bluuebunny/crossref_metadata_2025 huggingface dataset:
Dementia specific care structures in nursing homes—Study protocol of a telephone‐based survey study in a nationwide random sample
Authors: Hoffmann Anna Louisa , Bergmann Johannes Michael , Mueller‐Widmer René , Palm Rebecca
Published: May 2021

Aim

To describe a study protocol for a survey study in German nursing homes that (1) plans to enhance a typology of care units (2) and investigates the association between different care unit types and the provision of dementia‐specific interventions based on a stratified randomized sample.

Background

Many nursing homes in Germany provide Dementia Special Care Units. Existing definitions often do no justice to the complexity of their context. In this study, we define context as structural and organizational variables. It is necessary to define an empirical based set of indicators to characterize care units with respect to dementia care.

Design

Observational survey study with a cross‐sectional design.

Methods

We will use a stratified random nationwide sample of 160 German nursing homes. Stratification variables are federal state and the existence of a Dementia Special Care Unit. The sampling frame from which the participating nursing homes are selected is a list with the total population of German nursing homes (n = 11.658). Data will be gathered on the level of the nursing homes and one of their care units via computer‐assisted telephone interviews with a standardized questionnaire. The distribution of the assessed variables (contextual characteristics) will be described in absolute and relative frequencies for the whole sample in the first step in order to describe dementia‐specific care structures. In the second step, factor analysis of mixed data (FAMD) with hierarchical clustering (HC) will be applied to analyze relationships between variables. The study was ethically approved in October 2018.

Discussion

The typology can be used in future studies to define the context of care units in nursing homes. This may improve the interpretation of findings from future studies that investigated interventions in nursing homes.

Impact

The typology will visualize and describe the complexity of contextual characteristics of several care units.
Similarity bias in credit decisions for entrepreneurs on the brink of bankruptcy
Authors: Strohmaier Niek , Adriaanse Jan , van den Bos Kees , Pluut Helen
Published: May 2021

For entrepreneurs in financial distress, it is of vital importance that investors and bankers accurately assess the viability of their business, free of unwanted biases that bear no relevance to the assessment of the chance of survival. Despite the prevalence of entrepreneurs facing financial distress, little research has yet investigated the role of cognitive biases in funding decisions in this important context. The current research attends to this issue and investigated whether entrepreneurs who are perceived by a banker as more similar are more likely to receive capital to save their business from bankruptcy than entrepreneurs who are perceived as less similar to the banker. Additionally, we investigated whether similarity bias affected bankers' attributions of what caused the financial distress as well as their perceptions of entrepreneurs' trustworthiness. Using an experimental research design, we found a similarity bias in bankers' causal attributions and trustworthiness judgments, but not in their credit decisions. We contrast our findings with similarity bias research among equity investors and discuss the implications for theory and practice.
microRNA‐125b and its downstream Smurf1/KLF2/ATF2 axis as important promoters on neurological function recovery in rats with spinal cord injury
Authors: Zhao Kunchi , Li Ran , Ruan Qing , Meng Chunyang , Yin Fei , Zhu Qingsan
Published: May 2021

The purpose of this study is to investigate the role of microRNA‐125b (miR‐125b) and its mechanism in spinal cord injury (SCI) by targeting Smurf1. After loss‐ and gain‐function approaches were conducted in SCI rat models and neural stem cells (NSCs) isolated from foetal rats, the Basso‐Beattie‐Bresnahan (BBB) score was calculated, and related protein expression was determined by Western blot analysis and cell apoptosis by TUNEL staining. NSC viability was detected by CCK‐8, migration abilities by Transwell assay and apoptosis by flow cytometry. The relationship between miR‐125b, Smurf1 and KLF2 was evaluated by dual‐luciferase reporter gene experiments, Co‐IP and in vivo ubiquitin modification assays. Inhibition of miR‐125b and KLF2 and the up‐regulation of Smurf1 and ATF2 were observed in SCI rats. BBB scores were elevated, the expression of Nestin, NeuN, GFAP, NF‐200 and Bcl‐2 protein was enhanced but that of Bax protein was reduced, and cell apoptosis was inhibited in SCI rats after up‐regulating miR‐125b or silencing ATF2. Smurf1 was a target gene of miR‐125b, which promoted KLF2 degradation through its E3 ubiquitin ligase function, and KLF2 repressed the expression of ATF2 in NSCs. The results in vivo were replicated in vitro. miR‐125b overexpression promotes neurological function recovery after SCI.
Photobiomodulation therapy promotes the ATP‐binding cassette transporter A1‐dependent cholesterol efflux in macrophage to ameliorate atherosclerosis
Authors: Yin Qianxia , Chang Haocai , Shen Qi , Xing Da
Published: May 2021

Atherosclerosis is a chronic inflammatory disease related to a massive accumulation of cholesterol in the artery wall. Photobiomodulation therapy (PBMT) has been reported to possess cardioprotective effects but has no consensus on the underlying mechanisms. Here, we aimed to investigate whether PBMT could ameliorate atherosclerosis and explore the potential molecular mechanisms. The Apolipoprotein E (ApoE)−/− mice were fed with western diet (WD) for 18 weeks and treated with PBMT once a day in the last 10 weeks. Quantification based on Oil red O‐stained aortas showed that the average plaque area decreased 8.306 ± 2.012% after PBMT (P < .05). Meanwhile, we observed that high‐density lipoprotein cholesterol level in WD + PBMT mice increased from 0.309 ± 0.037 to 0.472 ± 0.038 nmol/L (P < .05) compared with WD mice. The further results suggested that PBMT could promote cholesterol efflux from lipid‐loaded primary peritoneal macrophages and inhibit foam cells formation via up‐regulating the ATP‐binding cassette transporters A1 expression. A contributing mechanism involved in activating the phosphatidylinositol 3‐kinases/protein kinase C zeta/specificity protein 1 signalling cascade. Our study outlines that PBMT has a protective role on atherosclerosis by promoting macrophages cholesterol efflux and provides a new strategy for treating atherosclerosis.
Position statement: The need for EU legislation to require disclosure and labelling of the composition of medical devices
Authors: Herman A. , Uter W. , Rustemeyer T. , Matura M. , Aalto‐Korte K. , Duus Johansen J. , Gonçalo M. , White I.R. , Balato A. , Giménez Arnau A.M. , Brockow K. , Mortz C.G. , Mahler V. , Goossens A. ,   the ESCD, EECDRG, EADV Contact Dermatitis Task Force, EAACI
Published: May 2021

Background

In recent years, skin reactions secondary to the use of medical devices (MD), such as allergic contact dermatitis have increasingly been observed (e.g. to continuous blood sugar monitoring systems, insulin pumps, wound dressings, medical gloves, etc.): this is regarded as a developing epidemic. Lack of labelling of the composition of MD, as well as frequent lack of cooperation of manufacturers to disclose this relevant information, even when contacted by the clinician for the individual case of an established adverse reaction, significantly impede patient care.

Objectives

To advocate for full ingredient labelling in the implementation of EU regulation for MD.

Methods

This position paper reviews the scientific literature, the current regulatory framework adopted for MD to date, and the likely impact, including some costs data in case of the absence of such labelling.

Results

Efforts made by several scientific teams, who are trying to identify the culprit of such adverse effects, either via asking for cooperation from companies, or using costly chemical analyses of MD, can only partly, and with considerable delay, compensate for the absence of meaningful information on the composition of MD; hence, patient management is compromised. Indeed, without knowing the chemical substances present, physicians are unable to inform patients about which substances they should avoid, and which alternative MD may be suitable/tolerated.

Conclusion

There is an urgent need for full and accurate labelling of the chemical composition of MD in contact with the human body.
Methodological assessment of systematic reviews and meta‐analyses on COVID‐19: A meta‐epidemiological study
Authors: Rosenberger Kristine J. , Xu Chang , Lin Lifeng
Published: May 2021

Rationale, aims, and objectives

COVID‐19 has caused an ongoing public health crisis. Many systematic reviews and meta‐analyses have been performed to synthesize evidence for better understanding this new disease. However, some concerns have been raised about rapid COVID‐19 research. This meta‐epidemiological study aims to methodologically assess the current systematic reviews and meta‐analyses on COVID‐19.

Methods

We searched in various databases for systematic reviews with meta‐analyses published between 1 January 2020 and 31 October 2020. We extracted their basic characteristics, data analyses, evidence appraisal, and assessment of publication bias and heterogeneity.

Results

We identified 295 systematic reviews on COVID‐19. The median time from submission to acceptance was 33 days. Among these systematic reviews, 73.9% evaluated clinical manifestations or comorbidities of COVID‐19. Stata was the most used software programme (43.39%). The odds ratio was the most used effect measure (34.24%). Moreover, 28.14% of the systematic reviews did not present evidence appraisal. Among those reporting the risk of bias results, 14.64% of studies had a high risk of bias. Egger's test was the most used method for assessing publication bias (38.31%), while 38.66% of the systematic reviews did not assess publication bias. The I2 statistic was widely used for assessing heterogeneity (92.20%); many meta‐analyses had high values of I2. Among the meta‐analyses using the random‐effects model, 75.82% did not report the methods for model implementation; among those meta‐analyses reporting implementation methods, the DerSimonian‐Laird method was the most used one.

Conclusions

The current systematic reviews and meta‐analyses on COVID‐19 might suffer from low transparency, high heterogeneity, and suboptimal statistical methods. It is recommended that future systematic reviews on COVID‐19 strictly follow well‐developed guidelines. Sensitivity analyses may be performed to examine how the synthesized evidence might depend on different methods for appraising evidence, assessing publication bias, and implementing meta‐analysis models.
Presumptive probiotic bacteria from traditionally fermented African food challenge the adhesion of enteroaggregative E. coli
Authors: Agbemavor Wisdom Selorm Kofi , Buys Elna Maria
Published: May 2021

Colonization of intestinal tract with the potential to exclude, displace, and inhibit enteric pathogens is principally dependent on the adhesion ability of probiotics. Therefore, probiotic efficacy is considered to be mainly determined by their adhesion ability. The current study reports the antagonistic effect of four lactic acid bacteria (LAB) on the adhesion profile of four diarrhoeagenic and one non‐diarrhoeagenic enteroaggregative Escherichia coli (EAEC). All the bacterial strains investigated adhered to the Caco‐2 cells. All the LAB tested competitively excluded, displaced, and inhibited at least three (non‐) diarrhoeagenic EAEC strains from adhesion (p < 0.05). In all, Lactobacillus plantarum, FS2 exhibited the strongest adhesion to the Caco‐2 cells, competitive exclusion (CE), displacement, and inhibition against most of the EAEC strains. Additionally, the competence to exclude, displace, and inhibit the EAEC from adhesion depended on both the pathogens and the LAB strains tested; signifying the participation of several mechanisms. Contrary to all the EAEC strains, gastro‐intestinal stress factors such as low pH (2.5) had no effect on the adhesion of the LAB. Unlike the gastro‐intestinal acidic conditions, bile salt conditioning (at pH 6.5) had no effect on the adhesion of both EAEC and LAB. In conclusion, all the LAB tested showed specific anti‐adherence effects including CE, displacement, and inhibition against the selected EAEC. The results indicate that all the LAB, particularly, the L. plantarum, FS2 had a good ability for exerting antagonistic effects against the selected EAEC for the prevention of gastrointestinal infection.
Bacteriophages for detection and control of foodborne bacterial pathogens—The case of Bacillus cereus and their phages
Authors: Abraha Haftom Baraki , Kim Kwang‐Pyo , Sbhatu Desta Berhe
Published: May 2021

Bacillus cereus is among the primary food‐poisoning pathogenic bacterium that causes diarrhea and emetic types of diseases throughout the world. Recent advances show that bacteriophages become important tools in detection and control of foodborne bacterial pathogens in foods. They gain the interest of researchers for the food industries mainly because they are host‐specific and harmless to humans. Studies showed that bacteriophages could be employed as natural or engineered, whole or part, and temperate or virulent type in designing a range of tools for the detection and control of foodborne bacterial pathogens. This article discusses the recent methods and advances in the utilization strategies of bacteriophages in detection and control of foodborne pathogens, with particular focus on B. cereus pathogen. Moreover, the article presents the latest and relevant information of B. cereus‐infecting phages with respect to their potential applications in foods to address food safety issues. It also reflects future research directions by indicating gap of studies on the area.
Community health workers and care of older adults: How to learn what we need to know
Authors: Thompson Katherine , Borson Soo
Published: May 2021

This editorial comments on the article by Kennedy et al. in this issue.
Use of neck circumference as a predictor of cardiovascular risk in chronic kidney patients undergoing haemodialysis who are candidates for transplantation
Authors: Torres Medeiros Lívia , Caldas Sales Andressa Eslayne , da Silva e Sousa Francisca Isabelle , Vieira Moreira Tyciane Maria , Vital Batista Ana Clara , Marques Braga Ribanna Aparecida , Camacho Santos Daltro Ana Filomena , Costa de Oliveira Claudia Maria
Published: May 2021

Introduction

Patients undergoing haemodialysis are at great cardiovascular risk. Neck circumference (NC) is a simple and low‐cost measure for estimating this risk precociously. The present study aimed to evaluate whether the cardiovascular risk obtained by NC is associated with the main cardiometabolic risk factors in patients on haemodialysis treatment who are on a waiting list for transplantation.

Methods

A cross‐sectional study was conducted including 96 patients in a single transplantation centre. Socio‐demographic, clinical‐laboratory and anthropometric data were collected. NC was considered as a dependent variable and the independent variables were body mass index (BMI), fasting glycaemia and lipid profile, triglyceride and high‐density lipoprotein‐cholesterol (TGL/HDL‐C) ratio, and triglyceride and glycaemia (TyG) index. For the comparison of averages, we used Mann–Whitney and Student’sttests, as well as one‐way analysis of variance and Kruskal–Wallis tests. Bivariate and multivariate logistic regression was performed for the association between NC and cardiometabolic risk factors.p < 0.05 was considered statistically significant.

Results

There were higher BMI averages, blood glucose, triglycerides (TGL), TGL/HDL‐C ratio and TyG index in the tertile 3 of the NC, whereas the HDL‐C decreased as the tertile increased. There was a statistically significant risk of cardiovascular disease that was asscoiated, according to NC, with being overweight, high levels of TGL, TGL/HDL‐C, TyG index and low HDL‐C.

Conclusions

NC is shown to be associated with cardiometabolic risk factors in kidney patients undergoing haemodialysis who are on a transplant waiting list.
Dinoprostone pessary for labor induction in Chinese patients with premature rupture of membranes at term: A retrospective cohort
Authors: Liu Haiyan , Yin Huifen , Zhang Huan , Zhu Hao , Hu Rong , Gu Weirong
Published: May 2021

Aim

Whether the use of dinoprostone pessary increased the vaginal delivery rate of labor induction in Chinese nulliparous women with term premature rupture of membranes (PROM) and unfavorable cervices?

Methods

PROM women at term with singleton pregnancies and Bishop scores ≤4 who needed labor induction were enrolled in this retrospective study. They received either the dinoprostone pessary followed by oxytocin infusion if necessary (n = 102, PGE2 group) or oxytocin infusion alone (n = 103, oxytocin group).

Results

Compared with oxytocin infusion alone, vaginal delivery within 12 h and total vaginal delivery were higher in the PGE2 group (28.4% vs 7.8%, p = 0.0001; 79.4% vs 62.1%, p = 0.009, respectively). There were no statistical differences between the two groups in terms of maternal and neonatal outcomes, such as postpartum hemorrhage, endometritis, third‐ and fourth‐degree vaginal lacerations and neonatal weight, 1‐ and 5‐min Apgar score ≤7, neonatal jaundice, and neonatal unit admission (p > 0.05). However, there was a higher rate of uterine hyperstimulation in the PGE2 group (20.6% vs 3.9%, p < 0.0001). The effective rate of cervical ripening increased in the PGE2 group at 8 and 12 h of labor induction (p < 0.001).

Conclusions

Despite higher rates of uterine hyperstimulation, the use of dinoprostone was associated with higher rates of vaginal deliveries in Chinese nulliparous women with term PROM and Bishop scores ≤4, compared with use of oxytocin only.
The novel collagen matrikine, endotrophin, is associated with mortality and cardiovascular events in patients with atherosclerosis
Authors: Holm Nielsen S. , Edsfeldt A. , Tengryd C. , Gustafsson H. , Shore A. C. , Natali A. , Khan F. , Genovese F. , Bengtsson E. , Karsdal M. , Leeming D. J. , Nilsson J. , Goncalves I.
Published: May 2021

Background

Rupture of atherosclerotic plaques is the major cause of acute cardiovascular events. The biomarker PRO‐C6 measuring Endotrophin, a matrikine of collagen type VI, may provide valuable information detecting subjects in need of intensified strategies for secondary prevention.

Objective

In this study, we evaluate endotrophin in human atherosclerotic plaques and circulating levels of PRO‐C6 in patients with atherosclerosis, to determine the predictive potential of the biomarker.

Methods

Sections from the stenotic human carotid plaques were stained with the PRO‐C6 antibody. PRO‐C6 was measured in serum of patients enrolled in the Carotid Plaque Imagining Project (CPIP) (discovery cohort, n = 577) and the innovative medicines initiative surrogate markers for micro‐ and macrovascular hard end‐points for innovative diabetes tools (IMI‐SUMMIT, validation cohort, n = 1,378). Median follow‐up was 43 months. Kaplan–Meier curves and log‐rank tests were performed in the discovery cohort. Cox proportional hazard regression analysis (HR with 95% CI) was used in the discovery cohort and binary logistic regression (OR with 95% CI) in the validation cohort.

Results

PRO‐C6 was localized in the core and shoulder of the atherosclerotic plaque. In the discovery cohort, PRO‐C6 independently predicted future cardiovascular events (HR 1.089 [95% CI 1.019 −1.164], p = 0.01), cardiovascular death (HR 1.118 [95% CI 1.008 −1.241], p = 0.04) and all‐cause death (HR 1.087 [95% CI 1.008 −1.172], p = 0.03). In the validation cohort, PRO‐C6 predicted future cardiovascular events (OR 1.063 [95% CI 1.011 −1.117], p = 0.017).

Conclusion

PRO‐C6 is present in the atherosclerotic plaque and associated with future cardiovascular events, cardiovascular death and all‐cause mortality in two large prospective cohorts.
Founder effects facilitate the use of a genotyping‐based approach to molecular diagnosis in Swedish patients with familial hypercholesterolaemia
Authors: Benedek P. , Jiao H. , Duvefelt K. , Skoog T. , Linde M. , Kiviluoma P. , Kere J. , Eriksson M. , Angelin B.
Published: May 2021

Aim

To investigate whether genotyping could be used as a cost‐effective screening step, preceding next‐generation sequencing (NGS), in molecular diagnosis of familial hypercholesterolaemia (FH) in Swedish patients.

Methods and results

Three hundred patients of Swedish origin with clinical suspicion of heterozygous FH were analysed using a specific array genotyping panel embedding 112 FH‐causing mutations in the LDLR, APOB and PCSK9 genes. The mutations had been selected from previous reports on FH patients in Scandinavia and Finland. Mutation‐negative cases were further analysed by NGS. In 181 patients with probable or definite FH using the Dutch lipid clinics network (DLCN) criteria (score ≥ 6), a causative mutation was identified in 116 (64%). Of these, 94 (81%) were detected by genotyping. Ten mutations accounted for more than 50% of the positive cases, with APOB c.10580G>A being the most common. Mutations in LDLR predominated, with (c.2311+1_2312‐1)(2514)del (FH Helsinki) and c.259T>G having the highest frequency. Two novel LDLR mutations were identified. In patients with DLCN score < 6, mutation detection rate was significantly higher at younger age.

Conclusion

A limited number of mutations explain a major fraction of FH cases in Sweden. Combination of selective genotyping and NGS facilitates the clinical challenge of cost‐effective genetic screening in suspected FH. The frequency of APOB c.10580G>A was higher than previously reported in Sweden. The lack of demonstrable mutations in the LDLR, APOB and PCSK9 genes in ~1/3 of patients with probable FH strongly suggests that additional genetic mechanisms are to be found in phenotypic FH.
Guilty pleas in children: legitimacy, vulnerability, and the need for increased protection
Authors: HELM REBECCA K.
Published: May 2021

This article assesses the extent to which current guilty plea procedure is consistent with legitimations of criminal convictions, with a focus on decision making in child defendants. I argue that in the context of plea decisions in children, the criminal justice system must ensure that defendants make decisions that result in accurate convictions that are reached in a fair way that respects rights. The current system does not do this due to an almost exclusive focus on autonomy. This focus is likely to be leading to illegitimate convictions, most importantly children pleading guilty when innocent. Drawing on psychological theory, I develop a model of guilty plea decision making and draw on this model to identify relevant vulnerabilities of child defendants. Based on this analysis, I identify ways in which current procedure in England and Wales may be leading to systematic problems with the legitimacy of convictions of children, and suggest reforms to enhance such legitimacy. These reform suggestions focus on England and Wales but have implications for plea systems around the world.
A nonrandomised pilot study to examine the feasibility and acceptability of reflexology in patients undergoing hospital‐based haemodialysis (solitude study)
Authors: Matthews Michael , Carswell Claire , Redmond Avril , Bolton Stephanie , Murphy Kim , Mullan Robert , McAneney Helen , McKeaveney Clare , Noble Helen
Published: May 2021

Background

Patients with end‐stage kidney disease, receiving haemodialysis can experience complications—hypotension, headache, muscle cramp, chest pain, nausea and vomiting. Patients who experience all or some of these symptoms will often report reduced health‐related quality of life (HRQOL) and poor sleep quality, which may lead to increased morbidity and mortality.

Objective

The objective of this pilot study is to evaluate the feasibility of a larger randomised controlled trial to determine the effect of foot reflexology on a cohort of patients undergoing hospital‐based haemodialysis.

Design

A nonrandomised pilot study using a multimethod approach.

Participants

Twenty patients undergoing hospital‐based haemodialysis treatment.

Measurements

HRQOL and quality of sleep were measured using the SF‐12 Health Survey and the Pittsburgh Sleep Quality Index (PSQI). Semi‐structured interviews were completed with 10 patients, exploring their experiences, opinions and perceptions of the intervention.

Results

There was an increase in the mean scores examining the total physical health and mental health components of the SF‐12. All corresponding p values were statistically significant following the intervention. The mean total sleep score postintervention signified positive changes in sleep quality, with the corresponding p values being statistically significant. The study established the feasibility of the intervention and the benefits for patients undergoing haemodialysis.

Conclusion

This pilot study demonstrated the possibility of recruiting and retaining patients undergoing haemodialysis to a reflexology study. The study did not impact the haemodialysis routine and was positively received. The intervention showed statistically significant improvements in patients' HRQOL and sleep quality.
Potential Utility of School‐Based Telehealth in the Era of COVID‐19
Authors: Williams Stormee , Xie Luyu , Hill Kristina , Mathew Matthew Sunil , Perry Tamara , Wesley Danielle , Messiah Sarah E.
Published: May 2021

BACKGROUND

The COVID‐19 pandemic presents unique opportunities for preexisting school telemedicine programs to reach pediatric populations that might otherwise experience a lapse in health care services.

METHODS

A retrospective analysis of one of the largest school‐based telemedicine programs in the country, based in the Dallas‐Fort Worth (DFW), Texas was conducted that included 7021 pediatric patients who engaged in telehealth visits from 2014 to 2019.

RESULTS

Asthma or other respiratory disease was the primary diagnosis (28.4%), followed by injury or trauma (18.4%), digestive disorders (6.9%), and ear/eye/skin disease (6.9%). More participants were from the North (34.4%) and West (33.2%) ISD compared to the South (20.6%) and East (11.7%) schools. Likewise, the majority of COVID‐19 cases were in the North (61.8%) and West (31.6%) DFW regions, leading to 989 (59.9%) and 551 (33.4%) deaths, respectively.

CONCLUSIONS

School‐based telehealth programs have the potential to reach large pediatric populations most in need of health care due to COVID‐19‐related lapses in services, and to address COVID‐19‐related health issues as schools reopen. In the future, utilization could be expanded to contact tracing, testing, and screening for COVID‐19.
Cytokines in gingival crevicular fluid in elderly rheumatoid arthritis patients in a population‐based cross‐sectional study: RANTES was associated with periodontitis
Authors: Söderlin Maria K. , Persson Gösta Rutger , Renvert Stefan , Sanmartin Berglund Johan
Published: May 2021

Objective

We studied cytokines in gingival crevicular fluid (GCF) in a cross‐sectional population‐based cohort of rheumatoid arthritis (RA) patients ≥61 years of age with and without a diagnosis of periodontitis.

Background data

Earlier studies on cytokines in GCF in RA patients have not given clear results.

Methods

In a population‐based cross‐sectional study of patients ≥61 years of age, 233 RA patients were identified. 132 (57%) dentate RA patients participated. All participants received rheumatological and dental examinations, and had a panoramic radiograph taken. GCF was sampled on each patient. Interleukins 1‐β (IL‐1β), IL‐4, IL‐6, IL‐10, IL‐17A, tumor necrosis factor alpha (TNF‐α), interferon gamma (IFN‐γ), and chemokines RANTES/CCL5, eotaxin and monocyte chemoattractant protein (MCP‐1) were analyzed in GCF. These cytokines were stratified for periodontitis, age, gender, body mass index (BMI), smoking, and anti‐cyclic citrullinated protein (anti‐CCP) status. Binary logistic regression analyses with periodontitis as outcome were performed adjusting for the above mentioned confounding factors including anti‐rheumatic medication, disease duration and the cytokine in question.

Results

Periodontitis was diagnosed in 80/132 (61%) of study participants. The 110 RA patients not participating were older, had a higher mean erythrocyte sedimentation rate (ESR), had a higher mean DAS28ESR (Disease Activity Score 28 using ESR) and were less often on biologic treatment. Only RANTES was associated with periodontitis (p = .049, OR 1.001, 95% CI 1.000–1.002) in the binary logistic regression analyses.

Conclusion

In this population‐based elderly RA cohort, neither pro‐inflammatory nor anti‐inflammatory cytokines in GCF were clearly associated with a diagnosis of periodontitis.
Psychological factors among Appalachian women with abnormal Pap results
Authors: Adegboyega Adebola , Dignan Mark , Sha Shuying , Nkwonta Chigozie , Williams Lovoria B.
Published: May 2021

Purpose

Women who receive an abnormal Pap result may experience negative psychological factors. The purpose of this study is to assess the baseline occurrence of negative psychological factors and evaluate the relationships between psychological factors and demographic characteristics among Appalachian women who received abnormal Pap results.

Methods

We conducted a secondary analysis of data collected from Appalachia Kentucky women (N = 521) ages ≥18 enrolled in an intervention. Data included sociodemographics, Beck depression and anxiety inventories, fatalism, and personal control measures. Multiple variable logistic regression was used to investigate the association between demographics and psychological factors.

Findings

Participants were predominantly White (96.2%), with mean age 28.93 ± 11.03 years, and the majority (77%) had yearly income below $20,000. Depression was reported by 34.6% (n = 173); 10% (n = 50) experienced moderate or severe anxiety; 20.6% (n = 107) had fatalistic beliefs; and 55.1% (n = 289) believed they lacked personal control over cancer. Women with lower income had higher occurrence of depression (P = .003). Women with moderate to severe anxiety were significantly older than those with low to moderate depression (34.44 vs 28.34, P < .001). Controlling for other variables, as age increased, the odds of fatalistic beliefs increased, OR (95%) = 1.042 (1.022, 1.062). When education level increased, the odds of fatalistic beliefs decreased, OR (95%) = 0.873 (0.800, 0.952).

Conclusions

Given the high occurrence of depression, anxiety, and fatalistic beliefs among this population, health care providers should assess for underlying mental health diagnoses and psychological distress during each patient encounter and provide recommendations to address them.
COVID‐19 lockdown and poor sleep quality: Not the whole story
Authors: Alfonsi Valentina , Gorgoni Maurizio , Scarpelli Serena , Zivi Pierpaolo , Sdoia Stefano , Mari Emanuela , Fraschetti Angelo , Ferlazzo Fabio , Giannini Anna Maria , De Gennaro Luigi
Published: May 2021

A growing body of evidence consistently describes the side‐effects of coronavirus disease 2019 lockdown on mental health and sleep quality. We conducted a longitudinal web‐based survey of 217 Italian participants at two time points: lockdown and subsequent follow‐up. To thoroughly investigate lockdown‐related changes in sleep quality, we first evaluated variations in overall sleep quality assessed by the Pittsburgh Sleep Quality Index. We then examined sleep changes in specific components of sleep quality. Results revealed a clear dissociation of sleep effects, as a function of the specific domain considered, with longer sleep latency, worse sleep efficiency, and massive sleep medication use during forced confinement. On the other hand, we simultaneously observed an increased sleep duration and better daytime functioning. Our present findings highlight the importance of an accurate examination of sleep quality during lockdown, as the effects were not uniform across populations and different sleep domains.
The social environment and childhood obesity: Implications for research and practice in the United States and countries in Latin America
Authors: Ayala Guadalupe X. , Monge‐Rojas Rafael , King Abby C. , Hunter Ruth , Berge Jerica M.
Published: May 2021

The environments of children influence their risk for childhood obesity through, among other factors, a child's weight‐related behaviors (i.e., diet and physical activity). In this article, we present evidence on social environmental factors associated with a child's diet and physical activity, and more generally, the prevention and control of childhood obesity among Hispanic/Latinx children in the United States and children from countries in Latin America. Using a socio‐ecologic lens, we present evidence from cross‐sectional and longitudinal studies conducted in the United States involving Hispanic/Latinx children, and evidence from studies involving children in Latin America. Studies examining parenting factors in the home environment (e.g., parenting strategies) are especially emphasized, with more limited evidence on social environmental factors in other lived contexts (e.g., school). The influence of acculturation on social relationships cuts across levels of the socio‐ecological framework. Intervention research identified strategies and research gaps for intervening on social factors to promote healthy behaviors and reduce risk for childhood obesity. Community health workers and others forms of peer support were identified as relevant approaches at multiple levels of the socio‐ecological framework. This article concludes with directions for future research to further understand the environment using newer information and communication technologies.
Axial length targets for myopia control
Authors: Chamberlain Paul , Lazon de la Jara Percy , Arumugam Baskar , Bullimore Mark A
Published: May 2021

Purpose

Both emmetropic and myopic eyes elongate throughout childhood. The goals of this study were to compare axial elongation among untreated progressing myopes, progressing myopes treated with a myopia control contact lens and emmetropes, in order to place axial elongation in the context of normal eye growth in emmetropic children, and to consider whether normal physiological eye growth places limits on what might be achieved with myopia control.

Methods

Axial elongation data were taken from the 3‐year randomised clinical trial of a myopia control dual‐focus (MiSight® 1 day) contact lens. These were compared with data for myopic and emmetropic children in two large cohort studies: the Orinda Longitudinal Study of Myopia (OLSM) and the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Each study's published equations were used to calculate annual axial elongation. Four virtual cohorts—myopic and emmetropic for each model—were created, each with the same age distribution as the MiSight clinical trial subjects and the predicted cumulative elongation calculated at years 1, 2 and 3 for myopes and emmetropes using both the OLSM and SCORM models.

Results

The untreated control myopes in the MiSight clinical trial showed mean axial elongation over 3 years (0.62 mm) similar to the virtual cohorts based on the OLSM (0.70 mm) and SCORM (0.65 mm) models. The predicted 3‐year axial elongation for the virtual cohorts of emmetropes was 0.24 mm for both the OLSM and SCORM models—similar to the mean 3‐year elongation in MiSight‐treated myopes (0.30 mm).

Conclusions

The 3‐year elongation in MiSight‐treated myopes approached that of virtual cohorts of emmetropes with the same age distribution. It is hypothesised that myopic axial elongation is superimposed on an underlying physiological axial elongation observed in emmetropic eyes, which reflects increases in body stature. We speculate that optically based myopia control treatments may minimise the myopic axial elongation but retain the underlying physiological elongation observed in emmetropic eyes.
Osteosarcoma in One of Identical Twins: Three Cases Report and a Literature Review
Authors: Zhao Jie , Wang Wei , Liu Zhiyong , Li Xiao , Cai Qiqing , Yu Xiuchun
Published: May 2021

Background

Osteosarcoma (OS) is the most common primary malignant bone tumor occurring mainly in children and young adults. OS is usually seen in sporadic cases, and it is an extremely rare phenomenon in blood relatives, particularly among identical twins.

Case Presentation

The present study reports three cases of OS occurring in only one of identical twins. The first case is a high‐grade OS in the left proximal tibia of a 16‐year‐old girl, treated with neo‐adjuvant chemotherapy, en bloc resection, and reconstruction with a modular knee tumor prosthesis. The second one is a high‐grade OS of the left proximal tibia of a 6‐year‐old girl. The patient was treated with neo‐adjuvant chemotherapy, en bloc resection, and reconstruction with inactived autograft. The third one is a conventional OS of the right proximal tibia of a 20‐year‐old woman. She was treated with neo‐adjuvant chemotherapy, en bloc resection, and reconstruction with a custom‐made prosthesis.

Conclusions

The occurrence of OS in one of identical twins is a relatively rare event but may present the best opportunity to understand the genetic mechanisms underlying the tumorigenesis and progression of this disease in humans. A longer follow‐up period and regular imaging evaluation are needed to confirm whether the identical twin of these patients will suffer OS in the future.
Application of Enhanced Recovery after Surgical Treatment of the Occipitocervical Region
Authors: Liu Peng , Nie Hai , Wang Zhuan , Yao Bao , Li Jia‐hong , Zhou Ji
Published: May 2021

Objective

The concept of enhanced recovery after surgery (ERAS) has been proposed to provide guidance for the improved postoperative rehabilitation of patients with occipitocervical region disease (ORD).

Methods

This study retrospectively investigated 208 consecutive patients (116 men and 92 women) ranging in age from 22 to 76 years with ORD between July 2014 and June 2017 in our medical center, who were divided into three groups that received different preoperative, intraoperative, and postoperative management plans: traditional group (n = 73), ameliorated group (n = 70), and ERAS group (n = 65). We compiled a range of data relating to demographics and postoperative changes in hemoglobin and albumin, surgery duration, intraoperative blood loss, number of postoperative hospitalization days and expenses, readmission rates, and visual analog scale pain symptoms. Data were statistically evaluated using one‐way analysis of variance with Student–Newman–Keuls‐q post hoc tests or chi‐square tests.

Results

There were no significant differences in terms of age (P = 0.235), gender (P = 0.691), body mass index (P = 0.723), American Society of Anesthesiologists grade (0.747), lesion character (P = 0.337) and lesion site (P = 0.957) between the three groups. Within a 6 months follow‐up period, there was no significant difference between the three groups in terms of surgery duration (P = 0.225), blood loss (P = 0.172), changes in hemoglobin (P = 0.255) and albumin (P = 0.178). However, postoperative hospitalization days (P = 0.000), postoperative costs (P = 0.019) and improvement of pain symptoms (P = 0.000) in ERAS group were significantly lower or higher than those in traditional group or ameliorated group, respectively. There were 29 (39.73%), 22 (31.43%), and 13 (20.00%), recorded cases of postoperative complications in traditional group, ameliorated group and ERAS group, respectively; complications in ERAS group were significantly lower than those in other two groups (P = 0.043). Moreover, all of the complications were mitigated effectively by the infusion of fluid, analgesia, treatment of infections, or antiemetic medications. There were 2 (2.74%), 3 (4.29%) and 2 (3.08%), recorded cases of re‐admission in traditional group, ameliorated group and ERAS group, respectively, but there were no statistically significant differences when compared across the three groups (P = 0.866).

Conclusions

ERAS can provide benefits when it applied to patients undergoing ORD surgery mainly in terms of reducing postoperative complications, however, ERAS does not increase the economic burden of patients or decrease the risk of readmission.
Non‐operative management of biliary complications after Liver Transplantation in pediatric patients: A 30‐year experience
Authors: Lee Andrew Y. , Lehrman Evan D. , Perito Emily R. , Kerlan Robert K. , Kohi Maureen P. , Kolli Kanti P. , Taylor Andrew G. , Ostroff James W. , Kang Sang‐Mo , Roberts John P. , Rhee Sue , Rosenthal Philip , Fidelman Nicholas
Published: May 2021

Background

To evaluate the efficacy of percutaneous and endoscopic therapeutic interventions for biliary strictures and leaks following LT in children.

Methods

Retrospective analysis of 49 consecutive pediatric liver transplant recipients (27 girls, 22 boys, mean age at transplant 3.9 years) treated at our institution from 1989 to 2019 for biliary leak and/or biliary stricture was performed. Minimally invasive approach was considered clinically successful if it resulted in patency of the narrowed biliary segment and/or correction of the biliary leak.

Results

Forty‐two patients had a stricture at the biliary anastomosis; seven had a biliary leak. After an average 13.8 years of follow‐up, long‐term clinical success with minimally invasive treatment (no surgery or re‐transplant) was achieved for 24 children (57%) with biliary stricture and 4 (57%) with biliary leaks. Eight patients required re‐transplant; however, only one was due to failure of both percutaneous and surgical management. For biliary strictures, failure of non‐surgical management was associated with younger age at stricture diagnosis (p < .02).

Conclusions

Percutaneous and endoscopic management of biliary strictures and leaks after LT in children is associated with a durable result in >50% of children.
The Independent and Shared Transcriptomic Response to UVA, UVB and Oxidative Stress in the Cyanobacterium Nostoc punctiforme ATCC 29133
Authors: Soule Tanya , Ferreira Daniela , Lothamer Justin , Garcia‐Pichel Ferran
Published: May 2021

Research on the UVA, UVB and oxidative (as reactive oxygen species, ROS) stress response in cyanobacteria has typically focused on each individual stress condition, with limited studies addressing the intersection. Here, we evaluated the transcriptomic responses of the model cyanobacterium Nostoc punctiforme after exposure to each of these conditions. Overall, response to UVA was characterized by more gene down‐regulation than the UVB or ROS response, although UVB affected over fourfold more genes than UVA or ROS. Regarding expression patterns, responses to UVA and ROS were more similar and differentiated from those to UVB. For example, genes involved in ROS metabolism were up‐regulated under both UVA and ROS. However, when it came to RNA and protein metabolism, there were more up‐regulated genes under UVB and ROS compared to UVA. This suggests that the response to UVB and ROS is more active than the response to UVA, which stimulated more genes in secondary metabolism. Histidine kinases and response regulators were often differentially expressed, demonstrating that regulatory systems were at the base of the patterns. This study provides background for future studies targeting different genes, proteins and systems sensitive to these conditions. It also highlights the significance of considering multiple stress conditions.
Nursing staff’s assessments of medication management process in the psychiatric and operative domains: A cross‐sectional study after introduction of an electronic medication chart
Authors: Kuusisto Anne , Santavirta Jenni , Saranto Kaija , Suominen Tarja , Asikainen Paula
Published: May 2021

Aims and objectives

To describe nursing staff's assessments of medication management process in the psychiatric and operative domains after introduction of an electronic medication chart.

Background

The medication management process includes all structures and practices within the organisation that guide and support medication administration and related procedures.

Design

A cross‐sectional survey.

Methods

A Finnish version of the Medication Administration System – Nurses Assessment of Satisfaction (modified MAS‐NAS) paper‐based questionnaire was sent to all nursing staff (N = 855) working in operative (n = 498) and psychiatric (n = 357) domains in one central hospital. Data were analysed using statistical methods.

Results

In total, 324 nursing staff members participated. More than half agreed that medication management is efficient (64%), safe for patients (76%), and that the current medication administration system provides the necessary medical treatment information (e.g. prescriptions by physicians, medication data) (64%). Respondents’ overall satisfaction with medication management process was slightly above average on a scale from 1 to 10 (mean = 6.2; SD = 1.8; median = 7, range 2–9). Respondents who used electronic medication chart reported higher overall satisfaction with medication management process (median = 7, mean = 6.1, SD = 1.8 and range 2–9) than those not using it (median = 6.5, mean = 6.3, SD = 1.6 and range 2–9). No statistically significant difference was found (U = 8552.000, p = 0.33).

Conclusions

This study revealed several problems in the medication management process. The results can be used in developing the medication management process.

Relevance to clinical practice

Electronic medication chart should be used and developed further in terms of efficacy, safety and access. One year after the electronic medication chart was introduced, only half of the respondents had used it. That is why implementation of electronic systems or technological applications should be carefully considered as a whole.