The impact of COVID-19 on the well-being of Victorian children born with cleft lip and/or palate.

BACKGROUND: A longitudinal cohort study was established to investigate the well-being of children born with cleft lip and/or palate (CL/P) during the COVID-19 pandemic, in Victoria, Australia. MATERIALS AND METHODS: The Royal Children's Hospital cleft service database was used to identify children aged between 4 and 17 years old born with an isolated CL/P. Families of eligible children who consented to participate were asked to complete the Strengths and Difficulties Questionnaire (SDQ) between October and December 2020 and again 6-month later. SDQ results from typically developing Australian children during the COVID-19 pandemic were utilized from a previously published study. RESULTS: 63 parents completed the baseline questionnaire, with 44 completing the 6-month follow-up. For participants at baseline, the mean age was 8.9 years, with 55% male. All outcome domains of the SDQ improved between baseline and timepoint 2, with the difference in total difficulties scores being statistically significant, indicating a reduction in total difficulties at timepoint 2, associated with the easing of COVID-19 restrictions. When compared with the Australian population during the COVID-19 pandemic, Victorian children born with CL/P had lower SDQ scores for all difficulties outcome domains, with statistically significant results for conduct problems, hyperactivity, peer problems and total difficulties, indicating fewer difficulties for children born with CL/P. CONCLUSIONS: Children born with CL/P experienced fewer difficulties when compared with the typically developing Australian population during the COVID-19 pandemic. The level of restrictions imposed because of the pandemic also had little influence on the well-being of these children.

Temporal trends in handgrip strength for older Japanese adults between 1998 and 2017.

OBJECTIVE: to estimate temporal trends in handgrip strength (HGS) for older Japanese adults between 1998 and 2017. DESIGN AND METHODS: adults aged 60-79 years were included. Annual nationally representative HGS data (n = 176,449) for the 19-year study period were obtained from the Japanese Ministry of Education, Culture, Sports, Science and Technology. Temporal trends in mean HGS were estimated by sample-weighted regression models relating the year of testing to mean HGS. National trends in absolute, percent and standardised HGS were estimated by a post-stratified population-weighting procedure. Temporal trends in variability were estimated as the ratio of coefficients of variation (CVs). RESULTS: collectively, there was a small improvement in mean HGS of 1.4 kg (95% confidence interval [CI]: 1.3-1.5), 4.5% (95%CI: 4.3-4.7) or 0.27 standard deviations (95%CI: 0.26-0.28) between 1998 and 2017. The rate of improvement progressively increased over time, with more recent values (post-2008) 1.5-fold larger than earlier values. Gender- and age-related temporal differences were negligible. Variability in HGS declined substantially over time (ratio of CVs [95%CI]: 0.88 [0.86-0.90]), with declines 1.9-fold larger in women compared to men and 1.7-fold larger in 70- to 79-year-olds compared to 60- to 69-year-olds. CONCLUSIONS: there has been a small, progressive improvement in mean HGS for older Japanese adults since 1998, which is suggestive of a corresponding improvement in strength capacity. The substantial decline in variability indicates that the improvement in mean HGS was not uniform across the population.

Coverage-dependent structural phase transformations in the adsorption of pentacene on an aperiodically modulated Cu film.

Surface ordering of pentacene molecules adsorbed on an aperiodic Cu surface has been studied with density functional theory (DFT) and scanning tunnelling microscopy as a function of coverage. Below 0.73 ML (5.3 × 1013 molecules cm-2), the adsorbate structure is row-like with the molecular axes aligned with the rows in the Cu structure. Between this coverage and 1 ML (7.3 × 1013 molecules cm-2), a structural phase with a checkerboard structure is seen. At this coverage region, the molecules are very close to each other which leads to unusual bending. At higher coverages, a further phase transition to a high-density row structure is seen for most of the film. DFT with van der Waals functionals is employed to study how the molecule-molecule and molecule-surface interactions evolve as a function of coverage.

Influence of footwear designed to boost energy return on running economy in comparison to a conventional running shoe.

Running economy is a reflection of the amount of inspired oxygen required to maintain a given velocity and is considered a determining factor for running performance. Athletic footwear has been advocated as a mechanism by which running economy can be enhanced. New commercially available footwear has been developed in order to increase energy return, although their efficacy has not been investigated. This study aimed to examine the effects of energy return footwear on running economy in relation to conventional running shoes. Twelve male runners completed 6-min steady-state runs in conventional and energy return footwear. Overall, oxygen consumption (VO2), heart rate, respiratory exchange ratio, shoe comfort and rating of perceived exertion were assessed. Moreover, participants subjectively indicated which shoe condition they preferred for running. Differences in shoe comfort and physiological parameters were examined using Wilcoxon signed-rank tests, whilst shoe preferences were tested using a chi-square analysis. The results showed that VO2 and respiratory exchange ratio were significantly lower, and shoe comfort was significantly greater, in the energy return footwear. Given the relationship between running economy and running performance, these observations indicate that the energy return footwear may be associated with enhanced running performance in comparison to conventional shoes.

Increased thrombin generation potential in symptomatic versus asymptomatic moderate or severe carotid stenosis and relationship with cerebral microemboli.

INTRODUCTION: The importance of thrombin generation in the pathogenesis of TIA or stroke and its relationship with cerebral microembolic signals (MES) in asymptomatic and symptomatic carotid stenosis has not been comprehensively assessed. METHODS: Plasma thrombin generation parameters from patients with moderate or severe (≥ 50%) asymptomatic carotid stenosis were compared with those from patients with symptomatic carotid stenosis in the early (≤ 4 weeks) and late phases (≥ 3 months) after TIA or stroke in this prospective, pilot observational study. Thrombin generation profile was longitudinally assessed in symptomatic patients with data at each time point. Bilateral transcranial Doppler ultrasound monitoring of the middle cerebral arteries was performed whenever possible to classify patients as MES-positive or MES-negative. RESULTS: Data from 31 asymptomatic, 46 'early symptomatic' and 35 'late symptomatic' patients were analysed. Peak thrombin (344.2 nM vs 305.3 nM; p = 0.01) and endogenous thrombin potential (1772.4 vs 1589.7; p = 0.047) were higher in early symptomatic than asymptomatic patients. Peak thrombin production decreased in symptomatic patients followed up from the early to late phase after TIA or stroke (339.7 nM vs 308.6 nM; p = 0.02). Transcranial Doppler ultrasound data were available in 25 asymptomatic, 31 early symptomatic and 27 late symptomatic patients. Early symptomatic MES-positive patients had a shorter 'time-to-peak thrombin' than asymptomatic MES-positive patients (p=0.04), suggesting a more procoagulant state in this early symptomatic subgroup. DISCUSSION: Thrombin generation potential is greater in patients with recently symptomatic than asymptomatic carotid stenosis, and decreases over time following TIA or stroke associated with carotid stenosis. These data improve our understanding of the haemostatic/thrombotic biomarker profile in moderate-severe carotid stenosis.

Influence of leaching on surface composition, microstructure, and valence band of single grain icosahedral Al-Cu-Fe quasicrystal.

The use of quasicrystals as precursors to catalysts for the steam reforming of methanol is potentially one of the most important applications of these new materials. To develop application as a technology requires a detailed understanding of the microscopic behavior of the catalyst. Here, we report the effect of leaching treatments on the surface microstructure, chemical composition, and valence band of the icosahedral (i-) Al-Cu-Fe quasicrystal in an attempt to prepare a model catalyst. The high symmetry fivefold surface of a single grain i-Al-Cu-Fe quasicrystal was leached with NaOH solution for varying times, and the resulting surface was characterized by x-ray photoelectron spectroscopy (XPS), ultraviolet photoelectron spectroscopy (UPS), scanning electron microscopy (SEM), and atomic force microscopy (AFM). The leaching treatments preferentially remove Al producing a capping layer consisting of Fe and Cu oxides. The subsurface layer contains elemental Fe and Cu in addition to the oxides. The quasicrystalline bulk structure beneath remains unchanged. The subsurface gradually becomes Fe3O4 rich with increasing leaching time. The surface after leaching exhibits micron sized dodecahedral cavities due to preferential leaching along the fivefold axis. Nanoparticles of the transition metals and their oxides are precipitated on the surface after leaching. The size of the nanoparticles is estimated by high resolution transmission microscopy to be 5-20 nm, which is in agreement with the AFM results. Selected area electron diffraction (SAED) confirms the crystalline nature of the nanoparticles. SAED further reveals the formation of an interface between the high atomic density lattice planes of nanoparticles and the quasicrystal. These results provide an important insight into the preparation of model catalysts of nanoparticles for steam reforming of methanol.

Templated quasicrystalline molecular ordering.

Quasicrystals are materials with long-range ordering but no periodicity. We report scanning tunneling microscopy (STM) observations of quasicrystalline molecular layers on 5-fold quasicrystal surfaces. The molecules adopt positions and orientations on the surface consistent with the quasicrystalline ordering of the substrate. Carbon-60 adsorbs atop sufficiently separated Fe atoms on icosahedral Al-Cu-Fe to form a unique quasicrystalline lattice, whereas further C60 molecules decorate remaining surface Fe atoms in a quasi-degenerate fashion. Pentacene (Pn) adsorbs at 10-fold symmetric points around surface-bisected rhombic triacontahedral clusters in icosahedral Ag-In-Yb. These systems constitute the first demonstrations of quasicrystalline molecular ordering on a template.

Quantitative adsorbate structure determination for quasicrystals using x-ray standing waves.

The quantitative structure determination of adsorbed species on quasicrystal surfaces has so far appeared to present insurmountable problems. The normal incidence standing x-ray wave field technique offers a simple solution, without extensive data sets or large computations. Its application to quasicrystals raises several conceptual difficulties that are related to the phase problem in x-ray diffraction. We demonstrate their solution for the case of Si atoms adsorbed on the decagonal Co-rich modification of the Al-Co-Ni quasicrystal to determine the local structure, comprising 6-atom clusters in particular hollow sites.

Increased endothelial activation in recently symptomatic versus asymptomatic carotid artery stenosis and in cerebral microembolic-signal-negative patient subgroups.

BACKGROUND AND PURPOSE: von Willebrand factor propeptide (VWF:Ag II) is potentially a more sensitive marker of acute endothelial activation than von Willebrand factor antigen (VWF:Ag). These biomarkers have not been simultaneously assessed in asymptomatic versus symptomatic carotid stenosis patients. The relationship between endothelial activation and cerebral microembolic signals (MESs) detected on transcranial Doppler ultrasound is unknown. METHODS: In this multicentre observational analytical study, plasma VWF:Ag and VWF:Ag II levels in patients with ≥50% asymptomatic carotid stenosis were compared with those from patients with ≥50% symptomatic carotid stenosis in the 'early' (≤4 weeks) and 'late' (≥3 months) phases after transient ischaemic attack or ischaemic stroke. Endothelial activation was also longitudinally assessed in symptomatic patients during follow-up. Transcranial Doppler ultrasound monitoring classified patients as MES-positive or MES-negative. RESULTS: Data from 31 asymptomatic patients were compared with those from 46 early symptomatic and 35 late phase symptomatic carotid stenosis patients, 23 of whom had undergone carotid intervention. VWF:Ag II levels were higher in early (12.8 µg/ml; P < 0.001), late (10.6 µg/ml; P = 0.01) and late post-intervention (10.6 µg/ml; P = 0.038) symptomatic patients than asymptomatic patients (8.9 µg/ml). VWF:Ag levels decreased in symptomatic patients followed up from the early to late phase after symptom onset (P = 0.048). Early symptomatic MES-negative patients had higher VWF: Ag II levels (13.3 vs. 9.0 µg/ml; P < 0.001) than asymptomatic MES-negative patients. CONCLUSIONS: Endothelial activation is enhanced in symptomatic versus asymptomatic carotid stenosis patients, in early symptomatic versus asymptomatic MES-negative patients, and decreases over time in symptomatic patients. VWF:Ag II levels are a more sensitive marker of endothelial activation than VWF:Ag levels in carotid stenosis. The potential value of endothelial biomarkers and concurrent cerebral MES detection at predicting stroke risk in carotid stenosis warrants further study.

Crystalline and quasicrystalline allotropes of Pb formed on the fivefold surface of icosahedral Ag-In-Yb.

Crystalline and quasicrystalline allotropes of Pb are formed by evaporation on the fivefold surface of the icosahedral (i) Ag-In-Yb quasicrystal under ultra-high vacuum. Lead grows in three dimensional quasicrystalline order and subsequently forms fivefold-twinned islands with the fcc(111) surface orientation atop of the quasicrystalline Pb. The islands exhibit specific heights (magic heights), possibly due to the confinement of electrons in the islands. We also study the adsorption behavior of C60 on the two allotropes of Pb. Scanning tunneling microcopy reveals that a high corrugation of the quasicrystalline Pb limits the diffusion of the C60 molecules and thus produces a disordered film, similar to adsorption behavior of the same molecules on the clean substrate surface. However, the sticking coefficient of C60 molecules atop the Pb islands approaches zero, regardless of the overall C60 coverage.

Mental health, psychological distress and burnout in Australian dental practitioners.

BACKGROUND: Dental practitioners are known to experience a high level of stress, but little is known about the mental health of Australian dental practitioners. The aim of this study was to investigate the prevalence of mental health conditions among Australian dental practitioners. METHODS: A cross sectional survey of 1483 Australian dental practitioners was carried out from October to December 2021. Participants reported aspects of mental health including depression, anxiety disorder, burnout (Sydney Burnout Measure) and psychological distress (Kessler Psychological Distress Scale and General Health Questionnaire 12). RESULTS: Self-reported psychological distress was high, with 32.0% rated as having moderate or severe psychological distress and 59.4% a high likelihood of minor (or more severe) psychological distress. One in four participants (24.8%) were classified as likely to be experiencing burnout, with 25.9% reporting ever having a diagnosis of depression, 11.4% a current diagnosis of depression, 23.1% ever having a diagnosis of anxiety disorder and 12.9% a current diagnosis of anxiety disorder. CONCLUSION: Australian dental practitioners reported a high burden of psychological distress, burnout and mental health issues, suggesting a need for education and programmes to support their mental health and wellbeing. © 2023 Australian Dental Association.

Australian dental practitioners experience of burnout.

BACKGROUND: The aim of this study was to investigate factors associated with burnout in Australian dental practitioners. METHODS: A cross-sectional survey of 1483 Australian dental practitioners was conducted from Oct to Dec 2021. Participants reported burnout using the Sydney Burnout Measure, and aspects of mental health including psychological distress, depression, and anxiety disorders. Predictors of burnout were explored using a generalized linear model with a stepped approach including demographic, health and risk factor variables. RESULTS: One in four participants were classified as likely to be experiencing burnout. Burnout was associated with working in a regional/rural location (ß = 2.82, p < 0.001), an academic/non-clinical role (ß = 5.01, p = 0.037), more years of experience as a dental practitioner (ß = 0.08, p = 0.022), a current diagnosis of depression (ß = 2.38, p = 0.049), moderate/severe psychological distress (ß = 7.16, p < 0.001), poor self-rated physical health (ß = 5.84, p < 0.001) and increasing alcohol consumption (ß = 0.17, p = 0.020). Participants who scored high on resilience (ß = -0.23, p = 0.002) or perfectionism (ß = -0.24, p < 0.001) had lower burnout scores. CONCLUSION: Australian dental practitioners appear to be at high risk of burnout which may impact on their health and wellbeing and ability to deliver patient care. There is a need for support services to manage burnout and education to address workplace and environmental factors that may contribute to burnout.

Lymphoma, thymoma and the wooden man: stiff-person syndrome post-thymoma excision and non-Hodgkin lymphoma remission.

Stiff-person syndrome (SPS) is an uncommon yet under-diagnosed, neuromuscular disorder characterised by progressive muscle rigidity with superimposed painful muscle spasms triggered by tactile, auditory or emotional stimulation. We describe the world's first case report of typical SPS in a patient with previously excised thymoma and treated non-Hodgkin lymphoma. This is of relevance because of the increasingly elucidated autoimmune aetiology of SPS.

Recommendations for Reducing Heterogeneity in Handgrip Strength Protocols.

Handgrip dynamometers are widely used to measure handgrip strength (HGS). HGS is a safe and easy to obtain measure of strength capacity, and a reliable assessment of muscle function. Although HGS provides robust prognostic value and utility, several protocol variants exist for HGS in clinical settings and translational research. This lack of methodological consistency could threaten the precision of HGS measurements and limit comparisons between the growing number of studies measuring HGS. Providing awareness of the protocol variants for HGS and making suggestions to reduce the implications of these variants will help to improve methodological consistency. Moreover, leveraging recent advancements in HGS equipment may enable us to use more sophisticated HGS dynamometer technologies to better assess muscle function. This Special Article will 1) highlight differences in HGS protocols and instrumentation, 2) provide recommendations to better specify HGS procedures and equipment, and 3) present future research directions for studies that measure HGS. We also provided a minimum reporting criteria framework to help future research studies avoid underreporting of HGS procedures.

Older American Women May Especially Benefit from Distributing and Consuming Protein for Decreasing Odds of Functional Limitations.

OBJECTIVES: Protein is a key macronutrient for preserving physical function, but the role of protein intake on functional status may differ in men and women. We sought to examine the associations of daily protein intake and distribution on functional limitations in older American men and women. DESIGN: Cross-sectional. SETTING: Population-based survey. PARTICIPANTS: The analytic sample included 3,976 men and 4,081 women aged ≥60-years from the 2007-2016 waves of the National Health and Nutrition Examination Survey. MEASUREMENTS: Participants reported their ability to perform basic activities of daily living, instrumental activities of daily living, leisure and social activities, lower extremity mobility activities, and general physical tasks. Those reporting difficulty or an inability in completing such functional tasks were considered as having a functional limitation. Protein intake was determined with dietary recalls and participants revealed functional limitations. Protein recommendations of ≥0.80, ≥1.00, and ≥1.50 g/kg/day were used. Based on these cut-points, we also investigated distribution of protein across 4 eating occasions at ≥0.20, ≥0.25, and ≥0.38 g/kg/meal, respectively. RESULTS: Older women meeting each recommendation had decreased odds for functional limitations: 0.55 (95% confidence interval (CI): 0.40-0.75) for ≥0.80 g/kg/day, 0.75 (CI: 0.58-0.97) for ≥1.00 g/kg/day, and 0.72 (CI: 0.55-0.94) for ≥1.5 g/kg/day. No significant associations were observed in older men. Further, older women with protein consumption ≥0.20 g/kg/meal had decreased odds for functional limitations: 0.24 (CI: 0.10-0.61) for 1 occasion, 0.20 (CI: 0.08-0.49) for 2 occasions, 0.16 (CI: 0.07-0.40) for 3 occasions, and 0.12 (CI: 0.04-0.32) for 4 occasions. A similar trend was observed for intake ≥0.25 g/kg/meal: 0.31 (CI: 0.16-0.62) for 2 occasions, 0.30 (CI: 0.14-0.61) for 3 occasions, and 0.31 (CI: 0.12-0.78) for 4 occasions. Women with 1 and 2 eating occasions at ≥0.38 g/kg/meal of protein had 0.66 (CI: 0.48-0.91) and 0.54 (CI: 0.37-0.79) decreased odds for functional limitations, respectively. CONCLUSION: Trials that are powered to detect the effects of protein on functional status in women will help to establish causality.

The surface science of quasicrystals.

The surfaces of quasicrystals have been extensively studied since about 1990. In this paper we review work on the structure and morphology of clean surfaces, and their electronic and phonon structure. We also describe progress in adsorption and epitaxy studies. The paper is illustrated throughout with examples from the literature. We offer some reflections on the wider impact of this body of work and anticipate areas for future development.

Weakness Is Associated with Time to Incident Chronic Heart Failure in Aging Americans.

OBJECTIVE: Handgrip strength is considered a biomarker of nutritional status and strength capacity, which are both linked to heart complications. However, it is not well understood how weakness, as measured by handgrip strength, factors into common heart conditions seen in aging adults such as chronic heart failure (CHF). The purpose of this study was to determine the association between weakness and incident CHF for aging Americans. DESIGN: Longitudinal-Panel. SETTING: Physical measures were completed during enhanced face-to-face interviews. The core interview was typically conducted over the telephone. PARTICIPANTS: Data from 17,431 adults aged at least 50 years who identified as Black or White, completed interviews without a proxy, and participated in at least one wave of the 2006-2014 waves of the Health and Retirement Study were included. MEASUREMENTS: Handgrip strength was measured with a hand-held dynamometer. Healthcare provider diagnosed CHF was self-reported at each wave. Sex- and race-specific maximal handgrip strength cut-points were used for determining weakness (Black men: <40-kilograms, Black women: <31-kilograms, White men: <35-kilograms, White women: <22-kilograms). A covariate-adjusted Cox model analyzed the association between weakness and incident CHF. RESULTS: Of those included, 5,397 (31.0%) were weak and 327 (1.9%) developed CHF during the mean follow-up of 4.7±2.7 years. Those who were weak had a 35% higher risk (hazard ratio: 1.35; 95% confidence interval: 1.05, 1.74) of developing CHF, compared to those who were not-weak. CONCLUSION: Measures of handgrip strength should be utilized by healthcare providers for assessing age-related weakness, nutritional status, and CHF risk. Likewise, interventions aiming to prevent or treat CHF in aging adults should incorporate measures of handgrip strength for helping to determine efficacy of intervention programs.

Light signal transduction in plants.

Light signal-transduction pathways are a central component of the mechanisms that regulate plant development. These pathways provide the means by which information from specific wavelengths of light may be amplified and coordinated, resulting in complex physiological and developmental responses. This review focuses upon recent approaches towards establishing the intermediates that transmit signals from photoreceptors, phytochromes in particular, to target elements in the promoters of light-regulated genes.

The Burden of Functional Disabilities for Middle-Aged and Older Adults in the United States.

OBJECTIVES: Understanding the role of functional capacity on longevity is important as the population in the United States ages. The purpose of this study was to determine the burden of instrumental activities of daily living (IADL) and activities of daily living (ADL) disabilities for a nationally-representative sample of middle-aged and older adults in the United States. DESIGN: Longitudinal-Panel. SETTING: Core interviews were often performed in person or over the telephone. PARTICIPANTS: A sub-sample of 31,055 participants aged at least 50 years from the 1998-2014 waves of the Health and Retirement Study who reported having a functional disability were included. MEASUREMENTS: Ability to perform IADLs and ADLs were self-reported at each wave. The National Death Index was used to ascertain date of death. The number of years of life that were lost (YLLs) and years lived with a disability (YLDs) were summed for the calculation of disability-adjusted life years (DALYs). Sampling weights were used in the analyses to make the DALYs nationally-representative. The results for YLLs, YLDs, and DALYs are reported in thousands. RESULTS: Of the participants included, 14,990 had an IADL disability and 13,136 had an ADL disability. Men and women with an IADL disability had 236,037 and 233,772 DALYs, respectively; whereas, there were 178,594 DALYs for males and 253,630 DALYs for females with an ADL disability. Collectively, there were 469,809 years of healthy life lost from IADL impairments, and 432,224 years of healthy life lost from ADL limitations. CONCLUSIONS: These findings should be used to inform healthcare providers and guide interventions aiming to preserve the functional capacity of aging adults. Prioritizing health-related resources for mitigating the burden of functional disabilities may help aging adults increase their quality of life and life expectancy over time.