bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective investigation of the prodromal stages of eating disorders and use of health services in young patients the year prior to the diagnosis
Authors: Gómez Del Barrio Andrés , Ruiz Guerrero Francisco , Benito Gonzalez Pilar , Perez Fernandez Marta , Sanchez Blanco Lucía , Losa Mugica Edurne , Calcedo Giraldo Gabriel , González Gómez Jana 
Published: March 2021

AbstractAimThe aim of this study was to analyse the characteristics and the frequency of medical consultations in the year prior to the diagnosis and the intervention onset of the Eating Disorder, as well as the different prodromal symptoms. The final aim was to understand the origin of all referrals and their possible influence on the duration of untreated illness.MethodsWe selected 99 young patients (15–25 years) and 61 healthy controls. Their primary and specialized care medical records were both studied retrospectively.Results87.6% of patients attended different consultations (primary care, specialized care and emergency department) the year prior compared to 67.2% of the controls (p = .002).The average number of consultations was 3.59 in the case group and 1.57 in the control group (p < .001).These consultations were related to prodromal symptoms in 57.4% compared to 16.4% for the controls (p < .001). They ranged from 29.8% of unspecific digestive symptoms, 22.8% of psychological symptoms, 19.3% of gynaecologic symptoms, 11.9% of weight variation, 8.8% of analytical changes, to 5.3% of malnutrition symptoms. Patients were mainly referred by Primary Care (42.7%). Overall, the mean of the Duration of Untreated Illness was of 7.45 months.ConclusionsThe majority of reasons for consultation were related to symptoms that could be prodromal symptoms, but the patients were not diagnosed with an eating disorder. These findings highlight the importance of professionals understanding how to identify the warning signs of an eating disorder, so they can refer patients to a specialized unit to establish an early treatment.
A video‐ and feedback‐based approach to teaching communication skills in undergraduate clinical dental education: The student perspective
Authors: Krause Felix , Ziebolz Dirk , Rockenbauch Katrin , Haak Rainer , Schmalz Gerhard 
Published: March 2021

AbstractObjectiveStudent evaluation of a communication‐education programme that combined patient consultation videos with peer‐ or expert‐based feedback.MethodsA self‐perception questionnaire was given to undergraduate dental students who had undertaken a curricular communication training and feedback programme, in which each participant was videoed three times during a patient interview or consultation, subsequently receiving either peer (PG) or expert feedback (EG). The questionnaire used feedback programme content to evaluate student perspectives, ascertaining whether the students experienced a gain in knowledge and professional conversational skills, whether videos or feedback helped them improve more and general questions about the structure and content of the curriculum. Differences between feedback groups were analysed (Mann‐Whitney U test).Results45 participants (peer group: n = 23, expert group: n = 22) took part in the study. The peer group experienced watching their video (38%) and receiving feedback (33%) as their major beneficial aspect to improve communication skills (watching fellow student´s video: 17%, providing feedback: 12%). The expert group experienced the major effect in receiving expert feedback (73%, video watching: 27%). The students said that communication skills should be a core competency in dental education learning outcomes (PG: 4.48 ± 0.67, EG: 4.41 ± 0.67; P > 0.05) and that communication curricula should include video‐based feedback (PG: 3.91 ± 0.73, EG: 4.00 ± 0.93; P > 0.05).ConclusionWatching videos and both receiving and providing peer group feedback were experienced as helpful in improving students’ communication skills. These findings suggest that a longitudinal communication curriculum, which includes both video‐based peer feedback and correlated self‐reflection, is a promising learning approach for dental education.
An emerging role for microglia in stress‐effects on memory
Authors: Sanguino‐Gómez Jeniffer , Buurstede Jacobus C. , Abiega Oihane , Fitzsimons Carlos P. , Lucassen Paul J. , Eggen Bart J. L. , Lesuis Sylvie L. , Meijer Onno C. , Krugers Harm J. 
Published: March 2021

AbstractStressful experiences evoke, among others, a rapid increase in brain (nor)epinephrine (NE) levels and a slower increase in glucocorticoid hormones (GCs) in the brain. Microglia are key regulators of neuronal function and contain receptors for NE and GCs. These brain cells may therefore potentially be involved in modulating stress effects on neuronal function and learning and memory. In this review, we discuss that stress induces (1) an increase in microglial numbers as well as (2) a shift toward a pro‐inflammatory profile. These microglia have (3) impaired crosstalk with neurons and (4) disrupted glutamate signaling. Moreover, microglial immune responses after stress (5) alter the kynurenine pathway through metabolites that impair glutamatergic transmission. All these effects could be involved in the impairments in memory and in synaptic plasticity caused by (prolonged) stress, implicating microglia as a potential novel target in stress‐related memory impairments.
Worldwide barriers to genetic testing for movement disorders
Authors: Gatto Emilia M. , Walker Ruth H. , Gonzalez Claudio , Cesarini Martin , Cossu Giovanni , Stephen Christopher D. , Balint Bettina , Rodríguez‐Violante Mayela , Jankovic Joseph , Morgante Francesca , Jinnah Hyder A. ,   the Rare Movement Disorders Study Group of the International Parkinson Disease, Movement Disorders Society
Published: March 2021

AbstractBackground and purposeDespite enormous advances in identifying genetic variants responsible for many neurological diseases, access to genetic testing may be limited in clinical practice. The objective of this study was to assess worldwide access to genetic tests for movement disorders and factors impacting their utilization.MethodsThe Rare Movement Disorders Study Group of the International Parkinson and Movement Disorder Society designed an online survey electronically mailed to all 7815 members.ResultsSurvey data completed by 1269 participants from 109 countries were analysed. Limited access to geneticists and genetic counsellors was reported in many world regions compared to Europe and North America. Availability of genetic testing was limited, with rates of access lower than 50%. Genetic testing for chorea was the most commonly available. For parkinsonism, dystonia, ataxia, hereditary spastic paraplegias and metabolic disorders, there was limited access to genetic testing in all countries compared to Europe and North America, with significant differences found for Africa, Central/South America, Asia. In many regions, genetic testing was supported by either private or public funding. Genetic testing was free of charge in Europe according to 63.5% of respondents. In North America, Africa, Central/South America, Asia and the Middle East access to free of charge genetic testing was by far significantly lower compared to Europe.ConclusionsThis survey highlights difficulties in accessing genetic testing and individuals with expertise in genetics at the worldwide level. In addition, major disparities in genetic testing amongst world regions are highlighted, probably due to a variety of factors including financial barriers.
The manifestation of participation within a co‐design process involving patients, significant others and health‐care professionals
Authors: Lindblom Sebastian , Flink Maria , Elf Marie , Laska Ann Charlotte , von Koch Lena , Ytterberg Charlotte 
Published: March 2021

AbstractBackgroundDespite intentions to increase user participation in the development of health services, the concept of participation and how it unfolds within studies with a participatory design has rarely been addressed.ObjectiveThe aim of this study was to describe how user participation manifests itself within a co‐design process involving patients, significant others and health‐care professionals, including potential enablers or barriers.MethodsThis study was conducted in the context of a co‐design process of a new person‐centred transition from a hospital to continued rehabilitation in the home involving three patients with stroke, one significant other and 11 professionals. Data were collected by observations during the workshops, semi‐structured interviews and questionnaires.ResultsFour categories: ‘Composition of individuals for an adaptive climate’; ‘The balancing of roles and power’; ‘Different perspectives as common ground for a shared understanding’; and ‘Facilitating an unpredictable and ever‐adaptive process’, with all together nine subcategories, resulted from the analysis. Participation varied between individuals, groups and steps within the process, and on the topic of discussions and the motivation to contribute.Discussion/ConclusionParticipation is not something that is realized by only applying participatory design methodology. Participation manifests itself through the interaction of the participants and their skills to handle different perspectives, roles and assignments. Participation is enabled by individual, group and facilitating aspects. Co‐design processes should allow for varying levels of participation among the participants and throughout the process.Patient or public contributionPatients, significant others and health‐care professionals participated as co‐designers of a care transition model between hospital and home.
Impacts of artificial lighting at night on insect conservation
Authors: Stewart Alan J. A. 
Published: March 2021

Abstract
The widespread adoption of artificial lighting at night (ALAN) presents a growing threat to biodiversity in general and nocturnally active insects in particular. ALAN may be contributing to widely reported declines in insect populations but supporting evidence is sparse. Recent advances in external lighting technology, particularly the increasing adoption of broad spectrum ‘white’ LEDs, suggest that impacts of ALAN on natural systems are likely to increase.
This special issue of Insect Conservation and Diversity presents some of the recent research addressing the impacts of ALAN on insects and their conservation. The papers cover (i) reviews of existing literature, (ii) results from experimental studies of impacts of ALAN on insects, from individual species to communities, (iii) priorities for future research, and (iv) best practice recommendations for designing future experimentation.
Collectively, the papers illustrate a vibrant and expanding field of enquiry. In addition to further studies of effects at the individual insect level, future research priorities will need to address how ALAN affects long‐term population dynamics, the composition of insect communities and ecosystem services.
A major challenge will be to devise novel ways to minimise the adverse effects of ALAN which can be used to inform conservation interventions. Various mitigation strategies are available, including modification of the spectral composition of lighting, dimming, shielding and controlling illumination using timers and motion sensors, but require customisation for particular species and situations.
Skin photoaging in young men: A clinical study by skin imaging techniques
Authors: Infante Victor Hugo Pacagnelli , Bagatin Ediléia , Maia Campos Patrícia M. B. G. 
Published: March 2021

AbstractObjectiveDifferences in skin physiology and lifestyle among people can influence the skin damage caused by solar radiation. Photoprotection habits play an important role to prevent skin photoaging. Thus, the objective of the present study was to evaluate the skin changes resulting from solar exposure in young men by skin imaging techniques.MethodsTwenty‐three male, aged 18–28 years, with and without photoprotection habits participated in the study. Instrumental measurements in terms of dermis thickness and echogenicity (20 mHz ultrasound – DermaScanC®), morphological and structural skin characterization (Reflectance Confocal Microscopy – VivaScope® 1500) and high‐resolution imaging (Visioface®) were performed in the malar region of the face.ResultsPigmentation disorders, telangiectasia, wrinkles and lower dermis echogenicity were observed in the skin of subjects without photoprotection habits. Reflectance Confocal Microscopy images showed an irregular honeycomb pattern (35%), polycyclic papillae (40%) and coarse collagen fibres (35%), which are related to photoaging.ConclusionSun exposure without photoprotection results in a loss of dermal echogenicity and changes in the epidermis structure and collagen fibres regardless of chronological age. Thus, the study adds data for a discussion about correct photoprotection habits among young people and can help to increase the use of sunscreens for male public.
Skin characteristics following repeated exposure to simulated outdoor and indoor summer temperatures in South Korea and Southeast Asia
Authors: Jang Sue Im , Lee Myeongryeol , Jung Yuchul , Jeong Min Kyung , Ryu Ja Hyun , Kim Beom Joon , Suh Byung‐Fhy , Kim Eunjoo 
Published: March 2021

AbstractBackgroundAlthough changes in skin depend on the external environment, researchers have performed only a few studies on effect of the actual environment. Most studies have researched skin characterization based on changes in the humidity or temperature.Aim/objectiveThis study aimed to evaluate changes in the skin based on the difference in indoor and outdoor temperatures and humidity during summer in South Korea and Southeast Asia.MethodsTwenty‐two female participants aged 25–39 years were included. Skin hydration, sebum (cheek, forehead), colour, transparency and pores of the participants were measured after a 30‐min exposure to high temperature and high humidity (HTHH) environment and a 30‐min exposure to low temperature and low humidity (LTLH) environment. Subsequently, exposure to HTHH environment for 30 min +LTLH environment for 30 min was performed after a total of 1 h and repeated.ResultsRepeated exposure to HTHH and LTLH environments increased the skin's sebum content and haemoglobin index. Additionally, skin elasticity was significantly reduced, with patients in their 30 s showing greater changes than those in their 20 s.ConclusionRepeated differences in temperature and humidity cause skin ageing, loosen skin vessels and reduce skin elasticity, thereby leading to skin ageing.
Effect of chronic unpredictable stress on the progression of experimental apical periodontitis in rats
Authors: Minhoto G. B. , Khoury R. D. , Orozco E. I. F. , Prado R. F. , Valera M. C. 
Published: March 2021

AbstractAimTo establish an experimental model combining chronic stress and apical periodontitis by assessing the development of periapical lesions in rats in three different time points.MethodologyForty‐eight male Wistar rats were randomly assigned into two equal groups: Apical periodontitis (AP) and AP + Stress (AP + S). The animals of the AP group were not exposed to stressful conditions whereas the AP + S group were exposed to a variety of stressors on a daily basis until the end of the experiment. After three weeks of chronic unpredictable stress, apical periodontitis was induced in both groups by exposing the pulpal tissue of the mandibular first molar to the oral environment. Each group was further subdivided into three subgroups according to the euthanasia period: 14, 21 and 28 days after pulp exposure. The animals were weighed, and the blood was collected for corticosterone serum dosage by radioimmunoassay. The mandibles were removed and submitted to histopathological and microtomography analyses to assess the inflammatory response and the progression of periapical lesions. Comparisons between the AP and AP + S groups were performed using Student’s t‐test and Mann–Whitney U‐test for parametric and nonparametric data, respectively. The one‐way anova test followed by Tukey’s test (parametric data) and Kruskal–Wallis followed by Dunn’s test (nonparametric data) were used for comparisons between the three time points within the same group (P < 0.05).ResultsThe AP + S group had a significantly lower average percentage of weight gain at 14 days and 21 days after AP induction (P < 0.05). Significantly higher levels of corticosterone were found in the AP + S group at 21 days (P < 0.05). The AP + S group had a significantly greater intensity and extension of inflammatory infiltrate with larger areas of bone loss compared to the AP groups at 21 days (P < 0.05). The volume of the periapical lesions in the AP + S group was significantly larger than that of the AP group 21 days following pulp exposure (P < 0.05).ConclusionsThe chronic unpredictable stress model applied for 6 weeks exacerbated the inflammatory response and increased bone loss associated with AP, especially 21 days after its induction. This model appears to be suitable for investigating the bidirectional relationship between apical periodontitis and chronic stress.
Self‐reported knowledge, attitudes, and practice of final‐year dental students in relation to child abuse: A multi‐centre study
Authors: Duman Canan , Al‐Batayneh Ola B. , Ahmad Sajjad , Durward Callum S. , Kobylińska Angelika , Vieira Alexandre R. , Tredoux Sheree , Okutan Alev Eda , Egil Edibe , Kalaoglu Elif Ece , Sirinoglu Capan Belen , Aksit Bicak Damla , Zafar Sobia 
Published: March 2021

AbstractBackgroundThe number of child abuse cases is increasing worldwide; therefore, it is important to educate individuals having contact with children about it. This includes dentists who play a pivotal role in detecting and reporting child abuse.AimTo identify and compare the final‐ year dental student's knowledge, attitudes, and practice in relation to child abuse.DesignA 38‐ item and four‐ part online questionnaire was distributed to students of 11 dental schools in 10 countries. SPSS and GraphPad Prism were used for data analysis. The levels of statistical significance were determined using a chi‐ square test. P ≤ .05 was considered to be statistically significant.ResultsA total of 660 students completed the survey. Fifty‐ six percent of the students received formal training on child abuse, and 86% wanted additional training. The knowledge of child abuse was significantly higher in Australia, the United States, and Jordan compared with other countries. Internet (60.3%) was commonly used as an information source for child abuse.ConclusionsThe study showed that dental students lack knowledge and experience in recognizing and reporting child abuse. Most respondents indicated a desire for additional training; therefore, dental schools should review what they are currently teaching and make changes as appropriate.
Effectiveness of oral health education methods on oral hygiene in children and adolescents with visual impairment: A systematic review
Authors: Chua Helene , Sardana Divesh , Turner Robin , Ting Graeme , Ekambaram Manikandan 
Published: March 2021

AbstractBackgroundConventional methods of oral health education (OHE) are not suitable for children with visual impairment, as these methods usually involve visual demonstration with models or plaque‐disclosing dyes.AimTo systematically review the literature to support the best approach for providing OHE to children and adolescents with visual impairment.DesignA systematic search of five electronic databases and grey literature was conducted. Randomized controlled trials that compared different OHE methods in children and adolescents with visual impairment were included. The Cochrane risk‐of‐bias tool (RoB 2) was used for the risk‐of‐bias assessment. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework was used to determine the certainty of evidence.ResultsNine randomized controlled trials with a total of 804 participants were included in this review. Seven OHE methods were compared. Seven studies were assessed to be at high risk of bias, one study was assessed to have some concerns, and one study was assessed to be at low risk of bias. The overall certainty of evidence was very low according to GRADE.ConclusionThere was insufficient evidence to recommend a particular method of OHE as more effective in improving the oral hygiene of children with visual impairment, but combination methods may show similar or better results.
Impacts of distributors and group purchasing organizations on hospital efficiency and profitability: a bilateral data envelopment analysis model
Authors: Lee C. Christopher , Langdo James , Hwang David , Marques Vanda , Hwang Pauline 
Published: March 2021

AbstractTotal health care expenses have risen significantly in the United States. There are many factors and variables that can impact hospital operating efficiencies. Among them, engaging a distributor or group purchasing organization (GPO) is one method to influence efficiency throughout the entire supply chain. This research investigates the impact of distributors and GPOs on hospital efficiency and profitability. The data from the 2015 American Hospital Association (AHA) Annual Hospital Survey of which 6251 hospitals participated are used. These hospitals were separated by those who purchased supplies through a distributor and those who did not. Likewise, the same was performed for those hospitals that used GPO and those that did not. This study employs DEA‐Solver software to develop four types of bilateral DEA models. The results of the DEA model use a ranking variable (rank sum) to rank the variables within the two groups (distributor and no distributor) to determine if there is a significant difference between distributor and nondistributor. The same is performed for GPO and non‐GPO. We examined the impact of the several control variables on hospital efficiency for distributors and GPOs. Results indicate that the control variables (region, education, profit/nonprofit, government/nongovernment, and system/nonsystem) made a significant difference for hospitals that used a distributor and a GPO. Lessons and implications are discussed for future research issues, such as quality of patient care and a frontier production function.
The in‐house logistics routing problem
Authors: Fabri Marcelus , Ramalhinho Helena 
Published: March 2021

AbstractIn this work, we consider the internal logistics processes in the car assembling company SEAT S.A (where SEAT is Sociedad Española de Automóviles de Turismo). We focus on the design of the supplying routes from the warehouse toward the workstations along a production line. The in‐house logistics routing problem (ILRP) can be seen as an extension of the classical vehicle routing problem considering special features such as long‐term fixed routes, unknown orders, backorders, and homogeneous fleet. To solve the ILRP, we propose an integer linear programming (ILP) model and a simulation‐based iterated local search (SimILS) algorithm. We conduct two computational experiments. The first experiment analyzes the methods' performance, and the second experiment compares the SimILS results with the current company's routes, considering real data provided by SEAT S.A. The results show that the SimILS provides the best overall results overcoming both the ILP approach and the current company's solution, leading to a significant improvement in the company's processes.