bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of a commercial accountable care organization on prescription drugs
Authors: Zhang Hui , Cowling David W. , Graham Joanne M. , Taylor Erik
Published: January 2021

Objective

To determine the long‐run impact of a commercial accountable care organization (ACO) on prescription drug spending, utilization, and related quality of care.

Data Sources/Study Setting

California Public Employees' Retirement System (CalPERS) health maintenance organization (HMO) member enrollment data and pharmacy benefit claims, including both retail and mail‐order generic and brand‐name prescription drugs.

Study Design

We applied a longitudinal retrospective cohort study design and propensity‐weighted difference‐in‐differences regression models. We examined the relative changes in outcome measures between two ACO cohorts and one non‐ACO cohort before and after the ACO implementation in 2010. The ACO directed provider prescribing patterns toward generic substitution for brand‐name prescription drugs to maximize shared savings in pharmacy spending.

Data Collection/Extraction Methods

The study sample included members continuously enrolled in a CalPERS commercial HMO from 2008 through 2014 in the Sacramento area.

Principal Findings

The cohort differences in baseline characteristics of 40 483 study participants were insignificant after propensity‐weighting adjustment. The ACO enrollees had no significant differential changes in either all or most of the five years of the ACO operation for the following measures: (1) average total spending and (2) average total scripts filled and days supplied on either generic or brand‐name prescription drugs, or the two combined; (3) average generic shares of total prescription drug spending, scripts filled or days supplied; (4) annual rates of 10 outpatient process quality of care metrics for medication prescribing or adherence.

Conclusions

Participation in the commercial ACO was associated with negligible differential changes in prescription drug spending, utilization, and related quality of care measures. Capped financial risk‐sharing and increased generics substitution for brand names are not enough to produce tangible performance improvement in ACOs. Measures to increase provider financial risk‐sharing shares and lower brand‐name drug prices are needed.
Delineating the relationship between immune system aging and myogenesis in muscle repair
Authors: Tobin Stephanie W. , Alibhai Faisal J. , Wlodarek Lukasz , Yeganeh Azadeh , Millar Sean , Wu Jun , Li Shu‐hong , Weisel Richard D. , Li Ren‐Ke
Published: January 2021

Recruited immune cells play a critical role in muscle repair, in part by interacting with local stem cell populations to regulate muscle regeneration. How aging affects their communication during myogenesis is unclear. Here, we investigate how aging impacts the cellular function of these two cell types after muscle injury during normal aging or after immune rejuvenation using a young to old (Y‐O) or old to old (O‐O) bone marrow (BM) transplant model. We found that skeletal muscle from old mice (20 months) exhibited elevated basal inflammation and possessed fewer satellite cells compared with young mice (3 months). After cardiotoxin muscle injury (CTX), old mice exhibited a blunted inflammatory response compared with young mice and enhanced M2 macrophage recruitment and IL‐10 expression. Temporal immune and cytokine responses of old mice were partially restored to a young phenotype following reconstitution with young cells (Y‐O chimeras). Improved immune responses in Y‐O chimeras were associated with greater satellite cell proliferation compared with O‐O chimeras. To identify how immune cell aging affects myoblast function, conditioned media (CM) from activated young or old macrophages was applied to cultured C2C12 myoblasts. CM from young macrophages inhibited myogenesis while CM from old macrophages reduced proliferation. These functional differences coincided with age‐related differences in macrophage cytokine expression. Together, this study examines the infiltration and proliferation of immune cells and satellite cells after injury in the context of aging and, using BM chimeras, demonstrates that young immune cells retain cell autonomy in an old host to increase satellite cell proliferation.
Similar topologies of individual‐based plant‐herbivorous networks in forest interior and anthropogenic edges
Authors: Carvalho Raquel L , Anjos Diego V , Fagundes Roberth , Luna Pedro , Ribeiro Sérvio Pontes
Published: January 2021

Understanding the impacts of edge effects on ecological interactions plays an integral role in planning ecosystem recovery from human perturbations, as well as conservation of habitats. Edge effects related to forest fragmentation cause changes in species diversity that can disrupt ecological networks. Here, we evaluated how the diversity of, and interactions between, herbivorous insects associated with individuals of a pioneer plant species, Mabea fistulifera (Euphorbiaceae) are affected by the disturbances related to edge effects. We addressed two specific questions: (i) How do the forest edges affect species richness, abundance and composition of herbivorous interacting with M. fistulifera? (ii) Do different disturbances related to edge effects affect the topology of individual‐based plant‐herbivorous networks? Herbivorous insects were sampled from three population patches of M. fistulifera in Brazilian Atlantic forest areas: two areas were subjected to distinct intensities of anthropogenic disturbances (firebreak and park access road, considered edges of low‐ and high‐impact, respectively), and one in the forest interior (control). We expected a lower species richness and abundance of herbivorous interacting with plants in forest edges than in the forest interior apart from to differences in the species composition. Therefore, based on these predictions, we expected that the various disturbances related to edge effects may change the topology of individual‐based plant‐herbivorous networks. We observed that species richness and abundance of herbivorous in high‐impact environments decreased in relation to forest interior, as well the species composition differed between these areas. Disturbance jeopardised network specialisation but did not change the topology of individual‐based networks, which presented a modular pattern. Edges affected herbivorous diversity and decreased the interaction overlap as individual‐based networks became highly specialised with increasing disturbance. These results enhance the understanding of edge effects and resilience of plant‐herbivorous interactions in regularly disturbed tropical environments.
Outcomes of extracorporeal membrane oxygenation in adults with active hematologic and nonhematologic malignancy
Authors: Park Chul , Ko Ui Won , Ko Ryoung‐Eun , Na Soo Jin , Yang Jeong Hoon , Jeon Kyeongman , Suh Gee Young , Sung Kiick , Cho Yang Hyun
Published: January 2021

Although the number of cancer patients admitted to the intensive care unit is increasing, the data on the use of extracorporeal membrane oxygenation in patients with malignancy are limited. We applied extracorporeal membrane oxygenation to carefully selected patients with active hematologic malignancy or nonhematologic malignancy who experienced respiratory or cardiac failure despite maximal conventional therapy. Patients with active malignancy who underwent extracorporeal membrane oxygenation in our institution between January 2012 and December 2016 were included in this study. The primary outcome of this study was defined as survival to hospital discharge. We also investigated the factors associated with survival to hospital discharge. There were 30 (30.6%) and 68 (69.4%) patients in the hematologic malignancy group and the nonhematologic malignancy group, respectively. Patients in the hematologic malignancy group were younger, more neutropenic, more hypotensive, had a lower Charlson Comorbidity Index, higher sequential organ failure assessment score, and lower platelet count than those in the nonhematologic malignancy group. Forty‐six (46.9%) patients were successfully weaned off extracorporeal membrane oxygenation, and 30 (30.6%) patients survived until hospital discharge. Hospital survival rate and survival status 6 months after hospital discharge were significantly lower in patients with hematologic malignancy than in those with nonhematologic malignancy (13.3% vs. 38.2%, P = .026 and 3.3% vs. 26.5%, P = .017, respectively). Multivariate analysis identified an active hematologic malignancy, older age, acidosis, thrombocytopenia, high vasoactive‐inotrope score, and respiratory failure as the risk factors for in‐hospital death. Patients with hematologic malignancy requiring extracorporeal membrane oxygenation support had significantly lower rates of hospital survival and 6‐month survival after discharge than patients with nonhematologic malignancy. Therefore, extracorporeal membrane oxygenation for treating cardiac or respiratory failure should only be considered in highly selected patients with hematologic malignancy.
HIF‐1α downregulation of miR‐433‐3p in adipocyte‐derived exosomes contributes to NPC progression via targeting SCD1
Authors: Yin Haimeng , Qiu Xiaoxia , Shan Ying , You Bo , Xie Lixiao , Zhang Panpan , Zhao Jianmei , You Yiwen
Published: January 2021

Resident adipocytes under a hypoxic tumor microenvironment exert an increasingly important role in cell growth, proliferation, and invasion in cancers. However, the communication between adipocytes and cancer cells during nasopharyngeal carcinoma (NPC) progression is poorly understood. Here, we demonstrate that hypoxic adipocyte‐derived exosomes are key information carriers that transfer low expression of miR‐433‐3p into NPC cells. In addition, luciferase reporter assays detected that hypoxia inducible factor‐1α (HIF‐1α) induced miR‐433‐3p transcription through five binding sites at its promoter region. Concordantly, the low expression of miR‐433‐3p promoted proliferation, migration, and lipid accumulation in NPC cells via targeting stearoyl‐CoA desaturase 1 (SCD1) are suggested by functional studies. Consistent with these findings, in tumor‐bearing mice, NPC cells with low HIF‐1α expression, high miR‐433‐3p expression, and low SCD1 expression were equally endowed with remarkably reduced potential of tumorigenesis. Collectively, our study highlights the critical role of the HIF‐1α‐miR‐433‐3p‐SCD1 axis in NPC progression, which can serve as a mechanism‐based potential therapeutic approach.
Partitioning cash flows to overcome retailer aversion to stocking new products
Authors: Devlin Anna G. , Elmaghraby Wedad J. , Hamilton Rebecca W.
Published: January 2021

Because decision makers tend to dislike ambiguity, the uncertainty surrounding new products can act as a barrier to retailer acceptance. We propose that by changing the structure of cash flows in the contract offered to a retailer (keeping net payments constant), a manufacturer can shift a retailer from making ambiguity‐averse to ambiguity‐neutral choices, thereby increasing the retailer's willingness to stock new products. In a series of studies, we demonstrate that contracts structured to provide positive cash flows after ambiguity has been resolved can increase the retailer's willingness to choose products with an unknown demand distribution. Thus, contracts with positive postdemand payments to the retailer have the potential to increase acceptance of new products.
A randomized, placebo‐controlled study to evaluate the efficacy and safety of adding omarigliptin to insulin therapy in Japanese patients with type 2 diabetes and inadequate glycaemic control
Authors: Kadowaki Takashi , Seino Yutaka , Kaku Kohei , Okamoto Taro , Kameya Miho , Sato Asako , Hirano Tomona , Oshima Nobuyuki , Gantz Ira , O'Neill Edward A. , Engel Samuel S. ,   the Omarigliptin Study 039 Group
Published: January 2021

Aim

To evaluate the efficacy and safety of adding the once‐weekly oral dipeptidyl peptidase‐4 inhibitor omarigliptin to treatment of Japanese patients with type 2 diabetes and inadequate glycaemic control on insulin monotherapy.

Materials and Methods

In a 52‐week clinical trial, Japanese patients on insulin monotherapy were randomized to once‐weekly omarigliptin 25 mg (N = 123) or placebo (N = 61) for a 16‐week, double‐blind, placebo‐controlled period. After Week 16, patients continued or switched to omarigliptin for a 36‐week open‐label period.

Results

From a mean baseline of approximately 8.8%, the Week 16 least squares mean changes in HbA1c were −0.61% (omarigliptin) and 0.29% (placebo); the between‐group difference was −0.90% (p < .001). At Week 52, the mean change from baseline in HbA1c was −0.57% in both the group on omarigliptin for 52 weeks and the group on omarigliptin for 36 weeks (switched from placebo at Week 16). During the first 16 weeks of treatment, the incidences of adverse events (AEs), serious AEs, drug‐related AEs and discontinuation from trial medication because of an AE were similar in both groups. A slight increase in incidence of symptomatic hypoglycaemia was observed in the omarigliptin group (n = 13 [10.6%]) compared with placebo (n = 4 [6.6%]). No severe hypoglycaemia was reported during the study. No new safety signals emerged with treatment beyond Week 16 through Week 52.

Conclusion

The addition of once‐weekly omarigliptin to insulin therapy for up to 52 weeks was generally well tolerated and provided clinically meaningful improvement in glycaemic control throughout the trial period. ClinicalTrials.gov: NCT02906709
Bilateral subthalamic nucleus deep brain stimulation is an effective treatment for diphasic dyskinesia
Authors: Kim Ahro , Kim Han‐Joon , Kim Aryun , Kim Yoon , Jang Mihee , Paek Sun Ha , Jeon Beomseok
Published: January 2021

Background and purpose

The purpose was to assess the effect of bilateral subthalamic nucleus deep brain stimulation (STN DBS) on diphasic dyskinesia in patients with Parkinson disease (PD) and to assess the factors associated with the remission of diphasic dyskinesia.

Methods

Medical records for PD patients who underwent bilateral STN DBS at the Movement Disorder Center of Seoul National University Hospital from March 2005 to November 2016 were reviewed. Patients were evaluated preoperatively and at 3, 6 and 12 months after surgery, and annually thereafter. The presence of peak‐dose dyskinesia and diphasic dyskinesia is based on the interview and examination of patients at baseline and at each follow‐up.

Results

Amongst 202 patients who underwent STN DBS, 66 patients who had diphasic dyskinesia preoperatively were included in the analysis. Diphasic dyskinesia disappeared in 49 (74%) after surgery. In 27 (55.1%) patients whose diphasic dyskinesia disappeared after DBS, peak‐dose and diphasic dyskinesia disappeared persistently from as early as 3 months postoperatively. Age at onset was younger and disease duration at surgery was longer in patients whose diphasic dyskinesia persisted compared with patients whose diphasic dyskinesia disappeared. Multivariate Cox regression analysis demonstrated that patients with greater postoperative decrease of dopaminergic medications were more likely to have remission of diphasic dyskinesia.

Conclusion

This study showed that bilateral STN DBS is effective in controlling diphasic dyskinesia and should be considered in PD patients with diphasic dyskinesia.
Predicted distributions could suggest regional sympatry in spite of local allopatry: The case of the dung beetle Canthon rutilans Castelnau, 1840 (Coleoptera: Scarabaeidae)
Authors: Hensen Maristela C. , Hernández Malva I. M. , Lobo Jorge M.
Published: January 2021

Studying the environmental characteristics of the localities in which different taxa have been observed could help to estimate probable niche differences. Previous studies on local distribution and reproductive behavior of the two subspecies of Canthon rutilans support their allopatry. Here we estimated the geographical distribution of these taxa to examine the congruency between the environmental characteristics of the occurrence localities derived from geographical and local data, in order to facilitate the future study of the causal factors that are more likely to explain their segregation. To do so, a database including most of the available distributional information about these subspecies was compiled. The data derived from 23 environmental variables in the occurrence cells were used to estimate those variables with different mean values among the two subspecies, and also to generate distributional maps reflecting the probable distribution of the two subspecies. Ten variables have statistically significant different values among both subspecies. Canthon rutilans rutilans would be present in colder places, living in the high elevation localities of the Atlantic Forest or Pampas biomes, whereas C. rutilans cyanescens seems to be restricted to lowland forested areas. Probable distribution maps show geographical sympatry in almost half of the distribution range of C. r. rutilans. As former results suggest that they are in allopatry at a local scale, these results propose that fine‐grain environmental factors would be promoting the segregation of taxa, but also that coarse‐grain data should be used with caution when the aim is to estimate niche differences.
Genomic vulnerability of a dominant seaweed points to future‐proofing pathways for Australia's underwater forests
Authors: Wood Georgina , Marzinelli Ezequiel M. , Campbell Alexandra H. , Steinberg Peter D. , Vergés Adriana , Coleman Melinda A.
Published: January 2021

Globally, critical habitats are in decline, threatening ecological, economic and social values and prompting calls for ‘future proofing’ efforts that enhance resilience to climate change. Such efforts rely on predicting how neutral and adaptive genomic patterns across a species' distribution will change under future climate scenarios, but data is scant for most species of conservation concern. Here, we use seascape genomics to characterise genetic diversity, structure and gene‐environmental associations in a dominant forest‐forming seaweed, Phyllospora comosa, along its entire latitudinal (12° latitude), and thermal (~14°C) range. Phyllospora showed high connectivity throughout its central range, with evidence of genetic structure and potential selection associated with sea surface temperatures (SSTs) at its rear and leading edges. Rear and leading‐edge populations harboured only half the genetic diversity of central populations. By modelling genetic turnover as a function of SST, we assessed the genomic vulnerability across Phyllospora's distributional range under climate change scenarios. Despite low diversity, range‐edge populations were predicted to harbour beneficial adaptations to marginal conditions and overall adaptability of the species may be compromised by their loss. Assisted gene flow from range edge populations may be required to enhance adaptation and increase resilience of central and leading‐edge populations under warming oceans. Understanding genomic vulnerability can inform proactive restoration and future‐proofing strategies for underwater forests and ensure their persistence in changing oceans.
Understanding the structure, thermal, and optical properties in Al2O3‐incorporated La2O3‐TiO2‐Nb2O5 glasses
Authors: Yang Jun , Li Jianqiang , Lu Ping
Published: January 2021

Glasses in the 30La2O3‐40TiO2‐30Nb2O5 system are known to have excellent optical properties such as refractive indices over 2.25 and wide transmittance within the visible to mid‐infrared (MIR) region. However, titanoniobate glasses also tend to crystallize easily, significantly limiting their applications in optical glasses due to processing challenges. Therefore, the 30La2O3‐40TiO2‐(30−x) Nb2O5‐xAl2O3 (LTNA) glass system was successfully synthesized using a aerodynamic containerless technique, which improves glass thermal stability and expands the glass‐forming region. The effects of Al2O3 on the structure, thermal, and optical properties of base composition glasses were investigated by XRD, DSC, NMR, Raman spectroscopy, and optical measurements. DSC results indicated that as the content of Al2O3 increased, the thermal stability of the glasses and glass‐forming ability increased, as the 30La2O3‐40TiO2‐25Nb2O5‐5Al2O3 (Nb‐Al‐5) glass obtained the highest ΔT value (103.5°C). Structural analysis indicates that the proportion of [AlO4] units increases gradually and participates in the glass network structure to increase connectivity, promoting more oxygen to become bridging oxygen and form [AlO4] tetrahedral linkages to [TiO5] and [NbO6] groups. The refractive index values of amorphous glasses remained above 2.1 upon Al2O3 substitution, and a transmittance exceeding 65% in the visible and mid‐infrared range. The crystallization activation energies of 30La2O3‐40TiO2‐30Nb2O5 (Nb‐Al‐0) and Nb‐Al‐5 glasses were calculated to be 611.7 and 561.4 kJ/mol, and the Avrami parameters are 5.28 and 4.96, respectively. These results are useful to design new optical glass with good thermal stability, high refractive index and low wavelength dispersion for optical applications such as lenses, endoscopes, mini size lasers, and optical couplers.
Efficacy of intentional permanent atrial pacing in the long‐term management of congenital long QT syndrome
Authors: Kowlgi Gurukripa N. , Giudicessi John R. , Barake Walid , Bos J. Martijn , Ackerman Michael J.
Published: January 2021

Background

Unfortunately, some patients with long QT syndrome (LQTS) experience breakthrough cardiac events (BCEs) despite maximal therapy. Small studies have shown that refractory LQTS cases may benefit from intentional permanent atrial pacing (IPAP). As such, we sought to determine the genotype‐specific utilization and efficacy of IPAP in a single‐center LQTS registry.

Methods and Results

In this retrospective study, electronic medical records from 1065 patients diagnosed with LQTS were used to identify individuals that received IPAP. Pre‐ and post‐IPAP heart rate, heart rate‐corrected QT (QTc) values, annual BCE rate, and IPAP‐related complications were compared between genotypes. BCEs were defined as LQTS‐associated syncope/seizures, sustained ventricular arrhythmia (VA)‐terminating ICD therapies, and sudden cardiac arrest/death.

Overall, 52 out of 1065 LQTS patients received adjunctive IPAP therapy (77% female; median age 18.5 [interquartile range, 1–35.5] years; 73% with prior VA). Over an average IPAP follow‐up of 121 ± 82 months, the average heart rate increased from 65.8 ± 20.4 bpm to 78.9 ± 17.1 bpm; (p < .01) and the average QTc decreased from 533.4 ± 66.6 to 488.3 ± 52.4 ms; (p < .01). The mean BCE rate dropped from 0.88 to 0.19 per patient‐year (p = .01), driven by a marked decrease in the LQT2 cohort (1.01 BCE/year to 0.02 BCE/year; p = .003). No serious IPAP‐related complications were observed.

Conclusion

In high‐risk LQTS patients, namely those with recalcitrant LQT2, IPAP appears to be a safe and efficacious adjunct therapy. The beneficial effects of IPAP may stem from attenuating the QTc and circumventing a pause‐dependent trigger. Whether IPAP might obviate the need for an ICD in some instances warrants further study.
Dental pulp–derived stem cells inhibit osteoclast differentiation by secreting osteoprotegerin and deactivating AKT signalling in myeloid cells
Authors: Kanji Suman , Sarkar Ripon , Pramanik Asmita , Kshirsagar Sudhir , Greene Carl J. , Das Hiranmoy
Published: January 2021

Osteoclasts (OCs) differentiate from the monocyte/macrophage lineage, critically regulate bone resorption and remodelling in both homeostasis and pathology. Various immune and non‐immune cells help initiating activation of myeloid cells for differentiation, whereas hyper‐activation leads to pathogenesis, and mechanisms are yet to be completely understood. Herein, we show the efficacy of dental pulp–derived stem cells (DPSCs) in limiting RAW 264.7 cell differentiation and underlying molecular mechanism, which has the potential for future therapeutic application in bone‐related disorders. We found that DPSCs inhibit induced OC differentiation of RAW 264.7 cells when co‐cultured in a contact‐free system. DPSCs reduced expression of key OC markers, such as NFATc1, cathepsin K, TRAP, RANK and MMP‐9 assessed by quantitative RT‐PCR, Western blotting and immunofluorescence detection methods. Furthermore, quantitative RT‐PCR analysis revealed that DPSCs mediated M2 polarization of RAW 264.7 cells. To define molecular mechanisms, we found that osteoprotegerin (OPG), an OC inhibitory factor, was up‐regulated in RAW 264.7 cells in the presence of DPSCs. Moreover, DPSCs also constitutively secrete OPG that contributed in limiting OC differentiation. Finally, the addition of recombinant OPG inhibited OC differentiation in a dose‐dependent manner by reducing the expression of OC differentiation markers, NFATc1, cathepsin K, TRAP, RANK and MMP9 in RAW 264.7 cells. RNAKL and M‐CSF phosphorylate AKT and activate PI3K‐AKT signalling pathway during osteoclast differentiation. We further confirmed that OPG‐mediated inhibition of the downstream activation of PI3K‐AKT signalling pathway was similar to the DPSC co‐culture–mediated inhibition of OC differentiation. This study provides novel evidence of DPSC‐mediated inhibition of osteoclastogenesis mechanisms.
Are older adults with excessive sodium intake at increased risk of hypohydration?
Authors: Gamba Marta , Moreira Pedro , Borges Nuno , Santos Alejandro , Afonso Cláudia , Amaral Teresa F. , Padrão Patrícia
Published: January 2021

Background

Sodium intake is expected to affect water needs, although compensation mechanisms may not work efficiently particularly in older adults. The aim of this cross‐sectional study was to quantify the association between sodium excretion and hydration status in a representative sample of Portuguese older adults.

Methods

A cluster sampling approach was used, representing Portuguese older adults (≥65 years) according to sex, education level and region. From a sample size of 1500 participants, 1318 were eligible for the present analysis. A 24‐h urine sample was collected, and volume, osmolality, creatinine and sodium were quantified. Free water reserve (FWR) was used to assess hydration status. Excessive sodium intake was defined as above 2000 mg day–1 as recommended by the World Health Organization. A multivariable binary logistic regression model was used to estimate the association between FWR and sodium excretion. Odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated.

Results

Excessive sodium excretion was observed in 80.0% of women and 91.5% of men, whereas hypohydration affected 10.9% of women and 23.6% of men. After adjusting for confounders, excessive sodium excretion was associated with an increased risk of hypohydration among men (OR = 2.75; 95% CI = 1.06–7.15).

Conclusions

These results stress the positive association between excessive sodium intake and hypohydration in men and highlight the need for implementing strategies regarding the reduction of salt consumption and the promotion of water intake.
Pseudomonas syringae pv. syringae as the new causal agent of cabbage leaf blight
Authors: Basavand Esmaeil , Khodaygan Pejman , Rahimian Heshmat , Babaeizad Valiollah , Mirhosseini Hossein Ali
Published: January 2021

Cabbage with excellent source of vitamins, antioxidants and minerals, is among the most popular vegetables worldwide. In 2016, during our surveys of cabbage diseases in the Mazandaran province, Iran, symptoms of blight and detaching of leaves, water soaking, browning and decline were observed on the mature plants of cabbage (Brassica oleracea var. capitata). Bacterial isolation from the infected plants was performed using conventional microbiological methods. The isolated strains were identified through amplification and sequencing of the partial gyrB and rpoD genes and also through standard biochemical, physiological, and pathogenicity tests. Analysis of the molecular data by bioinformatics software clustered representative isolates into Pseudomonas syringae sensu stricto. To the best of our knowledge, this is the first attempt to confirm the occurrence of bacterial leaf blight of cabbage caused by Pseudomonas syringae sensu stricto in Iran by a multiple approach.
Informing mothers of neonatal death and the need for family‐centered bereavement care: A phenomenological qualitative study
Authors: Abdel Razeq Nadin M. , Al‐Gamal Ekhlas
Published: January 2021

Purpose

To understand the lived experience of mothers surrounding the time of being informed of neonatal deaths in intensive care units.

Design

A phenomenological qualitative approach was employed.

Methods

Twelve mothers (age 24–41 years) were identified from the neonatal mortality records of two large neonatal intensive care units with high neonate turnover rates in Amman, Jordan. Data were collected using semistructured interviews with the participants. Interpretive phenomenology was used to generate themes regarding the essence of the mother's experience.

Results

Critical analyses of mothers' accounts revealed three major themes: (a) Minimize the hurt, which described how mothers intuited overprotection by their families while the news was conveyed indirectly to them; (b) The striking reality of death, which captured mothers' distressing experiences while realizing the loss of their neonates; and (c) Farwell my baby, which accentuated mothers' needs and experiences while neonates' bodies were honored and prepared for burial per the cultural norms in Jordan.

Practice Implications

Our findings highlighted the complex dynamics of familial interactions and cultural influences on mothers' bereavement experiences at the time of neonatal death. The grieving mothers expressed unfulfilled needs of receiving professional bereavement support at the time of neonatal death. Strategies are needed to optimize the supportive role of specialized nurses in providing family‐centered bereavement care to mothers and their families who experience neonatal death.
Conserved lysine residues in decorin binding proteins ofBorrelia gariniiare critical in adhesion to human brain microvascular endothelial cells
Authors: Pietikäinen Annukka , Åstrand Mia , Cuellar Julia , Glader Otto , Elovaara Heli , Rouhiainen Meri , Salo Jemiina , Furihata Tomomi , Salminen Tiina A. , Hytönen Jukka
Published: January 2021

Lyme borreliosis is a tick‐borne disease caused byBorrelia burgdorferisensu lato spirochetes (Lyme borreliae). When the disease affects the central nervous system, it is referred to as neuroborreliosis. In Europe, neuroborreliosis is most often caused byBorrelia garinii. Although it is known that in the host Lyme borreliae spread from the tick bite site to distant tissues via the blood vasculature, the adherence of Lyme borreliae to human brain microvascular endothelial cells has not been studied before. Decorin binding proteins are adhesins expressed on Lyme borreliae. They mediate the adhesion of Lyme borreliae to decorin and biglycan, and the lysine residues located in the binding site of decorin binding proteins are important to the binding activity. In this study, we show that lysine residues located in the canonical binding site can also be found in decorin binding proteins ofBorrelia garinii, and that these lysines contribute to biglycan and decorin binding. Most importantly, we show that the lysine residues are crucial for the binding of Lyme borreliae to decorin and biglycan expressing human brain microvascular endothelial cells, which in turn suggests that they are involved in the pathogenesis of neuroborreliosis.
The novel reconsidered: Emotions and anti‐realism in mid‐19th‐century Scandinavian literature
Authors: Bohlin Anna
Published: January 2021

The aim of the present article is to investigate the novel as remediation of nationalist pedagogy: how was the pedagogical, nationalist project charged with emotions? How did elements from non‐realist genres make emotions ‘stick’? And what are, in return, the implications of the use of non‐realist elements for the nationalist project, more specifically for nationalist temporalities? The hybrid novel form allowed for incorporating different kinds of archives, constructing a national heritage, such as material from collections of oral tradition, records from witchcraft trials, medieval manuscripts and geographical accounts including cartography. The novel added emotions to the nationalist pedagogical project by means of elements from decidedly non‐realist genres such as melodrama, the Gothic novel and allegory. I argue, contrary to Benedict Anderson, that ‘Messianic time’ was in fact essential in the novel's contribution to nationalism; a temporality of prefiguration and fulfilment made emotions stick.
Recurrent pneumococcal meningitis due to occult middle fossa encephalocele
Authors: Yokose Ozawa Misato , Koide Reiji , Ozawa Tadashi , Mashiko Takafumi , Kawai Kensuke , Fujimoto Shigeru
Published: January 2021

Recurrent bacterial meningitis is not a frequent clinical condition. We describe here the case of a woman with recurrent pneumococcal meningitis caused by the leakage of CSF due to an occult middle fossa encephalocele related to chronic otitis media. To detect an extremely small encephalocele, detailed evaluation by bone CT and RI cisternography are very useful. In the treatment of recurrent bacterial meningitis, clinicians should examine for the presence of a small encephalocele early and perform an appropriate surgical therapy, because the condition could be fatal.
Routine assessment of gastrointestinal symptom using a validated questionnaire in the clinical setting to assess the probability of organic or functional gastrointestinal diseases
Authors: Jones Michael P. , Shah Ayesha , Ben‐Jacob Ronen , Talley Nicholas J. , Hansen Teressa , Walker Marjorie M. , Gray Marcus , Koloski Natasha A. , Holtmann Gerald
Published: January 2021

Background

Patients presenting with gastrointestinal symptoms can be challenging in terms of determining etiology and management strategies. Identifying likely organic pathology is important since it can be treated and may result in further, long‐term harm to the patient if not treated. Currently, organic pathology is often identified via invasive procedures such as endoscopy or referral to a medical imaging service. We report on an approach that offers a first step at identifying patients with an organic gastrointestinal disease based on the SAGIS, a validated symptom questionnaire.

Methods

8,922 patients referred to a tertiary care hospital were classified as having either functional gastrointestinal disease or an organic gastrointestinal disease. A model was developed to distinguish organic from functional symptoms on one random split half of the sample and validated on the other half. The incremental benefit of including psychological conditions and extra‐gastrointestinal conditions was also evaluated.

Key results

Functional gastrointestinal patients scored higher on average than organic patients on all dimensions of the SAGIS and reported higher rates of psychological and extra‐gastrointestinal conditions. All five dimensions of the SAGIS provided statistically independent discrimination of organic from functional diagnoses with good overall discrimination (AUC = 0.75). However, there was no noticeable incremental benefit of adding either psychological or extra‐gastrointestinal conditions. Model performance was highly reproducible.

Conclusions and inferences

The proposed algorithm for identifying likely organic gastrointestinal disease applied to symptoms as recorded in the SAGIS questionnaire provides a useful tool for the clinician in deciding what or if further diagnostic testing is required.
A qualitative study exploring adolescents’ experience of brief behavioural activation for depression and its impact on the symptom of anhedonia
Authors: Watson Rebecca , Harvey Kate , Pass Laura , McCabe Ciara , Reynolds Shirley
Published: January 2021

Objectives

Anhedonia, the loss of interest and pleasure, is a core symptom of depression and is associated with deficits in reward processing. Behavioural Activation for depression may address this symptom due to its focus on identifying and increasing intrinsically rewarding activities.

Design

This was a qualitative study employing reflexive thematic analysis (TA).

Methods

Participants were eight treatment‐seeking adolescents with a recent primary diagnosis of depression who had received eight sessions of Brief Behavioural Activation. Qualitative semi‐structured interviews were conducted after treatment was completed.

Results

Three main themes emerged: (1) connecting, reviewing, and taking action: ‘focus on getting better rather than what you’re feeling’; (2) struggles, restrictors, and motivators: ‘it seemed really unachievable’; and (3) feeling, acting, or seeing things differently: ‘looking forwards in a more healthy way’.

Conclusions

Both specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic strategies (e.g., self‐monitoring) may be helpful in treating the symptom of anhedonia in adolescent depression. Motivational aspects of anhedonia, as well as anxiety, fatigue, and academic pressures act as potential barriers to recovery. This highlights the need for psychological treatments for adolescent depression to include explicit and targeted strategies to enhance motivation.

Practitioner points

Young people reported that specific Brief Behavioural Activation strategies (e.g., connecting with values) and more generic therapeutic techniques (e.g., self‐monitoring) had a role in treating anhedonia.

Barriers to engaging in Brief BA included: motivational anhedonia, fatigue, and academic demands.
Human Rationality: Descartes and Aristotle
Authors: Christofidou Andrea
Published: January 2021

Current debates on human rationality are divided between what Matthew Boyle calls the additive and transformative approaches. My concern is not with the current debate, but with Boyle’s alignment of Descartes and Aristotle with the modern approaches, directing his criticisms against the former, and his defence in support of the latter. What motivates my enquiry is whether Boyle’s use of the two philosophers’ theses stands up to scrutiny and consequently whether his alignments are cogent. I focus primarily on Descartes’ position, examining Boyle’s criticisms. Towards the end, I turn to Aristotle’s position and raise two central questions omitted by Boyle.
Genome‐wide association study of cyanogenic glycosides, proline, sugars, and pigments in Eucalyptus cladocalyx after 18 consecutive dry summers
Authors: Mora‐Poblete Freddy , Ballesta Paulina , Lobos Gustavo A. , Molina‐Montenegro Marco , Gleadow Roslyn , Ahmar Sunny , Jiménez‐Aspee Felipe
Published: January 2021

Natural variation of cyanogenic glycosides, soluble sugars, proline, and nondestructive optical sensing of pigments (chlorophyll, flavonols, and anthocyanins) was examined in ex situ natural populations of Eucalyptus cladocalyx F. Muell. grown under dry environmental conditions in the southern Atacama Desert, Chile. After 18 consecutive dry seasons, considerable plant‐to‐plant phenotypic variation for all the traits was observed in the field. For example, leaf hydrogen cyanide (HCN) concentrations varied from 0 (two acyanogenic individuals) to 1.54 mg cyanide g−1 DW. Subsequent genome‐wide association study revealed associations with several genes with a known function in plants. HCN content was associated robustly with genes encoding Cytochrome P450 proteins, and with genes involved in the detoxification mechanism of HCN in cells (β‐cyanoalanine synthase and cyanoalanine nitrilase). Another important finding was that sugars, proline, and pigment content were linked to genes involved in transport, biosynthesis, and/or catabolism. Estimates of genomic heritability (based on haplotypes) ranged between 0.46 and 0.84 (HCN and proline content, respectively). Proline and soluble sugars had the highest predictive ability of genomic prediction models (PA = 0.65 and PA = 0.71, respectively). PA values for HCN content and flavonols were relatively moderate, with estimates ranging from 0.44 to 0.50. These findings provide new understanding on the genetic architecture of cyanogenic capacity, and other key complex traits in cyanogenic E. cladocalyx.
Is British output growth related to its uncertainty? Evidence using eight centuries of data
Authors: Bredin Don , Fountas Stilianos , Savva Christos
Published: January 2021

We examine the empirical relationship between output variability and output growth for Britain using data for eight centuries covering the 1270 to 2014 period. Drawing on the economic history literature, we split the full sample period into four subperiods and use GARCH models to measure output growth uncertainty and estimate its effect on average growth. Within each sub‐sample, we allow output growth to depend on the state of the system, for example 2‐regime switching model would switch between high‐growth and low‐growth regimes. We find that the effect of uncertainty on growth differs depending on the existing growth regime. Low‐growth regimes are associated with a negative effect of uncertainty on growth, and medium or high‐growth regimes are associated with a positive effect. These findings are consistent across the four states of economic development. Our results indicate why the empirical literature to date has found mixed results when examining the effect of uncertainty on growth.
Retrospective evaluation of the performance of the electrical impedance spectroscopy system Nevisense in detecting keratinocyte cancers
Authors: Liebich Christoph , von Bruehl Marie‐Luise , Schubert Irene , Oberhoffer Renate , Sander Christian
Published: January 2021

Background

Keratinocyte cancers, also referred to as non‐melanoma skin cancers (NMSCs), are one of the most common malignant skin tumors. We performed a retrospective analysis of lesions from patients of a private dermatology practice to evaluate the use of electrical impedance spectroscopy (EIS) in detecting keratinocyte malignancies. The aim of the study is to assess the accuracy of the technique and to rate its use as supportive tool in NMSC diagnosis.

Material and Methods

The period evaluated ranges from September 2015 to November 2019. In total, 1712 lesions from 951 patients were included. All lesions suspicious for malignancy were gauged with the Nevisense device. Excised lesions were sent in for histopathological classification, and the results were compared to the Nevisense score.

Results

A total of 767 lesions (44.8%) received a negative score (0‐3) from the Nevisense system and 945 lesions (55.2%) a positive score (4‐10). The combination of the dermatologist's visual assessment plus the technical determined Neviscore resulted in the excision of 52.5% of all 1712 suspicious lesions whereof 15% were found to be malignant. The sensitivity of Nevisense was 98.4% for NMSC detection.

Conclusion

Electrical impedance spectroscopy was found to be a valuable adjunct support tool in clinical decisions for cases with suspicion for NMSC.
Sending money home: Transaction cost and remittances to developing countries
Authors: Ahmed Junaid , Mughal Mazhar , Martínez‐Zarzoso Inmaculada
Published: January 2021

Reducing the cost of remitting is one of the targets within the 2030 Sustainable Development Goals (SDG 10). A key factor that causes migrants to use informal channels when sending money back home is the high cost of transferring funds through formal channels. This study examines whether and to what extent the reduction in the cost of sending remittances increases the flow of remittances to developing countries, and whether larger amounts are remitted when the cost per transaction decreases (the so‐called scale effect). It uses bilateral data on remittance flows and exploits a novel dataset covering transaction costs for 30 sending and 75 receiving countries for the period 2011–2017. A gravity model of remittance flows is estimated using panel data and instrumental variable techniques to address endogeneity issues. We find that transaction cost is a significant predictor of the volume of formal remittances. A 1% decrease in the cost of remitting USD 200 leads to about a 1.6% increase in remittances. This association is robust to the different models and techniques employed. The findings suggest that policies designed to increase formal remittances need to focus on decreasing the cost of remitting through formal channels.
Numerical Investigation of the Dynamical Behavior of a Fluid-Filled Microparticle Suspended in Human Arteriole
Authors: El Jirari I. , El Baroudi A. , Ammar A.
Published: January 2021

The study of artificial microparticles (capsules and vesicles) has gained a growing interest with the emergence of bio-engineering. One of their promoting applications is their use as therapeutic vectors for drug delivery, when capsules and vesicles release their capacity in a targeted environment. The dynamic behavior of capsules and vesicles in confined or unbounded flows was widely studied in the literature and their mechanical response was truthfully described using constitutive laws with good agreement with experiences. However, in a context of biological application, to our knowledge, none of published studies investigating the mechanical response of deformable microparticle took into account the real physiological conditions: the rheological properties of blood such as carrying fluid and the mechanical properties of blood vessels. In this paper, we consider a hyperelastic microparticle suspended in human arteriole. We investigate the deformation of the microparticle resulting from its interaction with blood flow and the arteriolar wall using various capillary numbers and respecting physiological properties of blood and arterial wall. The influence of the blood viscosity model (Newtonian versus shear thinning) is investigated and a comparison with a rigid microchannel and a muscle-embedded arteriole is carried out. The fluid structure interaction (FSI) problem is solved using arbitrary Lagrangian Eulerian (ALE) method. Our simulations have revealed that the arteriolar wall distensibility deeply influences both the deformation and velocity of the microparticle: the deformation strongly increases while the velocity decreases in comparison to an infinitely rigid wall. In the context of therapeutic procedure of targeted drug-delivery, a particular attention should be addressed to these observations, in particular for their implication in the burst mechanism.
Spectral Imaging and Computer Vision for High-Throughput Defect Detection and Root-Cause Analysis of Silicon Nanopillar Arrays
Authors: Gawlik Brian , Barr Ariel R. , Mallavarapu Akhila , Yu Edward T. , Sreenivasan S. V.
Published: January 2021

Far-field spectral imaging, coupled with computer vision methods, is demonstrated as an effective inspection method for detection, classification, and root-cause analysis of manufacturing defects in large area Si nanopillar arrays. Si nanopillar arrays exhibit a variety of nanophotonic effects, causing them to produce colors and spectral signatures which are highly sensitive to defects, on both the macro- and nanoscales, which can be detected in far-field imaging. Compared with traditional nanometrology approaches like scanning electron microscopy (SEM), atomic force microscopy (AFM), and optical scatterometry, spectral imaging offers much higher throughput due to its large field of view (FOV), micrometer-scale imaging resolution, sensitivity to nm-scale feature geometric variations, and ability to be performed in-line and nondestructively. Thus, spectral imaging is an excellent choice for high-speed defect detection/classification in Si nanopillar arrays and potentially other types of large-area nanostructure arrays (LNAs) fabricated on Si wafers, glass sheets, and roll-to-roll webs. The origins of different types of nano-imprint patterning defects—including particle voids, etch delay, and nonfilling—and the unique ways in which they manifest as optical changes in the completed nanostructure arrays are discussed. With this understanding in mind, computer vision methods are applied to spectral image data to detect and classify various defects in a sample containing wine glass-shaped Si resonator arrays.