Abstract Objectives The primary aim of this study was to investigate partially dentate elders’ willingness-to-pay (WTP) for two different tooth replacement strategies: Removable Partial Dentures ...(RPDs) and, functionally orientated treatment according to the principles of the Shortened Dental Arch (SDA). The secondary aim was to measure the same patient groups’ WTP for dental implant treatment. Methods 55 patients who had completed a previous RCT comparing two tooth replacement strategies (RPDs (n = 27) and SDA (n = 28)) were recruited (Trial Registration no. ISRCTN26302774). Patients were asked to indicate their WTP for treatment to replace missing teeth in a number of hypothetical scenarios using the payment card method of contingency evaluation coupled to different costs. Data were collected on patients’ social class, income levels and other social circumstances. A Mann-Whitney U Test was used to compare differences in WTP between the two treatment groups. To investigate predictive factors for WTP, multiple linear regression analyses were conducted. Results The median age for the patient sample was 72.0 years (IQR: 71–75 years). Patients who had been provided with RPDs indicated that their WTP for this treatment strategy was significantly higher (€550; IQR: 500–650) than those patients who had received SDA treatment (€500; IQR: 450–550) (p = 0.003). However patients provided with RPDs indicated that their WTP for SDA treatment (€650; IQR: 600–650) was also significantly higher than those patients who had actually received functionally orientated treatment (€550; IQR: 500–600) (p < 0.001). The results indicated that both current income levels and previous treatment allocation were significantly correlated to WTP for both the RPD and the SDA groups. Patients in both treatment groups exhibited little WTP for dental implant treatment with a median value recorded which was half the market value for this treatment (€1000; IQR: 500–1000). Conclusions Amongst this patient cohort previous treatment experience had a strong influence on WTP as did current income levels. Both treatment groups indicated a very strong WTP for simpler, functionally orientated care using adhesive fixed prostheses (SDA) over conventional RPDs. Clinical significance Partially dentate older patients expressed a strong preference for functionally orientated tooth replacement as an alternative to conventional RPDs.
G-protein-coupled receptor (GPCR) agonists are well-known inducers of cardiac hypertrophy. We found that the shedding of heparin-binding epidermal growth factor (HB-EGF) resulting from ...metalloproteinase activation and subsequent transactivation of the epidermal growth factor receptor occurred when cardiomyocytes were stimulated by GPCR agonists, leading to cardiac hypertrophy. A new inhibitor of HB-EGF shedding, KB-R7785, blocked this signaling. We cloned a disintegrin and metalloprotease 12 (ADAM12) as a specific enzyme to shed HB-EGF in the heart and found that dominant-negative expression of ADAM12 abrogated this signaling. KB-R7785 bound directly to ADAM12, suggesting that inhibition of ADAM12 blocked the shedding of HB-EGF. In mice with cardiac hypertrophy, KB-R7785 inhibited the shedding of HB-EGF and attenuated hypertrophic changes. These data suggest that shedding of HB-EGF by ADAM12 plays an important role in cardiac hypertrophy, and that inhibition of HB-EGF shedding could be a potent therapeutic strategy for cardiac hypertrophy.
To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear.
To assess the trajectory of mental health symptoms during the ...first year of the pandemic and examine dose-response relations with characteristics of the pandemic and its containment.
Relevant articles were identified from the living evidence database of the COVID-19 Open Access Project, which indexes COVID-19-related publications from MEDLINE via PubMed, Embase via Ovid, and PsycInfo. Preprint publications were not considered.
Longitudinal studies that reported data on the general population's mental health using validated scales and that were published before 31 March 2021 were eligible.
An international crowd of 109 trained reviewers screened references and extracted study characteristics, participant characteristics, and symptom scores at each timepoint. Data were also included for the following country-specific variables: days since the first case of SARS-CoV-2 infection, the stringency of governmental containment measures, and the cumulative numbers of cases and deaths.
In a total of 43 studies (331 628 participants), changes in symptoms of psychological distress, sleep disturbances, and mental well-being varied substantially across studies. On average, depression and anxiety symptoms worsened in the first 2 months of the pandemic (standardized mean difference at 60 days, -0.39 95% credible interval, -0.76 to -0.03); thereafter, the trajectories were heterogeneous. There was a linear association of worsening depression and anxiety with increasing numbers of reported cases of SARS-CoV-2 infection and increasing stringency in governmental measures. Gender, age, country, deprivation, inequalities, risk of bias, and study design did not modify these associations.
The certainty of the evidence was low because of the high risk of bias in included studies and the large amount of heterogeneity. Stringency measures and surges in cases were strongly correlated and changed over time. The observed associations should not be interpreted as causal relationships.
Although an initial increase in average symptoms of depression and anxiety and an association between higher numbers of reported cases and more stringent measures were found, changes in mental health symptoms varied substantially across studies after the first 2 months of the pandemic. This suggests that different populations responded differently to the psychological stress generated by the pandemic and its containment measures.
Swiss National Science Foundation. (PROSPERO: CRD42020180049).
Lamellae-forming polystyrene-block-poly(methyl methacrylate) (PS-b-PMMA) films, with bulk period L 0, were directed to assemble on lithographically nanopatterned surfaces. The chemical pattern was ...comprised of “guiding” stripes of cross-linked polystyrene (X-PS) or poly(methyl methacrylate) (X-PMMA) mats, with width W, and interspatial “background” regions of a random copolymer brush of styrene and methyl methacrylate (P(S-r-MMA)). The fraction of styrene (f) in the brush was varied to control the chemistry of the background regions. The period of the pattern was L s. After assembly, the density of the features (domains) in the block copolymer film was an integer multiple (n) of the density of features of the chemical pattern, where n = L s/L 0. The quality of the assembled PS-b-PMMA films into patterns of dense lines as a function of n, W/L 0, and f was analyzed with top-down scanning electron microscopy. The most effective background chemistry for directed assembly with density multiplication corresponded to a brush chemistry (f) that minimized the interfacial energy between the background regions and the composition of the film overlying the background regions. The three-dimensional structure of the domains within the film was investigated using cross-sectional SEM and Monte Carlo simulations of a coarse-grained model and was found most closely to resemble perpendicularly oriented lamellae when W/L 0 ∼ 0.5–0.6. Directed self-assembly with density multiplication (n = 4) and W/L 0 = 1 or 1.5 yields pattern of high quality, parallel linear structures on the top surface of the assembled films, but complex, three-dimensional structures within the film.
Background: The prognostic effect of concomitant hypertrophic cardiomyopathy (HCM) on adverse events in patients with atrial fibrillation (AF) has not been evaluated in a multicenter prospective ...cohort study in Japan.Methods and Results: Using the Hokuriku-Plus AF Registry, 1,396 patients with nonvalvular AF (1,018 men, 72.3±9.7 years old) were assessed prospectively; 72 (5.2%) had concomitant HCM. During a median follow-up of 5.0 years (interquartile range 3.5–5.3 years), 79 cases of thromboembolism (1.3 per 100 person-years) and 192 of heart failure (HF) (3.2 per 100 person-years) occurred. Kaplan-Meier analysis revealed that the HCM group had a significantly greater incidence of thromboembolism (P=0.002 by log-rank test) and HF (P<0.0001 by a log-rank test) than the non-HCM group. The Cox proportional hazards model demonstrated that persistent AF (adjusted hazard ratio 2.98, 95% confidence interval 1.56–6.21), the CHA2DS2-VASc score (1.35, 1.18–1.54), and concomitant HCM (2.48, 1.16–4.79) were significantly associated with thromboembolism. Conversely, concomitant HCM (2.81, 1.72–4.43), older age (1.07, 1.05–1.10), lower body mass index (0.95, 0.91–0.99), a history of HF (2.49, 1.77–3.52), and lower left ventricular ejection fraction (0.98, 0.97–0.99) were significantly associated with the development of HF.Conclusions: Concomitant HCM predicts the incidence of thromboembolism and HF in AF patients.
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