bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disseminated drug‐resistant tuberculosis and multiple autoimmune syndrome in a child with selective IgA deficiency—An uncustomary combination
Authors: Nori Harshita , Vohra Viresh , Banday Aaqib Zaffar , Jindal Ankur Kumar , Tyagi Reva , Sodhi Mandeep Kaur , Bal Amanjit , Suri Deepti 
Published: January 2022

AbstractPolyautoimmunity or multiple autoimmune syndrome (MAIS) is increasingly being recognized in pediatric clinical practice, often in conjunction with systemic lupus erythematosus (SLE). Besides multi‐organ autoimmunity, children with SLE are often at a higher risk of developing infections including tuberculosis. The tendency to develop infections and multiple autoimmune diseases in childhood SLE often occurs in the absence of monogenic primary immunodeficiency disease. Conversely, children with inborn errors of immunity, of which selective IgA deficiency (sIgAD) is the most common, may develop recurrent infections and autoimmune disorders including SLE. Herein, we report a child with MAIS (including SLE) and sIgAD who developed drug‐resistant tuberculosis, which was managed successfully with second‐line anti‐tubercular drug therapy. To the best of our knowledge, this combination of rare findings has not been reported previously in the pediatric literature. Although a majority of patients with sIgAD are either asymptomatic or have mild infections/autoimmunity, the index child had a myriad of infectious illnesses and multi‐organ autoimmunity. Our case highlights the prudence of thoroughly evaluating children with SLE for other autoimmune diseases and vice versa. Given the higher probability of inherited disorders, including early complement deficiencies and monogenic interferonopathies, in childhood SLE compared with adult SLE, it may be prudent to perform a basic immunological workup (for example, immunoglobulin levels, 50% hemolytic complement) in such patients. A more extensive immunological and genetic evaluation (including next‐generation sequencing) may also be required in the presence of unusual clinical or laboratory features, a positive family history, or a complicated clinical course.
Group size and matching protocol in contests
Authors: Baik Kyung Hwan , Chowdhury Subhasish M. , Ramalingam Abhijit 
Published: January 2022

AbstractWe investigate the effects of group size and matching protocol in Tullock contest experiments. In a 2 × 2 factorial design, we implement partner and random stranger‐matching protocols in contests between two and between three players. Group size does not affect overall absolute bid levels, but the rate of overbidding is lower in two‐player groups across matching protocols. Matching protocol does not affect bidding behaviour for three‐player groups, but a partner matching reduces both the level and dispersion of bids in two‐player groups. These results show the joint effect of group size and matching protocol and suggest that identifiability in repeated play facilitates tacit collusion.
Guided discovery learning: A follow‐up study of try‐it‐yourself surgery and subsequent video‐assisted teaching for oral surgical skills training
Authors: Kniha Kristian , Bock Anna , Peters Florian , Heitzer Marius , Hölzle Frank , Raith Stefan , Modabber Ali , Möhlhenrich Stephan Christian 
Published: January 2022

AbstractIntroductionThe purpose of this follow‐up study was to assess the effects of discovery learning and subsequent standardised teaching on students’ advanced dental surgical skills.Materials and MethodsA total of 29 dental students who had no theoretical education on the Rehrmann flap were included in the skills training programme. Without prior teaching, the students were initially asked to perform a discovery surgery with a subsequent multiple‐choice test (MCT) on the first day. This was followed by a video‐assisted teaching lecture. On the same day and after 122 days, the surgery and MCT were repeated. Aside from the practical and theoretical assessment forms, the training was evaluated by the students themselves.ResultsRegarding the evaluation of surgery (EOS), significant improvements were measured between the first surgery and the second and third surgeries (p > .001). In addition, the theoretical test scores showed significant improvements after the first test when compared with the second (p = .004) and third tests (p < .001). For both assessments, no significant difference was found between the second and third attempts. The MCT and EOS in the second and third attempts strongly correlated (r = .77 andr = .71 respectively).ConclusionThe dental students in this study successfully learned a complex oral surgical procedure, the Rehrmann flap technique, for closing oro‐antral communications. The participants indicated their high satisfaction with the teaching approach. After 122 days of follow‐up, their practical and theoretical test scores remained high and presented no significant difference, which suggests that the newly learnt individual skills were retained.
Evaluation of anxiety‐provoking situations related to clinical training in dental education
Authors: Tokuc Muge , Alpkilic Dilara Seyma 
Published: January 2022

AbstractIntroductionThe aims of this study were to evaluate the situations that cause anxiety in clinical training and to discuss the precautions that can be taken to reduce clinical anxiety in dental education.Materials and MethodsThis multi‐centred survey‐based study was created through Google Docs, and 3rd, 4th and 5th grade dental students were included. The students were asked to rate their reactions on a 4‐point Likert scale “not anxious” to “very anxious” for 27 questions related to academics, communication and interaction, diagnosis, dental treatments, deficiencies and mistakes in the treatments.Results1332 students were reached, and 1320 students completed the questionnaire. Whilst extracting wrong tooth (3.53 ± 0.83), getting infected by patient (3.39 ± 0.85) and getting diagnosis wrong (3.31 ± 0.83) were identified as the 3 most anxiety‐provoking situations, taking panoramic radiograph (1.48 ± 0.71) and communication with patients and dental assistants/nurses (1.76 ± 0.87; 1.64 ± 0.76) were identified as 3 situations that cause the least anxiety. Female students reported higher anxiety levels than male students in most of the questions (p < .05). A statistically significant difference was observed between the grades of the students (p < .05). 3rd grade students showed statistically higher anxiety levels than higher grades in 16 out of 27 questions. No statistical significance was observed according to the status of the university (p > .05).ConclusionQuestions related to diagnosis, delivery of the dental treatments, deficiencies and mistakes in the treatments caused higher anxiety levels amongst dentistry students. As experience and time in the clinical training increase, the anxiety level of the students decreases. Orientation programmes and establishing an effective communication between grades are recommended. Also, gender‐based solutions must be taken into consideration.
The potential of a canister‐based single‐use negative‐pressure wound therapy system delivering a greater and continuous absolute pressure level to facilitate better surgical wound care
Authors: Orlov Aleksei , Gefen Amit 
Published: January 2022

AbstractTwo types of single‐use negative‐pressure wound therapy systems are currently available to treat surgical wounds: Canister‐based and canisterless. This work was aimed to evaluate the performance of a canister‐based vs a canisterless system, each with a different negative‐pressure setting and technology for fluid management. Continuous delivery of a specified level of negative pressure to the wound bed is hypothesised to be important for promoting surgical wound healing, by achieving continuous reduction of lateral tension in the wound, particularly through decrease of skin stress concentrations around suture insertion sites. To test the above hypothesis, we developed a computational modelling framework, a laboratory bench‐test for simulated clinical use and had further conducted a pre‐clinical study in a porcine model for closed incision. We specifically focussed on the impact of effective fluid management for continuous delivery of a stable, consistent negative pressure and the consequences of potential losses of the pressure level over the therapy period. We found that a greater (absolute) negative‐pressure level and its continuous, consistent delivery through controlled fluid management technology, by removing excess fluid from the dressing, provides far superior biomechanical performances. These conditions are more likely to result in better quality of the repaired tissues.
Associations of toddler mechanical/distress feeding problems with psychopathology symptoms five years later
Authors: Putnick Diane L. , Bell Erin M. , Ghassabian Akhgar , Polinski Kristen J. , Robinson Sonia L. , Sundaram Rajeshwari , Yeung Edwina 
Published: January 2022

BackgroundFeeding problems are common in early childhood, and some evidence suggests that feeding problems may be associated with psychopathology. Few prospective studies have explored whether toddler feeding problems predict later psychopathology.MethodsMothers of 1,136 children from the Upstate KIDS cohort study provided data when children were 2.5 and 8 years of age. Food refusal (picky eating) and mechanical/distress feeding problems and developmental delays were assessed at 2.5 years. Child eating behaviors (enjoyment of food, food fussiness, and emotional under and overeating) and child psychopathology (attention‐deficit/hyperactivity (ADHD), oppositional‐defiant (OD), conduct disorder (CD), and anxiety/depression) symptoms were assessed at 8 years.ResultsMechanical/distress feeding problems at age 2.5, but not food refusal problems, were associated with ADHD, problematic behavior (OD/CD), and anxiety/depression symptoms at 8 years in models adjusting for eating behaviors at 8 years and child and family covariates. Associations with mechanical/distress feeding problems were larger for ADHD and problematic behavior than anxiety/depression symptoms, though all were modest. Model estimates were similar for boys and girls.ConclusionsMuch of the research on feeding problems focuses on picky eating. This study suggests that early mechanical and mealtime distress problems may serve as better predictors of later psychopathology than food refusal. Parents and pediatricians could monitor children with mechanical/distress feeding problems for signs of developing psychopathology.
Effects of dietary starch sources on pellet‐processing characteristics, growth performance and caecal microflora of meat rabbits
Authors: Cong Xueyan , Li Xiuyi , Yang Guiqin , Guo Dongxin , Tian He , Li Jiantao 
Published: January 2022

AbstractThis study evaluated the effects of starch sources on pellet‐processing characteristics as well as the growth performance and caecal microflora of rabbits. Ninety‐six 35‐day‐old rabbits were randomly allocated to four groups with 24 rabbits per group and were fed diets with different starch sources (corn, wheat, potato or pea starch). The trial lasted for 40 days. The greatest hardness and lowest powder ratio of feed pellets was associated with the use of potato starch (p > 0.05). Pellet bulk density was the highest with corn starch, and the density was greater than that of pea starch by 5.91% (p < 0.05). The pulverisation ratio of corn starch pellets was the lowest, 43.67% lower than that of the pea starch pellets (p < 0.05). The average daily gain of rabbits in the corn starch group was higher than in the potato and pea starch groups, by 7.89% and 10.81%, respectively (p < 0.05). Rabbits in the corn starch group had the best feed conversion ratio (p > 0.05). The feed intake of rabbits in the potato starch group was higher than in the wheat and pea starch groups, by 4.30% and 5.16% respectively (p < 0.05). The dominant caecal bacteria phyla were Firmicutes, Bacteroidetes, Verrucomicrobia and Proteobacteria. There were 12 bacterial genera with proportions greater than 0.1%. The caecal proportion of Clostridium in the pea starch group was 1.8%, which was higher than those of the other groups (p = 0.057). There was no significant difference in caecal microbial diversity among groups (p > 0.05). The highest microbial clustering effect was found in the corn starch treatment. In conclusion, the best pellet quality was found using potato starch; for rabbit growth, the optimal source was corn starch.
The pituitary tumour‐transforming gene 1/delta‐like homologue 1 pathway plays a key role in liver fibrogenesis
Authors: Perramón Meritxell , Carvajal Silvia , Reichenbach Vedrana , Fernández‐Varo Guillermo , Boix Loreto , Macias‐Muñoz Laura , Melgar‐Lesmes Pedro , Bruix Jordi , Melmed Shlomo , Lamas Santiago , Jiménez Wladimiro 
Published: January 2022

AbstractBackground and AimsPTTG1 is almost undetectable in adult livers but is highly expressed in hepatocarcinoma. While little is known about its involvement in liver fibrosis, PTTG1 expression is associated with DLK1. We assessed the role of the PTTG1/DLK1 pathway in fibrosis progression and the potential therapeutic effect of PTTG1 silencing in fibrosis.MethodsPttg1 and Dlk1 were studied in liver and isolated cell populations of control and fibrotic rats and in human liver biopsies. The fibrotic molecular signature was analysed in Pttg1−/− and Pttg1+/+ fibrotic mice. Finally, Pttg1 silencing was evaluated in rats as a novel antifibrotic therapy.ResultsPttg1 and Dlk1 mRNA selectively increased in fibrotic rats paralleling fibrosis progression. Serum DLK1 concentrations correlated with hepatic collagen content and systemic and portal haemodynamics. Human cirrhotic livers showed greater PTTG1 and DLK1 transcript abundance than non‐cirrhotic, and reduced collagen was observed in Pttg1 Pttg1−/− mice. The liver fibrotic molecular signature revealed lower expression of genes related to extracellular matrix remodelling including Mmp8 and 9 and Timp4 and greater eotaxin and Mmp13 than fibrotic Pttg1+/+ mice. Finally, interfering Pttg1 resulted in reduced liver fibrotic area, lower α‐Sma and decreased portal pressure than fibrotic animals. Furthermore, Pttg1 silencing decreased the transcription of Dlk1, collagens I and III, Pdgfrβ, Tgfrβ, Timp1, Timp2 and Mmp2.ConclusionsPttg1/Dlk1 are selectively overexpressed in the cirrhotic liver and participate in ECM turnover regulation. Pttg1 disruption decreases Dlk1 transcription and attenuates collagen deposition. PTTG1/DLK1 signalling is a novel pathway for targeting the progression of liver fibrosis.
Impact of sound levels on physiological and consciousness state of cardiovascular patients
Authors: Morales‐Cané Ignacio , Moral‐Arroyo Juan Antonio , Debbia Fabio , Guler Ipek , Llamas‐Recio Francisca , Jiménez‐Pastor José Manuel , de la Cruz López‐Carrasco Juan , Acuña‐Castroviejo Darío , Rodríguez‐Borrego María Aurora , López‐Soto Pablo Jesús 
Published: January 2022

AbstractBackgroundPatients treated in intensive care units (ICUs) experience life‐threatening medical conditions but some external factors in ICUs do not help or even adversely affect and complicate their evolution. Among others, such factors include noise pollution due to alarms and medical clinical equipment, as well as the activities of the health care personnel themselves.AimThis study aimed to evaluate the influence of elevated sound levels on physiological variables and the consciousness state of patients treated in a cardiovascular area in an ICU.DesignA longitudinal study with several observations was carried out during 1 month in the cardiovascular area of an ICU of a third‐level hospital in southern Spain.MethodsSound levels were monitored in different work shifts and patients' physiological data and consciousness status were recorded. Generalized additive mixed models (GAMMs) were developed to detect the variability of the sound levels together with the vital parameters of the patients in the ICU.ResultsThirty‐eight patients were included. The mean sound level was 54.09 dBA. The GAMM sound levels analysis showed a significant increase in sound levels from 4:30 p.m. to 8:00 p.m. (1.83 dBA; P < .001) and 8:00 p.m. to 11:30 p.m. (3.06 dBA; P < .001). An increase in heart rate (3.66 bpm; P < .001), respiratory rate (2.62 rpm; P < .001) and the Glasgow Coma Scale (0.50 units; P = .002) was detected during the 4:30 p.m.–8:30 p.m. period.ConclusionsElevated sound levels in cardiovascular ICUs seem to influence positively the physiological and consciousness status of patients. Given the importance of the findings for patient safety, future intervention studies are recommended.Relevance to Clinical PracticeThe finding of this study could translate into structural changes in ICU facilities, as well as the development of clinical practice guidelines that influence the behaviour of health care professionals.
Malignant pleural mesothelioma patients’ experience by gender: findings from a cross-sectional UK-national questionnaire
Authors: Senek Michaela , Robertson Steve , Darlison Liz , Creech Lorraine , Tod Angela 
Published: January 2022

ObjectivesMalignant mesothelioma is an aggressive malignancy of mesothelial surfaces, most commonly those of the pleura. The aim of this study was to understand, using a national questionnaire, the gendered care experiences of patients with malignant pleural mesothelioma (MPM).Patients were asked about their experience of the diagnostic process, about information clarity, health care professionals’ knowledge, general practitioner support and overall satisfaction with care received.SettingRecruitment of patients was carried out in three UK countries (England, Wales and Scotland) via mesothelioma clinical nurse specialists.ParticipantsIn total, 503 patients completed the questionnaire. 460 had MPM, the remainder had other types of mesothelioma. In accord with the study protocol, only the MPM patients were included in this study.Primary and secondary measures were: (1) time from symptom to diagnosis, (2) satisfaction with the diagnosis and treatment, and (3) quality of life and well-being.ResultsThere were gender differences in time from symptom to diagnosis. The time from symptom to diagnosis was significantly longer for women than men (median=152 days vs men=92 days, p=0.01). Lack of a verified source of exposure to asbestos was a hindrance to private treatment access for women (95% of those that access private treatment are men). Patients were five times more likely to be satisfied if they thought that the doctors knew enough about their condition (OR=4.4, p=0.001) and nearly three times more likely to be satisfied if information was presented in a sensitive way (OR=2.8,p=0.01).ConclusionsThis study has several implications for clinical practice. Our findings suggest that the diagnostic time in women might be reduced by reviewing diagnostic processes including occupational history taking, and by revising the occupational risk of mesothelioma categorisation.
Activity, heart rate, and energy expenditure of a cold-climate mesocarnivore, the Canada lynx (Lynx canadensis)
Authors: Menzies Allyson K. , Studd Emily K. , Seguin Jacob L. , Derbyshire Rachael E. , Murray Dennis L. , Boutin Stan , Humphries Murray M. 
Published: January 2022

The energetic consequences of body size, behaviour, and fine-scale environmental variation remain understudied, particularly among free-ranging carnivores, due to logistical and methodological challenges of studying them in the field. Here, we present novel activity, heart rate, and metabolic data on free-ranging Canada lynx (Lynx canadensis Kerr, 1792) to (i) investigate intraspecific patterns of energy expenditure, particularly how they relate to body size, environmental conditions, and activity variation, and (ii) position lynx — a cold-climate, mesocarnivore — within interspecific allometries of carnivore energetics. Lynx demonstrated limited behavioural and metabolic responses to environmental conditions, despite extreme cold and moderate snow depths during our study, but marked body size patterns with larger lynx having higher activity and lower resting heart rate than smaller lynx. Compared with similar-sized carnivores, lynx were less active and had lower heart rate, likely due to their ambush hunting style, but higher energy expenditure, likely due to their cold-climate existence and access to abundant prey. Overall, lynx were more similar to other ambush hunters than to sympatric cold-climate species and mesocarnivores. Our data provide insight into the relative importance of abiotic and biotic drivers of carnivore energetics and the ways in which predators maintain energy balance in variable environments.
The Midlatitude Response to Polar Sea Ice Loss: Idealized Slab-Ocean Aquaplanet Experiments with Thermodynamic Sea Ice
Authors: Shaw Tiffany A. , Smith Zoë 
Published: January 2022

Abstract
Slab-ocean aquaplanet simulations with thermodynamic sea ice are used to study the zonally symmetric mechanisms whereby polar sea ice loss impacts the midlatitude atmosphere. Imposed sea ice loss (difference without and with sea ice with historical CO2 concentration) leads to global warming, polar amplified warming, and a weakening of poleward atmospheric energy transport and the midlatitude storm-track intensity. The simulations confirm an energetic mechanism that predicts a weakening of storm-track intensity in response to sea ice loss, given the change of surface albedo and assuming a passive ocean. Namely, sea ice loss increases the absorption of shortwave radiation by the surface (following the decrease of surface albedo), which increases surface turbulent fluxes into the atmosphere thereby weakening poleward atmospheric energy transport. The storm-track intensity weakens because it dominates poleward energy transport. The quantitative prediction underlying the mechanism captures the weakening but underestimates its amplitude. The weakening is also consistent with weaker mean available potential energy (polar amplified warming) and scales with sea ice extent, which is controlled by the slab-ocean depth. The energetic mechanism also operates in response to sea ice loss due to melting (difference of the response to quadrupled CO2 with and without sea ice). Finally, the midlatitude response to sea ice loss in the aquaplanet agrees qualitatively with the response in more complex climate models. Namely, the storm-track intensity weakens and the energetic mechanism operates, but the method used to impose sea ice loss in coupled models impacts the surface response.