bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interprofessional education in the Dentistry curriculum: Analysis of a teaching‐service‐community integration experience
Authors: Olsson Thaís Ostroski , Dalmoro Mateus , da Costa Marcelo Viana , Peduzzi Marina , Toassi Ramona Fernanda Ceriotti 
Published: April 2021

AbstractIntroductionInterprofessional education (IPE) offers relevant theoretical, conceptual and methodological approaches to the development of effective teamwork competencies.ObjectiveTo analyse an interprofessional experience of teaching‐service‐community integration carried out at a public university in the South of Brazil.MethodsA case study with a qualitative approach was carried out. The study's participants were thirty‐eight undergraduate dental students who attended the IPE activity between 2012 and 2019. Data collection was developed in two sequential steps that included the application of an online instrument and semi‐structured interviews. The textual material was interpreted by content analysis, considering Kirkpatrick's evaluation levels (reaction, learning and behaviour).ResultsIn the reaction level, students highlighted the contents provided by the National Curricular Guidelines regarding public health system and teamwork, as well as the pedagogical teaching proposal by tutoring groups, which stimulated students’ autonomy. It was observed that the learning was geared towards the development of collaborative teamwork competencies and cultural competencies. In the behaviour level, students perceived positive changes in their attitudes and behaviours towards patients, focused on needs related to life conditions, realising that dentists may work within a team. The elective/optional nature of the experience allied with the absence of other IPE activities in the curricular grid showed to be challenging.ConclusionIPE in undergraduate education presented positive results related to the reaction, learning and behaviour of dental students. We recommend the inclusion of interprofessional activities of teaching‐service‐community integration in Dentistry curricular structure to complement uniprofessional education.
Ecological and biogeographical predictors of taxonomic discord across the world’s birds
Authors: Neate‐Clegg Montague H. C. , Blount J. David , Şekercioğlu Çağan H. 
Published: April 2021

AbstractAimSpecies delimitation is fundamental to biology, but disagreement in species concepts and the application of those concepts can lead to substantial variation in species lists, with important implications for conservation. For birds, there are four widely used global checklists that vary in length and application. Here, we investigate the biogeographical and ecological predictors of taxonomic disagreement between the four world bird species lists.LocationGlobal.Time periodPresent.Major taxa studiedBirds.MethodsWe determined taxonomic agreement based on whether each bird species name represented only one species (‘agreement’), that is, no authorities have split the species, or represented multiple species (‘disagreement’) including disputed splits recognised by some authorities. We examined taxonomic agreement for all birds and for each family and biogeographical region. We then modelled taxonomic agreement as a function of six biogeographical and ecological variables: latitude, island endemism, log(mass), forest dependency, primary diet, and migratory status.ResultsOverall taxonomic agreement was 89.5%, and the remaining 10th of taxonomic names represented disputed splits upon which the four authorities disagreed. We found that taxonomic agreement was lowest for species in Southeast Asia/Australasia and the Southern Ocean, understudied regions where islands have driven high levels of cryptic diversification. In contrast, agreement was highest in the temperate Northern Hemisphere where diversity is lower and research is more extensive. Agreement was also higher for large, migratory species living in open habitats.Main conclusionsTaxonomic agreement was higher for species that are easier to study such as large, temperate species from open habitats. In addition, agreement was lower for lineages that are more likely to undergo cryptic divergence such as island endemics with intermediate forest dependency and mobility. Species with these traits should be the focus of taxonomic research in order to achieve reconciliation of the world's bird lists and to better conserve extant biodiversity.
Seed germination and biochemical responses of two Elytrigia elongata accessions exposed to abiotic stresses
Authors: Tian Xiaoxia , Mao Peichun , Zheng Mingli , Meng Qingyi , Meng Lin 
Published: April 2021

AbstractElytrigia elongata, a rhizomatous and sparse‐type perennial herb of the Triticeae tribe, with stronger drought and salt tolerance, is an important wild genetic resource for wheat variety improvement. However, no precise information about seed germination and biochemical responses of this species to drought, salinity and mixed saline–alkaline stresses is available. Hence, this experiment was conducted to investigate the effects of three abiotic stresses on seed germination and physiological characteristics of two E. elongata accessions. The results showed that drought and mixed saline–alkaline stresses impair seed germination and bud seedling growth of E. elongata. However, seed germination and bud seedling growth were promoted by 50 mmol/L, but inhibited by 100–200 mmol/L salinity treatments. The malondialdehyde (MDA) content was increased and the activities of superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD) in the bud seedlings were significantly increased (p <.05) with increasing osmotic stress from 0 to −0.4 MPa, and salinity and mixed saline–alkaline from 0 to 150 mmol/L, but reduced at −0.75 MPa osmotic stress and 200 mmol/L salinity and mixed saline–alkaline stresses. Under the same salinity and mixed saline–alkaline treatment, the activities of SOD and CAT of EE030 were higher than those of EE024 except in 200 mmol/L salinity treatment; however, the MDA content of EE030 was lower than that of EE024, except in 150 mmol/L salinity treatment. In conclusion, the results of this study demonstrated that E. elongata seeds are more tolerant to salinity stress than to drought and mixed saline–alkaline stresses, and EE030 seed are more tolerant to three abiotic stresses than are the seeds of EE024.
Mismatch repair deficiency is rare in bone and soft tissue tumors
Authors: Lam Suk Wai , Kostine Marie , de Miranda Noel F C C , Schöffski Patrick , Lee Che‐Jui , Morreau Hans , Bovée Judith V M G 
Published: April 2021

IntroductionThere has been an increased demand for mismatch repair (MMR) status testing in sarcoma patients after the success of immune checkpoint inhibition (ICI) in MMR deficient tumors. However, data on MMR deficiency in bone and soft tissue tumors is sparse, rendering it unclear if routine screening should be applied. Hence, we aimed to study the frequency of MMR deficiency in bone and soft tissue tumors after we were prompted by two (potential) Lynch syndrome patients developing sarcomas.MethodsImmunohistochemical expression of MLH1, PMS2, MSH2 and MSH6 was assessed on tissue micro arrays (TMAs), and included 353 bone and 539 soft tissue tumors. Molecular data was either retrieved from reports or microsatellite instability (MSI) analysis was performed. In MLH1 negative cases, additional MLH1 promoter hypermethylation analysis followed. Furthermore, a systematic literature review on MMR deficiency in bone and soft tissue tumors was conducted.ResultsEight MMR deficient tumors were identified (1%), which included four leiomyosarcoma, two rhabdomyosarcoma, one malignant peripheral nerve sheath tumor and one radiation‐associated sarcoma. Three patients were suspected for Lynch syndrome. Literature review revealed 30 MMR deficient sarcomas, of which 33% were undifferentiated/unclassifiable sarcomas. 57% of the patients were genetically predisposed.ConclusionMMR deficiency is rare in bone and soft tissue tumors. Screening focusing on tumors with myogenic differentiation, undifferentiated/unclassifiable sarcomas and in patients with a genetic predisposition / co‐occurrence of other malignancies can be helpful in identifying patients potentially eligible for ICI.
Rhabdomyolysis‐associated acute kidney injury: clinical characteristics and intensive care unit transfer analysis
Authors: Zhu De‐Cai , Li Wen‐Yan , Zhang Jia‐Wen , Tong Jun‐Sheng , Xie Wen‐Yuan , Qin Xiao‐Lan , Zhang Xiao‐Chun 
Published: April 2021

AbstractBackgroundInformation on rhabdomyolysis‐associated acute kidney injury (AKI) in the emergency department or general ward is limited.AimTo assess the risk factors, outcomes and clinical correlates with intensive care unit (ICU) transfer of patients with rhabdomyolysis‐associated AKI.MethodsPatients with rhabdomyolysis were divided into the rhabdomyolysis‐associated AKI group and the rhabdomyolysis without AKI group. Inhospital outcomes, including ICU transfer, mortality, length of stay, daily cost and renal recovery were analysed. Multivariate regression analysis was performed to identify the association between rhabdomyolysis‐associated AKI and ICU transfer.ResultsAmong 149 patients with rhabdomyolysis, 68 (45.6%) developed AKI. Age and urine protein were important risk factors for incidence of rhabdomyolysis‐associated AKI. Patients with rhabdomyolysis‐associated AKI had higher levels of undergoing dialysis (19.1% vs 2.5%; P < 0.01), all‐cause mortality (13.2% vs 1.2%; P < 0.01), cost of hospitalisation (10.8 1000 yuan, IQR (5.5, 3.5) vs 5.9 1000 yuan, IQR 5.9 (3.6, 9.9); P = 0.03), as well as longer length of hospital stay (8.0 days (5.0, 14.0)) versus (6.0 days (4.0, 11.0); P = 0.02). Additionally, the percentage of patients with AKI who transferred to ICU was higher than patients without AKI (33.8% vs 12.3%; P < 0.002) and rhabdomyolysis‐associated AKI was an independent risk factor for ICU transfer (adjusted odds ratio = 2.58; 95% confidence interval, 1.12–6.8, P = 0.03).ConclusionRhabdomyolysis‐associated AKI was common in the emergency department or general ward and led to more severe outcomes. It was also associated with an increased risk of ICU transfer.
Potential cost‐effectiveness of using adjunctive dehydrated human amnion/chorion membrane allograft in the management of non‐healing diabetic foot ulcers in the United Kingdom
Authors: Guest Julian F. , Atkin Leanne , Aitkins Christopher 
Published: April 2021

AbstractThe aim of this study was to estimate the cost‐effectiveness of using dehydrated human amnion/chorion membrane (dHACM) allografts (Epifix) as an adjunct to standard care, compared with standard care alone, to manage non‐healing diabetic foot ulcers (DFUs) in secondary care in the United Kingdom, from the perspective of the National Health Service (NHS). A Markov model was constructed to simulate the management of diabetic lower extremity ulcers over a period of 1 year. The model was used to estimate the cost‐effectiveness of using adjunctive dHACM, compared with standard care alone, to treat non‐healing DFUs in the United Kingdom, in terms of the incremental cost per quality‐adjusted life year (QALY) gained at 2019/2020 prices. The study estimated that at 12 months after the start of treatment, use of adjunctive dHACM instead of standard care alone is expected to lead to a 90% increase in the probability of healing, a 34% reduction in the probability of wound infection, a 57% reduction in the probability of wound recurrence, a 6% increase in the probability of avoiding an amputation, and 8% improvement in the number of QALYs. Additionally, if £4062 is spent on dHACM allografts per ulcer, then adjunctive use of dHACM instead of standard care alone is expected to lead to an incremental cost per QALY gain of £20 000. However, if the amount spent on dHACM allografts was ≤£3250 per ulcer, the 12‐month cost of managing an ulcer treated with adjunctive dHACM would break‐even with that of DFUs treated with standard care, and it would have a 0.95 probability of being cost‐effective at the £20 000 per QALY threshold. In conclusion, within the study's limitations, and within a certain price range, adjunctive dHACM allografts afford the NHS a cost‐effective intervention for the treatment of non‐healing DFUs within secondary care among adult patients with type 1 or 2 diabetes mellitus in the United Kingdom.
Prevalence and predictors of pacing‐induced cardiomyopathy in young adult patients (<60 years) with pacemakers
Authors: Li Dan L. , Yoneda Zachary T. , Issa Tariq Z. , Shoemaker M. Benjamin , Montgomery Jay A. 
Published: April 2021

AbstractIntroductionClinical trials and observational studies of pacing‐induced cardiomyopathy (PICM) have largely included elderly patients with mean age >70 years. The prevalence and predictors of PICM in younger patients (age < 60 years) after pacemaker implantation are not known.MethodsAdults (18–59 years) who received single‐chamber ventricular or dual‐chamber pacemakers at Vanderbilt University Medical Center from 1986 to 2015 were included. Patients without documented ventricular pacing burden and patients with baseline left ventricular ejection fraction (LVEF) <35% were excluded. PICM was defined as LVEF decrease of ≥ 10% and LVEF < 50% during follow‐up with right ventricular pacing ≥20%, and without alternative explanations for cardiomyopathy.ResultsA total of 325 patients were included in the study. During a median follow‐up duration of 11.5 (Interquartile range 7−17) years, 38 patients (11.7%) developed PICM (1.3 per 100 patient‐year). Older age (HR 2.5 for age ≥50 years, p = .013), reduced baseline LVEF (HR 2.4, p = .022), and preimplant AVB (HR 2.7, p = .007) were associated with an increased risk of PICM in the multivariate analysis. Furthermore, baseline AF conferred an increased risk of PICM only in patients without preimplant AVB but not patients with pre‐implant AVB.ConclusionsThe incidence of PICM in young patients was low, but PICM could occur more than a decade after pacemaker implantation. Older age, baseline reduced LVEF, and preimplant AVB were associated with an increased risk of PICM in the young patient cohort.
The Changing Face of Mercosur: Legitimacy and the Politics of Scale in South American Regionalism
Authors: Chodor Tom 
Published: April 2021

AbstractMercosur has undergone numerous transformations, from a customs union to an organization promoting development and consulting civil society. Recently, there has been a backlash against such ‘politicization’, and an attempt to return Mercosur to its origins. At each of these phases, Mercosur was plagued by questions about its legitimacy and purpose, and its leaders reached out to different types of actors to legitimize it. This article argues that each phase of Mercosur's evolution represented the ascendancy of a constellation of social forces, which sought to shift the governance of particular issues beyond the national scope, to secure their interests. In this context, the different legitimation processes and changing actors involved in them represent different balances of forces within Mercosur. The article traces the evolution of Mercosur and its legitimation processes, identifying the social struggles behind them, and the different conceptions of legitimacy constructed and contested as part of this process.
The predictive capacity of psychiatric and psychological polygenic risk scores for distinguishing cases in a child and adolescent psychiatric sample from controls
Authors: Jansen Arija G. , Jansen Philip R. , Savage Jeanne E. , Kraft Julia , Skarabis Nora , Polderman Tinca J. C. , Dieleman Gwen C. 
Published: April 2021

BackgroundPsychiatric traits are heritable, highly comorbid and genetically correlated, suggesting that genetic effects that are shared across disorders are at play. The aim of the present study is to quantify the predictive capacity of common genetic variation of a variety of traits, as captured by their PRS, to predict case‐control status in a child and adolescent psychiatric sample including controls to reveal which traits contribute to the shared genetic risk across disorders.MethodPolygenic risk scores (PRS) of 14 traits were used as predictor phenotypes to predict case‐control status in a clinical sample. Clinical cases (N = 1,402), age 1–21, diagnostic categories: Autism spectrum disorders (N = 492), Attention‐deficit/ hyperactivity disorders (N = 471), Anxiety (N = 293), disruptive behaviors (N = 101), eating disorders (N = 97), OCD (N = 43), Tic disorder (N = 50), Disorder of infancy, childhood or adolescence NOS (N = 65), depression (N = 64), motor, learning and communication disorders (N = 59), Anorexia Nervosa (N = 48), somatoform disorders (N = 47), Trauma/stress (N = 39) and controls (N = 1,448, age 17–84) of European ancestry. First, these 14 PRS were tested in univariate regression analyses. The traits that significantly predicted case‐control status were included in a multivariable regression model to investigate the gain in explained variance when leveraging the genetic effects of multiple traits simultaneously.ResultsIn the univariate analyses, we observed significant associations between clinical status and the PRS of educational attainment (EA), smoking initiation (SI), intelligence, neuroticism, alcohol dependence, ADHD, major depression and anti‐social behavior. EA (p‐value: 3.53E‐20, explained variance: 3.99%, OR: 0.66), and SI (p‐value: 4.77E‐10, explained variance: 1.91%, OR: 1.33) were the most predictive traits. In the multivariable analysis with these eight significant traits, EA and SI, remained significant predictors. The explained variance of the PRS in the model with these eight traits combined was 5.9%.ConclusionOur study provides more insights into the genetic signal that is shared between childhood and adolescent psychiatric disorders. As such, our findings might guide future studies on psychiatric comorbidity and offer insights into shared etiology between psychiatric disorders. The increase in explained variance when leveraging the genetic signal of different predictor traits supports a multivariable approach to optimize precision accuracy for general psychopathology.
Morbidity and mortality of rheumatic heart disease and acute rheumatic fever in the inpatient setting in Timor‐Leste
Authors: Davis Kimberly , de Oliveira Lidia NL , da Silva Almeida Ines , Noronha Mario , Martins Joao , dos Santos Milena , Monteiro Andre , Brewster David , Horton Ari , Remenyi Bo , Francis Joshua R 
Published: April 2021

AimTo describe the clinical features, treatment and outcomes of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in children admitted to the national referral hospital in Dili, Timor‐Leste.MethodsThis prospective study documented cases of ARF and RHD in children aged 14 years and under who were admitted between June 2017 and May 2019. ARF was diagnosed using an adapted version of the 2015 Jones criteria and presumed (rather than proven) exposure to group A Streptococcus. Clinical and echocardiographic findings, comorbidities and discharge outcomes are reported.ResultsA total of 63 patients were admitted with ARF or RHD; 54 were diagnosed with RHD for the first time. Median age was 11 years (range 3–14); 48% were female. Of those with echocardiograms, 56/58 had RHD, 55/56 (98%) had mitral regurgitation (37/55 (67%) severe), 11/56 (20%) had mitral stenosis and 43/56 (77%) had aortic regurgitation. Left ventricular dysfunction (55%), pulmonary hypertension (64%) and cardiac failure (78%) were common. Four (6%) patients died in hospital, and 30/59 (51%) of surviving patients were lost to follow up.ConclusionsCommunity echocardiography screening has reported a high prevalence of undetected mild to moderate cases of RHD in Timor‐Leste, whereas this hospital study documents mostly severe disease among hospitalised patients with a high case fatality rate and loss to follow up. RHD is a significant health problem in Timor‐Leste and improved recognition and diagnosis, as well as effective delivery of treatment and follow‐up are imperative.
Variations in IgG antibody subclass responses to oral bacteria: Effects of periodontal disease and modifying factors
Authors: Ebersole Jeffrey L. , Hamzeh Razan , Nguyen Linh , Al‐Sabbagh Mohanad , Dawson Dolph 
Published: April 2021

AbstractBackground and objectiveLocal and systemic IgG antibodies or oral bacteria have been described with periodontitis. We extended these observations by assessing the impact of a range of intrinsic factors on serum IgG subclass antibodies to both commensal and pathogenic oral bacteria that would contribute to variations in immune protection or disease susceptibility in periodontitis have not been described.MethodsSubjects (n = 278) were classified as healthy, gingivitis, or periodontitis and categorized as mild, moderate, and severe periodontitis. Demographic stratification included sex, age, race/ethnicity, smoking, and obesity. Whole formalin‐fixed bacteria were used as antigens to detect serum immunoglobulin (Ig)G subclass antibody levels using an ELISA.ResultsThe greatest differences in variations in IgG subclasses occurred in periodontitis versus health or gingivitis to bacteria considered oral pathogens (eg, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola) with IgG1, IgG2, and IgG4 increased by three‐ to sevenfold with Pg. Differences in subclass levels and distribution were also observed related to disease severity, particularly related to individual subclass responses to Pg. Examination of the overall population showed that females had elevated antibody, reflected by elevated IgG2 amounts/proportions. The older group of subjects demonstrated elevated antibody to multiple oral bacteria, lacking any particular subclass pattern. IgG2 antibody to Aa and Pg was increased in smokers. Multiple IgG subclass antibody levels to oral pathogens were significantly decreased in the obese subset within this population.ConclusionThis investigation identified patterns of IgG subclass antibody responses to oral bacteria and demonstrated substantial effects of disease impacting the level and subclass distribution of antibody to an array of oral bacteria. Altered subclass antibody profiles most often in IgG2 levels and for antibody to P. gingivalis were found related to sex, age, disease severity, race/ethnicity, smoking, and obesity to both pathogens and commensal bacteria.