bluuebunny/crossref_metadata_2025_split huggingface dataset:
Importance of gynecological assessment for the treatment of vaginismus as a predictive value
Authors: Eserdağ Süleyman , Anğın Ali Dogukan 
Published: December 2020

AbstractAimIn this study, we aimed to analyze the impact of a detailed anamnesis and gynecological examination findings of women with vaginismus on its treatment success in a tertiary therapy center with 18 years of experience.MethodsThe socio‐demographical factors, gynecological examination notes and the treatment results of 281 vaginismus patients were analyzed between July 2018 and July 2019. The relationship with these parameters and the number of sessions for treatment were evaluated.ResultsThe women with higher vaginismus grade had a longer duration of marriage (P < 0.001) and they needed more CBT sessions (P = 0.004). On the other hand, the age of the patient, duration of the relationship, education level, and surgical intervention (hymenotomy, hymenectomy) or presence of anatomically pathological hymen did not affect the outcomes regarding the number of sessions, duration of the treatment and the rate of successful penetration.ConclusionGynecological evaluation and detailed anamnesis that is taken upon the first admission has an important impact on the management of therapy and the treatment success.
How can dementia and disability be prevented in older adults: where are we today and where are we going?
Authors: Lisko I. , Kulmala J. , Annetorp M. , Ngandu T. , Mangialasche F. , Kivipelto M. 
Published: December 2020

AbstractAgeing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age‐related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle‐based intervention can prevent cognitive and functional decline amongst at‐risk older adults from the general population. Within the World‐Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self‐management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.
A National Analysis of State Policies on Lesbian, Gay, Bisexual, Transgender, and Questioning/Queer Inclusive Sex Education
Authors: Garg Namrata , Volerman Anna 
Published: December 2020

ABSTRACTBACKGROUNDMany youth engage in risky sexual behaviors that are associated with adverse sexual health outcomes. Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) youth are disproportionately affected. Comprehensive sex education is instrumental to minimize these outcomes; however, each state varies in the topics taught.METHODSThis paper is a comprehensive review of all 50 states and the District of Columbia's policies, including laws and education standards, for LGBTQ inclusive material in school‐based sex education for youth in K‐12.RESULTSOverall, 48 states have policies that mandate sex education in the public schools. This review describes policy differences relevant to students who identify as LGBTQ, by comparing required topics, parental/guardian permission, LGBTQ inclusion, and normative language requirements.CONCUSIONSThere is a lack of uniformity and presence of discrimination in school‐based sex education policies in the United States, particularly related to LGBTQ topics. Therefore, young people, especially LGBTQ students, face geographical barriers to accessing sexual health information and schools are limited in implementing curriculum essential for students to optimize sexual health outcomes. State policymakers, school administrators, child health advocates, and parents should work to eliminate barriers for comprehensive sex education.
Does detection of fetal growth restriction improve neonatal outcomes?
Authors: Selvaratnam Roshan J , Wallace Euan M , Treleaven Sophie , Hooper Stuart B , Davis Peter G , Davey Mary‐Ann 
Published: December 2020

AimTimely delivery of fetal growth restriction (FGR) is a balance between avoiding stillbirth and minimising prematurity. We sought to assess the neonatal outcomes for babies suspected of FGR, both true and false positives.MethodsThis population cohort study examined all singleton births in Victoria, Australia from 2000 to 2017 (n = 1 231 415). Neonatal morbidities associated with neonatal intensive care unit (NICU) admission were assessed for babies born ≥32 weeks' with severe FGR (<3rd centile) and babies with birthweight ≥10th centile who were iatrogenically delivered for suspected FGR.ResultsBabies with severe FGR iatrogenically delivered for suspected FGR were more likely to require NICU admission than babies with severe FGR who were not detected (3.0% vs. 1.1%, P < 0.001). After adjusting for potential confounders, the odds of NICU admission were increased (adjusted odds ratio (aOR) = 3.00, 95% confidence interval = 2.45–3.67; P < 0.001). Rates of NICU admission were also higher in ≥10th centile babies iatrogenically delivered for suspected FGR than for ≥10th centile babies who entered labour spontaneously (1.8% vs. 0.5%, P < 0.001). After adjustments, the odds of NICU admission were increased (aOR = 3.91, 95% confidence interval = 3.40–4.49; P < 0.001). NICU admissions were associated with morbidities related to iatrogenic prematurity.ConclusionsDetection and planned delivery of FGR reduces stillbirth but may be associated with increased neonatal morbidity related to iatrogenic prematurity.
The acute effects of sleep restriction therapy for insomnia on circadian timing and vigilance
Authors: Maurer Leonie F. , Ftouni Suzanne , Espie Colin A. , Bisdounis Lampros , Kyle Simon D. 
Published: December 2020

AbstractSleep‐restriction therapy (SRT) has been shown to improve insomnia symptoms by restricting sleep opportunity. Curtailment of time in bed affects the duration and consolidation of sleep, but also its timing. While recent work suggests that people with insomnia are characterised by misalignment between circadian and behavioural timing of sleep, no study has investigated if SRT modifies this relationship. The primary aim of the present study was to examine change in phase angle after 2 weeks of SRT. As a secondary aim, we also sought to assess the effect of SRT on psychomotor vigilance. Following a 1‐week baseline phase, participants implemented SRT for 2 consecutive weeks. Phase angle was derived from the difference between the decimal clock time of dim light melatonin onset (DLMO) and attempted sleep time. Secondary outcomes included vigilance (assessed via hourly measurement during the DLMO laboratory protocol), sleep continuity (assessed via sleep diary and actigraphy), and insomnia severity. Eighteen participants meeting insomnia criteria (mean [SD] age 37.06 [8.99] years) took part in the study. Consistent with previous research, participants showed robust improvements in subjective and objective sleep continuity, as well as reductions in insomnia severity. The primary outcome (phase angle) was measurable in 15 participants and revealed an increase of 34.8 min (~0.58 hr; 95% confidence interval [CI] 0.01–1.15) from baseline to post‐treatment (mean [SD] 2.27 [0.94] versus 2.85 [1.25] hr). DLMO remained relatively stable (20:49 versus 21:01 hours), while attempted sleep was 46.8 min later (~0.78 hr; 95%CI 0.41–1.15; 23:05 versus 23:52 hours). For psychomotor vigilance, reaction time was delayed (by 52.71 ms, 95% CI 34.44–70.97) and number of lapses increased (by 5.84, 95% CI 3.93–7.75) after SRT. We show that SRT increases phase angle during treatment, principally by delaying the timing of sleep attempt. Future studies are needed to test if an increase in phase angle is linked to clinical improvement. Finally, reduction in vigilance after SRT appears to be of similar magnitude to normal sleepers undergoing experimental sleep restriction, reinforcing the importance of appropriate safety advice during implementation.
Royal Free Hospital‐estimated glomerular filtration rate for prognostic stratification of first acute kidney injury in cirrhosis
Authors: Rodrigues Susana G. , Abraldes Juan G. , Tsochatzis Emmanouil , Bosch Jaime , Berzigotti Annalisa 
Published: December 2020

AbstractBackground & AimsRenal function is a major determinant of prognosis in patients with cirrhosis. Current guidelines only contemplate serum creatinine (sCr) to assess kidney injury. However, there are formulas to estimate glomerular filtration rate (eGFR) which better measure renal function in patients listed for liver transplantation. There is no data available on whether these formulas predict prognosis in patients with acute kidney injury (AKI).MethodsIn 143 patients presenting with a first episode of AKI, we compared the prognostic value of renal function estimated using sCr or eGFR assessed with Modification of Diet in Renal Disease (MDRD‐6), chronic kidney disease epidemiology (CKD‐EPI) and Royal Free Hospital (RFH) for renal replacement therapy (RRT) within 30 days of AKI, and 30‐ and 90‐day transplant‐free survival.ResultseGFR was calculated on values obtained before and at admission, at presentation of AKI (D0) and 48 hours after AKI (D2).15% of patients (more commonly in alcohol + metabolic etiology; P = .049 vs other) required RRT. Transplant‐free survival at 30‐and 90‐day were 77% and 63%. Among sCr, MDRD‐6, CKD‐EPI and RFH‐eGFR, the latter predicted best RRT (HR 0.937 95% CI 0.893‐0.982, P = .007), 30‐d (HR 0.936 95% CI 0.901‐0.972, P = .001) and 90‐d (HR 0.934 95% CI 0.908‐0.972, P < .001) mortality/OLT.ConclusionsRenal function estimated using the RFH‐eGFR calculated at D2 after AKI diagnosis is a strong predictor of RRT and of 30‐d and 90‐d transplant‐free survival. Results suggest that in cirrhosis, RFH‐eGFR may be a better indicator of prognosis in AKI than sCr.
Stability issues in Kaleckian models driven by autonomous demand growth—Harrodian instability and debt dynamics
Authors: Hein Eckhard , Woodgate Ryan 
Published: December 2020

AbstractSraffian supermultiplier models, as well as Kaleckian distribution and growth models that make use of non‐capacity creating autonomous demand growth to cope with Harrodian instability, have paid little attention to the financial side of autonomous demand growth as the driver of the system. Therefore, we link the issue of Harrodian instability in Kaleckian models driven by non‐capacity creating autonomous demand growth with the associated financial dynamics. For a simple model with autonomous government expenditure growth, zero interest rates and no consumption out of wealth, we find that adding debt dynamics does not change the results obtained by Skott (2017) based on Lavoie's (2016) model without debt, each published in this journal. Hence, in this simple model, the long‐run equilibrium is stable if Harrodian instability is not too strong and the autonomous growth rate does not exceed a maximum given by the long‐run equilibrium saving rate. Introducing interest payments on government debt as well as consumption out of wealth into the model, however, changes the stability requirements: First, the autonomous growth rate of government expenditures should not fall short of the exogenous monetary interest rate. Second, this growth rate should not exceed a maximum given by the saving rate in the long‐run equilibrium net of the propensity to consume out of wealth. Third, Harrodian instability may be almost as strong as in the simple model without violating long‐run overall stability, particularly if the propensity to consume out of wealth is low. We claim that irrespective of the relevance or irrelevance of Harrodian instability, it is necessary to introduce financial variables into models driven by non‐capacity creating autonomous demand in order to assess the long‐run (in‐)stability and sustainability of growth.
The necessary indeterminacy of self‐determination: Politics, law and conflict in the Horn of Africa
Authors: de Waal Alex , Nouwen Sarah M.H. 
Published: December 2020

AbstractThis article frames a themed collection on Nationalism and Self‐determination in the Horn of Africa. It demonstrates how the praxis of self‐determination in the Horn of Africa has contributed to normative developments. On the basis of case studies of Eritrea, Ethiopia, Somalia and Sudan/South Sudan this article argues that nationalism and self‐determination have had different meanings in the political cultures across the different countries and have changed over time. We contend that such indeterminacy is unavoidable and should be welcomed. Nationalism is driven by historical circumstances that are contingent and often transitory. Self‐determination claims based on such nationalism are equally contingent and transitory. When the principle of self‐determination gets translated into concrete legal entitlements (for instance, a referendum on independence), it tends to solve one problem only by creating others. Instead, the pursuit and realization of self‐determination require constant political processes.
Inhibition of the P53/P21 Pathway Attenuates the Effects of Senescent Nucleus Pulposus Cell‐Derived Exosomes on the Senescence of Nucleus Pulposus Cells
Authors: Chen Chang‐chun , Chen Jing , Wang Wen‐liang , Xie Liang , Shao Chuan‐qiang , Zhang Yan‐xiang 
Published: December 2020

ObjectiveThe purpose of this paper is to investigate the effects of senescent nucleus pulposus cell (NPC)‐derived exosomes (SNPC‐Exo) and the roles of the P53/P21 pathway on the senescence of NPC.MethodsThe senescent phenotypes of NPC were induced by interleukin‐1β treatment. SNPC‐Exo was extracted from the culture medium of senescent NPC and purified by differential centrifugation. The structure of SNPC‐Exo was identified by transmission electron microscopy and western blot analysis was used to determine the exosomal marker proteins CD63 and Tsg101. Western blot analysis was performed to determine the relative expression levels of P16, P21, and P53 in NPC. Senescence‐associated β‐galactosidase (SA‐β‐gal) staining was used to stain the senescent NPC and a phase contrast microscope was used to observe and count the SA‐β‐gal staining of NPC. The proliferation of SNPC‐Exo‐treated NPC was assessed using growth curve analysis and the colony formation assay. The cell cycle of SNPC‐Exo‐treated NPC was determined by flow cytometry. NPC were transfected with siRNA to knock down P53 and P21 expression.ResultsInterleukin‐1β‐treated NPC had a higher percentage of SA‐β‐gal positive cells (45%) than the control group (20%) and showed an increase in the relative expression of P16, P21, and P53 (P < 0.05). SNPC‐Exo were positive for exosomal marker protein CD63 and Tsg 101 and negative for calnexin, and successfully internalized as previously described. SNPC‐Exo‐treated NPC showed an increase in the relative expression of P21 and P53 (P < 0.05). Compared with the control group, the SNPC‐Exo‐treated NPC showed a lower growth rate (3 times lower on the 5th day and 2 times lower on the 7th day), fewer colony‐forming units (12.0%), and a higher percentage of SA‐β‐gal‐positive NPC (50.0%). The SNPC‐Exo‐treated NPC contained more G1 phase cells (68.0%) and fewer S phase (15.5%) cells than the control group (53.0% in G1 phase, 33.5% in S phase). The expression of P21 and P53 significantly decreased in SNPC‐exo‐treated NPC after siRNA transfection (P < 0.05), followed by a higher growth rate (2 times higher on the 5th day and 1.5 times higher on the 7th day) and lower percentage of SA‐β‐gal‐positive NPC (22.5%). Moreover, the inhibition of the P53/P21 pathway promoted the SNPC‐Exo‐treated NPC to enter the S phase (from 15.5% to 25.3%).ConclusionThe inhibition of the P53/P21 pathway attenuated the senescence of NPC induced by SNPC‐Exo.
Major Socioeconomic Driving Forces of Improving Population Health in China: 1978–2018
Authors: Zhao Zhongwei , Jia Hongbo , Chen Mengxue 
Published: December 2020

AbstractChina's post‐Cultural‐Revolution reform generated rapid economic growth. But it also brought about major negative changes, especially in the early stage, which jeopardized population health and mortality gains. Nonetheless, improvements continued. China had achieved the Millennium Development Goal target 4 of reducing under‐5 mortality by two‐thirds well before the target year of 2015. Life expectancy continued to rise and reached 76.6 years by 2018, notably higher than the world average and that recorded in many countries with similar per capita GDP. By describing China's recent economic growth, the rebuilding of nationwide health insurance systems, the development of medical financial assistance, and poverty alleviation programs, this paper shows how these improvements were achieved. Vulnerability to health and mortality risks has been reduced; the availability of, and people's access to, health insurance have increased; and better medical treatments and health services have become available and accessible. These macro‐socioeconomic determinants have played the central role in achieving further population health and mortality progress in China in the past four decades.
One‐time abscisic acid priming induces long‐term salinity resistance in Vicia faba: Changes in key transcripts, metabolites, and ionic relations
Authors: Sagervanshi Amit , Naeem Asif , Geilfus Christoph‐Martin , Kaiser Hartmut , Mühling Karl H. 
Published: December 2020

AbstractAbscisic acid (ABA) priming is known to enhance plant growth and survival under salinity. However, the mechanisms mediating this long‐term acclimatization to salt stress are still obscure. Specifically, the long‐term transcriptional changes and their effects on ion relations were never investigated. This motivated us to study the long‐term (8 days) effect of one‐time 24 h root priming treatment with 10 μM ABA on transcription levels of relevant regulated key genes, osmotically relevant metabolites, and ionic concentrations in Vicia faba grown under 50 mM NaCl salinity. The novelty of this study is that we could demonstrate long‐term effects of a one‐time ABA application. ABA‐priming was found to prevent the salt‐induced decline in root and shoot dry matter, improved photosynthesis, and inhibited terminal wilting of plants. It substantially increased the mRNA level of AAPK and 14‐3‐3 ABA inducible kinases and ion transporters (PM H+‐ATPase, VFK1, KUP7, SOS1, and CLC1). These ABA‐induced transcriptional changes went along with altered tissue ion patterns. Primed plants accumulated less Na+ and Cl− but more K+, Ca2+, Zn2+, Fe2+, Mn2+, NO3−, and SO42−. Priming changed the composition pattern of organic osmolytes under salinity, with glucose and fructose being dominant in unprimed, whereas sucrose was dominant in the primed plants. We conclude that one‐time ABA priming mitigates salt stress in Vicia faba by persistently changing transcription patterns of key genes, stabilizing the ionic and osmotic balance, and improving photosynthesis and growth.
It is all relative: Contextual influences on boredom and neural correlates of regulatory processes
Authors: Perone Sammy , Anderson Alana J. , Weybright Elizabeth H. 
Published: December 2020

AbstractInterest in the influences on and strategies to mitigate boredom has grown immensely. Boredom emerges in contexts in which people have difficulty paying attention, such as underchallenging relative to optimally challenging conditions. The current study probed contextual influences on peoples' experience of boredom by manipulating the order with which people performed easy and optimally challenging conditions of a task (N = 113). We measured frontal alpha asymmetry (FAA) and theta/beta as neural correlates of self‐regulatory and attentional control processes, respectively. Results showed self‐reported boredom was higher in the easy condition when the optimal condition was completed before it. Similarly, participant's FAA shifted rightward from the first to the second task when the optimal condition was completed prior to the easy condition, indicating that self‐regulatory processes were strongly engaged under these context‐specific conditions. Theta/beta was lower during the easy relative to the optimal condition, regardless of the task order, indicating that maintaining attention in the easy condition was more difficult. No relations between perceptions of the task and neural correlates were observed. Exploratory analyses revealed higher levels of variability in FAA and theta/beta were associated with less enjoyment and more boredom, respectively. We speculate these observations reflect the less consistent engagement of self‐regulatory and attentional control and, in turn, might play a role in peoples' subjective experience. We discuss the implications of our findings for our understanding of influences on and strategies to mitigate boredom, as well as how attentional and self‐regulatory processes operate under conditions boredom typically emerges.
Who said what? The effects of speech tempo on target detection and information extraction in a multi‐talker situation: An ERP and functional connectivity study
Authors: Szalárdy Orsolya , Tóth Brigitta , Farkas Dávid , Hajdu Botond , Orosz Gábor , Winkler István 
Published: December 2020

AbstractPeople with normal hearing can usually follow one of the several concurrent speakers. Speech tempo affects both the separation of concurrent speech streams and information extraction from them. The current study varied the tempo of two concurrent speech streams to investigate these processes in a multi‐talker situation. Listeners performed a target‐detection and a content‐tracking task, while target‐related ERPs and functional brain networks sensitive to speech tempo were extracted from the EEG signal. At slower than normal speech tempo, building the two streams required longer processing times, and possibly the utilization of higher‐order, for example, syntactic and semantic cues. The observed longer reaction times and higher connectivity strength in a theta band network associated with frontal control over auditory/speech processing are compatible with this notion. With increasing tempo, target detection performance decreased and the N2b and the P3b amplitudes increased. These data suggest an increased need for strictly allocating target‐detection‐related resources at higher tempo. This was also reflected by the observed increase in the strength of gamma‐band networks within and between frontal, temporal, and cingular areas. At the fastest tested speech tempo, there was a sharp drop in recognition memory performance, while target detection performance increased compared to the normal speech tempo. This was accompanied by a significant increase in the strength of a low alpha network associated with the suppression of task‐irrelevant speech. These results suggest that participants prioritized the immediate target detection task over the continuous content tracking, likely due to some capacity limit reached the fastest speech tempo.