bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for assessment of the pupillary light reflex in dogs without chemical restraint: preliminary investigation
Authors: Graham K. L. , McCowan C. I. , White A. 
Published: August 2020

ObjectiveTo explore the use of a modified pupillometry technique in dogs without chemical restraint.Materials and MethodsFollowing dark adaptation, pupillary light reflexes were assessed in six dogs with sudden acquired retinal degeneration syndrome, in the unaffected eye of eight dogs with unilateral primary glaucoma (“predisposed”), and in 11 healthy dogs. Responses to red, blue and white lights were recorded and relative pupil sizes subsequently determined based on video recordings of each test.ResultsMean testing time was 2.3 minutes (range 1.8 to 3.1 minutes), excluding time for dark adaptation. Baseline pupil size in dogs with sudden acquired retinal degeneration syndrome was greater than in normal and predisposed eyes. Pupil constriction was reduced in predisposed compared to normal and sudden acquired retinal degeneration syndrome eyes when stimulated with high‐intensity blue light. Compared to normal eyes, those with sudden acquired retinal degeneration syndrome had reduced pupil constriction when stimulated with low‐ and high‐intensity red light, low‐intensity blue light and white light.Clinical SignificanceQuantitative measures of pupil function were obtained from healthy and diseased eyes without the need for chemical restraint. Further investigations are warranted to validate the technique and evaluate its use in the management of canine glaucoma.
Assessing the rate and reversibility of large‐herbivore effects on community composition in a semi‐arid grassland ecosystem
Authors: Wilmer Hailey , Augustine David J. , Derner Justin D. , Milchunas Daniel G. 
Published: August 2020

AbstractQuestionsWhat are the rate, reversibility, and degree of symmetry in plant species compositional change in response to the addition and removal of cattle grazing in the shortgrass steppe? Specifically, how does the imposition and removal of grazing affect the abundance of perennial C4 shortgrasses and C3 midgrasses that are of primary importance for livestock production in the region?LocationShortgrass steppe, northeastern Colorado, USA, in the North American Great Plains.MethodsWe evaluate rates and magnitude of basal cover change in newly ungrazed and newly grazed sites (established in 1991), relative to change in long‐term (grazed and ungrazed) comparison treatments (established in 1939) over 25 years. We also compare shifts in species basal cover in newly implemented treatments relative to baseline community composition measured at the start of the study.ResultsUnlike the limited change observed in long‐term treatments between 1939 and 1991, we documented more rapid, reversible and largely symmetric effects of both the imposition and removal of grazing between 1992 and 2017. This was primarily due to differences in the rate of increase in basal cover of C3 midgrasses, litter, and bare ground. However, the rate and direction of change differed when assessed relative to continuously evaluated and (early‐treatment) baseline cover data.ConclusionsStudies of plant community change in response to large‐herbivore grazing under varying ecological conditions and management regimes are needed to effectively guide the development and revision of state‐and‐transition models (STMs) for grassland managers, and to better detect and plan for dynamic ecological conditions. Effective adaptive management and STM development under a changing climate will recognize that effects of grazing and removal of grazing on shortgrass steppe can be reversible in a relatively symmetrical pattern, occurring within 6–16 years.
‘I'm unworthy of being in this space’: The origins of shame in medical students
Authors: Bynum William E. , Varpio Lara , Lagoo Janaka , Teunissen Pim W. 
Published: August 2020

AbstractObjectivesShame results from a negative global self‐evaluation and can have devastating effects. Shame research has focused primarily on graduate medical education, yet medical students are also susceptible to its occurrence and negative effects. This study explores the development of shame in medical students by asking: how does shame originate in medical students? and what events trigger and factors influence the development of shame in medical students?MethodsThe study was conducted using hermeneutic phenomenology, which seeks to describe a phenomenon, convey its meaning and examine the contextual factors that influence it. Data were collected via a written reflection, semi‐structured interview and debriefing session. It was analysed in accordance with Ajjawi and Higgs' six steps of hermeneutic analysis: immersion, understanding, abstraction, synthesis, illumination and integration.ResultsData analysis yielded structural elements of students' shame experiences that were conceptualised through the metaphor of fire. Shame triggers were the specific events that sparked shame reactions, including interpersonal interactions (eg, receiving mistreatment) and learning (eg, low test scores). Shame promoters were the factors and characteristics that fuelled shame reactions, including those related to the individual (eg, underrepresentation), environment (eg, institutional expectations) and person‐environment interaction (eg, comparisons to others). The authors present three illustrative narratives to depict how these elements can interact to lead to shame in medical students.ConclusionsThis qualitative examination of shame in medical students reveals complex, deep‐seated aspects of medical students' emotional reactions as they navigate the learning environment. The authors posit that medical training environments may be combustible, or possessing inherent risk, for shame. Educators, leaders and institutions can mitigate this risk and contain damaging shame reactions by (a) instilling a true sense of belonging and inclusivity in medical learning environments, (b) facilitating growth mindsets in medical trainees and (c) eliminating intentional shaming in medical education.
Pharyngeal and upper esophageal sphincter motor dynamics during swallow in children
Authors: Damrongmanee Alisara , El‐Chammas Khalil , Fei Lin , Zang Huaiyu , Santucci Neha , Kaul Ajay 
Published: August 2020

AbstractBackgroundMotor abnormalities of pharyngeal contraction or upper esophageal sphincter (UES) relaxation can lead to swallowing problems.MethodsWe reviewed high‐resolution esophageal manometry of children ≤18 years and classified into two groups based on the results of videofluoroscopic study of swallow (VFSS), as normal or abnormal. The UES metrics (integrated relaxation pressure [IRP], resting pressure [URP], and nadir pressure [UNP]), as well as peak pharyngeal pressure (velopharyngeal and meso‐hypopharyngeal), were analyzed.ResultsUES metrics: There were 142 and 19 subjects in the normal and abnormal groups, respectively. In the normal group, the median UES‐IRP at 0.2, 0.4, 0.6, 0.8 seconds, URP, and UNP were 1.0, 4.0, 11.0, 18.0, 53.5, and −1.0 mm Hg while in the abnormal group were 10.0, 13.0, 21.0, 25.5, 47.0, and 8.0 mm Hg. The UES‐IRP at 0.2, 0.4, 0.6 seconds, and UNP was significantly higher in the abnormal group.Pharyngeal metrics: We included 58 subjects in normal and 10 subjects in the abnormal group. The median of peak velopharyngeal and meso‐hypopharyngeal pressures were lower in the abnormal group; 188.50 vs 210.50, P = .185 and 110.00 vs 144.75 mm Hg, P = .065.Conclusions and InferencesThe UES‐IRP was lower than adults, URP was higher than preterm but less than adults, and UNP was lower than neonates but similar to adults. The pharyngeal pressures were higher than those reported for neonates and adults. Our data indicate that motor dynamics of swallowing may change from neonates to adulthood and reflect a maturational process. The subjects with abnormal VFSS had significantly higher UES‐IRP and UNP compared to normal VFSS.
Decreased smooth muscle function, peristaltic activity, and gastrointestinal transit in dystrophic (mdx) mice
Authors: Singh Kulpreet , Randhwa Gurpreet , Salloum Fadi N. , Grider John R. , Murthy Karnam S. 
Published: August 2020

AbstractBackgroundDuchenne muscular dystrophy (DMD) is characterized by the lack of dystrophin in skeletal, cardiac, and smooth muscle. Slow colonic transit and constipation are common in DMD patients and animal models of DMD. However, the cause of this hypocontractility and the expression of contractile proteins in smooth muscle are unknown. The aim of the study was to investigate the expression of contractile proteins in the colonic smooth muscle and the function of the colon in control and mdx mice.MethodsMuscle contraction was measured in muscle strips and isolated muscle cells. Peristaltic activity was measured in ex vivo preparations by spatiotemporal mapping, and gastrointestinal (GI) transit in vivo was measured by the distribution of fluorescent marker along the intestine and colon. mRNA expression of contractile proteins smoothelin, caldesmon, calponin, and tropomyosin was measured by qRT‐PCR.ResultsExpression of mRNA for contractile proteins was decreased in colonic smooth muscle of mdx mice compared with control. Contraction in response to acetylcholine and KCl was decreased in colonic muscle strips and in isolated muscle cells of mdx mice. Distension of ex vivo colons with Krebs buffer induced peristalsis in both control and mdx mice; however, significantly fewer full peristaltic waves were recorded in the colons of mdx mice. GI transit was also inhibited in mdx mice.Conclusion and InferencesThe data indicate that the lack of dystrophin causes decrease in colonic smooth muscle contractility, peristalsis, and GI transit and provides the basis for analysis of mechanisms involved in smooth muscle dysfunction in DMD.
Turgor – a limiting factor for radial growth in mature conifers along an elevational gradient
Authors: Peters Richard L. , Steppe Kathy , Cuny Henri E. , De Pauw Dirk J.W. , Frank David C. , Schaub Marcus , Rathgeber Cyrille B.K. , Cabon Antoine , Fonti Patrick 
Published: August 2020

Summary

A valid representation of intra‐annual wood formation processes in global vegetation models is vital for assessing climate change impacts on the forest carbon stock. Yet, wood formation is generally modelled with photosynthesis, despite mounting evidence that cambial activity is rather directly constrained by limiting environmental factors.

Here, we apply a state‐of‐the‐art turgor‐driven growth model to simulate 4 yr of hourly stem radial increment from Picea abies (L.) Karst. and Larix decidua Mill. growing along an elevational gradient. For the first time, wood formation observations were used to validate weekly to annual stem radial increment simulations, while environmental measurements were used to assess the climatic constraints on turgor‐driven growth.

Model simulations matched the observed timing and dynamics of wood formation. Using the detailed model outputs, we identified a strict environmental regulation on stem growth (air temperature > 2°C and soil water potential > −0.6 MPa). Warmer and drier summers reduced the growth rate as a result of turgor limitation despite warmer temperatures being favourable for cambial activity.

These findings suggest that turgor is a central driver of the forest carbon sink and should be considered in next‐generation vegetation models, particularly in the context of global warming and increasing frequency of droughts.
Vortioxetine versus other antidepressants in the treatment of burning mouth syndrome: An open‐label randomized trial
Authors: Adamo Daniela , Pecoraro Giuseppe , Coppola Noemi , Calabria Elena , Aria Massimo , Mignogna Michele 
Published: August 2020

AbstractObjectivesThis randomized open‐label trial compared the efficacy and tolerability of vortioxetine (15 mg/daily) with different antidepressants in the treatment of patients with burning mouth syndrome (BMS).MethodsOne and hundred fifty BMS patients were randomized into five groups and treated with either vortioxetine, paroxetine (20 mg/daily), sertraline (50 mg/daily), escitalopram (10 mg/daily) or duloxetine (60 mg/daily). The Visual Analogue Scale (VAS), Total Pain Rating Index (T‐PRI), Hamilton Rating Scales for Depression (HAM‐D) and Anxiety (HAM‐A), and Clinical Global Impression Improvement (CGI‐I) and Efficacy scales (CGI‐E) were performed at baseline and after 2, 4, 6, and 12 months of treatment. Any adverse events (AEs) were tabulated for each group. Descriptive statistics, including the Kruskal–Wallis non‐parametric test and the Friedman non‐parametric test for median comparisons between different times, were used.ResultsAll the antidepressants (AD) were associated with a significant decrease in the VAS, T‐PRI, HAM‐A, HAM‐D, CGI‐I, and CGI‐E scores in the long‐term (p < .001). However, the response rate of the vortioxetine group showed a significant reduction after six months. The medians, after 6 months, were as follows: VAS 0.0; T‐PRI 2.0; HAM‐A 7.0; HAM‐D 7.0; CGI‐I 1.0; and CGI‐E 1.0 with a lower incidence of AEs (p < .019).ConclusionVortioxetine was efficacious with a shorter latency of action and fewer AEs compared with other ADs.
Direct‐acting oral anti‐coagulants in dental practice: A Retrospective Observational Study (Part 1)
Authors: Kim Tony , Finkelman Matthew , Desai Bhavik , Farag Arwa 
Published: August 2020

AbstractObjectivesThe objective of this retrospective observational study was to determine the incidence of direct‐acting oral anti‐coagulant (DOA) use in patients receiving invasive dental procedures. The secondary objective was to investigate the precautionary measures implemented and the post/intraoperative complications associated with DOA use.MethodsElectronic record database, Axium, was retrospectively reviewed, and patients using NGOA and treated between 2010 and 2017 were identified. Charts of patients who underwent invasive dental procedures were further reviewed to investigate the preoperative/intraoperative precautionary measures taken and identify any intraoperative/postoperative complications.ResultsA total of 130 patients were identified, with their annual number steadily rising from 12 in 2011 to 52 in 2016. Among those, 64 patients (49.23%) underwent invasive dental procedures. Pretreatment medical consults were obtained in all patients undergoing invasive procedures; however, only 7 (10.94%) were instructed to discontinue their DOA. Preoperative laboratory testing was obtained for two patients. Intraoperatively, 34 (53.13%) cases of excessive bleeding were reported, all were locally controlled with hemostatic agents. Only 4 instances of postoperative complications were documented.ConclusionsDespite the rise in the use of DOA, there is no consistent pattern for preoperative laboratory testing and DOA discontinuations. Expert consensus may be of great importance to develop practice guidelines.
Non‐impacted tooth extractions and antibiotic treatment: A RCT study
Authors: Cinquini Chiara , Marchionni Saverio , Derchi Giacomo , Miccoli Mario , Gabriele Mario , Barone Antonio 
Published: August 2020

AbstractObjectivesA controlled, single‐blind, randomized clinical trial was performed to evaluate usefulness of antibiotics in preventing pain and complications after tooth extractions and benefits of probiotics in reducing gastro‐intestinal symptoms associated with antibiotic therapy.Materials and methodsA total of 159 patients were enrolled in this trial. After tooth extractions, patients were allocated to one of the groups: group 1 received postoperatively amoxicillin + clavulanic acid; group 2 received the same antibiotic therapy with an adjunctive probiotic treatment; and group 3 received neither antibiotics nor probiotics. Follow‐up visits were planned at 7, 14, and 21 days after tooth extractions (T1, T2, and T3), and parameters assessed were pain, presence of abscess, edema, fever, alveolitis, trismus, pain, difficulty in daily routine activities, and gastro‐intestinal symptoms.ResultsThe number of patients reporting pain at T1 was significantly higher in the control group when compared to group 2 (p = .016), while no difference for pain intensity was observed between groups. No surgical site infection was observed in any of the groups. Intestinal symptoms seemed to be tackled by probiotic administration.ConclusionsPain was the most important symptom in the control group. Antibiotics were not necessary after non‐impacted tooth extractions, and probiotics can reduce gastro‐intestinal symptoms associated with antibiotics.
Metastasis to the oral and maxillofacial region: A systematic review
Authors: Kirschnick Laura Borges , Schuch Lauren Frenzel , Cademartori Mariana Gonzalez , Vasconcelos Ana Carolina Uchoa 
Published: August 2020

AbstractObjectivesThe purpose of this systematic review was to incorporate the information published on metastatic lesions in the in the oral and maxillofacial region into a comprehensive analysis of their demographic, clinical, and imaginological features and survival rate.Materials and methodsAn electronic search was undertaken in the subsequent databases: PubMed, Web of Science, Scopus, EMBASE, and LILACS. All papers included were case reports or case series. Absolute and relative frequencies were obtained by descriptive analysis. Overall survival was defined by the Kaplan–Meier method.ResultsThis systematic review identified 217 studies from 33 countries, comprising 348 cases. Male individuals were more affected (n = 199/57.68%) in the 5th to 7th decades of life. The most usual primary site was the lung in men (n = 49/14.08%) and the breast in women (n = 40/11.49%). Jawbones were affected in 183 cases (53.19%), with the posterior mandible (n = 96/66.66%) representing the preferred site. In soft tissues, the gingiva (n = 80/23.25%) was more affected. Clinical presentation was a nodular mass with or without ulceration (n = 280/85.89%). Imaginological examinations revealed radiolucent/hypodense lesions (n = 115/59.28%). The mean survival time was eight months.ConclusionDespite the rare occurrence of metastatic lesions in the oral and maxillofacial region, the current systematic review offers substantial data that could assist clinicians and surgeons.
Nurses’ perceptions of their role in functional focused care in hospitalised older people: An integrated review
Authors: Swoboda Nicholas Leo , Dahlke Sherry , Hunter Kathleen F. 
Published: August 2020

AbstractAimThe aim of this integrative review was to identify nurses’ perspectives of their role in influencing the functional status of hospitalised older people.MethodsAn integrative review using Whittemore and Knafls’ method was conducted using EBSCOhost CINAHL, Ovid MEDLINE(R), EBSCOhost, Social Gerontology, Cochrane Database of Systematic Reviews and ProQuest Dissertations & Theses data bases. Only studies with nurses’ perspectives, or beliefs about their role in function‐focused care were included. Content analysis was used to develop the themes nurses’ role in function‐focused care and barriers to functional care.ResultsThe review found 12 relevant articles. Nurses believed that they were responsible for function‐focused care, yet functional care tasks were often missed. Organisational contexts created many barriers to providing function‐focused care for patients. Nurses felt powerless to address these overarching problems in their organisations.ConclusionNurses understand the importance of functional care yet often fail to carry out functional care interventions. Lack of organisational support creates a workplace that is short on staff, time and equipment and does not prioritise functional care needs. Nurse leaders and healthcare organisations need to reprioritise function‐focused care for the good of patients, families and healthcare budgets.
The use of non‐surgical interventions in patients with peri‐implantitis; a systematic review and meta‐analysis
Authors: Almershed Nizar , Adams Robert , Mort Joelle , Farnell Damian , Thomas David W , Claydon Nicholas 
Published: August 2020

AbstractObjectivesTo systematically assess the efficacy of different non‐surgical treatment methods to manage peri‐implantitis reported to date in the literature, together with its correlation with time following therapy.Materials and MethodsA systematic literature review was undertaken to identify randomised control trials of the non‐surgical management of peri‐implantitis published up to November 2019. The search was limited to English language human studies containing follow‐up periods of ≥3 months and for sample size of 10 or more patients. A meta‐analysis was implemented for the following clinical parameters: Peri‐implant pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL), radiographic bone loss (RBL) and mucosal recession (MR).ResultsTwelve articles met the inclusion criteria. Two principal treatment modalities were identified; mechanical debridement and laser therapy, with two adjunctive therapies antimicrobial and antiseptic agents. Non‐surgical interventions (ultrasonic scalers, Er:YAG laser and powdered air‐abrasive devices) showed significant clinical improvement in the short term (<3 months). Clinical benefit was demonstrated with the adjunctive use of antimicrobial agents in the short term but diminished with time. Antiseptic agents alone have no significant effect. Non‐surgical therapies applied in these studies failed to arrest mucosal recession, peri‐implant bone loss or reduce the counts of viable pathogens in the long term.ConclusionThe evidence demonstrate that the clinical parameters of peri‐implantitis, i.e. BOP, PPD and CAL may all be improved by simple mechanical debridement, using either ultrasonic instrumentation or Er:YAG laser therapy; adjunctive antimicrobial and antiseptic therapy. Further randomised control trials in this area are, however, required.
Time‐ and frequency‐domain analysis of repolarization phase during recovery from exercise in healthy subjects
Authors: Piccirillo Gianfranco , Moscucci Federica , Iorio Claudia Di , Fabietti Marcella , Mastropietri Fabiola , Crapanzano Davide , Bertani Gaetano , Sabatino Teresa , Zaccagnini Giulia , Lospinuso Ilaria , Magrì Damiano 
Published: August 2020

AbstractBackground/aimRecently, data from temporal dispersion of myocardial repolarization analysis have gained a capital role in the sudden cardiac death risk stratification. Aim of this study was to evaluate the influence of heart rate, autonomic nervous system, and controlled breathing on different myocardial repolarization markers in healthy subjects.MethodMyocardial repolarization dispersion markers from short‐period (5 minutes) electrocardiogram (ECG) analysis (time and frequency domain) have been obtained in 21 healthy volunteers during the following conditions: free breathing (rest); controlled breathing (resp); the first 5 minutes of postexercise recovery phases (exercisePeak), maximum sympathetic activation; and during the second 5 minutes of postexercise recovery phases (exerciseRecovery), intermediate sympathetic activation. Finally, we analyzed the whole repolarization (QTe), the QT peak (QTp), and T peak ‐ T end intervals (Te).ResultsDuring the exercisePeak, major part of repolarization variables changed in comparison to the rest and resp conditions. Particularly, QTe, QTp, and Te standard deviations (QTeSD, QTpSD, and TeSD); variability indexes (QTeVI and QTpVI), normalized variances (QTeVN, QTpVN, and TeVN); and the ratio between short‐term QTe, QTp, and Te variability RR (STVQTe/RR, STVQTp/RR, and STVTe/RR) increased. During exerciseRecovery, QTpSD (P < .05), QTpVI (P < .05), QTeVN (P < .05), QTpVN (P < .001), TeVN (P < .05), STVQTe/RR (P < .05), STVQTp/RR (P < .001), and STVTe/RR (P < .001) were significantly higher in comparison to the rest. The slope between QTe (0.24 ± 0.06) or QTp (0.17 ± 0.06) and RR were significantly higher than Te (0.07 ± 0.06, P < .001).ConclusionHeart rate and sympathetic activity, obtained during exercise, seem able to influence the time domain markers of myocardial repolarization dispersion in healthy subjects, whereas they do not alter any spectral components.