bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of personalised, mobile‐accessible discharge instructions for patients leaving the emergency department: A randomised controlled trial
Authors: Doyle Sarah K , Rippey James C , Jacques Angela , Rea Alethea M , Kaiser Bronwyn N , Miller Suzanne M , Anstey Matthew HR
Published: May 2020

Objective

This pilot study assessed the efficacy of personalised, printed and mobile‐accessible discharge instructions for pain relief for patients discharged from the ED.

Methods

Patients presenting with pain caused by acute musculoskeletal or visceral complaints not requiring admission were eligible. Both groups received usual pain relief discharge advice, the intervention group received additional personalised printed and mobile‐accessible discharge instructions. Numerical Rating Scale pain scores were measured at ED visit. Pain scores, Patient Global Impression of Change scale improvement scores, satisfaction with instructions, recall of pain relief advice, receipt of side effects advice and unscheduled visits were measured at 5 days.

Results

A total of 80 patients, recruited over 14 days, were randomly allocated to the intervention or control group. Two patients were excluded and 81% (n = 65) were followed up at 5 days. There was no significant difference in change of pain scores or improvement scores between groups from visit to 5 day follow up. The intervention group showed significantly higher odds of being ‘very satisfied’ compared to the control group (odds ratio [OR] 7.14, 95% confidence interval [CI] 1.18–50.00), significantly higher odds of full recall of pain relief medication advice (OR 20.00, 95% CI 1.56–100.00) and significantly higher odds of receiving information on medication side effects (OR 6.25, 95% CI 1.67–20.00).

Conclusions

Patients who received personalised printed and mobile‐accessible ED discharge instructions for pain relief reported higher levels of satisfaction with their instructions, had better recall of their pain relief medications advice and received more information on medication side‐effects.
Anatomical and dosimetric assessment of the prostate apex: A pilot comparison of image‐guided transperineal ultrasound to conventional computed tomography simulation
Authors: Shanker Mihir D , Kim Anna NH , Brown Amy , Tan Alex HM
Published: May 2020

Introduction

Inaccuracies in prostate apex contour delineation based on simulation computed tomography (CT) imaging can impact treatment outcomes and toxicity profiles for prostate cancer radiotherapy. Transperineal ultrasound (TPUS) is a non‐invasive imaging modality that can improve delineation of prostate volumes. We performed a pilot analysis to assess for differences in anatomical position between conventional CT and a TPUS delineated prostate apex and determined whether these translated into a clinically significant difference in apical point dose.

Methods

A 2D 5 MHz TPUS autoscan image guidance system was utilised during definitive intensity‐modulated radiotherapy (IMRT) for prostate cancer. Distances were measured from a fixed reference point to prostate apex on both US and CT in the mid‐sagittal plane. Differences between groups were assessed using the Wilcoxon sign rank test with a two‐tailed significance of α = 0.05.

Results

Fifty‐nine consecutive patients were independently assessed. There was strong evidence of a difference between CT and TPUS delineated apex position (P = 0.0075). Median apex position was 3.6 mm caudal on TPUS vs. CT imaging (95% CI: 2.5–4.8 mm). There was strong evidence of a difference in point dose between CT and TPUS delineated apex (P = 0.0029). Median point dose at the TPUS contoured apex was 1.9 Gy lower than CT (95% CI: 0.7–3.1 Gy) corresponding to 98% of prescribed dose.

Conclusions

This study demonstrates a difference in anatomical delineation of prostate apex position between CT imaging compared to TPUS, corresponding to a statistically significant difference in apex point dose. Further analysis will determine whether this translates to a clinically significant difference in outcomes.
Impacts of selective logging on avian phylogenetic and functional diversity in the Amazon
Authors: Mestre L. A. M. , Cosset C. C. P. , Nienow S. S. , Krul R. , Rechetelo J. , Festti L. , Edwards D. P.
Published: May 2020

Selective logging is the most extensive land use threatening tropical forests worldwide, making our understanding of its impacts on biodiversity vital for the conservation of these hyperdiverse ecosystems. We investigated the effects of selective logging on the phylogenetic and functional diversity (FD) of Amazonian forest avifauna. We sampled the overall and the understorey bird community using point counts and mist‐netting, respectively, in logged and unlogged forests. The overall bird community showed significantly lower phylogenetic diversity (PD) and FD in logged than unlogged forests, but significantly higher standard effect size (ses) of PD, ses mean pairwise distance (MPD), mean nearest taxon distance (MNTD), ses functional MPD (sesfMPD) and functional MNTD (fMNTD) in logged sites. Evolutionary distinctiveness, sesMPD, sesFD, fMNTD and sesfMNTD of understorey birds were significantly higher in logged forests. Higher logging intensity affected some metrics negatively and others positively, although the relatively small changes in phylogenetic and FD suggest limited overall effects from logging at lower intensity. In combination, selective logging brings deleterious effects for some components of phylogenetic and FD of the overall Amazonian bird community. Nonetheless, selectively logged forests retain important avian diversity, underscoring their high conservation value. Relatively, low impacts of selective logging may be due to the reduced‐impact logging (RIL) techniques used, high connectivity with well‐preserved unlogged forests or focus on short‐term logging impacts. Because even low‐intensity RIL causes some losses in evolutionary history and functional traits, an optimal approach for conserving phylogenetic and FD requires incorporating some land‐sparing logging to protect more old‐growth patches within the logged matrix.
Digit innervation of the thoracic limb of Criollo horses: Anatomical description and consequences to perineural blocks
Authors: Silveira Bruno Belmonte , Souza Erick Candiota , dos Santos Matheus Damasceno Nunes , Porciuncula Marcelo Lameiro , Azevedo Marcos da Silva , Duarte Claudia Acosta , de Carvalho Amarílis Díaz , de Souza Junior Paulo
Published: May 2020

Criollo horse breeding is an important economic activity in South America. Because of their athletic performance, these animals tend to show great incidence of musculoskeletal disorders, many of them diagnosed by means of perineural blocks. However, incorrect interpretation of these blocks may be due to anatomical differences in nerve distribution. The objective of this study was to describe the innervation of the digit region of thoracic limbs in Criollo horses, in order to improve the interpretation of tests for claudication diagnosis based on nerve block. Thirty thoracic limbs from Criollo horses were dissected. It could be observed that in 90% of the limbs, dorsal branches of the palmar nerve originated proximally to the proximal sesamoid bone. In 93% of the cases, the palmar digital nerve and the dorsal branches communicated; in 87% of the cases, communication between branches of the dorsal branch was observed; and in 27% (8/30) of the limbs, the palmar metacarpal nerve and the dorsal branch presented communications. None of the specimens showed complete symmetry in the distribution of nerves in contralateral limbs. The high frequency of communication between the nerves may be a particularity of the Criollo breed that may interfere with the interpretation of perineural blocks. Based on the anatomical position, it may be inferred that divergent results in Criollo horses may occur when abaxial sesamoid nerve block is used. Palmar digital nerve block may be less influenced by these variations, provided it is performed as distal as possible from the ungular cartilage.
The complexity of T cell–mediated penicillin hypersensitivity reactions
Authors: Goh Shawn J. R. , Tuomisto Johanna E. E. , Purcell Anthony W. , Mifsud Nicole A. , Illing Patricia T.
Published: May 2020

Penicillin refers to a group of beta‐lactam antibiotics that are the first‐line treatment for a range of infections. However, they also possess the ability to form novel antigens, or neoantigens, through haptenation of proteins and can stimulate a range of immune‐mediated adverse reactions—collectively known as drug hypersensitivity reactions (DHRs). IgE‐mediated reactions towards these neoantigens are well studied; however, IgE‐independent reactions are less well understood. These reactions usually manifest in a delayed manner as different forms of cutaneous eruptions or liver injury consistent with priming of an immune response. Ex vivo studies have confirmed the infiltration of T cells into the site of inflammation, and the subsets of T cells involved appear dependent on the nature of the reaction. Here, we review the evidence that has led to our current understanding of these immune‐mediated reactions, discussing the nature of the lesional T cells, the characterization of drug‐responsive T cells isolated from patient blood, and the potential mechanisms by which penicillins enter the antigen processing and presentation pathway to stimulate these deleterious responses. Thus, we highlight the need for a more comprehensive understanding of the underlying genetic and molecular basis of penicillin‐induced DHRs.
Anticholinergic, anti‐depressant and other medication use is associated with clinically relevant oesophageal manometric abnormalities
Authors: Moosavi Sarvee , Woo Matthew , Jacob Deepti A. , Pradhan Sarah , Wilsack Lynn , Buresi Michelle , Gupta Milli , Al‐Awadh Yacoub , Li Dorothy , Andrews Christopher N.
Published: May 2020

Background

Medications can affect gastrointestinal tract motility. However, their effects on oesophageal motility in particular are often not as widely known or may be underestimated.

Aim

To review the effect of existing medication use on high‐resolution oesophageal manometry (HRM) in a ‘real‐world’ setting.

Methods

Adult patients with upper gut symptoms and normal endoscopy or imaging who had HRM over a 22‐month period were analysed. Achalasia and major disorders of peristalsis were excluded. All medications taken within 24 hours of the procedure were prospectively recorded and compared with HRM results, controlling for age, gender and proton pump inhibitor use.

Results

A total of 502 patients (323 female, mean age 51) were recruited. Of these, 41.2% had normal oesophageal HRM, while 41.4% had ineffective oesophageal motility (IOM) and 7.6% had oesophagogastric junction outflow obstruction (OGJOO). Serotonin/norepinephrine reuptake inhibitors (SNRI) and opioids were associated with significantly higher resting lower oesophageal sphincter pressure. Benzodiazepines and opioids were associated with elevated integrated relaxation pressure. SNRI and inhaled beta‐agonists were associated with increased distal contractile index, whereas calcium channel blockers were associated with a lower distal contractile index. Odds ratio of being on anticholinergics was higher in IOM patients vs normal (3.6, CI 1.2‐10.8). Odds ratio for anticholinergics, inhaled beta‐agonists, anticonvulsants, SNRIs and opioids (trend) were all > 3 for OGJOO patients vs normal.

Conclusion

Many medication classes are associated with abnormal HRM variables and diagnoses such as OGJOO and IOM; some of these associations are probably causal. These possible links should be taken into consideration during manometry interpretation.
Immune checkpoint blockade in solid organ tumours: Choice, dose and predictors of response
Authors: Navani Vishal , Graves Moira C. , Bowden Nikola A. , Van Der Westhuizen Andre
Published: May 2020

Immune checkpoint blockade has transformed outcomes across solid organ tumours. Monoclonal antibodies targeting the negative inhibitory cytotoxic T lymphocyte‐associated protein 4 and programmed‐death 1/programmed death‐ligand 1 axis can lead to deep and durable responses across several tumour streams in the advanced setting. This immunotherapy approach is increasingly used earlier in the treatment paradigm. A rapidly evolving regulatory, reimbursement and drug development landscape has accompanied this novel class of immunotherapy. Unfortunately, only a small proportion of patients respond meaningfully to these agents. Here we review how the underlying tumoural genomic, histological and immunological characteristics interact within various patient phenotypes, leading to variations in response to checkpoint blockade. Concurrently, we outline the clinical trial and real‐world evidence that allows for appropriate selection of agent, dose and schedule in solid organ malignancies. An exploration of current trends in basic and translational research in immune checkpoint blockade accompanies a commentary on future clinical directions for checkpoint blockade in oncology.
Once And For All Time, Always The Same?
Authors: Ginzburg Alessandra , Carvalho Richard
Published: May 2020

This paper gives an account of the early stages in the analysis of a young woman whose parents were unable to make sense of her feelings as a child because they were unable to do so for themselves and bombarded her with theirs. The result was that she remained a stranger to her feeling, which was largely dissociated having never been ‘mentalized’ or converted into alpha elements, so that she mostly experienced it as undifferentiated and inexplicable panic, while to some extent, she was also terrified that emotions, when they did emerge, might alienate those she depended on. This paper explores the logic, using Matte Blanco's conceptual apparatus, of why uncontained emotion should be so prohibitively terrifying in that it, like the unconscious, threatens to dissolve identity and to be experienced therefore as literally annihilating. The technical issue then is how to establish a relationship between the afflicted individual and their body with its terrifying emotion. This the authors address via the thinking of the Italian analyst, Armando Ferrari, for whom the body is mind's primary, original and originating object. The clinical implication of this is that it is sometimes necessary to privilege this relationship, that between the body and its mind, over the transference relationship, insistence on which may invite the patient to ignore it.
“Getting by”: People with learning disability and the financial responsibility of independent living
Authors: Conder Jennifer Ann , Mirfin‐Veitch Brigit Frances
Published: May 2020

Accessible summary

People with learning disability who are living independently can find it hard to live well on their limited income.

We interviewed 20 adults with learning disability who were living independently.

They told us that living independently meant that they had choices.

They also told us that it was difficult to afford things like going to dentists and doctors or going on holiday.

Some liked to manage their own money while others liked having other people help them manage their money.

Governments need to make sure people with learning disability are getting the support they need.

Background

Within Aotearoa New Zealand (ANZ), disability policy is directed at increasing choices for disabled people. However, funding to individuals remains insufficient to address wider social inequities that exist. While people with learning disability enjoy the freedom of living independently, they can be at risk of poor health outcomes and limited opportunities to fully engage within their community.

Method

This qualitative research explored the experience of living independently with 20 adults with learning disability within ANZ. Taking a constructivist perspective, interview transcripts were analysed to develop an understanding of their experience. Multiple readings resulted in comparison and contrast of data. The researchers discussed developing themes before settling on final themes.

Results

With regard to money management, two themes were identified. The first illustrates the challenges of managing a budget, while the second highlights what people's limited budgets meant in terms of how they were able to live.

Conclusion

This research reinforced previous studies whereby people with learning disability place a high value on having choices. However, it also demonstrated that social inequities within ANZ are not being addressed, as without other financial support, people on a benefit struggled to afford medical and dental care, or holidays and other leisure activities.
Talking Prose All These Years: Agent‐Based Modeling as Process‐Oriented Analysis
Authors: Chattoe‐Brown Edmund
Published: May 2020

This article considers the implications of an approach to computer simulation called agent‐based modeling for process‐oriented analysis. It argues that many theoretical and methodological debates found in the latter field can be effectively advanced by the former. The argument is presented and then extended using a ubiquitous agent‐based model proposed to improve understanding of ethnic residential segregation. The argument has three strands. The first is that theoretical and methodological debates are unlikely to progress unless they can be “cashed out” empirically. The second is that agent‐based modeling (and its distinctive methodology) has capabilities to do this that existing research methods lack and, in fact, that agent‐based models are a natural way to represent “social process” as apparently conceived by process‐oriented analysis. The third is that possibilities exist for productive synthesis between agent‐based modeling and process‐oriented analysis with the former clarifying, instantiating, and perhaps even testing notions of process developed by the latter.
Temporal Upsampling of Point Cloud Sequences by Optimal Transport for Plant Growth Visualization
Authors: Golla Tim , Kneiphof Tom , Kuhlmann Heiner , Weinmann Michael , Klein Reinhard
Published: May 2020

Plant growth visualization from a series of 3D scanner measurements is a challenging task. Time intervals between successive measurements are typically too large to allow a smooth animation of the growth process. Therefore, obtaining a smooth animation of the plant growth process requires a temporal upsampling of the point cloud sequence in order to obtain approximations of the intermediate states between successive measurements. Additionally, there are suddenly arising structural changes due to the occurrence of new plant parts such as new branches or leaves. We present a novel method that addresses these challenges via semantic segmentation and the generation of a segment hierarchy per scan, the matching of the hierarchical representations of successive scans and the segment‐wise computation of optimal transport. The transport problems' solutions yield the information required for a realistic temporal upsampling, which is generated in real time. Thereby, our method does not require shape templates, good correspondences or huge databases of examples. Newly grown and decayed parts of the plant are detected as unmatched segments and are handled by identifying corresponding bifurcation points and introducing virtual segments in the previous, respectively successive time step. Our method allows the generation of realistic upsampled growth animations with moderate computational effort.
Minority and low‐income patients are less likely to have a scale for self‐weighing in their home: A survey in primary care
Authors: Bramante Carolyn T. , Lee Grace , Amsili Safira S. , Linde Jennifer A. , Phelan Sean M. , Appel Lawrence J. , Bennett Wendy L. , Clark Jeanne M. , Gudzune Kimberly A.
Published: May 2020

Daily self‐weighing is a weight management behaviour that requires a scale; however, scale ownership may be cost‐prohibitive for some patients. Our objective was to understand the proportion of primary care patients with a scale at home, and factors associated with home scale access, to potentially inform future interventions that facilitate scale access. Cross sectional survey of 216 adult patients from three primary care clinics: mixed‐income urban/suburban (n = 68); mixed‐income urban (n = 70); low‐income urban (n = 74). The dependent variable was presence of a home scale; bivariate associations were conducted with variables including demographics, insurance type, clinic setting and self‐reported height/weight. Mean age was 53 years; 71% women; 71% racial minority; mean body mass index 32 kg/m2. Overall, 56% had a home scale. Most (79%) white patients owned a scale, compared to 46% of racial minority patients (P < .01); 33% of low‐income patients owned scale, compared to over 66% of patients at the clinics serving mixed‐income populations (P < .01). Most low‐income urban clinic patients do not own a home scale. Because self‐weighing is an effective weight‐management behaviour, clinicians could consider assessing scale access, and future research should assess the health impact of providing scales to patients with overweight/obesity who desire weight loss or maintenance.
EEG phase synchronization during semantic unification relates to individual differences in children’s vocabulary skill
Authors: Panda Erin J. , Emami Zahra , Valiante Taufik A. , Pang Elizabeth W.
Published: May 2020

As we listen to speech, our ability to understand what was said requires us to retrieve and bind together individual word meanings into a coherent discourse representation. This so‐called semantic unification is a fundamental cognitive skill, and its development relies on the integration of neural activity throughout widely distributed functional brain networks. In this proof‐of‐concept study, we examine, for the first time, how these functional brain networks develop in children. Twenty‐six children (ages 4–17) listened to well‐formed sentences and sentences containing a semantic violation, while EEG was recorded. Children with stronger vocabulary showed N400 effects that were more concentrated to centroparietal electrodes and greater EEG phase synchrony (phase lag index; PLI) between right centroparietal and bilateral frontocentral electrodes in the delta frequency band (1–3 Hz) 1.27–1.53 s after listening to well‐formed sentences compared to sentences containing a semantic violation. These effects related specifically to individual differences in receptive vocabulary, perhaps pointing to greater recruitment of functional brain networks important for top‐down semantic unification with development. Less skilled children showed greater delta phase synchrony for violation sentences 3.41–3.64 s after critical word onset. This later effect was partly driven by individual differences in nonverbal reasoning, perhaps pointing to non‐verbal compensatory processing to extract meaning from speech in children with less developed vocabulary. We suggest that functional brain network communication, as measured by momentary changes in the phase synchrony of EEG oscillations, develops throughout the school years to support language comprehension in different ways depending on children's verbal and nonverbal skill levels.
Diabetes or endocrinopathy admitted in the COVID‐19 ward
Authors: Clotman Katrien , Twickler Marcel B.
Published: May 2020

The Covid‐19 pandemic confronted us with unknown clinical pictures, also in diabetology and endocrinology. Sharing clinical experiences is therefore of enormous importance. Actually, information about the care given in the Covid‐19 ward (in contrast to that provided in the Emergency Room/ICU) is still sparse. The last weeks we built experience and gathered knowledge while giving hospital care to patients who had a pre‐existent endocrine disease (and diabetes; most patients suffered from a type two diabetes). In our contribution we presented our insights obtained from this intensive period obtained in the Covid‐19 ward.
Forest and connectivity loss drive changes in movement behavior of bird species
Authors: Ramos Danielle Leal , Pizo Marco Aurélio , Ribeiro Milton Cezar , Cruz Rafael Souza , Morales Juan Manuel , Ovaskainen Otso
Published: May 2020

In a rapidly changing world, it is important to understand how environmental modifications by humans affect species behavior. This is not a simple task, since we need to deal with a multitude of species and the different external contexts that affect their behavior. Here, we investigate how interpatch short‐distance movements of 73 common forest bird species can be predicted by forest cover and forest isolation. We modeled bird movement as a function of environmental covariates, species traits – body mass and feeding habit – and phylogenetic relationships using Joint Species Movement Models. We used field data collected in forest edges and open pastures of six 600 × 600 m plots in the Atlantic Forest biodiversity hotspot. We found that birds fly larger distances and visit more forest patches and remnant trees with decreasing forest cover. Increasing landscape isolation results in larger flight distances, and it increases the use of trees as stepping‐stones for most species. Our results show that birds can adjust their behavior as a response to spatial modification in resource distribution and landscape connectivity. These adjusted behaviors can potentially contribute to ecosystem responses to habitat modification.
Roscovitine differentially facilitates cerebellar glutamatergic and GABAergic neurotransmission by enhancing Cav2.1 channel‐mediated multivesicular release
Authors: Satake Shin’Ichiro , Konishi Shiro
Published: May 2020

Synaptic vesicle exocytosis is triggered by Ca2+ influx through several subtypes of voltage‐gated calcium channels in the presynaptic terminal. We previously reported that paired‐pulse stimulation at brief intervals increases Cav2.1 (P/Q‐type) channel‐mediated multivesicular release (MVR) at glutamatergic synapses between granule cells (GCs) and molecular layer interneurons (MLIs) in rat cerebellar slices. However, it has yet to be determined how Cav2 channel subtypes take part in MVR in single axon terminal. This study therefore aimed at examining the effects of roscovitine on different types of cerebellar synapses that make contacts with Purkinje cells (PCs), because this compound has been shown to enhance Cav2.1 channel‐mediated MVR at GC‐MLI synapses. Bath application of roscovitine profoundly increased the amplitude of excitatory postsynaptic currents (EPSCs) at GC‐PC synapses by a presynaptic mechanism as previously observed at GC‐MLI synapses, whereas it caused a marginal effect on climbing fiber‐mediated EPSCs in PCs. At MLI‐PC synapses, roscovitine increased both the amplitude and decay time of inhibitory postsynaptic currents (IPSCs) by enhancing multivesicular GABA release. When extracellular Ca2+ concentration ([Ca2+]e) decreased, roscovitine became less effective in increasing GC‐PC EPSCs. By contrast, roscovitine was able to augment MLI‐PC IPSCs in the low [Ca2+]e. The Cav2.1 channel blocker ω‐agatoxin IVA suppressed the roscovitine‐induced facilitatory actions on both GC‐PC EPSCs and MLI‐PC IPSCs. These results demonstrate that roscovitine enhances MVR at the GC‐PC excitatory synapses in a manner dependent on the driving force of Cav2.1 channel‐mediated Ca2+ influx into the nerve terminal, while it also facilitates MLI‐PC inhibitory transmission via Ca2+‐insensitive mechanisms.
Dopamine regulation of contextual fear and associated neural circuit function
Authors: Stubbendorff Christine , Stevenson Carl W.
Published: May 2020

Learning to associate certain contexts with threat and adapting to changing environmental contingencies by learning that such contexts are no longer associated with threat are both crucial for survival. Research over the last few decades has made considerable progress in determining the brain areas involved in the encoding, retrieval and extinction of contextual fear. These studies have identified the hippocampus and amygdala, along with the prefrontal cortex and other inter‐connected brain areas, as key players in contextual fear processing. In contrast to the neural circuit basis of contextual fear, the neurochemical mechanisms involved in its regulation remain poorly understood. Dopamine is well known for its role in appetitive learning but this neurotransmitter is also important for other types of learning, including spatial and aversive memory processing. Dopamine is ideally positioned to regulate contextual fear given that the areas involved receive dopamine input and express dopamine receptors. Moreover, neuronal activity, functional connectivity and synaptic plasticity in this neural circuitry are modulated by dopamine receptor signalling. Here, we review the evidence indicating that dopamine regulates various contextual fear processes, along with the more recent studies that have begun to elucidate the brain areas and neurophysiological mechanisms involved. From a fundamental research perspective, understanding how dopamine regulates contextual fear will lead to novel insights on the neurochemical modulation of neural circuit function underlying memory processing. This research may also have translational relevance given that contextual fear conditioning and extinction also provide useful preclinical models of certain aspects of anxiety‐related disorders and their treatment.
On cost effectiveness analysis and fairness: Normalizing control of and resistance to NICE technology appraisals
Authors: Chang Li‐Cheng
Published: May 2020

This study examines National Institute for Health and Care Excellence's (NICE) application of cost effectiveness analysis (CEA) for normalizing patients’ access to newly licensed health technologies. Drawing upon evidence from the appraisal of four drugs developed for a rare form of cancer, this study demonstrates that the discourse of CEA provided a medium whereby contradicting ideologies of fairness were contested and resistance was provoked. Far from being docile, the patients whom the NICE technology appraisal sought to administer were actively challenging the legitimacy of the calculation of CEA. The patients’ recalcitrance not only undermined the normalizing force but also compelled NICE to revise its application of CEA to suit their own interests. This study concludes that the discursive characteristic of calculating technologies not only constituted but was also constituted by conflicting interests and power struggles.
Targeting IL‐10, ZO‐1 gene expression and IL‐6/STAT‐3 trans‐signaling by a combination of atorvastatin and mesalazine to enhance anti‐inflammatory effects and attenuates progression of oxazolone‐induced colitis
Authors: El‐Mahdy Nageh Ahmed , El‐Sayad Magda El‐Sayed , El‐Kadem Aya Hassan , Abu‐Risha Sally El‐Sayed
Published: May 2020

Ulcerative colitis (UC) is a chronic inflammatory disease characterized by diffused inflammation of the colon and rectum mucosa. The pathogenesis of UC is multifactorial, and the exact underlying mechanisms remain poorly understood. This study aims to investigate the effect of mesalazine and atorvastatin combination in enhancing anti‐inflammatory effects and attenuates progression of oxazolone colitis in rats. In the present study, male albino rats (N = 60) were divided into six groups (10 rats each), the first two groups served as normal control and a control saline group. Colitis was induced by intra‐rectal administration of oxazolone in the 5th and 7th days after pre‐sensitization. Then, rats were divided into untreated group, groups treated with mesalazine or atorvastatin or their combination. Colitis was assessed by colon length, body weight, and incidence of diarrhea, rectal bleeding, and histopathology of colon tissue. Colon tissues were used for measuring interleukin 6 (IL‐6), tumor necrosis factor alpha (TNF‐α), IL‐13, signal transducer and activator of transcription‐3 (STAT‐3), myeloperoxidase activity (MPO), reduced glutathione(GSH), and tissue expression of IL‐10, tight junction protein zonula occludens (ZO‐1), and caspase‐3 genes. The combination therapy significantly attenuated progression of UC by decreasing incidence of diarrhea, rectal bleeding, weight loss, IL‐13, IL‐6, TNF‐α, STAT‐3, caspase‐3, and MPO activity and significantly increased IL‐10, ZO‐1, colon length, and GSH content, and these effects were more superior to single drugs. These findings showed that combination therapy was able to ameliorate progression of UC and enhance anti‐inflammatory effects possibly by restoring IL‐10 and ZO‐1 levels and limiting IL‐6/STAT‐3 trans‐signaling.
Genetic risk for Alzheimer disease in children: Evidence from early‐life IQ and brain white‐matter microstructure
Authors: Vinueza‐Veloz María Fernanda , Martín‐Román Carlos , Robalino‐Valdivieso María Paulina , White Tonya , Kushner Steven A. , De Zeeuw Chris I.
Published: May 2020

It remains unclear whether the genetic risk for late‐onset Alzheimer disease (AD) is linked to premorbid individual differences in general cognitive ability and brain structure. The objective of the present study was to determine whether the genetic risk of late‐onset AD is related to premorbid individual differences in intelligence quotient (IQ) and characteristics of the cerebral white‐matter in children. The study sample included children of the Generation R Study from Rotterdam, The Netherlands. IQ was measured using a well‐validated Dutch nonverbal IQ test (n = 1908) at ages 5 to 9 years. White‐matter microstructure was assessed by measuring fractional anisotropy (FA) of white‐matter tracts using diffusion tensor imaging (DTI) (n = 919) at ages 9 to 12 years. Genetic risk was quantified using three biologically defined genetic risk scores (GRSs) hypothesized to be related to the pathophysiology of late‐onset AD: immune response, cholesterol/lipid metabolism and endocytosis. Higher genetic risk for late‐onset AD that included genes associated with immune responsivity had a negative influence on cognition and cerebral white‐matter microstructure. For each unit increase in the immune response GRS, IQ decreased by 0.259 SD (95% CI [−0.500, −0.017]). For each unit increase in the immune response GRS, global FA decreased by 0.373 SD (95% CI [−0.721, −0.026]). Neither cholesterol/lipid metabolism nor endocytosis GRSs were associated with IQ or cerebral white‐matter microstructure. Our findings suggest that elevated genetic risk for late‐onset AD may in part be manifest during childhood neurodevelopment through alterations in immune responsivity.
The People's Microphone: Amplification and Circulation in Klopstock's Ode “Der Grenzstein” (1782)
Authors: Auer Michael
Published: May 2020

Klopstock's poetry speaks to a groundbreaking shift from the rhetoric of amplificatio to a medial strategy of amplification. In written and printed communication, sender and receiver need not be co‐present in the shared acoustic space of rhetoric. Klopstock avails himself of this qualitative “extension” of communicative channels in order to reach out to a broad, egalitarian audience. Informing his circulating texts with the emotive, conative, and performative properties of language crucial to rhetorical speech allows him to evoke a “voice” in the “ears” of his readers. That they can then lend their own voices to this voice lets the feedback of this amplificatory loop come full circle. For in receiving and emitting such a voice the audience does not simply become the loudspeaker of an authorial amplifier. Instead, Klopstock's odes pit their (lyrical) voice against their author‐function in such a way as to turn the audience into senders as well as receivers. Thus, poetry becomes a people's microphone. The ode “Der Grenzstein” from 1782 marks the border lines such a concept of lyric must cross.
Vampires and the Orient in Goethe's “Die Braut von Corinth”
Authors: Endres Johannes
Published: May 2020

In his poem “Die Braut von Corinth” (1797), Goethe introduces the figure of the vampire as an early agent of his concept of “Weltliteratur.” As such, his female vampire challenges critical assumptions of a cultural divide between Christian and “pagan” religions, vampire believers and non‐believers, and finally Western and Eastern literatures. Instead, Goethe's “Braut” offers herself as a specimen of literary and cultural hybridity in a textual format entertained by Goethe for its liminality and heterogeneity—that of the “Ballade.” As a genre of originality without origin, the “Ballade” features a, in Homi Bhabha's sense of the term, “traumatic” encounter with the unfathomable—the living dead, monstrous affection, and transcultural alterity—that can not be reconciled with one's own world view, but only endured. Once endured, however, the disparate starts to form alliances across boundaries that Goethe will later refer to as “Weltliteratur.”
Decentering Germany's Classical Center: Colonial Critique and Weimar Classicism
Authors: Kontje Todd
Published: May 2020

This essay reflects on the interrelated topics of the Germans’ response to intra‐European conflict and their relation to extra‐European imperialism. Against the myth that the politically fragmented Germans first found unity in the realm of culture and then joined together to defeat Napoleon and his armies, we find instead fictions of fractured identities, conflicts in border zones between collaborators and resistance fighters, regional loyalties, and cosmopolitan hopes. The era often celebrated as Germany's “classical center” was in fact radically decentered. This essay shifts the focus from precolonial fantasies that anticipated the empires of Bismarck and Hitler to efforts on the part of German intellectuals raised in the Holy Roman Empire to imagine alternatives to the imperialist nation‐state and to cast a critical eye on the European conquest of the globe.
Understanding evolving public motivational practices: An institutional analysis
Authors: Boruvka Elise , Perry James L.
Published: May 2020

New public management (NPM) has been the focus of research and reform practices in countries globally since the late 1970s. This article looks at NPM in historical perspective with particular attention to understanding the evolution of public motivational practices. Three different eras and motivational models common in OECD countries are discussed—the bureaucratic model, the NPM model, and the new public service model. This long‐linked historical perspective highlights the interplay between administrative theory and realpolitik. It is possible to see how certain priorities have been a result of or led to the preservation, the adaptation, or the discontinuation of practices in alignment with the values and behaviors of the successive reform eras. Additional research into the dynamics of change in the public sector is suggested.
Reducing the risk of intradialytic hypotension by altering the composition of the dialysate
Authors: Vareesangthip Kornchanok , Davenport Andrew
Published: May 2020

Hypotension is the most common complication of outpatient hemodialysis sessions, with a reported prevalence of 4% to 31%, depending on which definition has been used and whether patients are symptomatic and nursing interventions were required. Dialysis centers which mix the dialysate in the dialysis machine have the opportunity to individualize the composition of the dialysate for patients. This permits a choice of dialysate sodium, potassium, calcium, magnesium, bicarbonate, acetate, and citrate concentrations and temperature. Studies have reported a higher intradialytic systolic blood pressure and fewer episodes of intradialytic hypotension when using a higher dialysate sodium, calcium, magnesium concentrations and lower temperature, but no clinical advantage for changing the potassium, bicarbonate, or citrate for acetate concentrations. The introduction of newer technology allowing real time measurements of plasma electrolyte concentrations will potentially allow changing the dialysate composition to reduce the risk of intradialytic hypotension without increasing the risk of positive electrolyte balances.
A prospective study on the effect of coronal tooth structure loss on the 4‐year clinical survival of root canal retreated teeth and retrospective validation of the Dental Practicality Index
Authors: Al‐Nuaimi N. , Ciapryna S. , Chia M. , Patel S. , Mannocci F.
Published: May 2020

Aim

First, to examine the impact of the residual volume of coronal tooth structure in posterior teeth measured with an intra‐oral scanner on the 4‐year clinical survival of root canal retreated teeth. Secondly, to assess retrospectively the effectiveness of the Dental Practicality Index (DPI) in predicting the survival of root canal retreated teeth.

Methodology

A total of 156 posterior root canal treated teeth (140 patients) had baseline periapical radiographs (PA) and cone‐beam computed tomography (CBCT) scans taken prior to root canal retreatment. These teeth were followed up with a clinical examination at 1, 2, 3 and 4 years (T12, T24, T36 and T48) with periapical radiographs and CBCT images taken at T12, and PA taken at T24, T36 and T48 where appropriate. Root canal retreated teeth were dichotomized into ‘survived’ versus ‘extracted’. Fisher’s exact test was used to determine the association between the volume of remaining coronal tooth structure and the 4‐year tooth survival. The Dental Practicality Index for each tooth was established using the preoperative clinical and radiographical data. Fisher’s exact test was used to establish a relationship between categorical variables, the total score of DPI vs tooth outcome.

Results

The percentage of extractions associated with teeth with <29.5% remaining coronal tooth structure was 3 times higher (12.5%) compared to that of teeth with a residual tooth structure > 29.5% (3.5%), but with no significant difference (P = 0.073). There was a significant correlation between the outcome of root canal retreatments at 1 year, assessed by both PA and CBCT, and the 4‐year survival (Fisher’s exact test, P = 0.007 and P = 0.001, respectively). Teeth with DPI scores ≥ 6 were more likely to be extracted than teeth with DPI score < 6 (18.8% vs. 3.9%) (Fisher’s exact test, P = 0.045).

Conclusion

Teeth with <30% of remaining tooth structure were associated with a survival rate above 80% and teeth with more than 30% of residual tooth structure survived in more than 94% of the cases. The radiographic outcome of root canal treatment can also help to predict tooth survival with teeth having an unfavourable outcome at 1 year more likely to be extracted within 4 years of completion of treatment. The DPI score can potentially be used to identify teeth with failed root canal treatment, which are likely to be extracted following retreatment and cuspal coverage.
Tasks, occupations and wages in OECD countries
Authors: AGASISTI Tommaso , JOHNES Geraint , PACCAGNELLA Marco
Published: May 2020

This article investigates the links between earnings, human capital and job tasks, using internationally comparable information from the OECD Survey of Adult Skills. The authors use the theoretical framework developed by Autor and Handel (2013) and extend their empirical results to 21 OECD countries. The data allow for a richer characterization of workers' human capital by including both educational attainment and a measure of cognitive skills. Their findings confirm the predictive power of job tasks in explaining wage differences, both between and within occupations, and provide empirical support for the model's prediction in the vast majority of countries.
A comparison study on the substitution of Y3+−Al3+ by M2+−Si4+(M = Ba, Sr, Ca, Mg) in Y3Al5O12: Ce3+ phosphor
Authors: Jia Junjie , Qiang Yaochun , Xu Jianfei , Liang Mingzhang , Wang Wei , Yang Fengli , Cui Jun , Dong Quan , Ye Xinyu
Published: May 2020

Y1.94MAl4SiO12:0.06Ce3+ (M = Ba, Sr, Ca, Mg) phosphors were successfully prepared through a classic solid‐state reaction method. The crystal structures, photoluminescence spectra, quantum yields, and thermal stabilities of the phosphors were investigated in detail. The results indicate that all Y1.94MAl4SiO12:0.06Ce3+ phosphors maintain the crystal structure of garnets. The emission peaks of Y1.94MAl4SiO12:0.06Ce3+ (M = Ba, Sr, Ca, Mg) phosphors are located at 537, 538, 554, and 565 nm, respectively. A red‐shift trend of emission peak is observed with decreasing M radius, which can be ascribed to the increase in the crystal‐field splitting in the Ce3+ 5d level owing to the co‐doping of M2+−Si4+. Under 460 nm excitation, the luminescence quantum yields and thermal stabilities of the Y1.94MAl4SiO12:0.06Ce3+ phosphors decreased with the decrease of M radius. The IQE of the Y1.94BaAl4SiO12:0.06Ce3+ phosphor is 92.89%, and the resistance to thermal quenching is improved to be 93.32% at 150°C. In addition, the color shifts of Y1.94MAl4SiO12: 0.06Ce3+ phosphors with increasing temperature are all tiny, which also demonstrates good resistance to thermal quenching of luminescence. The linear shrinkage of Y1.94MAl4SiO12:0.06Ce3+ phosphors is significantly improved compared with that of YAG: Ce3+, which is expected to generate Y1.94MAl4SiO12:0.06Ce3+ transparent/translucent ceramics and fabricate high‐powder w‐LEDs for high‐quality solid‐state lighting in the future.
General glycosylated hemoglobin goals potentially increase myocardial infarction severity in diabetes patients with comorbidities: Insights from a nationwide multicenter study
Authors: Che Qianzi , Zhang Yan , Wang Jianan , Wan Zheng , Fu Xianghua , Chen Jiyan , Yan Hongbing , Chen Yundai , Ge Junbo , Chen Dafang , Huo Yong
Published: May 2020

Aims/Introduction

We aimed to investigate the relationship between glycemic status and coronary artery disease (CAD) extent and severity in ST‐elevation myocardial infarction (STEMI) patients, and further examine whether diabetes patients could benefit from glycosylated hemoglobin (HbA1c) below the recommended level.

Materials and Methods

Consecutive STEMI patients admitted in 2015–2017 across 244 hospitals were included in the China STEMI Care Project‐2. We carried out a cross‐sectional study comprising 8,370 participants with a record of HbA1c testing after admission. CAD extent and severity were assessed by admission heart rate, Killip classification and the number of stenosed vessels based on the coronary angiogram.

Results

Diabetes patients showed a greater risk for higher Killip class, admission tachycardia (admission heart rate ≥100 b.p.m.) and multivessel CAD (presence of left main and/or triple vessel disease). Likewise, HbA1c level was significantly associated with CAD extent and severity. While dividing diabetes patients according to general HbA1c targets (HbA1c ≤6.5, 6.5–7.0 and ≥7.0%), diabetes patients with HbA1c ≤6.5% showed a 1.30‐fold higher risk for multivessel CAD (adjusted odds ratio 1.30, 95% confidence interval 1.05–1.62). In stratified analysis, the association was even stronger in patients with hypertension (adjusted odds ratio 1.41, 95% confidence interval 1.08–1.86) or hyperlipidemia (adjusted odds ratio 1.57, 95% confidence interval 1.17–2.12).

Conclusions

HbA1c level is independently correlated with CAD extent and severity in STEMI patients. HbA1c below generally recommended levels might still increase the risk of CAD progression, especially for diabetes patients with hypertension or hyperlipidemia.