bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of gestational surrogates’ birthing experiences and relationships with intended parents during pregnancy and post‐birth
Authors: Yee Samantha , Librach Clifford L.
Published: September 2019

Background

This study investigated the surrogates’ birth experiences, their levels of emotional struggle at relinquishment, how often they thought about the surrogacy children, and the surrogate–parent relationship dynamics during pregnancy and post‐birth.

Methods

Data were collected from 06/2016 to 02/2017 using an anonymous questionnaire. Participants were Canadian gestational surrogates who had completed the process with or without a successful live birth, and who were at various stages of an ongoing surrogacy. For this paper, only a subgroup of cases with a successful live birth was selected for analysis.

Results

The data set included 131 births involving 90 surrogates who delivered 157 babies (105 singletons and 26 sets of twins). Their mean age at the time of surrogacy was 31.7 ± 5 years (range: 21‐47y). More than one‐third (37.4%) of the cases were for intended parents who were same‐sex male couples and single men. Surrogates assisting Canadian‐resident intended parents had an overall better birthing experience compared with those assisting nonresidents. There was none or very little struggle with the relinquishment of the baby in 96.9% of cases. Continued contact with parents after the births was reported in 93.0% of cases. Surrogates were significantly more likely to have frequent post‐birth contact with same‐sex and single fathers compared with heterosexual parents and single mothers (76.6% vs 54.3%).

Conclusions

Same‐sex male couples and single men can develop a long‐lasting relationship with their surrogates even when no intended female partners are involved. The development of institutional practice guidelines in standardizing surrogacy birth practice is paramount in optimizing surrogates’ care.
Dysregulated Fcγ receptor IIa-induced cytokine production in dendritic cells of lupus nephritis patients
Authors: Newling M , Fiechter R H , Sritharan L , Hoepel W , van Burgsteden J A , Hak A E , van Vollenhoven R F , van de Sande M G H , Baeten D L P , den Dunnen J
Published: September 2019

Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology. One of the key factors associated with SLE pathogenesis is excessive production of type I interferons (IFNs). This could result from increased activation of type I IFN-stimulating pathways, but also from decreased activation of type I IFN-inhibitory pathways. Recently, we have identified that immunoglobulin (Ig)G immune complexes strongly inhibit type I IFN production in healthy individuals by inhibitory signaling through Fcγ receptor IIa (FcγRIIa) on dendritic cells (DCs). Because, in SLE patients, immune complexes are characteristically present, we assessed whether FcγR-induced suppression of type I IFN is functional in DCs of SLE patients. We divided the SLE patients into one group without, and one group with, previous major organ involvement, for which we chose nephritis as a prototypical example. We show that DCs of lupus nephritis patients displayed impaired FcγR-mediated type I IFN inhibition compared to SLE patients without major organ involvement or healthy controls. We verified that this impaired type I IFN inhibition was not related to differences in disease activity, medication, FcγRIIa expression or expression of IFN regulatory transcription factors (IRF)1 and IRF5. In addition, we identified that DCs of lupus nephritis patients show increased FcγR-induced interleukin (IL)-1β production, which is another important cytokine that promotes kidney inflammation. Taken together, these data indicate that DCs of lupus nephritis patients display altered FcγR-mediated regulation of cytokine production, resulting in elevated levels of type I IFN and IL-1β. This dysregulation may contribute to the development of nephritis in SLE patients.
AGING OUT OF WOMEN INFANTS AND CHILDREN: AN INVESTIGATION OF THE COMPENSATION EFFECT OF PRIVATE NUTRITION ASSISTANCE PROGRAMS
Authors: Si Xia , Leonard Tammy
Published: September 2019

This paper is the first to address the causal relationship between an abrupt change in the availability of public nutrition assistance and low‐income households' private nutrition assistance utilization. In particular, we examined the way in which loss of Women Infants and Children (WIC) benefits impacted a household's utilization of private food assistance. Using a regression discontinuity analysis framework, we found that households significantly increased utilization of private nutrition assistance following an abrupt loss in public nutrition assistance. Estimates indicated that some households might have been able to compensate from about half to more than 90% of their loss in public WIC nutrition assistance. (JEL I38, C36, D12)
Synthetic resampling strategies and machine learning for digital soil mapping in Iran
Authors: Taghizadeh‐Mehrjardi Ruhollah , Schmidt Karsten , Eftekhari Kamran , Behrens Thorsten , Jamshidi Mohammad , Davatgar Naser , Toomanian Norair , Scholten Thomas
Published: September 2019

Most common machine learning (ML) algorithms usually work well on balanced training sets, that is, datasets in which all classes are approximately represented equally. Otherwise, the accuracy estimates may be unreliable and classes with only a few values are often misclassified or neglected. This is known as a class imbalance problem in machine learning and datasets that do not meet this criterion are referred to as imbalanced data. Most datasets of soil classes are, therefore, imbalanced data. One of our main objectives is to compare eight resampling strategies that have been developed to counteract the imbalanced data problem. We compared the performance of five of the most common ML algorithms with the resampling approaches. The highest increase in prediction accuracy was achieved with SMOTE (the synthetic minority oversampling technique). In comparison to the baseline prediction on the original dataset, we achieved an increase of about 10, 20 and 10% in the overall accuracy, kappa index and F‐score, respectively. Regarding the ML approaches, random forest (RF) showed the best performance with an overall accuracy, kappa index and F‐score of 66, 60 and 57%, respectively. Moreover, the combination of RF and SMOTE improved the accuracy of the individual soil classes, compared to RF trained on the original dataset and allowed better prediction of soil classes with a low number of samples in the corresponding soil profile database, in our case for Chernozems. Our results show that balancing existing soil legacy data using synthetic sampling strategies can significantly improve the prediction accuracy in digital soil mapping (DSM).

Highlights

Spatial distribution of soil classes in Iran can be predicted using machine learning (ML) algorithms.

The synthetic minority oversampling technique overcomes the drawback of imbalanced and highly biased soil legacy data.

When combining a random forest model with synthetic sampling strategies the prediction accuracy of the soil model improves significantly.

The resulting new soil map of Iran has a much higher spatial resolution compared to existing maps and displays new soil classes that have not yet been mapped in Iran.
Genetic and phenotypic characterization of NKX6‐2‐related spastic ataxia and hypomyelination
Authors: Chelban V. , Alsagob M. , Kloth K. , Chirita‐Emandi A. , Vandrovcova J. , Maroofian R. , Davagnanam I. , Bakhtiari S. , AlSayed M. D. , Rahbeeni Z. , AlZaidan H. , Malintan N. T. , Johannsen J. , Efthymiou S. , Ghayoor Karimiani E. , Mankad K. , Al‐Shahrani S. A. , Beiraghi Toosi M. , AlShammari M. , Groppa S. , Haridy N. A. , AlQuait L. , Qari A. , Huma R. , Salih M. A. , Almass R. , Almutairi F. B. , Hamad M. H. , Alorainy I. A. , Ramzan K. , Imtiaz F. , Puiu M. , Kruer M. C. , Bierhals T. , Wood N. W. , Colak D. , Houlden H. , Kaya N.
Published: September 2019

Background and purpose

Hypomyelinating leukodystrophies are a heterogeneous group of genetic disorders with a wide spectrum of phenotypes and a high rate of genetically unsolved cases. Bi‐allelic mutations in NKX6‐2 were recently linked to spastic ataxia 8 with hypomyelinating leukodystrophy.

Methods

Using a combination of homozygosity mapping, exome sequencing, and detailed clinical and neuroimaging assessment a series of new NKX6‐2 mutations in a multicentre setting is described. Then, all reported NKX6‐2 mutations and those identified in this study were combined and an in‐depth analysis of NKX6‐2‐related disease spectrum was provided.

Results

Eleven new cases from eight families of different ethnic backgrounds carrying compound heterozygous and homozygous pathogenic variants in NKX6‐2 were identified, evidencing a high NKX6‐2 mutation burden in the hypomyelinating leukodystrophy disease spectrum. Our data reveal a phenotype spectrum with neonatal onset, global psychomotor delay and worse prognosis at the severe end and a childhood onset with mainly motor phenotype at the milder end. The phenotypic and neuroimaging expression in NKX6‐2 is described and it is shown that phenotypes with epilepsy in the absence of overt hypomyelination and diffuse hypomyelination without seizures can occur.

Conclusions

NKX6‐2 mutations should be considered in patients with autosomal recessive, very early onset of nystagmus, cerebellar ataxia with hypotonia that rapidly progresses to spasticity, particularly when associated with neuroimaging signs of hypomyelination. Therefore, it is recommended that NXK6‐2 should be included in hypomyelinating leukodystrophy and spastic ataxia diagnostic panels.
Revisiting “what do tadpoles really eat?” A 10‐year perspective
Authors: Montaña Carmen G. , Silva Supuni D. G. T. M. , Hagyari David , Wager Jakob , Tiegs Lindsey , Sadeghian Cyrus , Schriever Tiffany A. , Schalk Christopher M.
Published: September 2019

Tadpoles are diverse and abundant consumers, and knowledge of their feeding ecology and trophic status is essential in understanding their functional roles within aquatic habitats. Here we revisit Altig, Whiles, and Taylor (2007)'s paper, which highlighted the knowledge gaps in tadpole feeding ecology and the application of modern techniques, such as stable isotope and fatty acid analyses to better quantify dominant food resources, food assimilation, and the trophic status of tadpoles.

We reviewed the ecological studies that have been published since 2007 that used stable isotopes and fatty acid analyses, also metagenomics and ecological stoichiometry analyses. We describe the ecological roles of tadpoles in freshwater ecosystems and identify knowledge gaps regarding tadpole feeding ecology across biogeographic regions.

Worldwide declines in amphibian abundance and diversity create an urgent need to document their feeding ecology and trophic status. As consumers, tadpoles play important functional roles in nutrient cycling, energy flow, and bioturbation. They also exhibit context‐dependent trophic plasticity in response to abiotic and biotic gradients, which complicates understanding of their trophic roles.

Most studies of tadpole trophic ecology have been conducted primarily on species from the families Ranidae, Bufonidae, and Hylidae from Neotropic and Nearctic regions, while species in tropical regions such as Africa and Asia lack ecological information for tadpoles. There continues to be a need for studies of tadpole diets and/or trophic ecology in Africa and Southeast Asia regions where species endemism is threated by the growth of anthropogenic activities.

The majority of studies have focused on trophic ecology of tadpoles from the perspective of single species or at relatively small spatial and temporal scales. Studies that address questions from an ecosystem perspective were scarce, but are critical for conservation and management. Future research should aim to address the role of tadpoles as consumers across broader spatiotemporal scales.
Land supply and urbanization strategy in the Yangtze River Delta region, China
Authors: Zhang Juan‐Feng , Zhang Dan‐Xia , Zhao Guo‐Chao , Zeng Hui , Wen Hai‐Zhen
Published: September 2019

China's urbanization rate is increasing beyond sustainable levels because it has increased by approximately 1% every year in the last 30 years. As an important part of urban development, the selection of an urbanization strategy has been the focus of local governments. As such, local governments play an important role in urbanization processes by coordinating land supply and population growth. Using the 2009–2013 panel data of 41 cities in the Yangtze River Delta (YRD) region, this research tests the relationship between land supply and population growth to explore the urbanization strategy adopted by local governments. Simultaneous equation models for land supply and population growth are developed in this research. Empirical results identify land supply as the cause and population growth as the effect. Findings suggest that local governments in the YRD choose an aggressive strategy in urbanization which treats land as a tool for accelerating the urbanization.
THE (DIS)CONTINUOUS HISTORY OF THE POLITICAL
Authors: Landwehr Achim
Published: September 2019

The political is not given. Understood as the space in which collectives think about how they should live together, the political has existed only since the seventeenth century—according to the thesis of Elías José Palti's Archaeology of the Political. Since then, a central problem of the political, namely how transcendence can be founded on immanence, has been posed in a completely new way. Palti follows this development from the seventeenth to the twentieth century, illustrated by a few individual examples. His reading of the problem is a possible one. But aren't the political questions arising from the combination of transcendence and immanence much older? Can the political really be reduced to the period so often referred to as “modernity”? In contrast to Palti, I would like to emphasize more strongly the continuities in the field of the political—continuities that can be attached to a void, to the search for a foundation that cannot be justified. But even if one may and should argue about the thesis of the book, it proves to be above all a stimulating study and an important contribution to the understanding of the political.
Agricultural field margins provide food and nesting resources to bumble bees (Bombus spp., Hymenoptera: Apidae) in Southwestern Ontario, Canada
Authors: Purvis Emily E.N. , Meehan Matthew L. , Lindo Zoë
Published: September 2019

Bumble bees are declining globally, largely due to habitat loss driven by agricultural intensification. Within agriculturally dominated landscapes, semi‐natural habitats (e.g. meadows, wetland edges) are fragmented, increasing the value of uncropped agricultural field margins for providing a source of food, nesting, and hibernation resources to bumble bees.

We compared bumble bee communities sampled in agricultural field margins and semi‐natural habitats across Southwestern Ontario, Canada in order to assess differences in habitat quality. We then examined the effect of floral resources and soil characteristics on the bumble bee communities present in each site, independent of the habitat type classification.

Our data revealed that bumble bee abundance, diversity, and community composition did not differ between habitat types. However, when examined independently of habitat type, bumble bee abundance and diversity increased with floral abundance, floral diversity, the number of rodent holes, and sandy soil texture.

These results suggest that agricultural field margins are not inherently degraded bumble bee habitat and have the potential to provide food and nesting resources comparable to semi‐natural habitats in a fragmented agricultural landscape. Ensuring field margins contain the necessary floral resources and soil characteristics for bumble bees has implications for conservation and mitigating habitat loss caused by the agricultural fields themselves.
Effects of metal phases on microstructure and mechanical properties of microwave‐sintered Ti(C, N)‐based cermet tool
Authors: Ye Jiadong , Yin Zengbin , Yuan Juntang , Li Zhiyuan , Zhu Zhiyong , Hong Dongbo
Published: September 2019

A kind of Ti(C, N)‐based cermet tool material was prepared by microwave sintering. The influence of metal phases (Ni, Co, and Mo) on densification and mechanical properties was studied by orthogonal test. The results indicated that Co was more significant in improving relative density and fracture toughness than Ni, while Ni and Co had the similar effects on increasing the hardness of Ti(C, N)‐based cermet. Mo can improve fracture toughness but decrease hardness. Ti(C, N)‐based cermet with 6 wt% Ni, 6 wt% Co and 6 wt% Mo (TN6C6M6) had the optimal comprehensive mechanical performances, and its fracture toughness and hardness were better than that of Ti(C, N)‐based cermet prepared by conventional sintering. The increasing of sintering temperature promoted the uniformity of microstructure and significantly improved densification and hardness of the Ti(C, N)‐based cermet. The highest fracture toughness of TN6C6M6 (12.41 ± 0.33 MPa·m1/2) was achieved when sintered at 1600°C. For the microwave‐sintered Ti(C, N)‐based cermet, heat preservation period had little effect on densification. The relative density can reach up to 98.6% even though the heat preservation period was 0 minute.
Onchocerciasis (river blindness): larva‐induced eczema (onchodermatitis) from an important oculocutaneous tropical disease spilling over into North America and Europe
Authors: Schwartz Robert A. , Al‐Qubati Yasin , Zieleniewski Łukasz , Shah Radhika , Kapila Rajendra
Published: September 2019

Onchocerciasis is a leading cause of blindness in the world. It may be seen in temperate climates of the United States and Europe in immigrants and travelers from endemic regions, often linked to poverty and war. One should be aware of an incubation period that can be up to 15 months. In its early stage and throughout its course, onchocerciasis has noteworthy skin findings, facilitating diagnosis, as onchodermatitis resembles common eczema with variable degrees of papular, lichenoid, atrophic, and pigmentary alterations, features not suggestive if one is unaware of an individual's immigration and travel history. The same concept applies for the encysted worms (onchocercomas), as they tend to appear as common skin cysts and benign neoplasms. New methods can be employed to increase diagnostic sensitivity and specificity. Ivermectin is the gold standard of therapy, the use of which has almost miraculously eliminated this disease from large areas of the earth. However, its effect remains isolated to microfilariae and can be devastating in those coinfected with Loa loa. Recently, the symbiotic relationship between adult worms and Wolbachia bacteria has been discovered and, with it, the possibility of adding doxycycline as a treatment option. We also discuss coinfection with HIV and other diseases.
Medicalization of Social Problems: Rising Depression‐related Absenteeism in Japan
Authors: Okuda Shoko
Published: September 2019

Increasing numbers of people are absent from work with a diagnosis of depression, and this has become a social problem in Japan. This study examines the hypothesis that this rise of depression‐related absenteeism in Japan is influenced by social factors that contribute to the medicalization of social problems. Here, “social factors” are corporate systems that affect workers' psychology and mental health, media coverage and disease awareness campaigns by pharmaceutical companies, the intentions of patients' physicians, as well as psychopathological factors such as increased workplace stress. Data were obtained from semi‐structured interviews conducted with 50 workers who had a history of taking depression‐related leaves of absence, and a re‐diagnosis by six physicians of 10 representative cases derived from categorizations based on data from the interviews. The data were analyzed to identify social factors underlying the rise in depression‐related absenteeism and the mechanisms of medicalization of social problems. Social factors found to affect the rise of depression‐related absenteeism include mentalities whereby patients, seeking to escape from harsh work environments, may wish to receive a diagnosis of depression to take a leave of absence; and the intention of participants' physicians to provide the diagnosis out of sympathy even when official diagnostic criteria are not met. Thus, it would seem that work‐related social problems that should normally be addressed by public policy measures are in fact being medicalized. Moreover, this study considers how “self‐medicalization” by patients renders the solution to social problems more complex by contributing to the further medicalization of social problems.
Semi‐automated von Willebrand factor multimer assay for von Willebrand disease: Further validation, benefits and limitations
Authors: Oliver Susan , Vanniasinkam Thiru , Mohammed Soma , Vong Ronny , Favaloro Emmanuel J.
Published: September 2019

Introduction

Accurate diagnosis of von Willebrand disease (VWD) enables effective patient management. von Willebrand factor (VWF) multimer analysis provides useful information regarding VWF multimer structure, thereby aiding VWD subtyping and management; however, historically technically challenging assays have had limited utility. This study evaluates the Sebia Hydrasys Hydragel‐11 semi‐automated VWF multimer assay and further validates the Hydragel‐5 gel system, as primarily pertaining to VWD diagnostics and monitoring of therapy.

Methods

Provisionally diagnosed (via a reference assay test panel) archived patient samples and prospective test patient samples, including those undergoing desmopressin trial or therapy monitoring, along with commercial and in‐house control material and various external quality assessment (EQA) samples, were analysed. VWF multimers were evaluated for presence, loss or partial loss of high molecular weight (HMWM) and intermediate molecular weight (IMWM) multimers by both visual inspection and densitometric scanning, and comparison with reference assay results.

Results

All anticipated multimer patterns were reproduced, with patients generally showing multimer profiles matching expected patterns according to VWD type based on reference test panel ‘diagnosis’. Occasional discrepancies were resolved by retesting. The increase in plasma VWF following desmopressin therapy was also clearly demonstrated. Multimer profiles of EQA samples complemented reference test panel results and matched EQA targets. There were some ‘technical’ limitations noted.

Conclusion

This easy to use, standardised, semi‐automated multimer analysis system can demonstrate the multimer profile of VWD patients, thus representing an additional laboratory tool for improved diagnosis, thereby facilitating appropriate patient management.
Intraoperative hypotension caused by oral administration of 5‐aminolevulinic acid for photodynamic diagnosis in patients with bladder cancer
Authors: Nohara Takahiro , Kato Yuki , Nakano Taito , Nakagawa Tomomi , Iwamoto Hiroaki , Yaegashi Hiroshi , Nakashima Kazufumi , Iijima Masashi , Kawaguchi Shohei , Shigehara Kazuyoshi , Izumi Kouji , Kadono Yoshifumi , Mizokami Atsushi
Published: September 2019

Objective

To analyze perioperative blood pressure in patients undergoing transurethral resection of bladder tumor with photodynamic diagnosis.

Methods

A total of 109 consecutive patients who underwent photodynamic diagnosis‐assisted transurethral resection of bladder tumor at Kanazawa University, Kanazawa, Ishikawa, Japan, were included in this study and considered as the photodynamic diagnosis group. Clinical data were collected, and perioperative systolic bladder pressure and vasopressor usage were analyzed. In contrast, consecutive patients who previously underwent conventional transurethral resection of bladder tumor (without the use of oral 5‐aminolevulinic acid) were used as the control group.

Results

The systolic blood pressure before anesthesia, lowest systolic blood pressure from the anesthesia induction to the start of operation and lowest systolic blood pressure during operation were significantly lower in the photodynamic diagnosis group. The rate of vasopressor use was significantly higher in the photodynamic diagnosis group. On multivariate analysis, we found that general anesthesia and regular use of renin–angiotensin system inhibitor were associated with an increased risk of hypotension (lowest systolic blood pressure from the anesthesia induction to the start of operation <80 mmHg).

Conclusions

Oral intake of 5‐aminolevulinic acid can obviously cause a drop in intraoperative blood pressure in patients undergoing transurethral resection of bladder tumor. Therefore, urologists and anesthesiologists should consider withdrawal of renin–angiotensin system inhibitors and monitor the blood pressure during photodynamic diagnosis‐assisted transurethral resection of bladder tumor.
Leukocytoclastic vasculitis associated with use of aromatase inhibitors
Authors: Woodford Rachel G. , Becker Gerrie J. , Jain Ankit
Published: September 2019

Leukocytoclastic vasculitis is an uncommon but important complication of aromatase inhibitor use which may have cosmetic and systemic ramifications. We present a case in which this reaction was observed and aim to compare the characteristics of patients and trajectory of disease in order to assist with early identification and treatment.
Recommendations for current and future countermeasures against sleep disorders and sleep loss to improve road safety in Australia
Authors: Wolkow Alexander P. , Rajaratnam Shantha M. W. , Anderson Clare , Howard Mark E. , Mansfield Darren
Published: September 2019

The Australian National Road Safety Strategy 2011–2020 framed a 19‐point action plan targeting a 30% reduction in road deaths by 2020. In achieving a 9% reduction to date, it is likely to fail this target. Sleep disorders and sleep loss did not feature prominently in this strategy, despite their high prevalence and effect on drowsiness and crashes. This article gathers sleep experts to provide recommendations addressing driver education and legislation to assist the response to this public health problem. Developments in drowsiness detection and sleep disorders management are also presented that offer innovative countermeasures that could enhance road safety beyond 2020.
Suggested clinical approach for the diagnosis and management of ‘statin intolerance’ with an emphasis on muscle‐related side‐effects
Authors: Sivashanmugarajah Anosh , Fulcher Jordan , Sullivan David , Elam Marshall , Jenkins Alicia , Keech Anthony
Published: September 2019

Hyperlipidaemia is a major risk factor for cardiovascular morbidity and mortality. 3‐hydroxy‐3‐methylglutaryl coenzyme‐A reductase inhibitors (‘statins’) are first‐line therapies for hyperlipidaemia. For each 1.0 mmoL/L reduction in low‐density lipoprotein (LDL)‐cholesterol, statins reduce the risk of major vascular events by 21% and all‐cause mortality by 9%. Owing to their clinical effectiveness and excellent safety profile, many Australians are prescribed statins. There has been widespread reporting of possible side‐effects, particularly muscle pains. Conversely, statin cessation relating to possible side‐effects exposes patients to increased risk of vascular events and death. Although there is clinical consensus for diagnosing rare side‐effects (e.g. myopathy or rhabdomyolysis), confirming that statins cause other less common side‐effects (e.g. memory impairment) is difficult as strong randomised trial evidence related to statins and non‐muscle‐related side‐effects is lacking. A stepwise approach to possible statin intolerance, consistent definitions and a simple flowchart may improve diagnosis and management. An increasing array of potential treatments is emerging, including intermittent statin dosing, new LDL‐lowering drugs, LDL apheresis and supplements. Optimal statin use and management of statin intolerance should improve cardiovascular care and clinical outcomes.
Intestinal epithelial cells: at the interface of the microbiota and mucosal immunity
Authors: Soderholm Amelia T. , Pedicord Virginia A.
Published: September 2019

The intestinal epithelium forms a barrier between the microbiota and the rest of the body. In addition, beyond acting as a physical barrier, the function of intestinal epithelial cells (IECs) in sensing and responding to microbial signals is increasingly appreciated and likely has numerous implications for the vast network of immune cells within and below the intestinal epithelium. IECs also respond to factors produced by immune cells, and these can regulate IEC barrier function, proliferation and differentiation, as well as influence the composition of the microbiota. The mechanisms involved in IEC–microbe–immune interactions, however, are not fully characterized. In this review, we explore the ability of IECs to direct intestinal homeostasis by orchestrating communication between intestinal microbes and mucosal innate and adaptive immune cells during physiological and inflammatory conditions. We focus primarily on the most recent findings and call attention to the numerous remaining unknowns regarding the complex crosstalk between IECs, the microbiota and intestinal immune cells.
Commitment decisions with demand information updating and a capital‐constrained supplier
Authors: Zhai Youzi , Xue Weili , Ma Lijun
Published: September 2019

In this paper, we study a single two‐echelon supply chain with a capital‐constrained supplier (manufacturer) and a retailer. The supply chain faces a stochastic demand. As the production lead time is long, the market demand is updated during the supplier's production lead time. The supplier needs to determine the production quantity based on the original demand forecast, and the retailer needs to determine the time and quantity to order. The retailer can place an order before the supplier's production (preorder) or after the supplier's production (regular order). We prove the existence of optimal equilibrium solutions under both preorder and regular order strategies. We analytically investigate the order strategies for the supply chain agents under perfect and worthless market information updating. Moreover, we numerically analyze the impact of the information updating quality on the order strategy selection, and the effect of exogenous shocks on the supply chain agents.
A RELIABLE CLINICAL TECHNIQUE FOR INVESTIGATION OF THE EXPERIENCED REALITY AND UNREALITY QUALITIES CONNECTED WITH EVERYDAY LIFE EXPERIENCES IN PSYCHOTIC AND NON‐PSYCHOTIC PERSONS
Authors: Aggernæs A. , Haugsted R. , Myschetzky A. , Paikin H. , Vitger J.
Published: September 2019

Eight different pairs of positive and negative qualities of experienced reality are defined. It is described in detail how these qualities can be recorded in relation to specified varieties of experience: a) sensory perceptions, b) fantasies, and c) “thinking of actually existing objects or properties in persons.”

In a study of 15 non‐psychotic patients it was found with a very high reliability that the three varieties of experience each had their characteristic constellation of positive and negative values of the eight qualities of reality.

It is pointed out that knowledge of such normal constellations is a logical prerequisite for being able to classify other varieties of experience (hallucinations, delusions, and others) as being pathological.
THE DURATION OF MAINTENANCE THERAPY IN CHRONIC SCHIZOPHRENIA
Authors: Johnson D. A. W.
Published: September 2019

The incidence of relapse was compared between two groups of chronic schizophrenic patients (mean duration periods 19 months and 29.5 months) discontinuing depot neuroleptic injections, and matched controls remaining on depot injections. The results show a higher relapse rate in patients discontinuing injections, significant at the 1 % level, in both groups. The proportion of patients improving upon resumption of depot injections confirms the importance of this form of medication in comparison to prescribed oral medication. The results strongly suggest that there is a significant therapeutic gain in continuing maintenance therapy with depot neuroleptic injections for a minimum period of 3 years after the last relapse in a substantial proportion of chronic schizophrenic patients.
Competition model for international comparisons of livestock
Authors: Schaeffer Larry R.
Published: September 2019

Interbull has been responsible for comparing dairy bulls across countries since the mid‐1980s. The current methodology is called MACE (multiple across country evaluations) which has been in use since 1995. Now that genomic data are being utilized in many countries, this has led to two serious problems. The first is that of preselection of young bulls such that the young animals are no longer a random sample of progeny from a sire by dam mating pair. Secondly, some countries are becoming less willing to share genomic data with Interbull. Both issues raise concern over the future of Interbull and international comparisons. This paper suggests a competition model as a potential replacement for MACE. The competition model makes pairwise comparisons between all pairs of bulls within a country and combines these differences across countries through bulls that are used in more than one country. Pedigree information is ignored as are all genomic data because bulls are treated as fixed. The model produces one international ranking of bulls averaging out any genotype by environment interactions which may exist. The competition model is illustrated by a small example. The limitations and advantages of the competition model are discussed.
Minimal defibrillation thresholds and the correlation with implant position in subcutaneous implantable‐defibrillator patients
Authors: Quast Anne‐Floor B.E. , Baalman Sarah W.E. , Van der Stuijt Willeke , Wilde Arthur A.M. , Knops Reinoud E.
Published: September 2019

Background

Since the introduction of the subcutaneous implantable‐defibrillator (S‐ICD) knowledge of factors elevating the defibrillation threshold (DFT), have increased. Optimal device positioning most likely results in a decrease in DFT. The PRAETORIAN score is a tool to systematically evaluate S‐ICD implant position and predict conversion success by estimating the DFT on a chest X‐ray. The objective of this study is to determine DFT in de novo S‐ICD patients.

Methods

De novo S‐ICD patients were enrolled with DFT testing using a single 30 J shock or a prespecified step‐down protocol. Chest X‐rays were obtained and implant position was evaluated using the PRAETORIAN score.

Results

Fifteen patients, age 47 (±18) years and body mass index (BMI) 25(±3) kg/m2, underwent conversion testing with a single 30 J shock. Fourteen patients (93%) converted successfully. Implant position was optimal in all patients, PRAETORIAN score of 30 (100%). Twelve patients were available for analysis in the step‐down DFT cohort, age 46 years (±15), left ventricular ejection fraction 50% (±15%) and a median BMI of 25.7 kg/m2 (range 23.8‐29.1 kg/m2). No complications occurred during DFT testing. Mean DFT was 29 J (±12 J). Time to shock was 11 seconds (±2 seconds) for a 20 J shock compared with 17 seconds in case of a 70 J shock output. Nearly all patients were implanted with optimal device positioning with the lowest possible PRAETORIAN score of 30 (92%).

Conclusion

DFT in S‐ICD patients with optimal device positioning is lower than previously reported. Conversion testing using a low shock output reduced time to therapy by 6 seconds on average.
Editorial: Suicide and self‐harm: advancing from science to preventing deaths
Authors: Asarnow Joan Rosenbaum , Ougrin Dennis
Published: September 2019

Globally, suicide is the second leading cause of death among youth ages 15–29‐years, and self‐harm is one of the strongest known predictors of death by suicide. This editorial introduces the Special Issue on suicide and self‐harm, emphasizing the research and policy implications of the included articles. By illustrating advances in our science, the Special Issue both celebrates our achievements and highlights the need to use our science to inform suicide prevention policy and practice to reduce the tragedy of suicide and premature deaths.
Limited gene exchange between two sister species of leaf beetles within a hybrid zone in the Alps
Authors: Kastally Chedly , Trasoletti Marta , Mardulyn Patrick
Published: September 2019

Analysing genomic variation within and between sister species is a first step towards understanding species boundaries. We focused on two sister species of cold‐resistant leaf beetles, Gonioctena quinquepunctata and G. intermedia, whose ranges overlap in the Alps. A previous study of DNA sequence variation had revealed multiple instances of mitochondrial genome introgression in this region, suggesting recent hybridization between the two species. To evaluate the extent of gene exchange resulting from these hybridization events, we sampled individuals of both species inside and outside the hybrid zone and analysed genomic variation among them using RAD‐seq markers. Individual levels of introgression in the nuclear genome were estimated first by defining species‐specific SNPs (displaying a fixed difference between species) a priori and second by using model‐based methods. Both types of analyses indicated little gene exchange, if any, between species at the level of the nuclear genome. Whereas the first method suggested slightly more gene flow, we argue that it has likely overestimated introgression in the phylogeographic context of this study. We conclude that strong intrinsic barriers prevent genetic exchange at the level of the nuclear genome between the two species. The apparent discrepancy observed between introgression occurring in the nuclear and mitochondrial genomes could be explained by selection acting in favour of the latter. Also, these results have consequences for the phylogeographic study of each species, since we can assume that genetic diversity in the overlapping portion of their ranges is not the product of introgression.
Practitioners' positive attitudes promote shared decision‐making in mental health care
Authors: Drivenes Karin , Haaland Vegard Øksendal , Mesel Terje , Tanum Lars
Published: September 2019

Rationale and aims

There is a growing expectation of implementing shared decision making (SDM) in today's health care service, including mental health care. Traditional understanding of SDM may be too narrow to capture the complexity of treatments of mental health problems. Although the patients' contribution to SDM is well described, the contribution from the health care practitioners is less explored. Therefore, our aim was to explore the attitudes of practitioners in mental health care and the associations between practitioners' attitudes and SDM.

Method

We performed a cross‐sectional study where practitioners reported their sharing and caring attitudes on the Patient‐Practitioner Orientation Scale (PPOS) and age, gender, profession, and clinical working site. The patients reported SDM using the CollaboRate tool. We used a mixed effect model linking the data from each practitioner to one or more patients. We presented the findings and used them as background for a more philosophic reflection.

Results

We included 312 practitioners with mean age 46.1 years. Of the practitioners, 60 held a medical doctors degree, 97 were psychologists, and 127 held a college degree in nursing, social science, or pedagogy. Female practitioners reported higher sharing (4.79 vs 4.67 [range 1‐6], P = .04) and caring scores (4.77 vs 4.65 [range 1‐6], P = .02) than males. The regression model contained 206 practitioners and 772 patients. We found a higher probability for the patient to report high SDM score if the practitioner reported higher sharing scores, and lower probability if the practitioner worked in ambulatory care.

Conclusions

SDM in mental health care is complex and demands multifaceted preparations from practitioners as well as patients. The practitioners' attitudes are not sufficiently explored using one instrument. The positive association between practitioners' patient‐centred attitudes and SDM found in this study implies a relevance of the practitioners' attitudes for accomplishment of SDM processes in mental health care.
The Safety and efficacy of botulinum toxin type A injection for postoperative scar prevention: A systematic review and meta‐analysis
Authors: Yang Wenhui , Li Guangxue
Published: September 2019

Background

Active prevention and treatment of scars are particularly important. Several studies have used botulinum toxin type A(BTXA) to prevent postoperative scarring. The aim of this systematic review and meta‐analysis was to systematically evaluate the efficacy and safety of BTXA in preventing and treating postoperative scars.

Methods

A computer‐based search was conducted for the five databases including PubMed, Cochrane Library, EMBASE, CNKI, and Wanfang up to May 22, 2019, to collect the relevant literatures on BTXA treatment of postoperative hypertrophic scars. A meta‐analysis was made with the software of Revman 5.3 based on the study endpoint of scar width, Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS) scores, and patient satisfaction as well.

Results

A total of 18 randomized controlled trials (RCTs) studies were included with 915 patients in all. The result showed that, compared with the control group, the scar width, VAS scores, and VSS scores of the BTXA group were significantly improved and higher patient satisfaction was achieved.

Conclusion

BTXA has a certain curative effect on postoperative scar prevention and treatment without obvious side effects.
Lesbian and bisexual women’s experiences of health care: “Do not say, ‘husband’, say, ‘spouse’”
Authors: Soinio Jenni Ija Ilona , Paavilainen Eija , Kylmä Jari Pekka Olavi
Published: September 2019

Aims and objectives

To describe the experiences and wishes of lesbian and bisexual women concerning health care in Finland.

Background

Sexual orientation is a personal aspect of identity and also an important aspect of holistic health care. Lesbian and bisexual women have unmet health needs. The way that healthcare personnel encounter lesbian and bisexual women affects whether they disclose their sexual orientation.

Design

Qualitative inductive survey.

Methods

The research data for this study were collected in spring 2018 using an electronic survey (n = 22). The data were analysed using inductive content analysis. The research report has been checked using COREQ checklist, see Appendix S1.

Results

The research data were divided into two main domains: experiences and wishes. Women described health care as being heteronormative. They had both good and bad experiences, and their own poor experiences and those of others had a negative impact on their utilisation of healthcare services. Women had apprehensions about encountering stereotyping in health care and did not always disclose their orientation, even though recognising it would be integral to the provision of holistic health care. Lesbian and bisexual women wished that health care would refrain from heteronormativity, acknowledge issues that were important to them and engage with them without any prejudgement. They also wished healthcare environments would be improved to reflect an open acceptance of sexual minorities and also co‐operate with sexual minority organisations.

Conclusions

Women had conflicting experiences. Heteronormativity was seen as an obstacle for holistic health care. Women hoped health care would collaborate with the third sector.

Relevance to clinical practice

Sexual diversity should be acknowledged and better communicated to patients. Women hoped personnel would have the understanding to treat them in the same professional way as any other patients, but with expertise specific to their needs, for example in sexual health guidance.
Language attitudes as predictors of morphosyntactic variation: Evidence from Catalan speakers in southern France
Authors: Hawkey James
Published: September 2019

This article explores the potential role of attitudes as motivating factors in language variation and change. This study represents an important departure from existing scholarship through its consideration of quantitative measures of language attitudes as factors in multivariate analyses of linguistic data. Four morphosyntactic variables in Northern Catalan (an obsolescent variety spoken in France) will be examined in order to determine which factors significantly correlate with use of local or supralocal variants. Linear regression modelling reveals firm correlations for two of the variables, wherein positive evaluations of Catalan varieties on the status dimension (cf. Carranza & Ryan, 1975; Woolard, 1989, inter alia) align with supralocal variant use. We will see that attitudes can be helpful in uncovering motivations for language variation, but that qualitative ideological data are indispensable in the interpretation of findings.
The health impact of delaying direct‐acting antiviral treatment for chronic hepatitis C: A decision‐analytic approach
Authors: Erman Aysegul , Wong William W. L. , Feld Jordan J. , Grootendorst Paul , Krahn Murray D.
Published: September 2019

Background & Aims

Direct‐acting antivirals (DAAs) are highly effective, but expensive treatments for chronic hepatitis C (CHC). To manage costs, drug plans worldwide have rationed access to DAAs in a variety of ways. This study quantifies the health impact of formulary restrictions and presents a clinical decision tool for informing treatment timing decisions.

Methods

A decision‐analytic model was developed to quantify the health impact of delaying DAAs for subpopulations stratified by age, fibrosis level, viral genotype, and injection drug use over their lifetime. The health impact was quantified in terms of quality‐adjusted life expectancy (quality‐adjusted life years, or QALYs) and life expectancy (years).

Results

Deferring DAAs for patients with no or mild fibrosis (F0/F1) for 1‐5 years is unlikely to result in life expectancy losses and leads only to marginal losses of 0.02‐0.06 QALYs per year of delay. However, for 30‐50‐year‐olds with advanced fibrosis (≥F3) delays as short as a year results in a considerable health loss (0.25‐1.04 QALYs and 0.19‐1.53 years). Reimbursement limits for those with substance use are associated with large health losses. People who actively inject drugs with advanced fibrosis (≥F3) may lose 0.18‐1.05 QALYs and 0.13‐1.16 years per year of delay, despite the risk of reinfection and competing mortality. Results are robust to parameter uncertainty and key assumptions.

Conclusions

We present a clinical decision tool for informing treatment timing for various CHC subpopulations. In general, findings suggest that patients with at least moderate fibrosis should be treated promptly regardless of active drug use.