bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resistance to antihypertensive treatment and long‐term risk: The Atherosclerosis Risk in Communities study
Authors: Wijkman Magnus O. , Malachias Marcus V.B. , Claggett Brian L. , Cheng Susan , Matsushita Kunihiro , Shah Amil M. , Jhund Pardeep S. , Coresh Josef , Solomon Scott D. , Vardeny Orly 
Published: September 2021

AbstractMore stringent blood pressure (BP) goals have led to greater prevalence of apparent resistant hypertension (ARH), yet the long‐term prognostic impact of ARH diagnosed according to these goals in the general population remains unknown. We assessed the prognostic impact of ARH according to contemporary BP goals in 9612 participants of the Atherosclerosis Risk in Communities (ARIC) study without previous cardiovascular disease. ARH, defined as BP above goal (traditional goal <140/90 mmHg, more stringent goal <130/80 mmHg) despite the use of ≥3 antihypertensive drug classes or any BP with ≥4 antihypertensive drug classes (one of which was required to be a diuretic) was compared with controlled hypertension (BP at goal with 1‐3 antihypertensive drug classes). Cox regression models were adjusted for age, sex, race, study center, BMI, heart rate, smoking, eGFR, LDL, HDL, triglycerides, and diabetes. Using the traditional BP goal, 133 participants (3.8% of the treated) had ARH. If the more stringent BP goal was instead applied, 785 participants (22.6% of the treated) were reclassified from controlled hypertension to uncontrolled hypertension (n = 725) or to ARH (n = 60). Over a median follow‐up time of 19 years, ARH was associated with increased risk for a composite end point (all‐cause mortality, hospitalization for myocardial infarction, stroke, or heart failure) regardless of whether traditional (adjusted HR 1.50, 95% CI: 1.23‐1.82) or more stringent (adjusted HR 1.43, 95% CI: 1.20‐1.70) blood pressure goals were applied. We conclude that in patients free from cardiovascular disease, ARH predicted long‐term risk regardless of whether traditional or more stringent BP criteria were applied.
Dose‐dependent effect of mesenchymal stromal cells co‐grafted with dopaminergic neurons in a Parkinson's disease rat model
Authors: Rodriguez‐Pallares Jannette , Garcia‐Garrote Maria , Parga Juan A. , Labandeira‐Garcia Jose Luis 
Published: September 2021

AbstractA major limiting factor for cell therapy in Parkinson's disease is the poor survival and reinnervation capacity of grafted dopaminergic neurons, independently of the cell source. Mesenchymal stromal cells (MSCs) have high capability to regulate the local environment through the release of trophic, antiapoptotic and immunomodulatory factors. In this work, we investigated whether co‐grafting of MSCs could improve the survival and reinnervation ability of dopaminergic precursors transplanted in animal models of Parkinson's disease. Rats with total unilateral dopaminergic denervation were grafted with a cell suspension of rat dopaminergic precursors (500,000 cells) with or without a high (200,000 cells) or low (25,000 cells) number of MSCs. Eight weeks after grafting, rats were tested for motor behaviour and sacrificed for histological analysis. Our results showed that the survival of dopaminergic neurons and graft‐derived striatal dopaminergic innervation was higher in rats that received co‐grafts containing a low number of MSCs than in non‐co‐grafted controls. However, the survival of dopaminergic neurons and graft‐derived dopaminergic reinnervation was lower in rats receiving co‐grafts with high number of MSCs than in non‐co‐grafted controls. In conclusion, co‐grafting with MSCs or MSCs‐derived products may constitute a useful strategy to improve dopaminergic graft survival and function. However, a tight control of MSCs density or levels of MSCs‐derived products is necessary.
Non‐carious cervical lesions (NCCLs) and associated factors: A multilevel analysis in a cohort study in southern Brazil
Authors: Demarco Flávio Fernando , Cademartori Mariana Gonzalez , Hartwig Andréia Drawanz , Lund Rafael Guerra , Azevedo Marina Sousa , Horta Bernardo Lessa , Corrêa Marcos Britto , Huysmans Marie‐Charlotte D. N. J. M. 
Published: September 2021

AbstractAimTo investigate the prevalence of non‐carious cervical lesions (NCCLs) and their association with individual and tooth‐related factors in adults from the 1982 Pelotas Birth Cohort.Materials and methodsParticipants were interviewed and clinically examined at the age of 31. NCCL was defined as loss of dental tissue without bacterial involvement in the cervical region. Independent variables were the socioeconomic, demographic, behavioural, and clinical characteristics. Associations were tested using a multilevel Poisson regression model.ResultsFive‐hundred and thirty‐nine participants were clinically examined, with a 26% prevalence of NCCLs, which were more prevalent in the maxilla (56.5%) and in premolars (72.9%). In the multilevel analysis, women presented lower prevalence than men [prevalence ratio (PR) 0.59 (0.48–0.73)]; those who reported smoking at both 22 and 30 years of age had more NCCLs than those who never smoked [PR 1.65 (1.31–2.07)]; and high‐frequency brushers presented higher prevalence than low‐frequency brushers [PR 1.26 (1.03–1.55)]. Gingival recession increased 10 times the prevalence of NCCLs [PR 10.03 (8.15–12.35)], while the presence of periodontal pockets (≥4 mm) reduced the prevalence of NCCLs [PR 0.43 (0.28–0.66)].ConclusionsNCCLs were more prevalent in males, smokers, and those with higher frequency of toothbrushing. While the presence of periodontal pockets was associated with a lower prevalence of NCCLs, gingival recession was a strong clinical indicator for the presence of NCCLs.
Serum antibody response against periodontal bacteria and coronary heart disease: Systematic review and meta‐analysis
Authors: Joshi Chaitanya , Bapat Ranjeet , Anderson William , Dawson Dana , Cherukara George , Hijazi Karolin 
Published: September 2021

AbstractAimThe present systematic review and meta‐analysis assessed the strength of a reported association between elevated serum anti‐periodontal bacterial antibody responses and coronary heart disease (CHD).Materials and methodsTwenty original studies were identified after systematically searching five databases. The majority (n = 11) compared serum anti‐Porphyromonas gingivalis (Pg) and/or anti‐Aggregatibacter actinomycetemcomitans (Aa) IgG antibody responses between CHD patients and control participants. The strength of the association between serum anti‐Pg antibodies and CHD (n = 10) and serum anti‐Aa antibodies and CHD (n = 6) was investigated using a meta‐analysis approach separately.ResultsMost studies (61%) reported that the serum IgG antibody responses were elevated in CHD patients than in controls. The meta‐analyses showed a significant association between elevated serum IgG antibody responses (anti‐Pg and anti‐Aa) and CHD, with pooled odds ratios of 1.23 [95% confidence interval (CI): 1.09–1.38, p = .001] and 1.25 (95% CI: 1.04–1.47, p = .0004), respectively.ConclusionsA modest increase of CHD events in individuals with higher serum anti‐Pg and anti‐Aa IgG antibody responses may support their use as potential biomarkers to detect and monitor at‐risk populations. However, the observed inconsistencies with the design and interpretation of immunoassays warrant standardization of the immunoassays assessing antibody responses against periodontal bacteria.
Life expectancy estimates based on comorbidities and frailty to inform preventive care
Authors: Schoenborn Nancy L. , Blackford Amanda L. , Joshu Corinne E. , Boyd Cynthia M. , Varadhan Ravi 
Published: September 2021

AbstractBackgroundLong‐term prognostication is important to inform preventive care in older adults. Existing prediction indices incorporate age and comorbidities. Frailty is another important factor in prognostication. In this project, we aimed at developing life expectancy estimates that incorporate both comorbidities and frailty.MethodsIn this retrospective cohort study, we used data from a 5% sample of Medicare beneficiaries with and without history of cancer from Surveillance, Epidemiology, and End Results (SEER) cancer registry areas. We included adults aged 66–95 years who were continuously enrolled in fee‐for‐service Medicare for ≥1 year from 1998 to 2014. Participants were followed for survival until 12/31/2015, death, or disenrollment. Comorbidity (none, low/medium, high) and frailty categories (low, high) were defined using established methods for claims. We estimated 5‐ and 10‐year survival probabilities and median life expectancies by age, sex, comorbidities, and frailty.ResultsThe study included 479,646 individuals (4,128,316 person‐years), of whom most were women (58.7%). Frailty scores varied widely among participants in the same comorbidity category. In Cox models, both comorbidities and frailty were independent predictors of mortality. Individuals with high comorbidities (HR, 3.24; 95% CI, 3.20–3.28) and low/medium comorbidities (HR, 1.36; 95% CI, 1.34–1.39) had higher risks of death than those with no comorbidities. Compared to low frailty, high frailty was associated with higher risk of death (HR, 1.55; 95% CI, 1.52–1.58). Frailty affected life expectancy estimates in ways relevant to preventive care (i.e., distinguishing <10‐year versus >10‐year life expectancy) in multiple subgroups.ConclusionIncorporating both comorbidities and frailty may be important in estimating long‐term life expectancies of older adults. Our life expectancy tables can aid clinicians' prognostication and inform simulation models and population health management.
Test–retest reliability of the Epworth Sleepiness Scale in clinical trial settings
Authors: Rosenberg Russell , Babson Kimberly , Menno Diane , Morris Susan , Baladi Michelle , Hyman Danielle , Black Jed 
Published: September 2021

SummaryThe present analysis examined the test–retest reliability of the Epworth Sleepiness Scale in participants with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea in three clinical trials. Intraclass correlation coefficient estimates for Epworth Sleepiness Scale scores from two solriamfetol 12‐week placebo‐controlled trials (one narcolepsy, one obstructive sleep apnea) and one long‐term open‐label extension trial (narcolepsy or obstructive sleep apnea) were calculated using postbaseline time‐point pairs for the overall population in each trial, by treatment, and by primary obstructive sleep apnea therapy adherence. In the 12‐week narcolepsy trial, intraclass correlation coefficients (95% confidence intervals) were 0.83 (0.79, 0.87) for weeks 4 and 8 (n = 199), 0.87 (0.83, 0.90) for weeks 8 and 12 (n = 196), and 0.81 (0.76, 0.85) for weeks 4 and 12 (n = 196). In the 12‐week obstructive sleep apnea trial, intraclass correlation coefficients (95% confidence intervals) were 0.74 (0.69, 0.78) (n = 416), 0.80 (0.76, 0.83) (n = 405), and 0.74 (0.69, 0.78) (n = 405), respectively. In the open‐label extension trial, intraclass correlation coefficients (95% confidence intervals) were 0.82 (0.79, 0.85) for weeks 14 and 26/27 (n = 495), 0.85 (0.82, 0.87) for weeks 26/27 and 39/40 (n = 463), and 0.78 (0.74, 0.81) for weeks 14 and 39/40 (n = 463). Placebo/solriamfetol treatment or adherence to primary obstructive sleep apnea therapy did not affect reliability. In conclusion, across three large clinical trials of participants with narcolepsy or obstructive sleep apnea, Epworth Sleepiness Scale scores demonstrated a robust acceptable level of test–retest reliability in evaluating treatment response over time.
Smartphone‐based virtual agents and insomnia management: A proof‐of‐concept study for new methods of autonomous screening and management of insomnia symptoms in the general population
Authors: Dupuy Lucile , Morin Charles M. , de Sevin Etienne , Taillard Jacques , Salles Nathalie , Bioulac Stéphanie , Auriacombe Marc , Micoulaud‐Franchi Jean‐Arthur , Philip Pierre 
Published: September 2021

SummaryInsomnia is the most frequent sleep disorder, and the COVID‐19 crisis has massively increased its prevalence in the population, due to psychosocial stress or direct viral contamination. KANOPEE_2 is a smartphone‐based application that provides interactions with a virtual agent to autonomously screen and alleviate insomnia symptoms through an intervention programme giving personalized advices regarding sleep hygiene, relaxation techniques and stimulus‐control. In this proof‐of‐concept study, we tested the effects of KANOPEE_2 among users from all over the country (France) who downloaded the app between 1 June and 26 October 2020 (to focus on effects after the end of COVID‐19 confinement). Outcome measures include insomnia severity (Insomnia Severity Index) and sleep/wake schedules measured by a sleep diary. One‐thousand and thirty‐four users answered the screening interview (Mage = 43.76 years; SD = 13.14), and 108 completed the two‐step programme (Mage = 46.64 years; SD = 13.63). Of those who answered the screening, 42.8% did not report sleep complaints, while 57.2% presented mild‐to‐severe insomnia symptoms. At the end of the intervention, users reported significantly fewer sleep complaints compared with the beginning of the intervention (Insomnia Severity Indexbeginning = 13.58; Insomnia Severity Indexend = 11.30; p < 0.001), and significantly increased their sleep efficiency (sleep efficiencybeginning = 76.46%; sleep efficiencyend = 80.17%; p = 0.013). KANOPEE_2 is a promising solution both to provide autonomous evaluation of individuals’ sleep hygiene and reduce insomnia symptoms over a brief and simple intervention. These results are very encouraging for addressing the issue of insomnia management in people exposed to major psychosocial stress and the consequences of COVID‐19 infection.
Using spatial patterns of seeds and saplings to assess the prevalence of heterospecific replacements among cloud forest canopy tree species
Authors: Mejía‐Domínguez Nancy R. , Meave Jorge A. , Díaz‐Ávalos Carlos , Gómez‐Aparicio Lorena 
Published: September 2021

AbstractQuestionsTo gain insights into the role of species‐by‐species replacements in cloud forest community structuring, we asked: (1) What are the effects of the spatial distribution of standing individuals on the seed rain, soil seed bank, and sapling density and survival in this cloud forest?; and (2) What is the prevalence of conspecific vs heterospecific replacements in the regeneration of this forest?LocationSanto Tomás Teipan, Oaxaca State, southern Mexico.MethodsIn a 1‐ha cloud forest plot, we assessed seed rain, seed bank, and sapling density and survival of four canopy tree species (Chiranthodendron pentadactylon, Cornus disciflora, Quercus laurina and Oreopanax xalapensis). All standing individuals of these and other tree species (diameter at breast height [DBH] ≥ 2.5 cm) were mapped. We used neighbourhood models to examine the spatial patterns of the three life cycle stages relative to the spatial distribution of adults. The neighbourhood effect was assessed through the Neighbourhood Index, which integrates information on size (DBH) and distance to adults. Data analysis was based on maximum likelihood and model selection procedures.ResultsWe found large between‐species differences regarding the spatial patterns of seeds and saplings. Three species showed evidence for the Janzen–Connell effect operating at the seed (Chiranthodendron pentadactylon and Quercus laurina) or sapling (Oreopanax xalapensis) stage. We also found support for a critical role of specific microsite factors (i.e. niche differentiation) in the regeneration of two species (Chiranthodendron pentadactylon and Cornus disciflora).ConclusionsSeed and sapling distribution patterns suggest the prevalence of heterospecific replacements and that both Janzen–Connell and niche differentiation effects contribute to this pattern. Our results largely support the notion that the prevalence of heterospecific replacements among canopy species promotes species co‐existence in cloud forests.
An introgression breakthrough left by an anthropogenic contact between two ascidians
Authors: Le Moan Alan , Roby Charlotte , Fraïsse Christelle , Daguin‐Thiébaut Claire , Bierne Nicolas , Viard Frédérique 
Published: September 2021

AbstractHuman‐driven translocations of species have diverse evolutionary consequences such as promoting hybridization between previously geographically isolated taxa. This is well illustrated by the solitary tunicate, Ciona robusta, native to the North East Pacific and introduced in the North East Atlantic. It is now co‐occurring with its congener Ciona intestinalis in the English Channel, and C. roulei in the Mediterranean Sea. Despite their long allopatric divergence, first and second generation crosses showed a high hybridization success between the introduced and native taxa in the laboratory. However, previous genetic studies failed to provide evidence of recent hybridization between C. robusta and C. intestinalis in the wild. Using SNPs obtained from ddRAD‐sequencing of 397 individuals from 26 populations, we further explored the genome‐wide population structure of the native Ciona taxa. We first confirmed results documented in previous studies, notably (i) a chaotic genetic structure at regional scale, and (ii) a high genetic similarity between C. roulei and C. intestinalis, which is calling for further taxonomic investigation. More importantly, and unexpectedly, we also observed a genomic hotspot of long introgressed C. robusta tracts into C. intestinalis genomes at several locations of their contact zone. Both the genomic architecture of introgression, restricted to a 1.5 Mb region of chromosome 5, and its absence in allopatric populations suggest introgression is recent and occurred after the introduction of the non‐native species. Overall, our study shows that anthropogenic hybridization can be effective in promoting introgression breakthroughs between species at a late stage of the speciation continuum.
Tackling the challenge of treating obesity using design research methods: A scoping review
Authors: Elliott Andrea , Lang Sarah , Truby Helen , Brennan Linda , Gibson Simone 
Published: September 2021

SummaryDesign research methods, including user‐centered design, human‐centered design, and design thinking, are iterative processes and frameworks that engage stakeholders to inform the design of initiatives, programs, or research interventions. Design research methods are not yet widely applied in healthcare. To date, there is a limited understanding of how design research methodologies can be applied to develop client‐centered weight loss interventions. This scoping review explores the extent, range, and nature of research projects that used design research methods to guide the development of an obesity treatment intervention. A systematic search of eight databases identified projects that used design research methods to develop a weight loss intervention or strategy. The method and practical application of design research processes for each eligible article were extracted and explored. Design research methods were used to generate ideas or guide the development of a mobile application (n = 6), mHealth device (n = 1), eHealth solution (n = 1), health promotion program (n = 1), or patient–clinician communication tools (n = 2). There was considerable variation in the application of design research processes between studies. Design research methods may provide an iterative, flexible framework to facilitate the development of client‐centered, inclusive interventions and strategies. Design research methods may support research teams to move away from the one‐size‐fits‐all approach to obesity treatment.
Informed consent challenges and strategies: A qualitative study of the orthodontists’ perspective
Authors: Conduru Fernandes Moreira Narjara , Keenan Louanne , Cummings Greta , Flores‐Mir Carlos 
Published: September 2021

AbstractObjectiveTo identify the barriers and strategies perceived by orthodontists when obtaining consent from their adult patients concerning patients’ comprehension or recollection of treatment information.Settings and Sample PopulationThe sample comprised 12 orthodontists working in 8 different cities in Alberta, Canada.MethodsAn exploratory investigation using qualitative inquiry was conducted. Participants were recruited through a combination of purposive, maximum variation and snowball sampling. Data were collected through audio‐recorded, semi‐structured interviews until saturation was reached. Then, data were analysed using thematic analysis. Quality and credibility were achieved by employing member checks, memo writing and analyst triangulation strategies.ResultsTwo major themes were identified, with subthemes: (1) Challenges that may interfere with patients’ comprehension and recollection of treatment information (i. patients’ internal barriers, ii. patients’ external barriers and iii. financial barriers); and (2) strategies to optimize information delivery and communication (i. tailoring the content to be delivered, ii. communication fashion, iii. communication timing and iv. being accommodative).ConclusionThe participants reported barriers that may be overlooked in the daily routine of orthodontic practices. Information is provided that may guide orthodontists to overcome or minimize these challenges, increase patient comprehension and improve the quality of informed consent processes.
Attitudes of optometrists in the UK and Ireland to Digital Eye Strain and approaches to assessment and management
Authors: Moore Patrick A , Wolffsohn James S , Sheppard Amy L 
Published: September 2021

AbstractPurposeTo investigate the attitudes and understanding of optometrists in the UK and Ireland towards Digital Eye Strain (DES), and to examine related practice patterns.MethodsAn anonymous online questionnaire was developed, covering attitude and understanding of DES, examination of patients who may be experiencing DES and approaches to management options. The questionnaire was promoted to UK and Ireland optometrists via professional bodies and local and area optometric committees.Results406 responses were included in the analysis. Most respondents agreed that DES was an important concern for optometrists (88.9%). 91.4% reported they felt confident in discussing possible symptoms of DES and management options; this was weakly and negatively associated with number of years qualified (rs = −0.198, p ≤ 0.001). Estimations of the proportion of patients affected by DES were lower than reports in the literature (median 25%, IQR 10%–50%). Most respondents always (60.6%) or frequently (21.9%) inquired about device usage in routine case history taking, and also asked follow‐up questions, although 29.3% only asked about the presence of symptoms half the time or less. Advising on regular breaks (84.0%), lubricants (55.7%) and environment/set up (69.2%) were felt to be extremely or very important by most respondents. Advising on specialist spectacle lenses, specifically blue filtering designs, was considered extremely or very important by 34.2% and 15.2%, respectively.ConclusionGiven the agreement that DES is a significant issue causing frequent and persistent symptoms, and practitioners reported high levels of confidence in discussing DES, patients can expect to receive advice on symptoms and management from their optometrist. Simple management strategies were felt to be most important to advise on, with more uncertainty linked to specialist spectacle lenses.
Causal Accounts of Harming
Authors: Carlson Erik , Johansson Jens , Risberg Olle 
Published: September 2021

AbstractA popular view of harming is the causal account (CA), on which harming is causing harm. CA has several attractive features. In particular, it appears well equipped to deal with the most important problems for its main competitor, the counterfactual comparative account (CCA). However, we argue that, despite its advantages, CA is ultimately an unacceptable theory of harming. Indeed, while CA avoids several counterexamples to CCA, it is vulnerable to close variants of some of the problems that beset CCA.