bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucocorticoid and β‐adrenergic regulation of hippocampal dendritic spines
Authors: Lesuis Sylvie L. , Timmermans Wendy , Lucassen Paul J. , Hoogenraad Casper C. , Krugers Harm J.
Published: November 2019

Glucocorticoid hormones are particularly potent with respect to enhancing memory formation. Notably, this occurs in close synergy with arousal (i.e., when norepinephrine levels are enhanced). In the present study, we examined whether glucocorticoid and norepinephrine hormones regulate the number of spines in hippocampal primary neurons. We report that brief administration of corticosterone or the β‐adrenergic receptor agonist isoproterenol alone increases spine number. This effect becomes particularly prominent when corticosterone and isoproterenol are administered together. In parallel, corticosterone and isoproterenol alone increased the amplitude of miniature excitatory postsynaptic currents, an effect that is not amplified when both hormones are administered together. The effects of co‐application of corticosterone and isoproterenol on spines could be prevented by blocking the glucocorticoid receptor antagonist RU486. Taken together, both corticosterone and β‐adrenergic receptor activation increase spine number, and they exert additive effects on spine number for which activation of glucocorticoid receptors is permissive.
Integration of skeletal traits in some passerines: impact (or the lack thereof) of body mass, phylogeny, diet and habitat
Authors: Shatkovska Oksana V. , Ghazali Maria
Published: November 2019

Morphological integration of the bird skeleton is of great interest because it relates to issues of specialization, plasticity, and rate of evolutionary transformations of a skeleton as a whole and its anatomical regions. Despite growing interest, the integration and modularity of the skeleton of birds, in general, remain little studied. We evaluated the change of relative sizes and integration of shapes of skull, sternum and pelvis, and factors that influence the covariation of these regions among passerines. Results of both standard and phylogenetic reduced major axis showed that the relative lengths of the most studied skeletal traits were largely determined by body mass. The length of the skull scaled isometrically on body mass, and the lengths of both synsacrum and ilium showed positive allometry. Within the skull, beak length was positively allometric, whereas cranium length was negatively allometric with body mass. We found the presence of covariation between shapes of skull, sternum and pelvis using standard partial least squares (PLS) analysis and absence of covariation between most of these blocks using evolutionary PLS analysis on phylogenetic independent contrasts. Evolutionary integration is confirmed only for shapes of skull and pelvis (dorsal view).
The association of malnutrition with falls and harm from falls in hospital inpatients: Findings from a 5‐year observational study
Authors: Lackoff Ariel S. , Hickling Donna , Collins Peter F. , Stevenson Katherine J. , Nowicki Tracy A. , Bell Jack J.
Published: November 2019

Background

Inpatient falls continue to be a significant clinical issue, and while malnutrition is a known risk factors for falls, few studies have investigated its association with inpatient falls. This study aimed to explore the independent association between malnutrition and fall risk as well as harm from falls in hospital inpatients.

Methods

Malnutrition identified in annual malnutrition audits was combined with inpatient fall data captured through the electronic patient incident reporting system in the 12 months following audit days. Audit data were available for 1,849 inpatients across 2011–2015, and covariate associations between age, gender, BMI, malnutrition, falls and harmful falls were analysed. The reporting of this paper is in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations (see Appendix S1).

Results

The prevalence of malnutrition was 32.4% (n = 543), and 171 (9.2%) inpatients experienced a fall with 0.7% (n = 13) categorised as harmful. In bivariate analysis, patients who fell were more likely to be older (median 79.0 vs. 70.0 years; p < .0001) or malnourished (40.9% vs. 31.5%; p = .021). Malnutrition (p < .0001) and having a lower BMI (p = .026) were significant predictors of harmful falls. Regression modelling demonstrated that only increasing age increased the likelihood of having an inpatient fall (OR 1.022 95% CI 1.021–1.046; p < .0001). Malnourished inpatients were almost 8 times more likely to have a harmful fall than those not malnourished (OR 7.94 95% CI 1.457–43.338; p = .017), independent of age and BMI.

Conclusions

Malnourished patients are more likely to experience a harmful fall. Assessment of malnutrition should be incorporated into fall risk assessments as a way of highlighting those patients at greater risk and to link to nutritional care pathways.
Challenges for nurses when communicating with people who have life‐limiting illness and their families: A focus group study
Authors: Kerr Debra , Milnes Sharyn , Ammentorp Jette , McKie Claire , Dunning Trisha , Ostaszkiewicz Joan , Wolderslund Maiken , Martin Peter
Published: November 2019

Aims and objectives

The proposed study aimed to answer the following question: What communication issues do nurses find challenging when caring for people with life‐limiting illness?

Background

Evidence suggests that attitudes, skills and knowledge about how nurses communicate effectively with patients and their families could be improved. However, the literature predominantly focuses on nurses working in oncology and the medical profession.

Design

A qualitative descriptive design was used.

Methods

Focus groups were conducted with 39 nurses from three wards within a regional healthcare organisation in Victoria, Australia. Data were analysed using thematic content analysis. The COREQ checklist was used to document reporting of the study.

Results

In their view, nurses have the potential to develop a strong bond with patients and their families. Three key themes were identified: (a) feeling unskilled to have difficult conversations with patients who have life‐limiting illness; (b) interacting with family members adds complexity to care of patients who have life‐limiting illness; and (c) organisational factors impede nurses' capacity to have meaningful conversations with patients and their families.

Conclusions

Caring for individuals with life‐limiting illness is complex and often occurs in an emotionally charged environment. However, nurses report being hampered by time restraints and lack of information about the patient's condition and goals of care. Limitations in conversation structure and a comprehensive range of core communication skills affect their ability to confidently engage in conversations, particularly when they are responding to prognostic questions.

Relevance to clinical practice

Whilst nurses are responsible for performing technical skills, they can maximise care by developing a trusting relationship with patients and their relatives. Increased acuity limits the time nurses have to talk with patients. In addition, they lack confidence to deal with difficult questions. Specific training may increase nurses' confidence and efficiency when communicating with patients and their families.
Quitting trajectories of Chinese women smokers following telephone smoking cessation counselling: A longitudinal study
Authors: Ho Ka Yan , Li Ho Cheung William , Lam Katherine Ka Wai , Wang Man Ping , Xia Wei , Ho Long Kwan Laurie , Ou Ying Jane , Chan Sophia Siu Chee , Lam Tai Hing
Published: November 2019

Aims and Objectives

This study mapped the quitting patterns (trajectories) of Hong Kong Chinese women smokers who had received counselling via a quitline service and examined factors correlated with different trajectories.

Background

Quitting smoking is always a gradual and progressive process. However, most existing studies on smoking cessation have adopted a cross‐sectional approach to conduct evaluation. Little is known about the quitting trajectories of smokers, particularly those who are women after receiving smoking cessation counselling.

Methods

We used a retrospective longitudinal design and analysed 474 women smokers who had called the quitline. Quitting trajectories were mapped using latent growth modelling. Multinomial logistic regression was performed to identify factors associated with class membership. A STROBE checklist was completed.

Results

We identified three trajectory groups: ‘quitters’ who quit smoking at 6 months and abstained from cigarettes up to 6 years; ‘reducers’ who cut down cigarette consumption ≥50% at 3 years and maintained reduced levels up to 6 years; and ‘increasers’ who increased smoking ≥20% at 3 years and continued smoking up to 6 years. Participants who perceived more difficulties in quitting were more likely to be increasers. Those with higher daily cigarette consumption at baseline were more likely to be reducers.

Conclusions

We clarified three trajectory groups of women smokers. The results indicate that existing cessation services need to be improved, especially for women smokers who do not quit after receiving telephone counselling.

Relevance to clinical practice

Existing cessation services need to be improved, especially for women smokers who do not quit after receiving telephone counselling. For those who reduce smoking but fail to quit, quit plans should be developed that provide step‐by‐step guidance in achieving abstinence through smoking reduction. Instant messages may complement telephone counselling to deliver cessation support for those who increase their cigarette consumption.
Are there changes to regional tissue oxygenation and circulation following umbilical artery catheter placement? A prospective cohort study in newborn infants
Authors: Jani Pranav , Hinder Murray , Badawi Nadia , Galea Claire , Goodwin Andrew , Tracy Mark
Published: November 2019

Aim

The use of umbilical arterial catheters (UACs) is a standard of care in monitoring critically unwell infants. Serious vascular complications are rare but when they do occur, they can be associated with significant morbidity, risking limb loss or even death. Near infra‐red spectroscopy has the potential to monitor limb perfusion. Our study investigates changes in tissue oxygenation and perfusion in the abdominal and leg circulation following UAC insertion.

Methods

A prospective observational study performing ultrasound pulsed Doppler measurements in the coeliac, superior mesenteric artery, renal arteries and the femoral arteries as well as near infrared spectroscopy measurements of both thighs at three time points (immediately before = Time 1, 1 h after = Time 2 and 24 h after UAC insertion = Time 3).

Results

We monitored 30 infants, the mean gestational age was 30 weeks (24–41) and the mean birthweight was 1720 g (600–4070 g). We observed statistically significant changes (P < 0.05) in pulse Doppler measurements in coeliac (mean peak systolic velocity (PSV): Time 1 = 70.51, Time 2 = 61.75; resistive index (RI): Time 1 = 0.75, Time 2 = 0.67), superior mesenteric (PSV: Time 1 = 41.72, Time 2 = 36.10; RI: Time 1 = 0.92, Time 2 = 0.87), renal (same side end‐diastolic velocity: Time 1 = 1.98, Time 2 = 3.80; RI: Time 1 = 0.93, Time 2 = 0.87; opposite side end‐diastolic velocity: Time 1 = 2.62, Time 2 = 3.84; RI: Time 1 = 0.92, Time 2 = 0.85) and femoral arteries (same side PSV: Time 1 = 72.75, Time 2 = 62.18; opposite side PSV: Time 1 = 81.89, Time 2 = 62.74). Tissue oxygenation in lower limbs remained unaffected (same side (mean): Time 1 = 68.59, Time 2 = 68.99, Time 3 = 66.40, opposite side: Time 1 = 67.72, Time 2 = 66.92, Time 3 = 65.40). All infants on clinical examination had normal lower limb perfusion, lower limb arterial pulses and normal perfusion to the gluteal region before and after insertion of UAC.

Conclusions

While sub‐clinical changes in perfusion occur in abdominal and leg circulation, these changes are not consistent across vessels and regional tissue oxygenation remains unaffected.
Meio‐epifaunal wood colonization in the vicinity of methane seeps
Authors: Gracia C. Adriana , Levin Lisa A. , Zea Sven
Published: November 2019

In deep‐sea environments, plant remains of several origins are found, including branches, twigs, leaves, and wood pieces, among others. As most of the deep‐sea bottoms are oligotrophic and nutrient‐limited, plant remains provide an oasis of localized organic enrichment and a substrate for colonization. Sunken wood was suggested to play an important evolutionary role in the diversification of chemosynthetic ecosystems, possibly representing stepping stones for the colonization between vent and seep ecosystems. In order to understand colonization processes of the Pacific Costa Rican meio‐epifaunal assemblages associated with sunken wood, a field experiment was conducted on Mound 12 (8°55.778′N, 84°18.730′W) at ~1,000 m water depth. Woodblocks were placed in four different habitats (Mussel beds, tube worms, near mussel beds, rubble bottoms), and different local environmental conditions (seepage‐active and seepage‐inactive sites). Seven experimental Douglas fir woodblocks (each 1,047 cm2 in surface area) were deployed from the R/V Atlantis using the manned submersible Alvin in February 2009 and recovered after 10.5 months in January 2010. Sample processing and analyses led to a data set of abundance (total 9,951 individuals) and spatial distribution of nine meio‐epifaunal higher taxa/groups. Meio‐epifaunal densities on individual woodblocks ranged from 3 to 26 ind.10 cm2. Copepods accounted for the highest abundances (75.1%), followed by nauplii larvae (11.7%) and nematodes (9.8%). The maximum number of individuals (26.3 ind.10 cm−2) was found in blocks placed in seepage‐inactive areas (near active mussel beds) in contrast to 2.9 ind.10 cm−2 in active areas (within a mussel bed). A hierarchical cluster analysis grouped blocks according to seepage activity and not to habitat, but tests of similarity showed no significant differences in higher taxon composition and abundances, probably owing either to substrate homogeneity or low sample size. Copepods were the most abundant representatives, suggesting that this group is one of the most successful in colonizing in the early stage of succession, in this case while hardwood substrates are not yet decomposed or bored by bivalves.
Nonlinear price impact and portfolio choice
Authors: Guasoni Paolo , Weber Marko Hans
Published: November 2019

In a market with price impact proportional to a power of the order flow, we find optimal trading policies and their implied performance for long‐term investors who have constant relative risk aversion and trade a safe asset and a risky asset following geometric Brownian motion. These quantities admit asymptotic explicit formulas up to a structural constant that depends only on the curvature of the price impact function. Trading rates are finite as with linear impact, but are lower near the target portfolio, and higher away from the target. The model nests the square‐root impact law and, as extreme cases, linear impact and proportional transaction costs.
Unlocking the genetic basis of monarch butterflies' use of medicinal plants
Authors: Smilanich Angela M. , Nuss Andrew B.
Published: November 2019

If there was any doubt of the primary role that plant secondary metabolites play in host–parasite co‐evolution, the “From the Cover” paper by Tan et al. (2019) featured in this issue of Molecular Ecology will lay these doubts to rest. The group's previous work on monarch butterflies (Danaus plexippus) infected with the protozoan pathogen Ophryocystis elektroscirrha (OE) demonstrated higher survival and lower spore load on high cardenolide‐producing milkweed (Asclepias curassavica) (Figure 1a) compared with low cardenolide‐producing milkweed (A. incarnata) (de Roode, Pedersen, Hunter, & Altizer, 2008) (Figure 1b). The mechanism of this protective effect is not directly clear, but a leading hypothesis is that the cardenolides confer protection through toxicity to the parasite. However, the role of the caterpillar immune system in managing this parasite is largely unknown. Novel insights into the influence of toxic plant metabolites on caterpillar immunity are explored in Tan et al. (2019). Using transcriptomics to probe this model system, the authors found that herbivore immune genes were down‐regulated and detoxification genes were up‐regulated when larvae were reared on the milkweed species with high cardenolide concentrations (A. curassavica). Surprisingly, immune genes were not significantly up‐ or down‐regulated in response to protozoan infection alone. This tantalizing result suggests that sequestered plant metabolites, not immunity, is reining in protozoan infections in these larvae, and promoting survival. As the authors point out, the strategy to invest in sequestration may come at a cost, which is to the detriment of the immune response (Smilanich, Dyer, Chambers, & Bowers, 2009). However, the cost becomes worth the investment when chemical sequestration takes on an antipathogen role. The novelty of the Tan et al. (2019) paper is that they show the investment in sequestration leading to a possible divestment in immunity.
In vivo positron emission tomography imaging of decreased parasympathetic innervation in the gut of vagotomized patients
Authors: Fedorova Tatyana Dmitrievna , Knudsen Karoline , Hartmann Bolette , Holst Jens J. , Viborg Mortensen Frank , Krogh Klaus , Borghammer Per
Published: November 2019

Background

Parasympathetic neuropathy is a key feature in many common disorders, including diabetes, neurological disorders, and cancers, but few objective methods exist for assessing damage to the parasympathetic nervous system, particularly in the gastrointestinal system. This study aimed to validate the use of 11C‐donepezil positron emission tomography (PET) to assess parasympathetic integrity in a group of vagotomized patients.

Methods

Sixteen healthy controls and 12 patients, vagotomized due to esophagectomy, underwent 11C‐donepezil PET, measurement of colonic transit time, quantification of plasma pancreatic polypeptide (PP), and assessment of subjective long‐term symptoms.

Key Results

Vagotomized patients had significantly decreased PET signal in the small intestine and colon compared with healthy controls (5.7 [4.4‐7.9] vs 7.4 [4.5‐11.3], P = .01 and 1.4 [1.1‐2.1] vs 1.6 [1.4‐2.4], P < .01, respectively). Vagotomized patients also displayed a significantly increased colonic transit time (2.9 ± 0.9 h vs 1.9 ± 0.8 h), P < .01 and increased volumes of the small intestine and colon (715 ccm [544‐1177] vs 443 ccm [307‐613], P < .01 and 971 ccm [713‐1389] vs 711 ccm [486‐1394], P = .01, respectively). Patients and controls did not differ in PP ratio levels after sham feeding, but PP ratio at 10 minutes. after sham feeding and PET signal intensity in the small intestine was positively correlated (P = .03).

Conclusions and Inferences

We found significantly decreased 11C‐donepezil signal in the intestine of vagotomized patients, supporting that 11C‐donepezil PET is a valid measure of intestinal parasympathetic denervation.
Identifying important interaction modifications in ecological systems
Authors: Terry J. Christopher D. , Bonsall Michael B. , Morris Rebecca J.
Published: November 2019

Trophic interaction modifications, where a consumer–resource link is affected by additional species, are widespread and significant causes of non‐trophic effects in ecological networks. The sheer number of potential interaction modifications in ecological systems poses a considerable challenge, making prioritisation for empirical study essential. Here, we introduce measures to quantify the topological relationship of individual interaction modifications relative to the underlying network. We use these, together with measures for the strength of trophic interaction modifications, to identify features of modifications that are most likely to exert significant effects on the dynamics of whole systems. Using a set of simulated food webs and randomly distributed interaction modifications, we test whether a subset of interaction modifications important for the local stability and direction of species responses to perturbation of complex networks can be identified. We show that trophic interaction modifications have particular importance for dynamics when they affect interactions with a high biomass flux, connect species otherwise distantly linked, and where high trophic‐level species modify interactions lower in the food web. In contrast, the centrality of modifications in the network provided little information. This work demonstrates that analyses of interaction modifications can be tractable at the network scale and highlights the importance of understanding the relationship between the distributions of trophic and non‐trophic effects.
Variability of Pneumocystis jirovecii prophylaxis use among pediatric solid organ transplant providers
Authors: Paulsen Grant , Michaels Marian G. , Danziger‐Isakov Lara , Dipchand Anne I. , Green Michael , McCulloch Mignon
Published: November 2019

Pneumocystis jirovecii pneumonia (PJP) prophylaxis after pediatric solid organ transplant (SOT) is routinely recommended, but practice varies. Online survey was sent in 2018 to 707 members of the International Pediatric Transplant Association. A total of 105 responded, representing 47 institutions in 18 countries consisting of transplant physicians (66%), transplant surgeons (19%), nurse practitioners (6%), infectious disease physicians (5%), or pharmacists (4%). PJP prophylaxis was reported by 88%, while 12% did not routinely give prophylaxis. The majority not using PJP prophylaxis performed renal transplants (67%) citing low incidence of PJP (62%). Trimethoprim/sulfamethoxazole was first‐line agent (95%). PJP prophylaxis for 4‐6 months was the most frequent duration following kidney (48%, 27/56), liver (42%, 13/31), and heart (40%, 10/25) transplant. Abdominal multivisceral providers equally gave 10‐12 months (47%) or lifelong (47%); most lung transplant providers gave lifelong prophylaxis (85%). Across all organs, 21% provided lifetime prophylaxis. After completion of prophylaxis, 32% do not restart for any reason; majority of the rest would restart for treatment of acute graft rejection. 83% reported no PJP cases in the prior 12 months; 14% reporting 1‐5 infections. Only 3% reported a case of PJP infection on prophylaxis; none in SOT. PJP prophylaxis is routinely provided to pediatric SOT patients though practice and duration vary by center and organ type. Durations of 4‐6 months were most common for renal, liver, and heart transplant recipients, while 10‐12 months or lifelong prophylaxis were commonly reported for abdominal multivisceral recipients and most lung transplant recipients are given lifelong prophylaxis.
Skilled action
Authors: Christensen Wayne
Published: November 2019

I focus on problems defining skill and a core theoretical dispute over whether skilled action is largely automatic or consciously controlled. The dominant view in philosophy and psychology has been that skills are automatic, but an emerging body of work suggests that conscious cognition plays a significant role.
“We didn’t forget” Utilizing a Community‐Nurse Partnership to Promote Health in Rockport, Texas after Hurricane Harvey
Authors: Salt Rebekah J. , Sickora Cindy , Page Tracey L. , Martinez Martha L. , Cantu Adelita G. , Schwab Karen W. , Lee Moonju
Published: November 2019

Background

On August 25th 2017 Harvey, a category 4 hurricane, made landfall on the south coast of Texas with heavy winds and rain that severely damaged the seaside town of Rockport. The challenge facing healthcare providers following a natural disaster is timely assessments of community need and available resources. One week later, faculty at the University of Texas Health Science Center San Antonio, School of Nursing (SON) completed a community assessment and developed valuable partnerships.

Aims

Eighteen days after the initial assessment, faculty had secured support from The Children’s Health Fund and operationalized strategies to provide disaster relief and experiential learning opportunities for the SON Population Focused Health undergraduate students.

Materials & Methods

The community‐as‐partner model served as the framework to apply the nursing process to a community in crisis. As the focus shifted to recovery, the team prioritized the need to address long‐term consequences for children after a natural disaster.

Results

Two educational sessions were designed using an interactive and instructional approach to discuss parental strategies to assess and support children as they navigated through loss after Harvey.

Discussion

This community‐nurse partnership has endured, and the SON faculty and students continue to travel to Rockport to promote health and provide education to the community.
Dibenzothiophene Sulfone Derivatives as Plasma Membrane Dyes
Authors: Petroff John T. , Grady Scott , Arnatt Christopher K. , McCulla Ryan D.
Published: November 2019

Dibenzothiophene 5,5‐dioxide (DBTOO) derivatives have recently been shown to processes utility as fluorescent cell dyes. In an effort to extend the functionality of DBTOO‐based dyes to include the visualization of cellular membranes, two lipophilic DBTOO were synthesized and their ability to incorporate into the plasma membrane of HeLa cells was examined by fluorescent microscopy. The photophysical properties of the two new DBTOO derivatives were determined and both have good fluorescent quantum yields and a visible blue emission. Due to agreeable wavelengths of excitation and emission, a standard 4′,6‐diamindino‐2‐phenylindole (DAPI) filter set worked well with these dyes. After co‐staining, it was confirmed that both DBTOO dyes localized in the plasma membrane. The quality of the overlap was quantified using Pearson correlation coefficient, which indicated a strong overlap between the DBTOO dyes and the standard plasma membrane dye. The novel dyes also displayed relatively low toxicity to the HeLa cells with IC50 between 10 and 100 µm. Thus, this work reports a new use of DBTOO derivatives as fluorescent microscopy stains.
Flexible moral theories: Complexity, domination, and indeterminacy
Authors: Garcia‐Gibson Francisco , Rivera‐López Eduardo
Published: November 2019

In this article we identify three previously unnoticed problems with flexible moral theories, i.e., theories according to which different moral rules apply when there is full compliance and when there is partial compliance. The first problem is that flexible theories are necessarily very complex, which undermines their ability to motivate and guide action. The second problem is that flexible theories allow for a troubling kind of (moral) domination: the duties an agent has depend on other agents' willingness to comply. Finally, flexible theories introduce indeterminacy: it is sometimes impossible to determine which moral rules apply. When agents stand at the threshold—i.e., when a different rule would apply if a single additional act of noncompliance took place—it is impossible to determine which rule should apply.
What Explains the Decline in Neonatal Mortality in India in the Last Three Decades? Evidence from Three Rounds of NFHS Surveys
Authors: Singh Abhishek , Kumar Kaushalendra , Singh Ashish
Published: November 2019

Identifying the factors that have contributed to recent declines in neonatal mortality in India may help determine which policies and programs are most likely to facilitate further reductions. We use data from the 1992–93, 2005–06, and 2015–16 National Family Health Surveys (NFHS) to examine trends in neonatal mortality in India. We use multivariable decomposition to estimate the contribution of different factors to the change in neonatal mortality in India in the last three decades. When limited to most recent births in the 1–47 months preceding the surveys, 70 percent of the decline in neonatal mortality from 1992–2016 is due to changes in utilization of maternal‐ and child‐care program factors and distribution of household, mother's, and child's characteristics. Improvement in “mother's schooling” and increase in utilization of “at least two tetanus toxoid injections” contributed the most followed by the increase in use of “at least three antenatal‐care visits” and “clean fuel for cooking.” The change in distribution of “birth order” also contributed significantly to the decline in neonatal mortality. Change in the benefits of “access to improved water,” “delivery in a medical facility,” and “mother's schooling” has led to a decline of 3 points, 2 points, and 1 point, respectively. More investments in maternal‐ and child‐health programs (including family planning) and providing clean fuel for cooking are likely to pay higher dividends.
Beyond tail median and conditional tail expectation: Extreme risk estimation using tail Lp‐optimization
Authors: Gardes Laurent , Girard Stéphane , Stupfler Gilles
Published: November 2019

The conditional tail expectation (CTE) is an indicator of tail behavior that takes into account both the frequency and magnitude of a tail event. However, the asymptotic normality of its empirical estimator requires that the underlying distribution possess a finite variance; this can be a strong restriction in actuarial and financial applications. A valuable alternative is the median shortfall (MS), although it only gives information about the frequency of a tail event. We construct a class of tail Lp‐medians encompassing the MS and CTE. For p in (1,2), a tail Lp‐median depends on both the frequency and magnitude of tail events, and its empirical estimator is, within the range of the data, asymptotically normal under a condition weaker than a finite variance. We extrapolate this estimator and another technique to extreme levels using the heavy‐tailed framework. The estimators are showcased on a simulation study and on real fire insurance data.
Urban annexation of the rural:kebunculture in Malaysia
Authors: Thompson Eric C.
Published: November 2019

‘Kebunculture’ is a distinctive, emergent form of rural sensibility and social‐economic relations in Malaysia. As a contribution to theories of ‘planetary’ or thoroughgoing urbanization, the ethnographic evidence presented in the article illustrate a case of urban annexation of rurality, in whichkebun(orchards) are detached from the social organization of rural villages and incorporated into urban‐centered Malay society.Kebun, as productive land with non‐rice crops, have traditionally been associated with rural kampung (village). In the late twentieth century, thoroughgoing urbanization, driven by both rural‐to‐urban migration and in situ urbanization of rural kampung, simultaneously produced a social disintegration of Malay kampung and increasingly urban‐oriented Malay society. Thekebun, which previously was an ancillary part of kampung social ecology has become dissociated from kampung and instead operates as an annex of urban‐centered social lives.Kebunare also distinctively individuated rather than communal socio‐economic projects. In both reserve lands and kampung areas, urban‐based Malays and rural‐to‐urban return migrants are involved in kebun projects, through which they engage with nostalgic notions of rurality, but without the social entanglements of kampung social relations. At the same time, throughkebunprojects, urban Malay subjects enter into new social relations, albeit ones marked by commodification.
Ultra‐triathlon—Pacing, performance trends, the role of nationality, and sex differences in finishers and non‐finishers
Authors: Sousa Caio Victor , Nikolaidis Pantelis Theodoros , Knechtle Beat
Published: November 2019

Ultra‐triathlons are defined as triathlons longer than the traditional Ironman distance and became more popular in the last two decades; however, scarce scientific evidence of these events are available. Therefore, we aimed to investigate the trends of performance, pacing, nationality, sex differences, and rate of non‐finishers in ultra‐triathlons. Data from 1985 to 2018 were collected including Double Iron, Triple Iron, Quintuple Iron, and Deca Iron ultra‐triathlons. Different pacing patterns by event and sex were observed (P < .05); athletes spent less %time in swimming and cycling, and more %time in running as the distance of event was longer; women spent more %time in cycling and less% time in running in Double and Triple. Performance analysis showed a negative trend over time for men and women since 1985. Switzerland, France, and Germany were the fastest nations in ultra‐triathlons. The frequency of North Americans competing in Europe was very low (<5%), whereas Europeans often competed in North America (~25%). The rate of non‐finishers between sexes was similar in all races with the exception of Deca Iron ultra‐triathlon, which was much greater (~20%) for women. Non‐finishers had slower race times in swimming and cycling splits than finishers. In conclusion, ultra‐triathletes should redistribute their energy among swimming, cycling, and running depending on their sex and distance of race. Performance in ultra‐triathlons has been decreasing in men and women over the years, but sex difference in performance remained. Europeans were the fastest ultra‐triathletes and compete in Europe and North America. Additionally, non‐finishers were slower swimmers and cyclists than finishers.
Jamestown Canyon virus encephalitis in a heart transplant patient
Authors: Askar Wajih , Menaria Puneet , Thohan Vinay , Brummitt Charles F.
Published: November 2019

Jamestown Canyon virus (JtCV) is an arbovirus and a member of the California serogroup. To our knowledge, all the cases of JtCV have been reported in immunocompetent patients since it was first detected in 1997. We report a case of JtCV encephalitis in a solid organ transplant patient. A 48‐year‐old woman from Wisconsin had multiple hospital admissions for symptoms of progressive confusion, visual hallucinations, and inability to perform self‐care. Initial evaluation was significant for lymphocytes in cerebrospinal fluid (CSF), and multiple infectious and metabolic causes were excluded. Further investigation found JtCV IgM in serum, and CSF. The patient's clinical course was compatible with JtCV encephalitis, and she was treated with ribavirin in addition to reduction of her immunosuppressive medications. She showed gradual and significant improvement in her mental and functional status. JtCV can cause a variety of symptoms that range from a flu‐like syndrome to encephalitis. There have been an increased number of reported cases in recent years which is attributed to increased physician awareness and the availability of laboratory testing. Optimal treatment is still not known.
Mycobacterium tuberculosis DNA in living donor transplanted livers and donor‐related tuberculosis in recipients: A retrospective longitudinal cohort study
Authors: Alrajhi Abdulrahman A. , Alotaibi Jawaher , Alghamdi Ali M. , Almanea Hadeel , AlSebayel Mohammed , Al‐Meshari Khalid , Al‐Hajoj Sahal
Published: November 2019

Objectives

Mycobacterium tuberculosis DNA has been detected in multiple organs in people without active tuberculosis or a history of tuberculosis. Molecular testing for metabolic activity has suggested that M tuberculosis DNA represents viable bacilli. Whether transplanted organs with M tuberculosis DNA can result in tuberculosis in recipients has not been assessed.

Methods

Biopsies obtained at the time of living donor liver transplantation were tested for the presence of M tuberculosis DNA using in situ PCR. The cohort of recipients was longitudinally followed for the development of tuberculosis.

Results

Living donor liver transplantation was performed for 270 patients. Mean age was 33 years (median: 41 years, range: 1‐80 years). Recipients were followed for a mean of 68 months (median: 72 months, range: 1‐138 months) after transplantation. Mycobacterium tuberculosis DNA was detected in 25 of 155 donated livers (16%) with liver biopsies available for testing. None of the recipients of these livers received tuberculosis chemoprophylaxis and only one (4%) developed tuberculosis 15 months after transplantation. Among the entire cohort of 270 patients, post‐transplant tuberculosis was diagnosed in four patients (1.48%) at an incidence rate of 2.61 cases per 1000 transplant‐years. No factors associated with developing tuberculosis were identified, including positive M tuberculosis DNA in transplanted livers.

Conclusions

Mycobacterium tuberculosis DNA in living donor transplanted livers did not result in tuberculosis despite post‐transplant immunosuppression.
Scoping review: Community‐based programmes with people affected by leprosy
Authors: Martos‐Casado Gema , Vives‐Cases Carmen , Gil‐González Diana
Published: November 2019

Objective

To analyse community intervention programmes for people affected by leprosy in ‘global priority countries’.

Methods

Scoping review of articles in the databases PubMed, Scopus, SciELO, Lilacs and Web of Knowledge that made reference to community intervention programmes aimed at people affected by leprosy in global priority countries and which presented an evaluation of results. Analytical variables analysed were methodological characteristics of the study, type of intervention classified according to the Community‐Based Rehabilitation Matrix, indicators and results of the evaluation, and the degree of participation of the community, which was graphically represented as a spidergram.

Results

Thirty articles met the inclusion criteria. They were mostly related to the health component of the RBC matrix and aimed at the adult population. All evaluated the indicators used positively. The degree of participation generally ranged between mobilisation and collaboration.

Conclusion

Community intervention programmes for people affected by leprosy have a positive effect on health. There are attempts to include affected people and the community in implementing these programmes, but it is not possible to establish a direct relationship with effects of their participation on health due to the study designs used. Future research using more robust methods that include leprosy patients are necessary to evaluate the effectiveness of community participation.
Effectiveness of operative interventions for hemi or total hip arthroplasty patients who sustain a Vancouver B2 peri-prosthetic femoral fracture: a systematic review protocol
Authors: Ianunzio Jamie Raffaele , Munn Zachary , Mandziak Daniel , Stephenson Matthew , Cain Megan Elizabeth
Published: November 2019

Review objective:

The objective of this review is to identify the effectiveness of operative interventions for individuals who have undergone a hemi or total hip arthroplasty who sustain a Vancouver type B2 peri-prosthetic femoral fracture or equivalent. Specifically, this review will investigate open reduction and internal fixation and femoral revision arthroplasty with or without internal fixation.
Effectiveness of expanded cardiac rehabilitation in patients diagnosed with coronary heart disease: a systematic review protocol
Authors: Momsen Anne-Mette Hedeager , Hald Kathrine , Nielsen Claus Vinther , Larsen Mogens Lytken
Published: November 2019

Review objective/question:

The objective of this review is to identify the effectiveness of expanded cardiac rehabilitation (CR) in patients diagnosed with coronary heart disease (CHD). Specifically, the review question is: What is the effectiveness of expanded CR compared to standard CR in adult patients diagnosed with CHD? Effectiveness will be assessed by the effect on mortality and readmissions due to all causes or any cardiac event, systolic blood pressure, cholesterol levels and adherence to recommendations in secondary prevention guidelines.
The meanings young people assign to living with mental illness and their experiences in managing their health and lives: a systematic review of qualitative evidence
Authors: Woodgate Roberta L. , Sigurdson Corey , Demczuk Lisa , Tennent Pauline , Wallis Bernadine , Wener Pamela
Published: November 2019

EXECUTIVE SUMMARY

Background:

It is estimated that less than 25% of young people in need of treatment for mental illness receive specialized services, and even fewer receive a diagnosis by their doctor. These findings are troubling given that living with a mental illness can have a significant impact on a young person's life, the lives of his/her family members, the young person's community and society generally.

Objective:

The objective of this systematic review was to synthesize the best available qualitative evidence on the meanings young people assign to living with mental illness and their experiences in managing their health and lives.

Inclusion criteria:

The current review considered both interpretive and critical research studies that drew on the experiences of young people with mental illness.

Search strategy:

The search for published studies included the following databases: MEDLINE, CINAHL, Social Sciences Full Text, PsycINFO, Social Work Abstracts, Sociological Abstracts, Embase, Social Services Abstracts, Child Development and Adolescent Studies, Scopus, Web of Science and Academic Search Complete. The search for unpublished studies included conference proceedings and ProQuest Dissertations and Theses Database.

Methodological quality:

Each paper was assessed independently by two reviewers for methodological quality. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to appraise the methodological quality of the articles.

Data extraction:

Qualitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-QARI.

Data synthesis:

JBI-QARI was used to pool findings based on their similarity of meaning and developed into four synthesized findings.

Results:

Fifty-four research papers generated 304 study findings that were aggregated into nine categories. The nine categories were further aggregated into four synthesis statements: (1) A different way of being, (2) Getting through the difficult times, (3) Yearning for acceptance and (4) Room for improvement.

Conclusion:

Young people with mental illness experienced a range of feelings and thoughts that at times left them feeling uncomfortable in their body and world. Rejection by family and friends was a common fear. The changes experienced by young people required them to use a variety of strategies that were both negative and positive. The challenges young people faced in seeking and receiving care reinforce that there is a need for improvement in mental health services for youth living with mental illness.
Shear‐thinning behaviour of blood in response to active hyperaemia: Implications for the assessment of arterial shear stress‐mediated dilatation
Authors: Leo Jeffrey A. , Simmonds Michael J. , Sabapathy Surendran
Published: November 2019

New Findings

What is the central question of this study?

Quantitative values of shear rate‐specific blood viscosity and shear stress in the human macrovasculature in response to exercise hyperaemia are unknown.

What is the main finding and its importance?

Using the handgrip exercise model, we showed that an increase in brachial artery shear rate led to a decrease in blood viscosity, despite concomitant haemoconcentration. This shear‐thinning behaviour of blood, secondary to increased erythrocyte deformability, blunted the expected increase in brachial artery shear stress based on shear rate prediction. Our data yield new insights into the magnitude and regulation of macrovascular blood viscosity and shear stress in physiological conditions of elevated metabolic demand and blood flow in humans.

Blood viscosity is a well‐known determinant of shear stress and vascular resistance; however, accurate quantitative assessments of shear rate‐specific blood viscosity in the macrovasculature in conditions of elevated blood flow are inherently difficult, owing to the shear‐thinning behaviour of blood. Herein, 12 men performed graded rhythmic handgrip exercise at 20, 40, 60 and 80% of their maximal workload. Brachial artery shear rate and diameter were measured via high‐resolution Duplex ultrasound. Blood was sampled serially from an i.v. cannula in the exercising arm for the assessment of blood viscosity (cone‐plates viscometer). We measured ex vivo blood viscosity at 10 discrete shear rates within the physiological range documented for the brachial artery in basal and exercise conditions. Subsequently, the blood viscosity data were fitted with a two‐phase exponential decay, facilitating interpolation of blood viscosity values corresponding to the ultrasound‐derived shear rate. Brachial artery shear rate and shear stress increased in a stepwise manner with increasing exercise intensity, reaching peak values of 940 ± 245 s−1 and 3.68 ± 0.92 Pa, respectively. Conversely, brachial artery shear rate‐specific blood viscosity decreased with respect to baseline values throughout all exercise intensities by ∼6–11%, reaching a minimal value of 3.92 ± 0.35 mPa s, despite concomitant haemoconcentration. This shear‐thinning behaviour of blood, secondary to increased erythrocyte deformability, blunted the expected increase in shear stress based on shear rate prediction. Consequently, the use of shear stress yielded a higher slope for the brachial artery stimulus versus dilatation relationship than shear rate. Collectively, our data refute the use of shear rate to infer arterial shear stress‐mediated processes.
Failure Prognosis of Complex Equipment With Multistream Deep Recurrent Neural Network
Authors: Su Yonghe , Tao Fei , Jin Jian , Wang Tian , Wang Qingguo , Wang Lei
Published: November 2019

The failure prognosis is crucial for industrial equipment in prognostics and health management field. The vibration signal is the commonly used data for failure prognosis. The conventional prognostic approaches have limitations to handle the features extracted from the vibration signal because of the large data quantity, complex feature relations, and limited degeneration mechanisms. In this paper, a deep learning-based approach is proposed to predict the failure of the complex equipment. To supply plenty of features, three different domain features are extracted from vibration signals. Next, these features are preprocessed and reconstructed by arctangent normalization and data stream, respectively. Finally, a deep neural network, namely, multistream deep recurrent neural network (MS-DRNN) is built to fuse these features for failure target. The presented deep neural network is hybrid, involving recurrent layer, fusion layer, fully connected layer, and linear layer. To benchmark the proposed approach, several prognosis approaches are evaluated with the testing data from six large bearing datasets. Simulation results demonstrate that the prediction performance of the MS-DRNN-based approach is effective and reliable.
Support Vector Regression for Optimal Robotic Force Control Assembly
Authors: Li Binbin , Chen Heping , Jin Tongdan
Published: November 2019

Advanced industrial robotic assembly requires the process parameters to be tuned to achieve high efficiency: short assembly cycle (AC) time and high first-time throughput (FTT) rate. This task is usually undertaken offline because of the difficulties in real-time modeling and the lack of efficient algorithms. This paper proposes a support vector regression (SVR)-enabled method to optimize the assembly process parameters without interrupting the normal production process. To reduce the risk of obtaining a local minimum, we consider the trade-off between exploration and exploitation and propose an adaptive optimization process to balance the production processes and the optimization outcome. The proposed methods have been verified using a typical peg-in-hole robotic assembly process, and the results are compared with design of experiment (DOE) methods and genetic algorithm (GA) method in terms of efficiency and accuracy. The experimental results show that our methods are able to maintain the high FTT rate when it drops below 99%, shorten the average AC time by 3.4%, and reduce the number of assembly trials to find the optimized process parameters by 99.6%.