On the other hand, control considerations also have a significant impact on leverage ratios, as family firms adjust their capital structure dependent on shareholder and creditor rights in their home country. Our study highlights the importance of the institutional setting on firms' financing patterns.

Practitioner/Policy Implications

The results suggest a significant impact of a country's institutional setting in general, and its strength on shareholder and creditor rights in particular, on family firms' capital structure decisions. Control considerations result in a strategic use of debt financing that ensures the owner family's dominant position in the firm and prevents potentially harmful conflicts with minority shareholders or creditors.
Knowledge of obstructive sleep apnoea in final year medical students and junior doctors‐a multi‐centre cross‐sectional study
Authors: Zaidi Gull Afshan , Rehman Syed Tabish , Shafiq Muhammad Mudassir , Zehra Talat , Israar Muhammad , Hussain Syed Mazher
Published: November 2020

Background

Sleep medicine is an under‐recognised medical specialty in Pakistan and obstructive sleep apnoea (OSA) often goes unnoticed. Final year medical students and junior doctors are the primary medical contact to elicit patient history and physical examination. We aimed to measure the current knowledge of OSA amongst the final year medical students and junior doctors at four university teaching hospitals across three large Pakistani cities.

Methods

Cross‐sectional survey of final year medical students and junior doctors rotating through medical wards of four university teaching hospitals were conducted during August–October 2019. The knowledge section of the OSA knowledge and attitude (OSAKA) questionnaire was used. Descriptive statistics were used to present the data with Chi‐Square test and independent samples student t‐test to compare the differences between individual items and mean scores of the participants, respectively.

Results

A total 282 final year medical students and 204 junior doctors completed the survey yielding a response rate of 53% for medical students and 97% for junior doctors. The knowledge of sleep apnoea was poor in both groups of participants with a mean score of 7.6 (42%) on the knowledge scale of OSAKA questionnaire. Medical students scored higher on the item related to snoring as the most prevalent symptom in OSA patients when compared to the junior doctors (χ2 = 8.92, P = 0.003). More junior doctors responded correctly about the role of uvulopalatopharyngoplasty in the management of OSA when compared to the medical students (χ2 = 5.14, P = 0.02). Differences in scores of both groups of participants on other items were small and did not reach statistical significance.

Conclusion

Final year medical students and junior doctors from a sample of four university teaching hospitals in three large cities of Pakistan have limited knowledge about the diagnosis and management of OSA. The observed limited knowledge of OSA may contribute towards under‐diagnosis of this increasingly prevalent medical condition.
Epidemiology and issues of NIV‐treated AECOPD patients with hypercapnic respiratory failure in Shanghai: A multicentre retrospective survey
Authors: Wang Sheng‐mei , Zhang Feng‐ying , Du Chun‐ling , Wang Xiong‐biao , Li Fan , Hang Jing‐qing , Chen Yuan‐jing , Cheng Ke‐wen , Zhao Lei , Jin Xiao‐yan , Shi Jin‐dong , Jie Zhi‐jun , Qu Jie‐ming ,   Shanghai Primary Respiratory Care Union, Shanghai Respiratory Society
Published: November 2020

Objective

To investigate the epidemiology, clinical features, treatment and outcome of Noninvasive ventilation (NIV)‐treated acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients in secondary hospitals of Shanghai.

Method

Relying on Shanghai alliances for respiratory diseases, a retrospective observational study was performed in 34 secondary hospitals of Shanghai. The AECOPD patients treated with NIV and admitted to the respiratory department or respiratory intensive care unit were recruited between December 1, 2016, and November 30, 2017.

Results

There were 555 patients finally recruited in this study. The age was 75.8 ± 9.6 years old and 380 patients (68.5%) were male. 70.5% of all patients had respiratory acidosis (pH <7.35). 55.3% of all patients received nebulised bronchodilator and 77.7% were treated with systemic or inhaled corticosteroids during hospitalisation. 525 patients (94.6%) recovered successfully and the mortality was 3.2%. The hospitalisation was 15.3 ± 6.7 days and hospital expenses were 22 911 ± 13 595 RMB. Inadequate and nonstandard drug treatments were the most important problems during management.

Conclusion

The NIV can be successfully used for AECOP patients in local hospitals of Shanghai, but accompanied by high costs and long hospital stays. However, the treatments for exacerbation and stable COPD patients are still insufficient.
“Rambo root” to the rescue: How a simple, low‐cost solution can lead to multiple sustainable development gains
Authors: Villarino Ma. Eliza J , Da Silva Mayesse , Becerra Lopez‐Lavalle Luis Augusto , Castro‐Nuñez Augusto
Published: November 2020

Rugged and resilient, cassava is a bulky root crop that can thrive on poor soils. Cultivating it offers the potential to restore degraded land, which in turn may reduce hunger, generate livelihoods, fight climate change and even promote peace. As such, farming cassava offers a nature‐based solution that can contribute to achieving numerous sustainable development targets. The authors acknowledge that scaling up production of any commodity may bring risks of deforestation and biodiversity loss through clearing forest areas. In the case of increasing cassava production, though, this may not be the case because cassava can be cultivated on land affected by degradation, and this resource is abundant; policies and initiatives exist to mitigate those risks; and the principal goal is to scale up a sustainable land use system.
Can the Timed Up & Go Test and Montreal Cognitive Assessment predict outcomes in patients waitlisted for renal transplant?
Authors: Bozhilov Kliment , Vo Kristine B. , Wong Linda L.
Published: November 2020

Purpose

Frail patients who undergo renal transplantation (RT) have more complications; however, little is known if these patients can sustain the wait to RT. We used the Timed Up and Go Test (TUGT) and Montreal Cognitive Assessment (MoCA) to determine outcomes of RT candidates.

Methods

In this retrospective study, 526 RT candidates underwent TUGT and MoCA (2015‐2019) and were divided into “favorable” (transplanted or remained on the list) or “unfavorable” (not listed, removed from list, or died) outcome. Demographics, education, language, comorbidities, dialysis type, use of a walking device, TUGT, and MoCA were compared by outcome.

Results

Overall, 230 patients (43.7%) passed TUG, 268 (51%) passed MoCA, 133 (25.3%) passed both, and 161 (30.6%) failed both tests. Multivariate analysis demonstrated age ≥ 65 (OR 1.58, CI 1.03–2.43), cardiac disease (OR 3.09, CI 2.02–4.72), ≥36 months on dialysis (OR 1.80, CI 1.24–2.69), EPTS < 20% at time of MoCA (OR 0.26, CI 0.07–0.98), and failing TUGT (OR 2.14, CI 1.43–3.19) were associated with unfavorable outcome. Failing MoCA was not associated with outcome.

Conclusions

MoCA test results were not associated with RT waitlist outcomes; however, passing the TUGT was associated with receiving RT or remaining on the list. Additional studies are needed to validate this and determine outcome after RT.
A case of oral foreign‐body granuloma due to diatoms
Authors: Brody Gabrielle , Yale Katerina , Slater Lee J. , Lanzon Jesse , Carey David L. , Ragsdale Bruce D.
Published: November 2020

Diatoms are photosynthetic algae with a siliceous exoskeleton. Diatoms are utilized by a wide array of industries for applications such as filtration and pest control. Unsubstantiated claims have also propelled their societal reach to trendy oral and topical uses. This case highlights a rare case of an oral granuloma secondary to diatoms. An 80‐year‐old woman presented with a mobile, firm, asymptomatic submucosal mass on her lower left mandibular vestibular mucosa. Histopathology showed a non‐caseating granulomatous reaction to diatoms. Her only verified contact with a diatomaceous earth product was a dental impression using alginate after upper front teeth trauma 5 months before. Although there have been several cases of allergic contact dermatitis attributed to diatoms, there are no reported cases of diatom‐induced granuloma formation found in the literature. There are, however, ample data on granulomas initiated by silica. Given the silica‐based composition of diatoms, and the broad use of diatoms in industry and alternative medicine, it is unclear why diatom‐induced granulomas are not more widely described. This report may alert clinicians to the existence of diatom granulomas and incline them to tailor their history to cover questions about possible exposure when evaluating patients presenting with a localized oral lesion.
DNA ploidy measurement and human papillomavirus in abnormal cervical cytology
Authors: Costa Ane Francyne , Pogere Adriane , Pasinato Ana Paula Beltrame Farina , Bello Edson Jose Monteiro , Onofre Alexandre Sherlley Casimiro , Onofre Fabiana Botelho de Miranda
Published: November 2020

Objective

To compare the efficacy of high‐risk human papillomavirus (HR‐HPV) and DNA image cytometry (DNA‐ICM) status for identifying high‐grade cervical intraepithelial neoplasia or worse (≥CIN2).

Methods

This cross‐sectional study was performed in women undergoing follow‐up procedure after a previous abnormal cervical cytology. Cervical cells were collected for HPV detection and DNA ploidy measurement. Biopsy samples were taken for histological confirmation. Sensitivity and specificity values for ≥CIN2 detection with HR‐HPV and DNA‐ICM were determined.

Results

HR‐HPV was present in 74.5% of the women. The most frequent HPV infection was HPV 16, followed by HPV 31, 33 and 58. Aneuploidy was observed in 60.6% of all cases. Referral cytology revealed 78.0% sensitivity and 68.6% specificity for detecting a ≥CIN2 lesion. The HR‐HPV test alone showed 92.7% sensitivity, albeit it was not statistically different from DNA‐ICM (88.1%, P > .05). Positivity for HPV or DNA‐ICM resulted in 100% sensitivity. Higher specificity was observed for the combination of HR‐HPV and DNA‐ICM (88.6%), with no difference from DNA‐ICM alone (85.7%, P > .05).

Conclusion

DNA‐ICM or HR‐HPV positivity identified all cases of ≥CIN2 in women undergoing follow‐up procedure after a previous abnormal cervical cytology. Routine cervical cancer screening could be improved by the incorporation of DNA‐ICM as a complementary method to primary screening to identify which women need closer follow‐up.
Can long‐lived species keep pace with climate change? Evidence of local persistence potential in a widespread conifer
Authors: Bisbing Sarah M. , Urza Alexandra K. , Buma Brian J. , Cooper David J. , Matocq Marjorie , Angert Amy L.
Published: November 2020

Aim

Climate change poses significant challenges for tree species, which are slow to adapt and migrate. Insight into genetic and phenotypic variation under current landscape conditions can be used to gauge persistence potential to future conditions and determine conservation priorities, but landscape effects have been minimally tested in trees. Here, we use Pinus contorta, one of the most widely distributed conifers in North America, to evaluate the influence of landscape heterogeneity on genetic structure as well as the magnitude of local adaptation versus phenotypic plasticity in a widespread tree species.

Location

Western North America.

Methods

We paired landscape genetics with fully reciprocal in situ common gardens to evaluate landscape influence on neutral and adaptive variation across all subspecies of P. contorta.

Results

Landscape barriers alone play a minor role in limiting gene flow, creating marginal geographically‐based structure. Local climate determines population performance, with survival highest at home but growth greatest in mild climates (e.g., warm, wet). Survival of two of the three populations tested was consistent with patterns of local adaptation documented for P. contorta, while growth was indicative of plasticity for populations grown under novel conditions and suggesting that some populations are not currently occupying their climatic optimum.

Main Conclusions

Our findings provide insight into the role of the landscape in shaping population genetic structure in a widespread tree species as well as the potential response of local populations to novel conditions, knowledge critical to understanding how widely distributed species may respond to climate change. Geographically based genetic structure and reduced survival under water‐limited conditions may make some populations of widespread tree species more vulnerable to local maladaptation and extirpation. However, genetically diverse and phenotypically plastic populations of widespread trees, such as many of the P. contorta populations sampled and tested here, likely possess high persistence potential.
Remediation of a phonological representation deficit in Chinese children with dyslexia: A comparison between metalinguistic training and working memory training
Authors: Wang Jie , Wu Ka Chun , Mo Jianhong , Wong Wai Leung , Siu Tik Sze Carrey , McBride Catherine , Chung Kevin Kien Hoa , Wong Patrick C. M. , Maurer Urs
Published: November 2020

A form‐preparation task in the language production field was adopted to examine output phonological representations in Chinese dyslexia and their susceptibility to training. Forty‐one Chinese children with dyslexia (7–11 years old) and 36 chronological age controls completed this task. The controls demonstrated a marginally significant syllable facilitation effect (d = −0.13), indicating their use of syllable‐sized phonological representations during speech production, while the group with dyslexia showed a significantly different pattern (d = 0.04), opposite to the direction of a facilitation effect. The children with dyslexia were then randomly assigned to either metalinguistic training (N = 22) or working memory training (N = 19). Only the metalinguistic training subgroup demonstrated a significant syllable facilitation effect afterward (metalinguistic: d = −0.13; working memory: d = −0.01). The results suggest the presence of a phonological representation deficit at the syllable level in Chinese dyslexia and its possible remediation by metalinguistic training. Such a phonological deficit in readers of a logographic script strongly supports the impaired phonological representation view of developmental dyslexia. A video abstract of this article can be viewed at https://youtu.be/zT2Be0xMkh0.
Add‐on therapy with dapagliflozin under full closed loop control improves time in range in adolescents and young adults with type 1 diabetes: The DAPADream study
Authors: Biester Torben , Muller Ido , von dem Berge Thekla , Atlas Eran , Nimri Revital , Phillip Moshe , Battelino Tadej , Bratina Natasa , Dovc Klemen , Scheerer Markus F. , Kordonouri Olga , Danne Thomas
Published: November 2020

Aim

To investigate the effect of the sodium‐glucose co‐transporter‐2 inhibitor dapagliflozin on glucose levels overnight and during the following day after two unannounced meals under full closed loop (FCL) conditions.

Materials and Methods

For this single‐centre, double‐blind, randomized, placebo‐controlled, cross‐over trial, non‐obese persons with type 1 diabetes (T1D) were studied twice (10 mg dapagliflozin bid vs. placebo) for 24 hours with two unannounced mixed meal tests 6 hours apart under FCL conditions. Primary outcome was sensor glucose time in range (TIR; 3.9‐10 mmol/L). For safety evaluation, ß‐hydroxybutyrate (BHB), glucagon, insulin and gastric inhibitory polypeptide were measured.

Results

Fifteen adolescents (aged 15.4 ± 1.6 years, diabetes duration 10.0 ± 3.4 years, HbA1c 8.4% ± 0.9% [67.7 ± 10.1 mmol/mol]) and 15 young adults (aged 18.7 ± 0.8 years; diabetes duration 12.5 ± 3.6 years; HbA1c 8.3% ± 0.9% [68.5 ± 11.2 mmol/mol]) completed the trial. TIR was significantly higher in the intervention group compared with placebo (68% ± 6% vs. 50% ± 13%; P < .001); nocturnal glucose was significantly lower with dapagliflozin (6.2 ± 0.7 vs. 7.3 ± 1.7 mmol/L; P = .003) without an increase in time at less than 3.9 mmol/L (3.3% ± 6.0% vs 3.1% ± 5.2%; P = .75). Urinary glucose excretion was increased 3‐fold using dapagliflozin (149 ± 42 vs. 49 ± 23 g/24 hours) with a total insulin reduction of 22% (39.7 ± 12.7 vs. 30.6 ± 10.4 U; P = .004). No abnormal elevated BHB values were observed.

Conclusions

In adolescents and adults with T1D, dapagliflozin significantly increased TIR on average by 259 minutes/day while reducing glycaemic variability during FCL control without any signs of hypoglycaemia or ketosis.
Echocardiographic diagnosis of permanent pacemaker lead malposition in the left ventricle: A case study
Authors: Luke Peter , Shepherd Ewen , Irvine Tim , Duncan Rae
Published: November 2020

Inadvertent endocardial lead malposition is recognized as a rare incident which is usually underreported and if recognized during implantation can be easily corrected. This phenomenon is caused by the ventricular lead unintentionally crossing a pre‐existing patent foremen ovale, septal defects (atrial or ventricular) or directly from the aorta via an accidental subclavian puncture resulting in the lead implanting into the left ventricle. While this is a rare occurrence we report, the incidental finding of pacemaker lead malposition during a routine follow‐up transthoracic echocardiogram and the benefits of three‐dimensional transesophageal echocardiography in this patient prior to lead extraction.
Atrial fibrillation and Alzheimer’s disease: A conundrum
Authors: Benenati Stefano , Canale Claudia , De Marzo Vincenzo , Della Bona Roberta , Rosa Gian Marco , Porto Italo
Published: November 2020

During ageing, the prevalence of Alzheimer's disease (AD) and of cardiovascular disease CVD) increases. Our aim is to investigate the relationship between AD and CVD and its risk factors, with a view to explaining the underlying mechanisms of this association. This review is based on the material obtained via MEDLINE (PubMed), Embase and Clinical Trials databases, from January 1980 until May 2019. The search term used was “Alzheimer's disease”, combined with “cardiovascular disease”, “hypertension”, “dyslipidaemia”, “diabetes mellitus”, “atrial fibrillation”, “coronary artery disease”, “heart valve disease”, “heart failure”. Out of the 1328 papers initially retrieved, 431 duplicates and 216 records in languages other than English were removed; thus, only 98 papers were included in our research material. We have found that AD and CVD are frequently associated, while both of them, alone may be considered deleterious to health, the study of their combination constitutes a clinical challenge. Further research will help to clarify the real impact of CVD and its risk factors on AD, in order to better comprehend the effects of subclinical and clinical cardiovascular diseases on the brain. It may be hypothesized that there are various mechanisms underlying the association between AD and CVD, the main ones being: hypoperfusion and emboli, atherosclerosis, furthermore in both the heart and brain of AD patients, amyloid deposits may be present, thus causing damage to these organs. We need to clarify the real impact of these underlying hypothesized mechanisms and to investigate gender issues.
Global status of knowledge for prevention and emergency management of traumatic dental injuries in sports persons and coaches: A systematic review
Authors: Tewari Nitesh , Johnson Riya Marie , Mathur Vijay Prakash , Rahul Morankar , Goel Shubhi , Ritwik Priyanshi , Bansal Kalpana , Atif Mohammad
Published: November 2020

Background/Aims

Sports‐related dental injuries can cause pain, disfigurement, and broken teeth which may affect the athlete's well‐being and psychological status. Such injuries may also lead to the fear of re‐injury and other problems. Since a delay in adequate emergency treatment can have adverse effects, it is imperative that athletes and coaches have sufficient awareness of emergency treatment options. Hence, the aim of this systematic review was to evaluate the global status of knowledge among athletes and coaches regarding the prevention and emergency management of traumatic dental injuries.

Methods

The protocol was designed using the PRISMA guidelines and registered in PROSPERO (CRD42020184956). A broad‐based search using text words and MeSH terms was performed in established databases according to a predefined strategy without any distinction of language and year of publication. Studies without details of the questionnaire, knowledge score, validity, and reliability were excluded. Data extraction was performed and risk‐of‐bias assessment was done by means of the Joanna Briggs Institute's critical appraisal tool.

Results

Nine studies published between 2005 and 2020 were included for qualitative synthesis. They were primarily from Asia with none from North America and Australia. Most of them were cross‐sectional, used convenience sampling, and were interview‐based. Less than 10% of the participants in two studies had adequate knowledge of the immediate emergency management of tooth avulsion, while only 2.4% of basketball players and coaches knew that it was necessary to collect the avulsed tooth or broken tooth fragments. The overall level of knowledge was reported as poor or insufficient in all studies, with moderate or high risk‐of‐bias in six studies.

Conclusion

The knowledge regarding emergency management of TDI was found to be low globally. Along with the choice of the sport, there was a high level of variability in the study design and sampling characteristics.
Cumulative socio‐economic disadvantage and traumatic dental injuries during adolescence
Authors: Mira Rolla Saud , Marcenes Wagner , Stansfeld Stephen A. , Bernabé Eduardo
Published: November 2020

Background/aim

Studies on the association between socio‐economic circumstances and traumatic dental injuries (TDIs) are cross‐sectional and inconclusive. The aim of this study was to investigate the association between cumulative socio‐economic disadvantage and TDIs among adolescents.

Method

Data from 668 participants in the East London Adolescents Community Health Survey (RELACHS) were analysed. Family socio‐economic indicators (parental employment, car ownership and eligibility for free school meals) were collected when participants were in grades 7 (11‐12 years), 9 (13‐14 years) and 11 (15‐16 years). The number of periods (RELACHS waves) adolescents lived in socio‐economic disadvantage was counted for each socio‐economic measure, ranging from 0 (never in disadvantage) to 3 (always in disadvantage). Adolescents were dentally examined for TDIs at age 15‐16 years. The association between each measure of cumulative socio‐economic disadvantage and TDIs was tested in logistic regression models adjusting for demographic factors.

Results

Significant positive linear trends in the prevalence of TDIs were observed by the number of periods of parental unemployment and being without a family car, but not by eligibility for free school meals. Adolescents whose parents were always unemployed had 2.06 (95% CI: 1.12‐3.80) greater odds of having TDIs than those whose parents were never unemployed. Similarly, adolescents from families that never owned a car had 2.17 (95% CI: 1.26‐3.74) greater odds of having TDIs than those that always had a family car.

Conclusion

Cumulative socio‐economic disadvantage during adolescence was associated with greater odds of having TDIs.
Dental education and undue exposure of patients’ image in social media: A literature review
Authors: Santos Pablo Silveira , do Nascimento Luiza Pereira , Martorell Leandro Brambilla , de Carvalho Raquel Baroni , Finkler Mirelle
Published: November 2020

Introduction

The benefits of social media for health education and communication have been discussed in the literature. However, the indiscriminate utilisation by dental students and professionals, and the effects on patients' privacy and confidentiality are still little explored.

Objective

To investigate the exposure of patients' images in social media by dental students and professionals, as well as to explore how this issue is addressed in dental schools.

Materials and Methods

A literature review was performed. Search strategies were developed for the following bibliographic databases: PubMed/MEDLINE, Latin American and Caribbean Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), and Scopus. There were no restrictions about the year of publication.

Results

231 articles were identified through search strategies. After a two‐phase process of selection, 7 studies were included. Articles mainly described how social media have been used by healthcare students and professionals and warned that this usage has often been unprofessional, risking patients’ privacy and confidentiality. Thus, it is the faculty's role, as a whole, to instruct students about the wise social media usage.

Conclusion

The undue exposure of patients' images by dental students and professionals in social media has often been observed. Educators should include social media awareness discussions on the undergraduate curriculum.
Exploring the term “resilience” as understood and experienced by dental educators
Authors: Fulton Charlotte , Carr Andrew , Penlington Chris
Published: November 2020

Introduction

Working as a dentist is a demanding and stressful occupation. Resilience is therefore widely thought to be a desirable quality in dentists, and these attitudes are likely to be initially formed during undergraduate training. The attitudes and experiences of dental educators are important as they are likely to influence dental undergraduates. This study describes how dentists working within an academic setting understand and experience resilience.

Methods

A series of qualitative interviews were conducted with a purposive sample of 12 dentists working within an academic setting in the UK. All interviews were digitally recorded and transcribed verbatim. A structured process of thematic analysis was followed in order to describe key themes that arose in the interviews.

Results

There was a common acknowledgement that resilience is the result of a dynamic process involving multiple factors. Six factors were described as relating to resilience: background and personal characteristics, environment, life challenges, mood, attitudes and expectations and actions and strategies. Each of these factors was also described as affecting the others in a reciprocal manner.

Conclusion

The academics in this study described resilience in terms of both personal and environmental factors and their interactions. This understanding could inform the development of programmes designed to enhance resilience for both dental educators and students, which might usefully focus on a range of individual and systemic factors.
Novel variants broaden the phenotypic spectrum of PLEKHG5‐associated neuropathies
Authors: Chen Zhongbo , Maroofian Reza , Başak A. Nazlı , Shingavi Leena , Karakaya Mert , Efthymiou Stephanie , Gustavsson Emil K. , Meier Leyla , Polavarapu Kiran , Vengalil Seena , Preethish‐Kumar Veeramani , Nandeesh Bevinahalli N. , Gökçe Güneş Nalan , Akan Onur , Candan Fatma , Schrank Bertold , Zuchner Stephan , Murphy David , Kapoor Mahima , Ryten Mina , Wirth Brunhilde , Reilly Mary M. , Nalini Atchayaram , Houlden Henry , Sarraf Payam
Published: November 2020

Background and purpose

Pathogenic variants in PLEKHG5 have been reported to date to be causative in three unrelated families with autosomal recessive intermediate Charcot‐Marie‐Tooth disease (CMT) and in one consanguineous family with spinal muscular atrophy (SMA). PLEKHG5 is known to be expressed in the human peripheral nervous system, and previous studies have shown its function in axon terminal autophagy of synaptic vesicles, lending support to its underlying pathogenetic mechanism. Despite this, there is limited knowledge of the clinical and genetic spectrum of disease.

Methods

We leverage the diagnostic utility of exome and genome sequencing and describe novel biallelic variants in PLEKHG5 in 13 individuals from nine unrelated families originating from four different countries. We compare our phenotypic and genotypic findings with a comprehensive review of cases previously described in the literature.

Results

We found that patients presented with variable disease severity at different ages of onset (8–25 years). In our cases, weakness usually started proximally, progressing distally, and can be associated with intermediate slow conduction velocities and minor clinical sensory involvement. We report three novel nonsense and four novel missense pathogenic variants associated with these PLEKHG5‐associated neuropathies, which are phenotypically spinal muscular atrophy (SMA) or intermediate Charcot‐Marie‐Tooth disease.

Conclusions

PLEKHG5‐associated neuropathies should be considered as an important differential in non‐5q SMAs even in the presence of mild sensory impairment and a candidate causative gene for a wide range of hereditary neuropathies. We present this series of cases to further the understanding of the phenotypic and molecular spectrum of PLEKHG5‐associated diseases.
Machine‐learning‐based outcome prediction in stroke patients with middle cerebral artery‐M1 occlusions and early thrombectomy
Authors: Hamann Janne , Herzog Lisa , Wehrli Carina , Dobrocky Tomas , Bink Andrea , Piccirelli Marco , Panos Leonidas , Kaesmacher Johannes , Fischer Urs , Stippich Christoph , Luft Andreas R. , Gralla Jan , Arnold Marcel , Wiest Roland , Sick Beate , Wegener Susanne
Published: November 2020

Background and purpose

Clinical outcomes vary substantially among individuals with large vessel occlusion (LVO) stroke. A small infarct core and large imaging mismatch were found to be associated with good recovery. The aim of this study was to investigate whether those imaging variables would improve individual prediction of functional outcome after early (<6 h) endovascular treatment (EVT) in LVO stroke.

Methods

We included 222 patients with acute ischemic stroke due to middle cerebral artery (MCA)‐M1 occlusion who received EVT. As predictors, we used clinical variables and region of interest (ROI)‐based magnetic resonance imaging features. We developed different machine‐learning models and quantified their prediction performance according to the area under the receiver‐operating characteristic curves and the Brier score.

Results

The rate of successful recanalization was 78%, with 54% patients having a favorable outcome (modified Rankin scale score 0–2). Small infarct core was associated with favorable functional outcome. Outcome prediction improved only slightly when imaging was added to patient variables. Age was the driving factor, with a sharp decrease in likelihood of favorable functional outcome above the age of 78 years.

Conclusions

In patients with MCA‐M1 occlusion strokes referred to EVT within 6 h of symptom onset, infarct core volume was associated with outcome. However, ROI‐based imaging variables led to no significant improvement in outcome prediction at an individual patient level when added to a set of clinical predictors. Our study is in concordance with current practice, where imaging mismatch or collateral readouts are not recommended as factors for excluding patients with MCA‐M1 occlusion for early EVT.
The European Academy of Neurology COVID‐19 registry (ENERGY): an international instrument for surveillance of neurological complications in patients with COVID‐19
Authors: Beghi Ettore , Helbok Raimund , Crean Michael , Chou Sherry Hsiang‐Yi , McNett Molly , Moro Elena , Bassetti Claudio ,   for the EAN Neuro‐COVID Task Force
Published: November 2020

The COVID‐19 pandemic is a global public health issue. Neurological complications have been reported in up to one‐third of affected cases, but their distribution varies significantly in terms of prevalence, incidence and phenotypical characteristics. Variability can be mostly explained by the differing sources of cases (hospital vs. community‐based), the accuracy of the diagnostic approach and the interpretation of the patients’ complaints. Moreover, after recovering, patients can still experience neurological symptoms. To obtain a more precise picture of the neurological manifestations and outcome of the COVID‐19 infection, an international registry (ENERGY) has been created by the European Academy of Neurology in collaboration with European national neurological societies and the Neurocritical Care Society and Research Network. ENERGY can be implemented as a stand‐alone instrument for patients with suspected or confirmed COVID‐19 and neurological findings or as an addendum to an existing registry not targeting neurological symptoms. Data are also collected to study the impact of neurological symptoms and neurological complications on outcomes. The variables included in the registry have been selected in the interests of most countries, to favour pooling with data from other sources and to facilitate data collection even in resource‐poor countries. Included are adults with suspected or confirmed COVID‐19 infection, ascertained through neurological consultation, and providing informed consent. Key demographic and clinical findings are collected at registration. Patients are followed up to 12 months in search of incident neurological manifestations. As of 19 August, 254 centres from 69 countries and four continents have made requests to join the study.
Myelitis in inflammatory disorders associated with myelin oligodendrocyte glycoprotein antibody and aquaporin‐4 antibody: A comparative study in Chinese Han patients
Authors: ZhangBao Jingzi , Huang Wenjuan , Zhou Lei , Wang Liang , Chang Xuechun , Lu Chuanzhen , Zhao Chongbo , Lu Jiahong , Quan Chao
Published: November 2020

Background and purpose

Myelitis is an important clinical component of myelin oligodendrocyte glycoprotein antibody (MOG‐ab)‐associated disease (MOGAD) and aquaporin‐4 antibody (AQP4‐ab)‐positive neuromyelitis optica spectrum disorder (NMOSD). The aim of this work was to evaluate the differentiating features of myelitis between the two diseases.

Methods

Myelitis‐related clinical and radiologic data from 130 patients with MOGAD and 125 patients with AQP4‐ab–positive NMOSD were retrospectively reviewed and compared. A scoring model was established to differentiate MOG‐ab–associated myelitis from AQP4‐ab–associated myelitis.

Results

Overall, 29.2% (38/130) of patients with MOGAD and 66.4% (83/125) of patients with AQP4‐ab–positive NMOSD had ever experienced myelitis. Compared with those with NMOSD, patients with MOGAD exhibited a lower frequency of myelitis, either during the first episode (p < 0.0001) or throughout the disease duration (p < 0.0001). Compared with AQP4‐ab–associated myelitis, MOG‐ab–associated myelitis manifested a higher male‐to‐female ratio (p < 0.0001), younger age at disease onset (p = 0.0004), more prodromic influenza‐like symptoms (p = 0.030), more prodromic fever (p = 0.0003), more bowel and bladder dysfunction (p = 0.011), less painful tonic spasms (p < 0.0001), and lower Expanded Disability Status Scale scores after treatment (p < 0.0001). On magnetic resonance imaging, lower spinal cord lesions (p = 0.023), short‐segment lesions (p = 0.021), conus involvement (p = 0.0001), and H sign (p < 0.0001) were more common in MOG‐ab–associated myelitis. A scoring model with a cutoff value of 4 differentiated MOG‐ab–associated myelitis from AQP4‐ab–associated myelitis with a sensitivity of 87.9% and a specificity of 90.1%.

Conclusions

Myelitis was less commonly observed in MOGAD and exhibited distinct features compared to those of AQP4‐ab–positive NMOSD.
Report of Drosophila suzukii (Matsumura) (Diptera: Drosophilidae) from the high‐altitude and cold arid region of Ladakh, India
Authors: Hussain B. , Akbar S. A. , ur Rehman M. , Un Nabi S. , Ganie S. A. , Rasheed War A.
Published: November 2020

Report of Drosophila suzukii (Matsumura) (Diptera: Drosophilidae) from the high‐altitude and cold arid region of Ladakh, India

Drosophila suzukii (Matsumura, 1931) is here reported for the first time from the high‐altitude and cold arid region of Ladakh, which is a Northwestern Himalayan region of India and is the second coldest inhabited place in the world. The species is emerging in the Ladakh region as a serious apricot pest, causing a considerable amount of economic loss.
Investigating the association of Lamotrigine and Phenytoin‐induced Stevens‐Johnson syndrome/Toxic Epidermal Necrolysis with HLA‐B*1502 in Iranian population
Authors: Sabourirad Sara , Mortezaee Reza , Mojarad Majid , Eslahi Atieh , Shahrokhi Yahya , Kiafar Bita , Jarahi Lida , Afkhami Ardakani Saman , Farrokhi Shima
Published: November 2020

Previous studies have found an association between HLA‐B*1502 allele and lamotrigine‐induced Stevens‐Johnson syndrome (SJS)/ toxic epidermal necrosis (TEN) spectrum in Han Chinese populations. This study aims to investigate the association between HLA‐B*1502 and lamotrigine‐ or phenytoin‐ induced SJS/TEN in an Iranian population. The medical records of twenty‐eight lamotrigine‐induced SJS/TEN patients and twenty‐five lamotrigine‐tolerant controls as well as eight phenytoin‐induced SJS/TEN and twelve phenytoin‐tolerant controls were extracted between March 2013 and March 2019 from the university hospitals in Mashhad, Iran. The presence of HLA‐B*1502 allele was determined using real‐time polymerase chain reaction (PCR). Among lamotrigine‐induced patients with SJS/TEN, 11 (39.3%) patients tested positive for the HLA‐B*1502 while only 3 (12.0%) of the lamotrigine‐tolerant controls tested positive for this allele. The risk of lamotrigine‐induced SJS/TEN was significantly higher in patients with HLA‐B*1502, with an odds ratio (OR) of 4.74 [95% confidence interval (CI) 1.14–19.73, p = 0.032]. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HLA‐B*1502 for lamotrigine‐induced SJS/TEN was 39.29%, 88.00%, 78.57% and 56.41%, respectively. The HLA‐B*1502 allele was present in 2 (25.0%) of phenytoin‐induced SJS/TEN cases and 5 (41.7%) of the phenytoin‐tolerant controls tested positive for HLA‐B*1502 allele. The risk of phenytoin‐induced SJS/TEN was not higher in the patients with HLA‐B*1502 (OR = 0.467 [95% confidence interval (CI) 0.065‐3.34, p = 0.642]). Lamotrigine‐induced SJS/TEN is associated with HLA‐B*1502 allele in an Iranian population but this is not the case for phenytoin‐induced SJS/TEN.