bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stigma is associated with illness self‐concept in individuals with concealable chronic illnesses
Authors: O’Donnell Aisling T. , Habenicht Andrea E. 
Published: May 2021

ObjectivesPrevious research suggests that chronic illnesses can elicit stigma, even when those illnesses are concealable. Such stigmatization is assumed to lead to a stigmatized identity. Additionally, chronic illness affects one’s self‐concept, as one reconstructs a sense of self with illness incorporated. However, no research has examined the interplay between stigma and self‐concept in those with concealable chronic illnesses. Therefore, we investigated the extent to which experienced, anticipated, and internalized stigma are associated with illness self‐concept in individuals living with concealable chronic illnesses. Furthermore, we explored if the aforementioned aspects of stigma are associated with enrichment in the self‐concept in the same cohort.DesignAn online correlational survey of people with concealable chronic illness (N = 446).MethodsParticipants completed self‐report measures of chronic illness‐specific measures of stigma and illness self‐concept, both negative and positive.ResultsResults indicated that there is a positive relationship between experienced, anticipated, and internalized stigma and illness self‐concept, indicating that stigma is associated with increased preoccupation and perceived impact of one’s illness on the self. Although there is also a negative relationship between anticipated and internalized stigma and enrichment, only internalized stigma is associated with enrichment over and above the effects of control variables such as personal control.ConclusionsOur findings bridge the existing literature on illness self‐concept and stigma for chronic illness groups, with a specific focus on those with concealable chronic illnesses. More varied approaches to coping with illness should be encouraged, including encouraging enrichment aspects to potentially act as a buffer between the effects of stigma and illness self‐concept.
Spontaneous pneumothorax—When do we need to intervene?
Authors: Ashkenazi Moshe , Bak Alon , Sarouk Ifat , Bar Aluma Bat El , Dagan Adi , Bezalel Yael , Vilozni Daphna , Efrati Ori 
Published: May 2021

AbstractBackgroundPneumothorax can be classified as traumatic, iatrogenic or spontaneous (SP), which can be subdivided into primary spontaneous pneumothorax (PSP), a condition without preexisting lung disease, or secondary spontaneous pneumothorax (SSP) a complication of a preexisting lung disease. Recurrence rate of PSP is 30% whereas for SSP rate is unknown. This article explores the experience of a tertiary center over 20 years.MethodsA retrospective case review of patients hospitalized with pneumothorax to investigate the natural history and treatment of SP in a young population in a single tertiary center was conducted. A search of the digital archive (going back to 01/01/1995) of Sheba Medical Center identified hospitalized patients below the age of 40.ResultsThe database was composed of the records of 750 patients (612 males, 138 females) who were hospitalized. The recurrence risk for SP after nonoperative treatment was significantly higher. Women were found to have an increased risk of SSP when having SP (OR 2.78). Asthma was the most prevalent disease causing SSP in young people.ConclusionsIn this large cohort, we found that operative procedure has clear protective effect from recurrence in SP, so surgery should be positively considered when treating SP in hospitalized patients. Among young people and particularly in pediatric patients, when females have a SP, we strongly recommend looking for primary lung disease. More studies are needed to determine the risk factors and produce clear guidelines regarding surgery as first treatment.
Conservation practice insights from a comparative case study of two shoreline stabilization projects in Boston Harbor, MA
Authors: Castagno Katherine A. , Bowden Alison A. , Roberts Eric J. , Burns Sara E. , Harlan Sharon L. , Senier Laura , Scyphers Steven B. 
Published: May 2021

AbstractAs sea levels rise and the frequency of flooding events increases, so do efforts to stabilize coastal shorelines. Nature‐based solutions to shoreline stabilization (“green” solutions, as opposed to traditional “grey” shoreline hardening) have been increasingly adopted in the Gulf of Mexico and mid‐Atlantic regions of the United States, but they are only beginning to be implemented, documented, and understood in the northeastern United States. This case study contrasts two shoreline stabilization projects directly across from each other on the banks of the Mystic River, Boston Harbor, MA. These two projects, one private and one public, employ a spectrum of green‐grey shoreline stabilization techniques. Originally planned as traditional grey shoreline stabilizations, both projects shifted toward greener solutions due to local environmental group advocacy, highlighting the influence of outside groups as advocates for nature‐based solutions. This study documents the evolution of both projects, highlighting common challenges in permitting and vegetation maintenance, as well as critical differences in project goals, funding sources, and biodiversity impacts.
Decreasing prevalence of retinopathy in childhood‐onset type 1 diabetes over the last decade: A comparison of two cohorts diagnosed 10 years apart
Authors: Salardi Silvana , Porta Massimo , Maltoni Giulio , Bassi Marta , Minuto Nicola , D'Annunzio Giuseppe , Baltatescu Tamara , Ariaudo Maria , Zucchini Stefano , Levantini Gabriella , Tumini Stefano , Franceschi Roberto , Cauvin Vittoria , Toni Sonia , de Nitto Elena , Salvatoni Alessandro , Schiaffini Riccardo 
Published: May 2021

AbstractAimTo ascertain whether the prevalence of retinopathy has declined over the last 2 decades in individuals with childhood‐onset type 1 diabetes and whether this might be explained by changes in lifetime HbA1c.Materials and MethodsA multicentre, retrospective, observational study, comparing 128 subjects with diabetes onset in 2000‐2003 assessed for retinopathy in 2016‐2019, with a previous cohort of 115 individuals diagnosed in 1990‐1993 and assessed for retinopathy in 2007‐2009, was conducted. The two cohorts had both a similar diabetes duration and age at diagnosis. Retinal photographs were centrally graded. Lifetime HbA1c and its variability, estimated as the ratio between intrapersonal mean and standard deviation of HbA1c, were evaluated.ResultsThe prevalence of any retinopathy in the new and old cohort was 24.2% and 43.5% (P < .003), respectively, and that of severe retinopathy was 1.7% and 9.6% (P = .018). Lifetime HbA1c was lower in the new cohort (7.8% ± 0.8% vs. 8.1% ± 0.8%; P = .002) during all periods following the first 5 years after diagnosis. Patients without retinopathy in the two cohorts had similar levels of HbA1c. Compared with patients without retinopathy, those with retinopathy had higher lifetime HbA1c and long‐term HbA1c variability. However, on multiple regression analysis, only lifetime HbA1c was independently associated with retinopathy (P = .0018).ConclusionsThe risk of developing retinopathy was nearly halved in children who developed type 1 diabetes in the new millennium compared with previous cohorts. These results confirm that maintaining the lowest possible levels of HbA1c throughout lifetime protects from diabetic retinopathy.
Relationships between early age at onset of psychotic symptoms and treatment resistant schizophrenia
Authors: Iasevoli Felice , Razzino Eugenio , Altavilla Benedetta , Avagliano Camilla , Barone Annarita , Ciccarelli Mariateresa , D'Ambrosio Luigi , Matrone Marta , Milandri Federica , Notar Francesco Danilo , Fornaro Michele , de Bartolomeis Andrea 
Published: May 2021

AbstractAimEarly age at schizophrenia onset (EOS) has been associated with a worse clinical course, although previous studies reported substantial heterogeneity. Despite the relevance of the subject, the relationship between the age of onset and treatment resistant schizophrenia (TRS) is less clear.MethodsWe screened 197 non‐affective psychotic patients. Of these, 99 suffered from schizophrenia and were putative TRS and were included in a prospective 4‐to‐8‐week trial to assess their response to antipsychotics. According to status (TRS/nonTRS) and age‐at‐onset (early: ≤18 years, EOS; adult: >18 years, adult onset schizophrenia [AOS]) patients were subdivided in EOS‐TRS, EOS‐nonTRS, AOS‐TRS, AOS‐nonTRS. Multiple clinical variables were measured and compared by analysis of covariance (ANCOVA), using age as a covariate. Two‐way analysis of variance (ANOVA) was used to assess whether significant differences were attributable to TRS status or age‐at‐onset.ResultsThe rate of TRS patients was significantly higher in EOS compared to AOS. At the ANCOVA, EOS‐TRS had significantly worse clinical, cognitive, and psychosocial outcomes compared to the other groups. Overall, EOS‐TRS were more impaired than EOS‐nonTRS, while significant differences with AOS‐TRS were less consistent, albeit appreciable. Two‐way ANOVA demonstrated that, in the majority of the investigated variables, the significant differences among groups were attributable to the TRS status effect rather than to age‐at‐onset or combined effects.ConclusionsThese results suggest that refractoriness to antipsychotics may be strongly linked to the early onset of psychotic symptoms, possibly as a result of common neurobiology.
Montane species track rising temperatures better in the tropics than in the temperate zone
Authors: Freeman Benjamin G. , Song Yiluan , Feeley Kenneth J. , Zhu Kai 
Published: May 2021

AbstractMany species are responding to global warming by shifting their distributions upslope to higher elevations, but the observed rates of shifts vary considerably among studies. Here, we test the hypothesis that this variation is in part explained by latitude, with tropical species being particularly responsive to warming temperatures. We analyze two independent empirical datasets—shifts in species’ elevational ranges, and changes in composition of forest inventory tree plots. Tropical species are tracking rising temperatures 2.1–2.4 times (range shift dataset) and 10 times (tree plot dataset) better than their temperate counterparts. Models predict that for a 100 m upslope shift in temperature isotherm, species at the equator have shifted their elevational ranges 93–96 m upslope, while species at 45° latitude have shifted only 37–42 m upslope. For tree plots, models predict that a 1°C increase in temperature leads to an increase in community temperature index (CTI), a metric of the average temperature optima of tree species within a plot, of 0.56°C at the equator but no change in CTI at 45° latitude (–0.033°C). This latitudinal gradient in temperature tracking suggests that tropical montane communities may be on an “escalator to extinction” as global temperatures continue to rise.
Tuberculosis infection in HIV vs. non‐HIV patients
Authors: Rego de Figueiredo I , Branco Ferrão J , Dias S , Vieira Alves R , Drummond Borges D , Torres M , Guerreiro Castro S , Lourenço F , Antunes AM , Gruner H , Panarra A 
Published: May 2021

ObjectivesTuberculosis (TB) is the most common opportunistic infection and cause of mortality among people living with HIV, and it is possible that it may also influence the evolution of the HIV infection. We assessed the differences between HIV‐positive and ‐negative people infected with TB.MethodsThe present study is a cross‐sectional retrospective study by electronic record revision. We included patients admitted to a tertiary hospital with a diagnosis of TB between 2011 and 2016, comparing those with HIV coinfection with non‐HIV patients, according to demographic and clinical characteristics.ResultsThis study included 591 patients, of whom 32% were HIV‐coinfected. HIV‐TB patients were younger, with a predominance of male gender. Considering TB risk factors, there was a higher prevalence of homelessness and intravenous drug use in the HIV group. In the non‐HIV group, direct contact with other patients with TB and immunosuppression were more prevalent. Relative to TB characteristics, the HIV‐coinfected group presents with a higher prevalence of disseminated disease and a higher occurrence of previous TB infection. Cancer was the most frequent cause of immunosuppression in the HIV group and the number testing positive for TB via microbiological culture was lower. Assessment of microbiological resistance and in‐hospital mortality showed similar numbers in both groups.ConclusionsThere are few papers comparing clinical course of TB between HIV‐infected and non‐infected patients. Our study differs from others in the literature as we focused on a country with middling incidence of TB and further characterized the differences between HIV‐infected and non‐infected patients which can contribute to the management of these patients.
The peptides in oat and malt extracts that are preferentially absorbed by Lactobacillus plantarum and stimulates its proliferation in milk
Authors: Jiang Yuanzhi , Shi Yangyang , Li Rui , Hang Feng , Zhao Jianxin , Zhang Hao , Chen Wei 
Published: May 2021

SummaryLactobacillus plantarum proliferates inefficiently in milk, mainly because of its lack of cell envelope proteases and its inability to hydrolyse proteins in milk. Our previous study showed that this strain could grow well in milk with the addition of oat and malt extracts. To investigate the usage and preference for polypeptides and oligopeptides for this strain, sodium dodecyl sulphate‐polyacrylamide gel electrophoresis (SDS‐PAGE), o‐phthaldialdehyde (OPA), high‐performance liquid chromatography (HPLC), plate counting and other methods were used in this study. The results showed that proteins in fermented milk cannot be absorbed and utilised by L. plantarum, whereas polypeptides and oligopeptides provide available nitrogen sources for their growth. Short‐chain peptides were more conducive to absorption and utilisation than long‐chain peptides. In particular, peptides with molecular weights in the range of 200–1400 Da in the oat extract and 100–700 Da in the malt extract were preferentially absorbed and utilised.
Comparing periodontitis biomarkers in saliva, oral rinse and gingival crevicular fluid: A pilot study
Authors: Katsiki Panagiota , Nazmi Kamran , Loos Bruno G. , Laine Marja L. , Schaap Kim , Hepdenizli Esen , Bikker Floris J. , Brand Henk S. , Veerman Enno C.I. , Nicu Elena A. 
Published: May 2021

AbstractAimTo explore the feasibility of screening for periodontitis by measuring biomarkers, namely total proteolytic activity (TPA), matrix metalloproteinase (MMP)‐8, chitinase, lysozyme or their combination, in saliva, oral rinse and gingival crevicular fluid (GCF).Material and methodsSubjects were recruited among healthy/gingivitis individuals and untreated periodontitis patients in Academic Centre for Dentistry Amsterdam (ACTA). All participants donated samples of unstimulated whole saliva, oral rinse and GCF. The protein concentrations and MMP‐8 levels were determined by ELISA. Enzymatic activities were measured using appropriate fluorogenic substrates.ResultsIn oral rinse samples, periodontitis patients (n = 19) exhibited significantly higher concentrations of MMP‐8 and TPA than controls (n = 20). MMP‐8 in combination with chitinase explained 88% of the variance and assigned a subject to control or periodontitis group, with best accuracy (87.2%) in oral rinse.ConclusionsThe combination of MMP‐8 and chitinase in the current oral rinse procedure has the potential to discriminate periodontitis from periodontal health/gingivitis.
Diagnostic accuracy of a point‐of‐care aMMP‐8 test in the discrimination of periodontal health and disease
Authors: Deng Ke , Pelekos George , Jin Lijian , Tonetti Maurizio S. 
Published: May 2021

AbstractAimTo assess the diagnostic utility of an oral rinse active matrix metalloproteinase‐8 (aMMP‐8) point‐of‐care test (POCT) for differentiating periodontal health, gingivitis, as well as different stages and grades of periodontitis.Materials & MethodsThe aMMP‐8 index test was undertaken in 408 consecutive adults, followed by a full‐mouth periodontal examination. The reference standard was the 2017 World Workshop classification of periodontal diseases. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUROC) were assessed.Results68.6% of the participants were diagnosed with periodontitis, including Stages I (15.9%), II (15.9%), III (29.7%) and IV (7.1%). A positive aMMP‐8 POCT was associated with periodontitis after adjusting for age, gender, tobacco smoking and systemic diseases, while it was unable to differentiate among the stages/grades of periodontitis and between gingivitis/periodontal health. This test showed a sensitivity of 33.2% and a specificity of 93.0% for detecting periodontitis (threshold level >10 ng/ml). The levels of aMMP‐8 adjusted by the number of teeth present (aMMP‐8/NTP) performed better for periodontitis (sensitivity: 67.1%; specificity: 68.8%). Notably, aMMP‐8/NTP were strongly predictive for Stage IV periodontitis (threshold level =0.4312 ng/ml) (sensitivity: 89.7%; specificity: 73.6%; and AUROC: 0.856). The test performance greatly improved in combination with age and smoking, with a sensitivity of 82.5%, a specificity of 84.4%, and an AUROC of 0.883.ConclusionThis aMMP‐8 POCT is able to detect periodontitis with better specificity than sensitivity across the spectrum of its severity. This test may be useful for periodontal screening in conjunction with subject characteristics and/or other sensitive screening tools. Further validation studies are needed.
Maintenance visit regularity has a different impact on periodontitis‐related tooth loss depending on patient staging and grading
Authors: Ravidà Andrea , Galli Matthew , Saleh Muhammad H. A. , Rodriguez Maria Vera , Qazi Musa , Troiano Giuseppe , Chan Hsun‐Liang , Wang Hom‐Lay 
Published: May 2021

AbstractAimTo assess whether maintenance variables have a differential effect on tooth loss due to periodontitis (TLP) based on staging and grading.Materials and MethodsPatients treated for periodontitis for a minimum of ≥10 years follow‐up were included and categorized according to their stage and grade at baseline. Impact of number, regularity, and pattern of supportive periodontal therapy visits (SPT) on TLP was explored by dividing teeth into test (5 year time periods prior to TLP events) and control groups (random 5 year periods without tooth loss).ResultsThe regularity of maintenance visits, but not the overall quantity, had a significant impact on risk of TLP and showed higher importance as staging and grading increased (larger impact for stages III/IV and grade C). The minimum threshold of visits below which the risk of TLP was equivalent to that of the control group was one visit every 7.4 months for stages I‐II, 6.7 months for stage III‐IV, 7.2 months for grade B and 6.7 months for grade C. This frequency should be increased for former and current smokers, diabetics and elderly patients. Stage III and IV patients who skip more than 1 year of maintenance in a 5 year period have an increased risk of TLP (OR = 2.55) compared to those only miss 1 year. A similar trend was noted for grade C patients, but not for stages I/II or grades A/B.ConclusionsLack of SPT regularity and missing multiple years of maintenance had a larger influence on risk of TLP for higher‐level staging and grading.
On the precision of information
Authors: Pereira Samuel C. A. 
Published: May 2021

AbstractThis paper explores a model in which the agent's effort affects (solely) the precision (variance) of a performance measure (signal) of the outcome. Both the principal and the agent are risk averse. The contract the principal offers is composed of a fixed payment plus variable compensation, depending on the outcome and based on a (linear) risk‐sharing rule between the principal and the agent. Moral hazard alone leads to an upward distortion (above the first‐best) of the risk‐sharing rule. This serves to induce more effort to increase information precision. Adverse selection alone introduces two new features. First, to reduce informational rents, the risk‐sharing rule is distorted downward below the first‐best. Second, to induce truthful information revelation, the risk‐sharing rule becomes increasing with the expected outcome—the agent's private information. When moral hazard and adverse selection are considered together, and there is enough uncertainty related to adverse selection, the risk‐sharing rule is above the first‐best for more efficient types, but below the first‐best for less efficient types. Further, the precision of the signal increases with the expected outcome.
Comparative study between fractional carbon dioxide laser versus retinoic acid chemical peel in the treatment of acanthosis nigricans
Authors: Abu Oun Ayat A , Ahmed Naglaa A. , Hafiz Hala S.A. 
Published: May 2021

AbstractBackgroundAcanthosis nigricans (AN) is a common dermatological issue with several therapeutic modalities to treat. Despite retinoid is the first drug of choice in the treatment, the fractional‐ablative carbon dioxide (CO2) laser has revealed as a promising procedure for the management of neck‐AN, outstanding to its ability for superficial ablation of the skin surface, with trans‐epidermal melanin elimination.ObjectivesTo decide whether fractional‐ablative CO2 laser or retinoic acid (5%) peel is the more effective and safe choice for AN treatment.MethodsIn this study, twenty Egyptian cases with neck‐AN were enrolled, where each case was exposed to four sessions with 2 weeks apart of both fractional CO2 laser on the right half of the neck and retinoic acid peel on the left half of the neck. Cases were assessed by a scoring system: Acanthosis Nigricans Area and Severity Index (ANASI) score, two blinded dermatologists, and dermoscopically before and one month after treatment.ResultsWe found a highly statistically significant improvement among both treated groups regarding (ANASI) score and dermatologist's assessments. Bedside, the degree of sulci cutis, cristae cutis, brown‐to‐dark brown dots, and milia‐like cysts, dermoscopic sign improvement was evident in both treated groups. However, fractional CO2 laser shows the superior result to retinoic acid peel in the treatment.ConclusionFractional CO2 laser and retinoic acid peel are considered effective modalities for neck‐AN treatment. However, fractional CO2 laser was more effective.