bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual selection predicts the persistence of populations within altered environments
Authors: Parrett Jonathan M. , Mann Darren J. , Chung Arthur Y. C. , Slade Eleanor M. , Knell Robert J.
Published: July 2019

The effect of sexual selection on species persistence remains unclear. The cost of bearing ornaments or armaments might increase extinction risk, but sexual selection can also enhance the spread of beneficial alleles and increase the removal of deleterious alleles, potentially reducing extinction risk. Here we investigate the effect of sexual selection on species persistence in a community of 34 species of dung beetles across a gradient of environmental disturbance ranging from old growth forest to oil palm plantation. Horns are sexually selected traits used in contests between males, and we find that both horn presence and relative size are strongly positively associated with species persistence and abundance in altered habitats. Testes mass, an indicator of post‐copulatory selection, is, however, negatively linked with the abundance of species within the most disturbed habitats. This study represents the first evidence from a field system of a population‐level benefit from pre‐copulatory sexual selection.
Safety and efficacy of midazolam nasal spray in the outpatient treatment of patients with seizure clusters: An open‐label extension trial
Authors: Wheless James W. , Meng Tze‐Chiang , Van Ess Peter J. , Detyniecki Kamil , Sequeira David J. , Pullman William E.
Published: July 2019

Objective

To evaluate safety‐ and seizure‐related outcomes with repeated intermittent use of a novel formulation of midazolam administered as a single‐dose nasal spray (MDZ‐NS) in the outpatient treatment of patients experiencing seizure clusters (SCs).

Methods

In this open‐label extension trial (ClinicalTrials.gov NCT01529034), patients aged ≥12 years and on a stable regimen of antiepileptic drugs who completed the original phase III, randomized controlled trial were enrolled. Caregivers administered MDZ‐NS 5 mg when patients experienced SCs; a second dose could be given if seizures did not terminate within 10 minutes or recurred within 10 minutes‐6 hours. Patients were monitored for treatment‐emergent adverse events (TEAEs) throughout, and the main seizure‐related outcome was treatment success, defined as seizure termination within 10 minutes and no recurrence 10 minutes‐6 hours after drug administration.

Results

Of 175 patients enrolled, 161 (92.0%) received ≥1 MDZ‐NS dose, for a total of 1998 SC episodes. Median time spent by patients in the trial was 16.8 months (range = 1‐55.7 months). TEAEs were experienced by 40.4% of patients within 2 days of drug administration and 57.1% overall. TEAEs reported by most patients (within 2 days and overall) were nasal discomfort (12.4%) and somnolence (9.3%). One patient each discontinued due to treatment‐related nasal discomfort and somnolence. There were no patients with treatment‐related respiratory depression, and none with TEAEs indicative of drug abuse or dependence. Treatment success criteria were met in 55% (1108/1998) of SC episodes after administration of a single 5‐mg dose and in 80.2% (617/769) with the second dose. Treatment success was consistent over treated episode number.

Significance

Repeated, intermittent, acute treatment of patients experiencing SCs with MDZ‐NS in the outpatient setting was well tolerated over an extended period, with maintenance of efficacy suggesting lack of development of tolerance.
Acquired cardiac channelopathies in epilepsy: Evidence, mechanisms, and clinical significance
Authors: Li Michael C. H. , O'Brien Terence J. , Todaro Marian , Powell Kim L.
Published: July 2019

There is growing evidence that cardiac dysfunction in patients with chronic epilepsy could play a pathogenic role in sudden unexpected death in epilepsy (SUDEP). Recent animal studies have revealed that epilepsy secondarily alters the expression of cardiac ion channels alongside abnormal cardiac electrophysiology and remodeling. These molecular findings represent novel evidence for an acquired cardiac channelopathy in epilepsy, distinct from inherited ion channels mutations associated with cardiocerebral phenotypes. Specifically, seizure activity has been shown to alter the messenger RNA (mRNA) and protein expression of voltage‐gated sodium channels (Nav1.1, Nav1.5), voltage‐gated potassium channels (Kv4.2, Kv4.3), sodium‐calcium exchangers (NCX1), and nonspecific cation‐conducting channels (HCN2, HCN4). The pathophysiology may involve autonomic dysfunction and structural cardiac disease, as both are independently associated with epilepsy and ion channel dysregulation. Indeed, in vivo and in vitro studies of cardiac pathology reveal a complex network of signaling pathways and transcription factors regulating ion channel expression in the setting of sympathetic overactivity, cardiac failure, and hypertrophy. Other mechanisms such as circulating inflammatory mediators or exogenous effects of antiepileptic medications lack evidence. Moreover, an acquired cardiac channelopathy may underlie the electrophysiologic cardiac abnormalities seen in chronic epilepsy, potentially contributing to the increased risk of malignant arrhythmias and sudden death. Therefore, further investigation is necessary to establish whether cardiac ion channel dysregulation similarly occurs in patients with epilepsy, and to characterize any pathogenic relationship with SUDEP.
Exploring the complex associations over time among albendazole treatment, cyst evolution, and seizure outcomes in neurocysticercosis
Authors: Carpio Arturo , Chang Mindy , Zhang Hongbin , Romo Matthew L. , Jaramillo Alex , Hauser W. Allen , Kelvin Elizabeth A.
Published: July 2019

Objective

To develop a causal model for the occurrence of neurocysticercosis (NC)‐related seizures and test hypotheses generated from the model.

Methods

We used data from a randomized controlled trial comparing albendazole with placebo among patients newly diagnosed with NC. Based on our causal model, we explored the associations among albendazole treatment, NC cyst evolution, and seizure outcomes over 24 months of follow‐up using generalized linear mixed effect models.

Results

We included 153 participants, of whom 51% received albendazole. The association between seizure outcomes and treatment over time demonstrated lack of linearity and heterogeneity, requiring the inclusion of time‐treatment interaction terms for valid modeling. Participants in the albendazole group had fewer seizures overall and of partial onset at all time points compared with the placebo group, but the difference increased over the first few months following treatment, then decreased over time. Generalized seizures exhibited a more complex association; those in the albendazole group had fewer seizures compared with those in the placebo group for the first few months after treatment, and then the association reversed and those in the placebo arm had fewer seizures. Adjusting for the number of NC cysts in each phase resulted in an attenuation of the strength of association between albendazole and seizure outcomes, consistent with mediation. Among participants in whom all cysts had disappeared (n = 21), none continued to have seizures.

Significance

Albendazole treatment is associated with a possible reduction in focal seizures in the short term (3‐6 months), perhaps by hastening the resolution of the cysts. However, the effect is not discernible over the long term, because most cysts either calcify or resolve completely, regardless of whether treated with albendazole. The stage of evolution of the cysticercus is an important consideration in the evaluation of albendazole effect on seizure outcome.
Radiographic and arthroscopic features of third carpal bone slab fractures and their impact on racing performance following arthroscopic repair in a population of racing Thoroughbreds in the UK
Authors: Baldwin C. M. , Smith M. R. W. , Allen S. , Wright I. M.
Published: July 2019

Background

Slab fractures of the third carpal bone (C3) are a common injury of Thoroughbred racehorses. Results of arthroscopically guided repair have not been reported since the initial description of the technique in 1986. Additionally, fracture details and racing outcomes in a population of Thoroughbreds racing under UK jurisdiction have not previously been described.

Objectives

To report the frequency distribution of C3 slab fractures and to determine the impact on racing performance following arthroscopically guided repair in a population of Thoroughbred racehorses.

Study design

Retrospective case series.

Methods

Case records of Thoroughbred racehorses undergoing arthroscopically guided repair of C3 slab fractures at Newmarket Equine Hospital between 2006 and 2015 were retrieved. Radiographs and arthroscopic studies were reviewed. The effect of demography and fracture morphology on racing outcome was evaluated.

Results

C3 slab fractures occurred most commonly through the radial facet in a frontal plane (45/71 63.4%). Comminution was identified during arthroscopy in 42/71 (59.2%) fractures and occurred most frequently at the palmar margin of the fracture. Forty‐one out of 65 horses (63.1%) raced at least once post‐operatively. Females were less likely to return to racing compared to males (P<0.001). Horses that had raced before injury were more likely (OR 4.4, 95% CI 1.4–13.5, P = 0.01) to race after injury compared to horses that were unraced at the time of injury. After injury horses had a small but significant reduction in racing performance.

Main limitations

The series is a preselected population of Thoroughbred racehorses which referring veterinary surgeons considered potential candidates for surgical repair.

Conclusion

Fracture configurations can be identified radiographically but is not a reliable predictor of comminution or other intra‐articular lesions. Arthroscopy not only directs repair but also identifies and facilitates management of concurrent lesions. The results reported should assist in formulating appropriate prognoses for Thoroughbred horses racing in the UK.
Stability analysis in identification of interval type‐2 adaptive neuro‐fuzzy inference system: Contribution to a novel Lyapunov function
Authors: Zabihi Shesh Poli Mohammad Mahdi , Aliyari Shoorehdeli Mahdi , Moarefianpour Ali
Published: July 2019

In recent years, control research has strongly highlighted the issue of training stability in the identification of non‐linear systems. This paper investigates the stability analysis of an interval type‐2 adaptive neuro‐fuzzy inference system (IT2ANFIS) as an identifier through a novel Lyapunov function. In so doing, stability analysis is initially conducted on the IT2ANFIS identifier, while performing the online training of both the antecedent and the consequent parameters by the gradient descent (GD) algorithm. In addition, the same stability analysis is carried out when the antecedent and the consequent parameters are trained by GD and forgetting factor recursive least square (FRLS) algorithms, respectively (GD + FRLS). A novel Lyapunov function is proposed in this study in order for the identifier stability to attain the required conditions. These conditions determine the permissible boundaries for the covariance matrix and the learning rates at every iteration of the identification procedure. Stability analysis reveals that wide range of learning rates is obtained. Furthermore, simulation results indicate that when the permissible boundaries are selected according to the proposed stability analysis, a stable identification process with appropriate performance is achieved.
A clustering‐based feature selection framework for handwritten Indic script classification
Authors: Chatterjee Iman , Ghosh Manosij , Singh Pawan Kumar , Sarkar Ram , Nasipuri Mita
Published: July 2019

In India, which has numerous officially recognized scripts, there is a primary need for categorizing the documents on the basis of the scripts used therein. Identification of script used in a document is essential for its effective handling both manually and digitally. Identification of script in a document image is an important research problem in the pattern recognition field, which, at times, suffers from the issue of growing dimensionality of the feature vector and requires an efficient feature selection technique. Keeping this fact in mind, in this paper, we propose a clustering‐based filter feature selection framework in order to extract an optimal and effective feature subset from the original feature vector. The present feature selection methodology is evaluated on a script classification problem involving handwritten documents in 12 major Indic scripts. Experiments are done at word‐level, text‐line‐level, and block‐level. Experiments demonstrate that a reasonable increment in classification accuracy has been realized using comparatively lesser number of features. The proposed framework for feature selection is computationally inexpensive and can be applied to other pattern recognition problems as well.
Developmental temperature affects phenotypic means and variability: A meta‐analysis of fish data
Authors: O'Dea Rose E. , Lagisz Malgorzata , Hendry Andrew P. , Nakagawa Shinichi
Published: July 2019

Fishes are sensitive to their thermal environment and face an uncertain future in a warming world. Theoretically, populations in novel environments might express greater levels of phenotypic variability to increase the chance of surviving—and eventually thriving—in the new conditions. Most research on the effect of the early thermal environment in fish species focuses on average phenotypic effects rather than phenotypic variability, but to understand how fishes will respond to rising temperatures we need to consider both the average response of the population, as well as the breadth of individual responses. Here we present the first meta‐analysis on the effects of developmental temperature in fishes. Using data from 43 species and over 6,000 individual fish, we show that a change in developmental temperature induces a significant change in phenotypic means and variability, but differently depending on whether the temperature is increased or decreased. Decreases in temperature (cool environments) showed a significant decrease in phenotypic means and no change in phenotypic variability. Increases in temperature (warm environments) showed a non‐significant increase in phenotypic means and a marginally significant increase in phenotypic variability. Larger increases in temperature saw greater increases in phenotypic variability, but no increase in the mean phenotypic response. Together, our results suggest that fishes exhibit both directed and stochastic developmental plasticity in response to warming temperatures, which could facilitate or accelerate adaptation to a changing environment.
Responses of benthic algae to nutrient enrichment in a shallow lake: Linking community production, biomass, and composition
Authors: McCormick Amanda R. , Phillips Joseph S. , Ives Anthony R.
Published: July 2019

Understanding how nutrient limitation affects algal biomass and production is a long‐standing interest in aquatic ecology. Nutrients can influence these whole‐community characteristics through several mechanisms, including shifting community composition. Therefore, incorporating the joint responses of biomass, taxonomic composition, and production of algal communities, and relationships among them, is important for understanding effects of nutrient enrichment.

In shallow subarctic Lake Mývatn, Iceland, benthic algae compose a majority of whole‐lake primary production, support high secondary production, and influence nutrient cycling. Given the importance of these ecosystem processes, the factors that limit benthic algae have a large effect on the function and dynamics of the Mývatn system.

In a 33‐day nutrient enrichment experiment conducted in Lake Mývatn, we measured the joint responses of benthic algal biomass, primary production, and composition to nitrogen (N) and phosphorus (P) supplementation. We enriched N and P using nutrient‐diffusing agar overlain by sediment, with three levels of N and P that were crossed in a factorial design.

We found little evidence of community‐wide nutrient limitation, as chlorophyll‐a concentrations showed a negligible response to nutrients. Gross primary production (GPP) was unaffected by P and inhibited by N enrichment after 10 days, although the inhibitory effect of N diminished by day 33.

In contrast to biomass and primary production, community composition was strongly affected by N and marginally affected by P, with some algal groups increasing and others decreasing with enrichment. The taxa with the most negative and positive responses to N enrichment were Fragilariaceae and Scenedesmus, respectively.

The abundances of particular algal groups, based on standardised cell counts, were related to GPP measured at the end of the experiment. Oocystis was negatively associated with GPP but was unaffected by N or P, while Fragilariaceae and Scenedesmus were positively associated with GPP but had opposite responses to N. As a result, nutrient‐induced compositional shifts did not alter GPP.

Overall, our results show that nutrient enrichment can have large effects on algal community composition while having little effect on total biomass and primary production. Our study suggests that nutrient‐driven compositional shifts may not alter the overall ecological function of algal communities if (1) taxa have contrasting responses to nutrient enrichment but have similar effects on ecological processes, and/or (2) taxa that have strong influences on ecological function are not strongly affected by nutrients.
Public involvement in the dissemination of the North West Coast Household Health Survey: Experiences and lessons of co‐producing research together
Authors: Giebel Clarissa , Hassan Shaima , McIntyre Jason C , Corcoran Rhiannon , Barr Ben , Gabbay Mark , Downing Jennifer , Comerford Terence , Alfirevic Ana
Published: July 2019

Background

Engaging with the public is a key element of health research; however, little work has examined experiences of public involvement in research dissemination. The aim of this paper was to assess the extent of public involvement, experiences of public advisers and resulting changes in the dissemination of the North West Coast Household Health Survey (HHS).

Methods

Three writing groups allowed public advisers to contribute to the dissemination of the HHS. A public workshop was set up to aid the co‐production of the research evidence and discuss the experiences of public advisers involved with the survey in March 2018. A focus group with public advisers was conducted in August 2018 to understand their experiences of involvement. Data were analysed using thematic analysis and coded by two researchers. Writing groups are still on‐going.

Results

Fourteen public advisers contributed via three face‐to‐face writing groups, by actively interpreting findings and helping in the write‐up of research articles and by presenting talks at the public workshop. At the workshop, seven public advisors contributed to setting priorities for data analysis from the HHS. Five public advisers took part in the focus group, which highlighted that whilst public advisers were generally satisfied with their involvement, they would like to be involved in more activities.

Conclusions

Members of the public shaped the dissemination of evidence and provided guidance for future steps. Public advisers were mostly positive about their involvement in the dissemination of the HHS, but highlighted the need for more transparency and support from researchers.
Hepatic sclerosing cavernous haemangioma can mimic the nodular elastosis stage of segmental atrophy
Authors: Findeis‐Hosey Jennifer J , Zhou Zhongren , Gonzalez Raul S
Published: July 2019

Aims

Segmental atrophy (SA) of the liver is a recently described pseudotumour that can show a broad spectrum of histological changes. The previously described histological differential diagnosis of SA has included cystic disease of the liver, amyloid, cancer‐associated elastosis, and epithelioid haemangioendothelioma. We have observed that sclerosing cavernous haemangiomas (SCHs) can mimic the nodular elastosis stage of SA; the aim of this study was to explore this differential diagnosis.

Methods and results

We identified 20 SCHs and 12 SAs, excluding haemangiomas with treatment effect. Several clinical and morphologic characteristics were examined, and elastin and CD34 staining was performed on cases with available tissue. SA was always asymptomatic, whereas SCH caused symptoms in 56% of patients (P = 0.026); SCH also tended to be larger (mean size: SCH, 47 mm; SA, 16 mm; P = 0.027). Thick‐walled blood vessels were more common in SA than in SCH (92% versus 45%, P = 0.011), as was ductular reaction (50% versus 5%, P = 0.0057). The two lesions had similar rates of border irregularity, residual entrapped hepatocytes, matrix oedema, and at least mild elastic fibrosis as seen on special staining, although staining was typically dense and diffuse in SA. CD34 immunostaining demonstrated at least scattered vessels in all cases of SA and SCH.

Conclusions

SCH can mimic SA, although it is generally larger and more often symptomatic. Elastin staining provides a useful adjunct to standard haematoxylin and eosin histological examination in resolving this differential diagnosis.
The improving thick film properties of Er2O3 doping fcc‐ZrO2 type solid electrolyte for SOFC applications
Authors: Yildiz Esra , Özdal Hilal , Kepenek Sevgi Ata , Türkoğlu Orhan
Published: July 2019

In this study, the binary system of (ZrO2)1‐x(Er2O3)x was investigated in the doping range of x; 0.02 ≤ x ≤ 0.12 by the Pechini method. According to X‐ray diffraction (XRD) measurement results, Er2O3 doping face‐centered cubic (fcc) ZrO2‐based solid solution was stabilized in the doping range of 0.08 ≤ x ≤ 0.12 at 1200°C for 12 hours. Thick films of fcc‐ZrO2 type powders were produced using ethyl cellulose organic binder mixture and spin‐coating method. The crystallographic, microstructural, and electrical conductivity properties of the thick films were characterized via XRD, SEM, and a.c. impedance measurements, respectively. 8‐ESZ ((ZrO2)1‐x(Er2O3)x, x = 0.08) thick film electrolyte showed the highest electrical conduction level which is 2.51 × 10−2 ohm−1 cm−1 at 850°C under 150 mL min−1 O2 volumetric flow rate. All thick film properties of fcc‐ESZ materials were optimized and improved experimentally for using as a solid electrolyte component in solid oxide fuel cell (SOFC) systems. A pre‐treatment of 8‐ESZ and the cathode‐supported type electrochemical cell were primarily fabricated. The power density measurements of 40‐LNF (LaNi1‐xFexO3, x = 0.4) Cathode|Cathode Active (50:50 wt % 40‐LNF:8‐ESZ)| 8‐ESZ Electrolyte|Anode Active (60:40 wt % NiO:8‐ESZ)|NiO Anode Electrode cell stack suggest that the produced electrolytes had the usefully properties for SOFC applications.
STING pathway agonism as a cancer therapeutic
Authors: Flood Blake A. , Higgs Emily F. , Li Shuyin , Luke Jason J. , Gajewski Thomas F.
Published: July 2019

The fact that a subset of human cancers showed evidence for a spontaneous adaptive immune response as reflected by the T cell‐inflamed tumor microenvironment phenotype led to the search for candidate innate immune pathways that might be driving such endogenous responses. Preclinical studies indicated a major role for the host STING pathway, a cytosolic DNA sensing pathway, as a proximal event required for optimal type I interferon production, dendritic cell activation, and priming of CD8+ T cells against tumor‐associated antigens. STING agonists are therefore being developed as a novel cancer therapeutic, and a greater understanding of STING pathway regulation is leading to a broadened list of candidate immune regulatory targets. Early phase clinical trials of intratumoral STING agonists are already showing promise, alone and in combination with checkpoint blockade. Further advancement will derive from a deeper understanding of STING pathway biology as well as mechanisms of response vs resistance in individual cancer patients.
Immune checkpoint inhibitors: The linchpins of modern immunotherapy
Authors: Wilky Breelyn A.
Published: July 2019

Immune checkpoint inhibitors (ICIs) have revolutionized our approach to cancer treatment in the past decade. While monoclonal antibodies to CTLA‐4 and PD‐1/PD‐L1 have produced remarkable and durable responses in a subset of patients, the majority of patients will still develop primary or adaptive resistance. With complex mechanisms of resistance limiting the efficacy of checkpoint inhibitor monotherapy, it is critical to develop combination approaches to allow more patients to benefit from immunotherapy. In this review, I approach the current landscape of ICI research from the perspective of sarcomas, a rare group of bone and soft tissue cancers that have had limited benefit from checkpoint inhibitor monotherapy, and little investigation of biomarkers to predict responses. By surveying the various mechanisms of resistance and treatment modalities being explored in other solid tumors, I outline how ICIs will undoubtedly serve as the critical foundation for future directions in modern immunotherapy.
T cell receptor‐based cancer immunotherapy: Emerging efficacy and pathways of resistance
Authors: Chandran Smita S. , Klebanoff Christopher A.
Published: July 2019

Adoptive cell transfer (ACT) using chimeric antigen receptor (CAR)‐modified T cells can induce durable remissions in patients with refractory B‐lymphoid cancers. By contrast, results applying CAR‐modified T cells to solid malignancies have been comparatively modest. Alternative strategies to redirect T cell specificity and cytolytic function are therefore necessary if ACT is to serve a greater role in human cancer treatments. T cell receptors (TCRs) are antigen recognition structures physiologically expressed by all T cells that have complementary, and in some cases superior, properties to CARs. Unlike CARs, TCRs confer recognition to epitopes derived from proteins residing within any subcellular compartment, including the membrane, cytoplasm and nucleus. This enables TCRs to detect a broad universe of targets, such as neoantigens, cancer germline antigens, and viral oncoproteins. Moreover, because TCRs have evolved to efficiently detect and amplify antigenic signals, these receptors respond to epitope densities many fold smaller than required for CAR‐signaling. Herein, we summarize recent clinical data demonstrating that TCR‐based immunotherapies can mediate regression of solid malignancies, including immune‐checkpoint inhibitor refractory cancers. These trials simultaneously highlight emerging mechanisms of TCR resistance. We conclude by discussing how TCR‐based immunotherapies can achieve broader dissemination through innovations in cell manufacturing and non‐viral genome integration techniques.
CAR T cells for brain tumors: Lessons learned and road ahead
Authors: Akhavan David , Alizadeh Darya , Wang Dongrui , Weist Michael R. , Shepphird Jennifer K. , Brown Christine E.
Published: July 2019

Malignant brain tumors, including glioblastoma, represent some of the most difficult to treat of solid tumors. Nevertheless, recent progress in immunotherapy, across a broad range of tumor types, provides hope that immunological approaches will have the potential to improve outcomes for patients with brain tumors. Chimeric antigen receptors (CAR) T cells, a promising immunotherapeutic modality, utilizes the tumor targeting specificity of any antibody or receptor ligand to redirect the cytolytic potency of T cells. The remarkable clinical response rates of CD19‐targeted CAR T cells and early clinical experiences in glioblastoma demonstrating safety and evidence for disease modifying activity support the potential of further advancements ultimately providing clinical benefit for patients. The brain, however, is an immune specialized organ presenting unique and specific challenges to immune‐based therapies. Remaining barriers to be overcome for achieving effective CAR T cell therapy in the central nervous system (CNS) include tumor antigenic heterogeneity, an immune‐suppressive microenvironment, unique properties of the CNS that limit T cell entry, and risks of immune‐based toxicities in this highly sensitive organ. This review will summarize preclinical and clinical data for CAR T cell immunotherapy in glioblastoma and other malignant brain tumors, including present obstacles to advancement.
‘It is meant to be heart rather than head’; International perspectives of teaching from lived experience in mental health nursing programs
Authors: Bocking Julia , Happell Brenda , Scholz Brett , Horgan Aine , Goodwin John , Lahti Mari , Platania‐Phung Chris , MacGabhann Liam , Greaney Sonya , Granerud Arild , Griffin Martha , Russell Siobhan , Bjornsson Einar , van der Vaart Kornelis Jan , Ellilä Heikki , Hals Elisabeth , Doody Rory , Vatula Annaliina , Pulli Jarmo , Manning Fionnuala , Allon Jerry , Biering Pall
Published: July 2019

Consumer participation is a clear expectation of contemporary mental health policy. Most activity has concentrated in direct service delivery, and academic roles for mental health consumers have been slow to establish. An international project was undertaken to implement and evaluate meaningful consumer involvement in mental health nursing education. A learning module was co‐produced between ‘Experts by Experience’ (drawing on experience of mental distress and service use) and Mental Health Nurse Academics. This qualitative exploratory study aimed to capture how Experts by Experience perceive their contribution. Interviews were undertaken with Experts by Experience who delivered the learning module. Data were analysed thematically and subsequently interpreted with Critical Social Theory. Two main themes emerged from the findings: ‘there wasn't a barrier’ described how personal narratives enhanced relationships between Experts by Experience and students; and ‘made the human being visible’, described their experiences of allowing students to see the person behind a diagnosis. These findings suggest Experts by Experience teaching is valuable and potentially a tool in redressing stigma. Addressing poor public perceptions could attract higher numbers of quality practitioners to mental health and meet identified workforce shortages. The findings presented here strengthen the evidence base for Expert by Experience roles in mental health professional education. These findings can be considered in international curricula reviews and aid progress towards a more socio‐political, humanistic focus in mental health nursing, congruent with rights‐based reform agendas.
A case of pyoderma gangrenosum induced by insulin
Authors: Noronha Malcom , Arora Sukriti , Pai Kantilatha , Sathish Pai B. , Jindal Anuradha
Published: July 2019

Pyoderma gangrenosum (PG) is a rare auto‐inflammatory, neutrophilic, ulcerative disorder characterised by acutely painful, rapidly spreading, sterile ulcers over the trunk and lower limbs. The pathogenic mechansim of PG is under constant evolution and drugs are emerging to be a an important trigger. In the literature, 52 cases of drug‐induced PG have been documented, of which cocaine laced with levamisole has shown most direct association, with a mean Naranjo score of 9. Other drugs probably associated with PG are isotretinoin, sunitinib, and propylthiouracil. We describe a case of a 59‐year‐old male who had multiple well‐defined ulcers with a violaceous, undermined edge limited to the site of subcutaneous injection of insulin. Histopathological examination showed psoriasiform hyperplasia in the epidermis, with abundant infiltration of neutrophils in the dermis, consistent with the clinical diagnosis of PG. As per the modified Naranjo algorithm, the patient's total score was 7, indicating insulin to be the probable causative agent in our case. So, compiling temporal localisation of lesions to the site of administration of insulin and clinical, histopathological, and Naranjo score evidence all prompt the diagnosis of PG. Insulin stimulates the release of matrix‐metalloproteinases 9 which acts as endopeptidases and also results in the chemotaxis of neutrophils, causing ulcer formation. This is the first case reporting PG triggered by insulin.
Comparison of rheological properties of different protein/gum arabic complex coacervates
Authors: Dong Die , Cui Bo
Published: July 2019

This study mainly focused on the comparison of rheological properties of soy proteins (SP)/gum arabic (GA) complex coacervates and gelatin (G)/gum arabic (GA) complex coacervates. Frequency sweeping (0.1–100 Hz) results at 25°C showed that SP/GA coacervates storage modulus and loss modulus were crossed at a frequency of 30 Hz. According to the Doi‐Onuki model, it was confirmed that SP/GA complex coacervates were structured with a characteristic length scale (L) of 40 nm, which was much larger than others. It meant that the structure of SP/GA complex coacervates was less tight. Temperature sweeping (40–10°C) results illustrated that L of G/GA complex coacervates were decreased from 600 to 10 nm during the cooling process due to the formation of hydrogen bonds, while L of SP/GA complex coacervates were not changed greatly. Light microscopy observations revealed that the G/GA complex coacervates were more regular after cooling to 10°C. All the results indicated that protein types greatly influenced the structures of the complex coacervates. The results in this article will be useful for clarifying the reasons why different complex coacervates showed different morphologies and will provide theoretical support for rational use of protein/polysaccharide complex coacervates in food industry.

Practical applications

Complex coacervation between proteins and polysaccharides is a common phenomenon in the food processing. Understanding the interactions of proteins and polysaccharides is of importance not only in making cost‐efficient use of functional ingredients, but also in designing novel foods, controlling and improving structures of food ingredients and textural properties of fabricated foods. This study mainly focused on the rheological properties of soy proteins/gum arabic (SP/GA) complex coacervates and gelatin/gum arabic (G/GA) complex coacervates. The results indicated that protein types greatly influenced the structures of the complex coacervates. Structures of SP/GA coacervates were less tight than others. Characteristic length scales of G/GA coacervate significantly decreased during cooling process. The results in this paper will provide theoretical support for rational use of protein/polysaccharide complex coacervates in food industry.
Improvement of the polyphenol extraction from avocado peel by assisted ultrasound and microwaves
Authors: Trujillo‐Mayol Igor , Céspedes‐Acuña Carlos , Silva Fabiana L. , Alarcón‐Enos Julio
Published: July 2019

Ultrasound (UAE) and microwave (MAE) are green technologies to assist in the extraction of polyphenols. The goals were to study the application of sonication temperature (40–60°C), time (15–60 min), microwave power (250–750 W) at 30–120 s; and to combine the principal factors of each method for the maximum recovery of total phenolics from avocado peel employing a response surface methodology. The phytochemical, biological, and feasibility characteristics of the hydroethanolic extracts were analyzed. The combination of 15 min of sonication followed by 95.1 s of microwaving were the optimal parameters to recover 166.3 ± 4.9 mg GAE/g dry matter, which was 1.3, 1.2, and 1.1 times higher than UAE, MAE, and maceration, respectively. Likewise, the U‐MAE was upper in yield (25.3 ± 0.6%), TPC (281.4 ± 0.2 mg GAE), TFC (62.0 ± 0.4 mg QuE), and TAC (4.8 ± 0.1 mg cyanidin‐3‐O‐glucoside) and DPPH, FRAP and LPO (779.1 ± 0.6, 167.0 ± 2.3 μg TEAC, 70.03 ± 0.62%, respectively) per gram of dry extract. All the extracts displayed antibacterial activity. The economic feasibility analysis indicated MAE to be highly effective when energy is less affordable, whereas, if the cost associated with the raw material is high, the U‐MAE is suitable.

Practical Applications

The extraction industry is moving fast into sustainable processes based on the implementation of ecologically friendly methods of extraction and the utilization of by‐products to obtain bioactive metabolites to be used in the food and pharmaceutical industries. The results here presented were meant to design efficiently extracting procedures. Hence, the correct selection of factors that affect the extraction such as sonication temperature as well as microwave power is vital to reduce the resource consumption; especially raw material and time. Moreover, the exploitation of by‐products as the avocado peel will reduce the negative impact on the environment and enhance the value chain of avocado production.
Association between High Proportions of Seriously Mentally Ill Nursing Home Residents and the Quality of Resident Care
Authors: McGarry Brian E. , Joyce Nina R. , McGuire Thomas G. , Mitchell Susan L. , Bartels Stephen J. , Grabowski David C.
Published: July 2019

OBJECTIVES

To examine the association between the quality of care delivered to nursing home residents with and without a serious mental illness (SMI) and the proportion of nursing home residents with SMI.

DESIGN

Instrumental variable study. Relative distance to the nearest nursing home with a high proportion of SMI residents was used to account for potential selection of patients between high‐ and low‐SMI facilities. Data were obtained from the 2006‐2010 Minimum Data Set assessments linked with Medicare claims and nursing home information from the Online Survey, Certification, and Reporting database.

SETTING

Nursing homes with high (defined as at least 10% of a facility's population having an SMI diagnosis) and low proportions of SMI residents.

PARTICIPANTS

A total of 58 571 Medicare nursing residents with an SMI diagnosis (ie, schizophrenia or bipolar disorder) and 558 699 individuals without an SMI diagnosis who were admitted to the same nursing homes.

MEASUREMENTS

Outcomes were nursing home quality measures: (1) use of physical restraints, (2) any hospitalization in the last 3 months, (3) use of an indwelling catheter, (4) use of a feeding tube, and (5) presence of pressure ulcer(s).

RESULTS

For individuals with SMI, admission to a high‐SMI facility was associated with a 3.7 percentage point (95% confidence interval [CI] = 1.4‐6.0) increase in the probability of feeding tube use relative to individuals admitted to a low‐SMI facility. Among individuals without SMI, admission to a high‐SMI facility was associated with a 1.7 percentage point increase in the probability of catheter use (95 CI = .03‐3.47), a 3.8 percentage point increase in the probability of being hospitalized (95% CI = 2.16‐5.44), and a 2.1 percentage point increase in the probability of having a feeding tube (95% CI = .43‐3.74).

CONCLUSION

Admission to nursing homes with high concentrations of residents with SMI is associated with worse outcomes for both residents with and without SMI. J Am Geriatr Soc 67:2346–2352, 2019
The Three‐Item Thinking about Your Partner’s Drinking Scale (TPD‐3): Item Response Theory, Reliability, and Validity
Authors: Rodriguez Lindsey M. , Webster Gregory D.
Published: July 2019

Interdependence is a defining feature of close relationships, and alcohol use is one domain where one person’s motivations and behaviors can affect a partner’s well‐being. Concern about partner drinking is a gauge that determines whether a partner’s alcohol use has the potential to be problematic to the relationship, and brief and efficient measurement of this construct can be used to serve clinicians, scientists, and practitioners. Across four studies (N = 1,807), we use item response theory analysis to present a 3‐item brief screening tool assessing concern about partner drinking: Thinking about your Partner’s Drinking‐3 (TPD‐3). The TPD‐3 revealed strong test–retest reliability and expected patterns of convergent, concurrent, and incremental validity with perceived partner drinking and alcohol‐related consequences, behavioral responses to partner drinking, and relationship well‐being. We present the TPD‐3 as a useful screening tool and for measurement of concern about partner drinking when efficient assessment is desired.
SPATIAL LIMITED DEPENDENT VARIABLE MODELS: A REVIEW FOCUSED ON SPECIFICATION, ESTIMATION, AND HEALTH ECONOMICS APPLICATIONS
Authors: Billé Anna Gloria , Arbia Giuseppe
Published: July 2019

Modeling individual choices is one of the main aim in microeconometrics. Discrete choice models have been widely used to describe economic agents' utility functions and most of them play a paramount role in applied health economics. On the other hand, spatial econometrics collects a series of econometric tools, which are particularly useful when we deal with spatially distributed data sets. Accounting for spatial dependence can avoid inconsistency problems of the commonly used statistical estimators. However, the complex structure of spatial dependence in most of the nonlinear models still precludes a large diffusion of these spatial techniques. The purpose of this paper is then twofold. The former is to review the main methodological problems and their different solutions in spatial nonlinear modeling. The latter is to review their applications to health issues, especially those appeared in the last few years, by highlighting the main reasons why spatial discrete neighboring effects should be considered and suggesting possible future lines of development in this emerging field. Particular attention has been paid to cross‐sectional spatial discrete choice modeling. However, discussions on the main methodological advancements in other spatial limited dependent variable models and spatial panel data models are also included.
Effect of monoacylglycerol lipase on the tumor growth in endometrial cancer
Authors: Li Xin , Gao Shuhong , Li Wenzhi , Liu Zhiming , Shi Zhengzheng , Qiu Chunping , Jiang Jie
Published: July 2019

Aim

Abnormal lipid metabolism plays a dual role in tumorigenesis, specifically in the occurrence and development of cancers. Monoacylglycerol lipase (MAGL), a hydrolase that is important for lipid metabolism, plays a vital role in different aspects of tumorigenesis. Many studies have shown that MAGL is highly elevated in a variety of cancers and plays an active role. However, its potential role in supporting endometrial cancer (EC) growth and progression has not yet been explored in depth.

Methods

Immunohistochemistry and quantitative real‐time reverse transcription polymerase chain reaction were performed to estimate the protein and messenger RNA (mRNA) levels of MAGL in tumor tissues. Then, JZL184 and small interfering RNA (siRNA) were used to decrease the expression of MAGL in EC cells. The gene and protein expression levels of MAGL were measured using quantitative real‐time PCR and western blotting, respectively. Additionally, the effect of MAGL on tumor growth in EC was detected by 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide , cell cycle and western blotting assay in vitro.

Results

We found that MAGL was overexpressed in EC and was significantly correlated with surgical‐pathological stage, myometrial invasion, number of pregnancies and body mass index. The growth and cell cycle progression of tumor cells were significantly impaired in vitro by the pharmacological and siRNA‐mediated MAGL inhibition. In addition, MAGL inhibition seemed to repress two target genes, Cyclin D1 and Bcl‐2.

Conclusion

In summary, we have demonstrated that MAGL is involved in EC growth and progression. Our results suggest that targeting MAGL may be a novel and valid treatment for EC.
Jaw‐neck movement integration in 6‐year‐old children differs from that of adults
Authors: Österlund Catharina , Nilsson Evelina , Hellström Fredrik , Häger Charlotte K. , Häggman‐Henrikson Birgitta
Published: July 2019

Background

A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children.

Objectives

To determine the movement integration between the jaw and neck during jaw motor tasks in 6‐year‐olds, whether there is a difference between children and adults.

Methods

Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6‐year‐olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening‐closing and self‐paced gum chewing. Jaw and neck movement amplitudes, intra‐individual variation in movement amplitude, ratio between neck‐jaw movement amplitudes and movement cycle time were analysed. Differences between children and adults were evaluated with Mann‐Whitney U test for independent samples.

Results

Compared to adults, 6‐year‐old children showed larger neck movement amplitudes (P = .008) during chewing, higher intra‐individual variability in amplitudes of jaw (P = .008) and neck (P = .001) movements, higher ratio between neck‐jaw movement amplitudes for jaw opening‐closing (P = .026) and chewing (P = .003), and longer jaw movement cycle time (P ≤ .0001) during the jaw opening‐closing task.

Conclusion

Despite integrated jaw‐neck movements in 6‐year‐old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw‐neck motor behaviour. The well‐integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well‐controlled longitudinal studies to map this development in order to provide appropriate age‐related clinical treatment for functional disorders.
Enhanced T‐cell proliferation and IL‐6 secretion mediated by overexpression of TRIM21 in oral lesions of patients with oral lichen planus
Authors: Wei Wei , Wang Yufeng , Sun Qianqian , Jiang Chenyan , Zhu Mengxue , Song Chencheng , Li Chenxi , Du Guanhuan , Deng Yiwen , Nie Hong , Tang Guoyao
Published: July 2019

Backgrounds

To explore the expression and functions of the tripartite motif‐containing protein 21 (TRIM21) in oral lichen planus(OLP) lesions.

Methods

Paraffin sections of buccal mucosa samples from 15 cases of reticular oral lichen planus (OLP) patients and 10 healthy controls were used for immunohistochemistry to determine expression and distribution of TRIM21. Buccal mucosae from 11 OLP patients and seven healthy controls were analyzed by qPCR to quantify its gene expression. Peripheral blood mononuclear cells and CD3+ cells from four pairs of age‐ and sex‐matched OLP patients and healthy controls were isolated for immunocytochemistry and culture. Following lentivirus‐mediated overexpression of TRIM21 gene in CD3+ cells, CCK‐8 was applied to evaluate cell proliferation. Cytokines including IL‐2, IL‐4, IL‐5, IL‐6, IL‐10, TNF‐α, and IFN‐γ in the supernatants were measured by the cytometric bead array and verified by ELISA.

Results

A larger number of TRIM21‐positive cells infiltrating the lamina propria were observed in OLP lesions by immunohistochemistry than those of healthy controls. Significantly higher transcription of TRIM21 was revealed by qPCR. TRIM21 overexpression in CD3+ cells significantly enhanced the proliferation and IL‐6 secretion in CD3+ cells from 12 to 72 hours.

Conclusion

Overexpressed TRIM21 in OLP may be a primary proinflammatory molecule rather than a secondary and inducible regulatory factor in immunopathogenesis of OLP.