Young people's and adults' views and experiences of decision-making to manage compromised first permanent molars: a qualitative study.

BACKGROUND: Little information on young people's and adults' views and experiences on decision-making for managing compromised first permanent molars (cFPM) exists. AIM: To establish young people's and adults' views and experiences of decision-making for managing cFPM. DESIGN: Face-to-face (online) semi-structured interviews were undertaken using an iteratively designed topic guide. Participants aged 12-65 were purposively sampled with recruitment from different dental clinics (three primary care, an out-of-hours emergency and one dental hospital). Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Three themes were generated from young people's interviews (n = 9): (i) influencing factors; (ii) long-term considerations; and (iii) shared decision-making. Three themes were generated from adults' interviews (n = 13): (i) influences that affect decisions; (ii) perceptions of the specialist's role; and (iii) importance of shared decision-making for children and young people. CONCLUSION: Several factors influenced decision-making; for young people, professional opinions were important, and parental/peer influences less so. For adults, it was based on decisions on their prior experiences. Adults felt young people were abnormal if referred to a specialist. Young people wanted autonomy in decision-making to be respected; in reality, their views were rarely heard. There is potential to increase young people's involvement in shared decision-making for cFPM, which aligns with their aspirations.

Coverage and determinants of infant postnatal care in Nigeria: A population-based cross-sectional study.

Importance: In 2019, Nigeria had the largest number of under-5 child deaths globally and many of these deaths occurred within the first week of life. The World Health Organization recommends infant postnatal care (PNC) attendance to support newborn survival; however, utilization of PNC is known to be low in many contexts. Objective: This study examined coverage and individual-level determinants of infant PNC attendance in Nigeria. Methods: Nigeria Demographic Health Survey (NDHS) 2018 data were used to evaluate infant PNC coverage and determinants. Infant PNC was defined as receipt of care within 2 days of birth. Children delivered up to 2 years before the 2018 NDHS were included. We examined predictors of infant PNC with modified Poisson regression models to estimate relative risks (RRs). Results: The national coverage of infant PNC was 37.3% (95% confidence interval [CI]: 35.8%-38.7%). Significant heterogeneity in PNC attendance existed at state and regional levels. Facility delivery was strongly associated with the uptake of PNC (RR: 6.07; 95% CI: 5.60-6.58). Greater maternal education, maternal employment, urban residence, female head of household, and greater wealth were also associated with an increased likelihood of PNC visits. Interpretation: The uptake of infant PNC is low and interventions are urgently needed to promote equity in access and increase demand for PNC in Nigeria.

Income Source Confusion Using the SILC.

We use a unique panel of household survey data-the Austrian version of the European Union Statistics on Income and Living Conditions (SILC) for 2008-2011-which have been linked to individual administrative records on both state unemployment benefits and earnings. We assess the extent and structure of misreporting across similar benefits and between benefits and earnings. We document that many respondents fail to report participation in one or more of the unemployment programs. Moreover, they inflate earnings for periods when they are unemployed but receiving unemployment compensation. To demonstrate the impact of income source confusion on estimators, we estimate standard Mincer wage equations. Since unemployment is associated with lower education, the reports of unemployment benefits as earnings bias downward the returns to education. Failure to report unemployment benefits also leads to substantial sample bias when selecting on these benefits, as one might in estimating the returns to job training.

Ocular factors predicting requirement for corneal protective oculoplastic surgery.

BACKGROUND: Currently there is no universally agreed schema for predicting ocular morbidity in facial nerve palsy. The House Brackmann Scale has limitations in assessing ocular morbidity from facial nerve palsy. Our aim was to create a scoring system to help quantify ocular morbidity to aid in decision making regarding the need for corneal protective oculoplastic surgery. METHODS: We conducted a large cohort study observing 606 patients attending the specialist facial palsy clinic in Manchester UK between March 2002 and October 2017. Retrospective multivariate analysis identified clinical predictors for the 316 patients that required oculoplastic surgery. ß coefficients generated in the multivariate analysis helped formulate a new facial nerve palsy scoring instrument to predict the need for corneal protective oculoplastic surgery. RESULTS: The House Brackmann Scale, corneal lagophthalmos and loss of corneal sensation proved clinically significant predictors for requiring corneal protective oculoplastic surgery. The scoring system derived from these factors provided an accurate and repeatable prediction tool demonstrated by validation studies on our patient population. The area under the ROC curve for the multivariate prediction model was 0.769 (0.726, 0.811). A score of 5 points out of a possible 8 was the best cut off score to recommend oculoplastic surgery, giving a sensitivity of 0.750 and a specificity of 0.671. CONCLUSION: This study demonstrates that corneal lagophthalmos, corneal sensation and the House Brackmann Scale are important in predicting the need for corneal protective oculoplastic surgery. Our scoring tool is an important clinical decision tool for ophthalmic and ENT colleagues.

Association of Exposure to Intimate Partner Violence With Maternal Depressive Symptoms and Early Childhood Socioemotional Development Among Mothers and Children in Rural Tanzania.

Importance: Approximately 1 in 4 women experience intimate partner violence (IPV) or nonpartner sexual violence during their lifetime. Mothers exposed to IPV are more likely to experience depressive symptoms and to discipline their children harshly, which may affect their children's socioemotional development; however, there is limited evidence on these outcomes. Objective: To examine the association between IPV, maternal depressive symptoms, harsh child discipline, and child stimulation with child socioemotional development. Design, Setting, and Participants: This study used cross-sectional follow-up data collected from February 19 to October 10, 2014, from a birth cohort of children aged 18 to 36 months who were enrolled in a randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation in the Morogoro region of Tanzania. Data analysis occurred between September 10, 2019, and January 20, 2020. Exposures: Lifetime experience of IPV was assessed using an abbreviated module of the Tanzania Demographic and Health Survey, maternal depressive symptoms were assessed with the Patient Health Questionnaire, and data on harsh child discipline and maternal stimulation of their children were collected using modules of the United Nations Children's Fund Multiple Indicator Cluster Survey. Main Outcomes and Measures: Child socioemotional development was measured by the Caregiver-Reported Early Childhood Development Instruments. Results: A total of 981 mother-child dyads were included in the analytic sample; 388 children (39.6%) were between ages 18 and 24 (mean [SD] age, 27.06 [6.08]) months, and 515 (52.5%) were male children. A negative association was observed between maternal report of physical IPV only (mean difference, -0.022; 95% CI, -0.045 to -0.006) and physical and sexual IPV (mean difference, -0.045; 95% CI, -0.077 to -0.013) with child socioemotional scores, but neither was statistically significant after including depressive symptoms in the model, which is consistent with mediation. Furthermore, a negative association was observed between maternal mild to severe depressive symptoms and child socioemotional development, including adjustment for IPV (mean difference, -0.073; 95% CI, -0.103 to -0.043). Harsh disciplinary practices and stimulation were not associated with child socioemotional development after adjusting for IPV, maternal depressive symptoms, and other factors. Conclusions and Relevance: The findings of this study suggest that maternal depressive symptoms may explain the negative association between IPV and child socioemotional development.

Childhood Diarrhea Prevalence and Uptake of Oral Rehydration Solution and Zinc Treatment in Nigeria.

Given the disproportionate burden of childhood diarrhea deaths in Nigeria, this study assessed the prevalence and predictors of the disease and the uptake of ORS and zinc supplementation as treatments in a population-based national survey. Cross-sectional data from the 2018 Nigeria Demographic Health Survey were used. A log-Poisson regression was used to estimate the relative risks (RR) for the individual-level predictors of childhood diarrhea and the uptake of ORS and zinc treatments. A total of 30,713 children under 5 years of age were included in the survey. The period prevalence of reported diarrhea in the last two weeks was 12.9% (95% CI: 12.5%, 13.3%). Among the children with diarrhea, the proportion who received ORS was 39.7% (95% CI: 38.2%, 41.3%), while 29.1% of them received zinc supplements (95% CI: 27.7%, 30.5%), and 21.8% of them received both the ORS and zinc treatments as recommended. Children under 6 months of age with diarrhea had a significantly lower likelihood of being given ORS or zinc when they were compared to the older children. The institutional delivery of them, maternal employment, and improved water sources were also independent predictors of the uptake of ORS and zinc treatments for diarrhea (p-values < 0.05). Interventions to prevent childhood diarrhea and improve the coverage of ORS and zinc treatments may reduce the large burden of childhood diarrhea deaths in Nigeria.

New Zealand's first practical demonstration of the telemedicine system specific to ophthalmology: MedicMind teleophthalmology platform.

Nil.

Evidence for Effects of Extracellular Vesicles on Physical, Inflammatory, Transcriptome and Reward Behaviour Status in Mice.

Immune-inflammatory activation impacts extracellular vesicles (EVs), including their miRNA cargo. There is evidence for changes in the EV miRNome in inflammation-associated neuropsychiatric disorders. This mouse study investigated: (1) effects of systemic lipopolysaccharide (LPS) and chronic social stress (CSS) on plasma EV miRNome; and (2) physiological, transcriptional, and behavioural effects of peripheral or central delivered LPS-activated EVs in recipient mice. LPS or CSS effects on the plasma EV miRNome were assessed by using microRNA sequencing. Recipient mice received plasma EVs isolated from LPS-treated or SAL-treated donor mice or vehicle only, either intravenously or into the nucleus accumbens (NAc), on three consecutive days. Bodyweight, spleen or NAc transcriptome and reward (sucrose) motivation were assessed. LPS and CSS increased the expression of 122 and decreased expression of 20 plasma EV miRNAs, respectively. Peripheral LPS-EVs reduced bodyweight, and both LPS-EVs and SAL-EVs increased spleen expression of immune-relevant genes. NAc-infused LPS-EVs increased the expression of 10 immune-inflammatory genes. Whereas motivation increased similarly across test days in all groups, the effect of test days was more pronounced in mice that received peripheral or central LPS-EVs compared with other groups. This study provides causal evidence that increased EV levels impact physiological and behavioural processes and are of potential relevance to neuropsychiatric disorders.

Plant species of the genus Uvaria: ethnobotanical uses, biological activities and phytochemistry.

The genus Uvaria (Annonaceae) comprises of climbing or trailing shrubs and rarely trees. Its plant species are widely distributed across tropical Africa, Asia and Australia. The genus Uvaria is known for various ethnobotanical uses including the treatment of tumours and the control of fever. Some of plant species in this genus have been studied for their ethnobotanical uses, biological activities and phytochemistry. The aim of the present study is to give a comprehensive review of plant species from the genus Uvaria in terms of their ethnobotanical uses, biological activities and phytochemistry. This review is expected to lay a foundation for further studies of this genus in terms of ethnobotanical applicability, biological activities and phytochemistry. Since many compounds currently known from the genus Uvaria have not yet been investigated for their biological activities, this review will be useful for future studies in the phytochemical investigations of lead compounds from this genus.

Correction: Fossil and Genetic Evidence for the Polyphyletic Nature of the Planktonic Foraminifera "Globigerinoides", and Description of the New Genus Trilobatus.

[This corrects the article DOI: 10.1371/journal.pone.0128108.].

Screen time and early childhood development in Ceará, Brazil: a population-based study.

BACKGROUND: Globally, children's exposure to digital screens continues to increase and is associated with adverse effects on child health. We aimed to evaluate the association of screen exposure with child communication, gross-motor, fine-motor, problem-solving, and personal-social development scores. METHODS: We conducted a population-based, cross-sectional study with cluster sampling among children 0-60 months of age living in the state of Ceará, Brazil. Child screen time was assessed by maternal report and the World Health Organization (WHO) recommendations were used to define excessive screen time exposure. Child development was assessed with the Brazilian Ages and Stages Questionnaire. Generalized linear regression was used to determine the association of screen exposure with developmental outcomes. We also examined the potential non-linear relationship of screen time with development scores using spline analyses. RESULTS: A total of 3155 children 0-60 months of age had screen time exposure evaluated and 69% percent were identified as exposed to excessive screen time. This percentage of excess screen time increased with child age from 41.7% for children 0-12 months to 85.2% for children 49-60 months. Each additional hour of screen time was associated with lower child communication (standardized mean difference (SMD): -0.03; 95% CI: - 0.04, - 0.02), problem solving (SMD: -0.03; 95% CI: - 0.05, - 0.02) and personal-social (SMD: -0.04; 95% CI: - 0.06, - 0.03) domain scores. CONCLUSIONS: Excess screen time exposure was highly prevalent and independently associated with poorer development outcomes among children under 5 years of age in Ceará, Brazil.

Pilot study to investigate the effect of long-term exposure to high pCO2 on adult cod (Gadus morhua) otolith morphology and calcium carbonate deposition.

To date the study of ocean acidification on fish otolith formation has been mainly focused on larval and juvenile stages. In the present pilot study, wild-captured adult Atlantic cod (Gadus morhua) were exposed to two different levels of pCO2, 422µatm (ambient, low pCO2) or 1091µatm (high pCO2), for a period of 30 weeks (from mid-October to early April 2014-2015) in order to study the effects on otolith size, shape and CaCO3 crystallization amongst other biological parameters. We found that otoliths from cod exposed to high pCO2 were slightly smaller (- 3.4% in length; - 3.3% in perimeter), rounder (- 2.9% circularity and + 4% roundness) but heavier (+ 5%) than the low pCO2 group. Interestingly, there were different effects in males and females; for instance, male cods exposed to high pCO2 exhibited significant changes in circularity (- 3%) and roundness (+ 4%) compared to the low pCO2 males, but without significant changes on otolith dimensions, while females exposed to high pCO2 had smaller otoliths as shown for length (- 5.6%), width (- 2%), perimeter (- 3.5%) and area (- 4.8%). Furthermore, while the majority of the otoliths analysed showed normal aragonite deposition, 10% of fish exposed to 1091µatm of pCO2 had an abnormal accretion of calcite, suggesting a shift on calcium carbonate polymorph crystallization in some individuals under high pCO2 conditions. Our preliminary results indicate that high levels of pCO2 in adult Atlantic cod might affect otolith growth in a gender-specific way. Our findings reveal that otoliths from adult cod are affected by ocean acidification, and we believe that the present study will prompt further research into this currently under-explored area.

Hormone replacement therapy and cancer survival: a longitudinal cohort study: protocol paper.

INTRODUCTION: Hormone replacement therapy (HRT) can help women experiencing menopausal symptoms, but usage has declined due to uncertainty around risks of cancer and some cardiovascular diseases (CVD). Moreover, improved cancer survival rates mean that more women who survive cancer go on to experience menopausal symptoms. Understanding these relationships is important so that women and their clinicians can make informed decisions around the risks and benefits of HRT. This study's primary aim is to determine the association between HRT use after cancer diagnosis and the risk of cancer-specific mortality. The secondary aims are to investigate the risks of HRT on subsequent cancer, all-cause mortality and CVD. METHODS AND ANALYSIS: We will conduct a population-based longitudinal cohort study of 18-79 year-old women diagnosed with cancer between 1998 and 2020, using the QResearch database. The main exposure is HRT use, categorised based on compound, dose and route of administration, and modelled as a time-varying covariate. Analysis of HRT use precancer and postcancer diagnosis will be conducted separately. The primary outcome is cancer-specific mortality, which will be stratified by cancer site. Secondary outcomes include subsequent cancer diagnosis, CVD (including venous thrombo-embolism) and all-cause mortality. Adjustment will be made for key confounders such as age, body mass index, ethnicity, deprivation index, comorbidities, and cancer grade, stage and treatment. Statistical analysis will include descriptive statistics and Cox proportional hazards models to calculate HRs and 95% CIs. ETHICS AND DISSEMINATION: Ethical approval for this project was obtained from the QResearch Scientific Committee (Ref: OX24, project title 'Use of hormone replacement therapy and survival from cancer'). This project has been, and will continue to be, supported by patient and public involvement panels. We intend to the submit the findings for peer-reviewed publication in an academic journal and disseminate them to the public through Cancer Research UK.

The Role of Organizational Culture and Climate for Well-Being among Police Custody Personnel: A Multilevel Examination.

United Kingdom Police custody is one of the most challenging of work environments, liable to excessive demands and reduced well-being. Being difficult to access, it is also a much-neglected area of research that has focused on one or two roles, rather than the full range available, and on individual-level research, rather than a more comprehensive multilevel understanding of how organizational culture and climate can simultaneously influence a range of well-being outcomes. The present longitudinal study explored all types of roles, in both the public and private sectors, across seven English police forces and 26 custody sites (N = 333, response rate 46.57%, with repeated returns = 370). The Integrated Multilevel Model of Organizational Culture and Climate (IMMOCC) was applied to examine the organizational-level influences on individual well-being. Results indicated that (1) custody sergeants were most vulnerable to low well-being, followed by publicly contracted detention officers; (2) shared leadership (a source of team cohesion) was linked to four of six well-being outcomes; (3) two sub-components of culture reflected tensions never acknowledged before, especially in respect of role; and (4) reverse relationships existed between well-being outcomes and the dimensions of culture and climate. The findings inform practical recommendations, including resilience training and the need to raise the status of police custody, while also highlighting concerns about private sector scrutiny that may be relevant to other professions.

First report of Fusarium fujikuroi causing root rot and seedling elongation of soybean in Indiana.

In summer 2020, 127 soybean (Glycine max (L.) Merr) seedlings (V1-V3 stage) showing reduced vigor or crown lesions were collected at Purdue's Agronomy Center for Research and Education in West Lafayette, Indiana. Root tissues from two seedlings with necrotic cotyledons and root rot were surface-sterilized and plated on dichloran-chloramphenicol-peptone agar (Andrews and Pitt 1986). Emerging hyphal tips were transferred to potato dextrose agar (PDA). Single-spore cultures were obtained and grown on PDA. Both isolates developed floccose white aerial mycelia with reddish-pink coloration in the media in 2 weeks on the benchtop. On carnation leaf agar, macroconidia formed on orange sporodochia within 2 weeks in darkness at 25C. Macroconidia were 3-5 septate, measuring 26 - 41 × 2.5 - 3.7 µm (avg. 34.8 × 3.2 µm, n=40). Microconidia were abundant in chains and false heads forming on both mono- and polyphialides, and measured 2.5 - 8.75 x 2.5 µm (avg. 5.9 × 2.5 µm, n=40). These characteristics were consistent with species descriptions of F. fujikuroi [Sawada] Wollenw. (teleomorph Gibberella fujikuroi) (Leslie and Summerell 2006). DNA was extracted from mycelium and the following genes were amplified and sequenced: the internal transcriber spacer (ITS) region using ITS1/ITS4 primers (White et al. 1990) (GenBank accessions MW463362/MW463363), the mitochondrial small subunit (mtSSU) rDNA using MS1/MS2 primers (White et al. 1990) (MW465310/MW465307), and the partial translation elongation factor 1-alpha (TEF1α) gene using 983F/1567R primers (Rehner and Buckley 205) (MW475297/MW475298). In GenBank BLAST searches, these sequences showed 100% identity to both F. proliferatum and F. fujikuroi. Species-specific forward primers Fuji1F and Proli1F were then used in combination with reverse primer TEF1R to amplify another region in the TEF1α gene (Amatulli et al. 2012). Proli1F/TEF1R primers failed under a variety of annealing temperatures while Fuji1F/TEF1R primers succeeded, and the products were sequenced (MW475299/MW475300). GenBank BLAST searches revealed 100% identity of both isolates to F. fujikuroi (MT448248.1). A pathogenicity test was conducted with isolate AC13 in the greenhouse following the protocol of (Ellis et al. 2013). Ten seeds (cv. Williams) each were used for inoculation and control, respectively, with one seed per cup. Root rot symptoms similar to those observed in the field were observed 14 days after planting on all inoculated plants but not on controls (VC stage). Infected plants showed symptoms of pre-emergence damping off, reddish-brown lesions on the tap and lateral roots, and root necrosis. Three plants also exhibited hyper-elongation of the stem (12.5, 11.1, and 18 cm, vs controls: avg. 6.8 cm, max. 8.5 cm, stdev 0.78 cm). F. fujikuroi was successfully reisolated from inoculated plants but not from controls and identified as described above. F. fujikuroi has been reported causing soybean root rot in China (Zhao et al. 2020), Korea (Choi et al. 2019), and the state of Kansas (Pedrozo et al. 2015). To our knowledge this is the first report of F. fujikuroi infecting soybeans in the state of Indiana. F. fujikuroi is known to cause elongated seedlings in rice (Leslie and Summerell 2006). Pedrozo et al. (2015) reported that F. fujikuroi isolated from soybean caused seedling elongation in rice but not in soybean. The increased distribution and new host symptomology observed here warrants heightened attention for the control of this pathogen.

Correction: Comprehensive survey of United States internet users' sentiments towards cryopreservation.

[This corrects the article DOI: 10.1371/journal.pone.0244980.].

Antiphospholipid syndrome leading to paradoxical embolus and stroke via secundum atrial septal defect.

We have presented a case of a 22-year-old man, presenting with cerebral infarct, subsequently found to have antiphospholipid syndrome (APS), deep venous thrombosis, pulmonary embolism and atrial septal defect (ASD), thereby confirming the presence of infarct due to paradoxical embolism in this patient. The importance of ASD in the patients of APS, resulting in paradoxical embolism is debatable, with recent studies undermining its importance. We have demonstrated that it does indeed happen. This would have implications in the risk assessment and management of ASD in such patients. This case report is intended to serve as a reminder of this association and the need to perform further research in this area.

Comprehensive survey of United States internet users' sentiments towards cryopreservation.

Medical cryopreservation is the speculative practice of using low temperatures and medical-grade cryoprotective agents to halt the decay of a recently-deceased person's brain and body for the prospect of future resuscitation and restoration of function. We conducted a survey of 1,487 internet users in the United States to measure familiarity with, interest in, beliefs about, and attitudes towards cryopreservation. The majority of respondents (75%) had previously heard of the topic. Respondents tended to underestimate the cost of cryopreservation and number of previous cases but overestimate the number of providers. While many respondents expressed interest in signing up (20%) or had actively researched the topic (21%), a much smaller fraction have decided to be cryopreserved (6%). This level of interest is much greater than the number of previous preservation cases would indicate. We found that respondents' attitudes towards death significantly correlated with their general sentiments towards the topic, with those expressing a desire for longer life or to see the future being more interested and positively inclined. Fear of death was not associated with interest in cryopreservation. Negative sentiments towards cryopreservation were less common than respondents perceived. For example, 14% of respondents believed that "most people" think cryopreservation should be illegal, but only 4% of respondents actually did. Many respondents (42%) were pessimistic regarding the likelihood of cryopreservation being successful, but the mean estimate of time until revival of cryopreserved bodies would be possible was 82 years.

A new indole alkaloid and other constituents from Monodora minor and Uvaria tanzaniae: their antitrypanosomal and antiplasmodial evaluation.

Phytochemical investigation of the methanolic extract of Monodora minor Engl. & Diels (Annonaceae) stem bark yielded a new indole (E)-4-(1H-indol-5-yl)-but-3-en-2-one (1), a known indole 5-formyl-1H-indole (2) and an ubiquitous steroid sitosterol (3). The investigations of the methanolic extract of Uvaria tanzaniae Verdc. (Annonaceae) root bark yielded two previously reported C-benzylated dihydrochalcones namely uvaretin (4) and diuvaretin (5). Structures of the isolated compounds were elucidated based on NMR spectroscopy and high resolution electron ionization mass spectrometry (HR-EI-MS) data. All compounds were tested against Trypanosoma brucei brucei and Plasmodium falciparum. At a single concentration (20 µM) in the antitrypanosomal and antiplasmodial assays, compound 4 exhibited remarkable activities against T. brucei brucei and P. falciparum with percentage inhibition of 97.3% and 83.0% respectively, whereas compounds 1, 2, 3 and 5 were inactive. In a dose response antiplasmodial assay compound 4 exhibited moderate activity against P. falciparum with an IC50 value of 7.20 µM.