bluuebunny/crossref_metadata_2025 huggingface dataset:
Can the intermediate disturbance hypothesis explain grazing–diversity relations at a global scale?
Authors: Gao Junjing , Carmel Yohay
Published: December 2019

In the context of grazing, the intermediate disturbance hypothesis (IDH) predicts that plant diversity peaks under moderate grazing, resulting in a hump‐shape pattern for the grazing–diversity relationship. Although this has been debated due to contradictory empirical results, the IDH is still widely accepted among rangeland ecologists. The Milchunas–Sala–Lauenroth (MSL) model predicts that in arid areas grazing affects diversity negatively regardless of grazing intensity, whereas in mesic areas grazing effects on plant diversity are the same as predicted by the IDH. Very few studies have attempted to specifically evaluate the applicability of the IDH and MSL to grazing systems at a global scale, accounting for the possible effects of climate. We conducted a meta‐analysis and vote‐counting analysis to evaluate these two hypotheses. The results of both analyses show that the IDH cannot be applied globally and that its application largely depends on aridity. The IDH prediction of a hump‐shape curve is supported in wet areas, while in dry areas there is a slight decrease in species richness with increasing grazing intensity. Overall, the MSL model correctly predicted grazing–diversity relations in both wet and dry areas. Looking at specific ecosystem types, we found that these results hold in grasslands, but not in woodlands. Differences between livestock types, not considered by the MSL model, were found to be important. Mixed sheep and goat grazing in dry areas resulted in a significant decline of species richness with grazing intensity, while grazing by sheep only had little effect on species richness. Cattle grazing and yak grazing in wet areas yielded a clear hump‐shape pattern. Therefore, we conclude that the climate‐specific MSL model better predicts the impact of grazing on diversity than the IDH in rangelands, and that the response patterns of plant richness to grazing are dependent on aridity, grazing intensity and grazer type.
People with physical disability in Serbia: Relationship between internalized stigma, experienced and anticipated discrimination, and empowerment
Authors: Milačić‐Vidojević Ivona , Čolić Marija , Tošković Oliver , Dragojević Nada
Published: December 2019

The aim of present study was to explore relationships between experienced and anticipated discrimination, internalized stigma, and empowerment among people with physical disabilities in Serbia. The convenience sample consisted of persons with different types of physical disabilities. The following scales were administrated: The Discrimination and Stigma Scale, the Internalized Stigma of Mental Illness Scale, and the Boston University Empowerment Scale. An analysis showed that internalized stigma was correlated with experienced and anticipated discrimination and empowerment, while no correlation was found between empowerment and discrimination. People with physical disabilities who experienced and anticipated discrimination are at higher risk of reporting internalized stigma.
Encountering Each Other in Glasgow: Spaces of Intersecting Lives in Contemporary Scotland
Authors: Peterson Melike
Published: December 2019

This paper uses the concept of intersectionality to think about the ways people negotiate diversity on a daily basis in Glasgow, Scotland. The paper draws on ethnographic fieldwork, in‐depth interviews and focus groups carried out in semi‐formal spaces such as public libraries, community‐centres and local cafes. Discussing the ways in which people speak about their experiences of encountering others across ethnicity, age, gender, religion, and class, the paper examines situations where different positionalities interconnect to produce mundane and fleeting moments of relation. Despite tensions, misunderstandings and moments of uneasiness, the paper finds that connections and relations are built. Set in the political context of contemporary Scotland, the paper argues that being together in diversity can be a decisive act that marks the everyday as political. It contends that an openness to and through these intersectional relations can counteract notions of crisis and emergency normatively constructed around issues of immigration and multiculturalism in Scotland.
Comparative genomics of six Juglans species reveals disease‐associated gene family contractions
Authors: Trouern‐Trend Alexander J. , Falk Taylor , Zaman Sumaira , Caballero Madison , Neale David B. , Langley Charles H. , Dandekar Abhaya M. , Stevens Kristian A. , Wegrzyn Jill L.
Published: December 2019

Juglans (walnuts), the most speciose genus in the walnut family (Juglandaceae), represents most of the family's commercially valuable fruit and wood‐producing trees. It includes several species used as rootstock for their resistance to various abiotic and biotic stressors. We present the full structural and functional genome annotations of six Juglans species and one outgroup within Juglandaceae (Juglans regia, J. cathayensis, J. hindsii, J. microcarpa, J. nigra, J. sigillata and Pterocarya stenoptera) produced using BRAKER2 semi‐unsupervised gene prediction pipeline and additional tools. For each annotation, gene predictors were trained using 19 tissue‐specific J. regia transcriptomes aligned to the genomes. Additional functional evidence and filters were applied to multi‐exonic and mono‐exonic putative genes to yield between 27 000 and 44 000 high‐confidence gene models per species. Comparison of gene models to the BUSCO embryophyta dataset suggested that, on average, genome annotation completeness was 85.6%. We utilized these high‐quality annotations to assess gene family evolution within Juglans, and among Juglans and selected Eurosid species. We found notable contractions in several gene families in J. hindsii, including disease resistance‐related wall‐associated kinase (WAK), Catharanthus roseus receptor‐like kinase (CrRLK1L) and others involved in abiotic stress response. Finally, we confirmed an ancient whole‐genome duplication that took place in a common ancestor of Juglandaceae using site substitution comparative analysis.
Inhibition of glycogenolysis prolongs action potential repriming period and impairs muscle function in rat skeletal muscle
Authors: Jensen Rasmus , Nielsen Joachim , Ørtenblad Niels
Published: December 2019

Key points

Muscle glycogen content is associated with muscle function, but the physiological link between the two is poorly understood.

This study investigated the effects of inhibiting glycogenolysis, while maintaining high overall energy status, on different aspects of muscle function.

We demonstrate here that Na+,K+‐ATPase activity depends on glycogenolytically derived ATP regardless of high global ATP, with a decrease in activity leading to reduced force production and accelerated fatigue development.

The results support the concept of compartmentalized energy transfer with glycogen metabolism playing a crucial role in intramuscular ATP resynthesis and ion regulation.

This study gives specific insights into muscular function and may help towards a better understanding of glycogen storage diseases and muscle fatigue.

Skeletal muscle glycogen content is associated with muscle function and fatigability. However, little is known about the physiological link between glycogen content and muscle function. Here we aimed to investigate the importance of glycogenolytically derived ATP per se on muscle force and action potential (AP) repriming period, i.e. the time before a second AP can be produced (indicative of Na+,K+‐ATPase activity). Single fibres from rat extensor digitorum longus muscles were isolated and mechanically skinned in order to investigate force production and the AP repriming period while global ATP and PCr concentrations were kept high. The importance of glycogenolytically derived ATP was studied by inhibition of glycogen phosphorylase (1,4‐dideoxy‐1,4‐imino‐d‐arabinitol (DAB; 2 mm) or CP‐316,819 (CP; 10 µm)) or glycogen removal (amyloglucosidase, 20 U ml−1). Tetanic force decreased by (mean (SD)) 21 (15)% (P < 0.001) and 76 (28)% (DAB) or 94 (6)% (CP, P < 0.001) in well‐polarized and partially depolarized fibres, respectively. In depolarized fibres, twitch force decreased by 16 (10)% and 55 (26)% with DAB and CP, respectively, with no effect in well‐polarized fibres (84 (10)%, P = 0.14). There was no effect of glycogen phosphorylase inhibition on repriming period in well‐polarized fibres (median (25th, 75th percentile): 5 (4, 5) vs. 4 (4, 5) ms, P = 0.26), while the repriming period was prolonged from 6 (5, 7) to 8 (7, 10) ms (P = 0.01) in partially depolarized fibres. In line with this, glycogen removal increased repriming period from 5 (5, 6) to 6 (5, 7) ms (P = 0.003) in depolarized fibres. Together, these data strongly indicate that blocking glycogenolysis attenuates Na+,K+‐ATPase activity, which in turn increases the repriming period and reduces force, demonstrating a functional link between glycogenolytically derived ATP and force production.
La apropiación en la comunicación y en la educación. Construcción teórica de la apropiación desde las experiencias comunicativas de estudiantes universitarios
Authors: Agudelo Vergara Andrés Camilo
Published: December 2019

Este artículo evidencia las primeras reflexiones teóricas de una investigación en curso acerca del concepto de apropiación en los estudiantes de la Licenciatura en Comunicación e Informática Educativa. Dadas las densidades comunicativas de las culturas mediáticas actuales, resulta pertinente buscar un concepto que no solo se relacione con la recepción, sino también con la interacción. Se emplea una metodología cualitativa e interpretativa, tomando elementos de la Teoría Fundamentada para construir dimensiones teóricas de la apropiación en el contexto observado. Estas dimensiones son: problemáticas de sentido, interpelación, interpretación e interacción. Se encontró, en esas dimensiones, que los lineamientos teórico-curriculares de la Comunicación en la Licenciatura han generado incertidumbres en los estudiantes relacionadas con sus perfiles profesionales. Esta contingencia, a la vez apertura, ha posibilitado que produzcan apropiaciones significativas con medios y tecnologías. Estas primeras reflexiones ofrecen un marco de análisis interpretativo para repensar las culturas mediáticas y la educación en tecnologías.
La enseñanza de la comunicación: una mirada a los enfoques teóricos y metodológicos de profesores y programas de teorías de comunicación en Bogotá
Authors: García Corredor Claudia Pilar , Castellanos Barbosa Ángela Marcela , Pereira González José Miguel
Published: December 2019

A la luz de teorías que iluminan el campo y los enfoques pedagógicos, el presente texto se ocupa de hacer una mirada a la enseñanza de las teorías de comunicación en diferentes facultades de comunicación de Bogotá. Es claro que en todo proceso de enseñanza-aprendizaje, un actor fundamental es el estudiante; sin embargo, la investigación aborda la tensión entre dos sujetos del proceso: los maestros y los programas de teorías de comunicación.
El glifosato alza el vuelo. Análisis retórico del discurso en la prensa nacional de Colombia (2018-2019)
Authors: Mejía Maryluz Vallejo , Agudelo - Londoño Sandra Milena
Published: December 2019

Desde 1984, Colombia ha asperjado glifosato como principal estrategia para el control de cultivos ilícitos. En 2015 las fumigaciones se suspendieron debido a sus efectos nocivos sobre la salud humana y el ecosistema. Pero en 2018, con el anuncio de su retorno por parte del Gobierno, se produjo un intenso debate público que recogieron los medios de comunicación. Con el fin de identificar los artefactos retóricos más eficaces usados por simpatizantes y detractores de la medida se analizaron 167 piezas, el total de las publicadas en cuatro medios de prensa nacional entre junio de 2018 y julio de 2019. El debate, que osciló entre la necesidad de la aspersión para combatir el narcotráfico y el deber estatal de proteger los derechos humanos y ecosistémicos, cesó temporalmente con una confusa declaración de la Corte Constitucional, que avaló las aspersiones.
Mixed Magnetoconvection of Nanofluids in a Long Vertical Porous Channel
Authors: Borrelli Alessandra , Giantesio Giulia , Cristina Patria Maria
Published: December 2019

This paper aimed to study the flow of a nanofluid in a long vertical porous channel when an external uniform magnetic field is impressed. The Buongiorno two-phase model of nanofluid is supposed to be slightly compressible in order to assume the Oberbeck–Boussinesq approximation. The velocity, the induced magnetic field, the temperature, and the nanoparticle volume fraction are analytically obtained. Detailed considerations are drawn for the occurrence of the reverse flow phenomenon. Moreover, a selected set of plots illustrating the influence of various parameters involved in the problem is presented and discussed.
Design of Track-Type Climbing Robots Using Dry Adhesives and Compliant Suspension for Scalable Payloads
Authors: Demirjian Wesley , Powelson Matthew , Canfield Stephen
Published: December 2019

Climbing robots offer advanced motion capabilities to perform inspection, manufacturing, or rescue tasks. Climbing requires the robot to generate adhering forces with the climbing surface. Dry adhesives present a category of adhesion that could be advantageous for climbing a variety of surfaces. Current literature shows climbing robots using dry adhesives typically exhibit minimal payloads and are considered useful for tasks involving lightweight sensors, such as surveillance. However, dry adhesives routinely demonstrate adhering pressures in the range of 20–50 kPa, suggesting that a small robot (3 × 30 cm footprint, for example) could theoretically have a significant payload (in the order of 18–45 kg). Existing designs demonstrate small payloads primarily because they fail to distribute the adhesion forces over the entire adhering region available to these robots. Further, existing design methods do not demonstrate scalability of payload-to-vehicle size but, in fact, indicate such robots are not scalable (Gorb et al., 2007, “Insects Did It First: A Micropatterned Adhesive Tape for Robotic Applications,” Bioinspir. Biomim., 2(4), pp. 117–125.). This paper presents a design procedure for track-type climbing robots that use dry adhesives to generate tractive forces and a passive suspension that distributes the climbing loads over the track in a preferred manner. This procedure simultaneously considers the behavior of both the adhesive material at the track-surface interface and the distribution of the adhesive forces over the full contact surface. The paper will demonstrate that dry-adhesive-based climbing robots can be designed to achieve high payloads and are scalable, thus enabling them to be used in applications previously thought to be impossible with dry adhesives.
Effectiveness of Mechanical Air Conditioning as a Protective Factor Against Indoor Exposure to Heat Among the Elderly
Authors: Baniassadi Amir , Sailor David J. , O’Lenick Cassandra R. , Wilhelmi Olga V. , Crank Peter J. , Chester Mikhail V. , Reddy Agami T.
Published: December 2019

In many US cities, indoor exposure to heat continues to be the underlying cause of a considerable fraction (up to 80% during extreme events) of heat-related mortality and morbidity, even in locations where most citizens have air conditioning (AC). Nevertheless, the existing literature on indoor exposure to heat often regards AC as a binary variable and assumes that its presence inevitably results in a safe thermal environment. This is also reflected in heat vulnerability assessments that assign a binary attribute to AC. In this study, we used thermal simulation of buildings to investigate overheating in residential buildings in three US cities (Houston, Phoenix, and Los Angeles) and focused on scenarios where an AC system is present; yet not fully functional. Moreover, we identified the role of key building characteristics and investigated the sensitivity of indoor environment to the ambient temperature. Our results show that energy poverty and/or faulty systems can expose a considerable fraction of AC-owning elderly in Phoenix and Houston to excess heat for more than 50% of summer. This highlights the need to reevaluate AC as the primary protective factor against heat and introduces several implications that need to be considered in heat vulnerability assessments.
A terrestrial gamma-ray flash and ionospheric ultraviolet emissions powered by lightning
Authors: Neubert Torsten , Østgaard Nikolai , Reglero Victor , Chanrion Olivier , Heumesser Matthias , Dimitriadou Krystallia , Christiansen Freddy , Budtz-Jørgensen Carl , Kuvvetli Irfan , Rasmussen Ib Lundgaard , Mezentsev Andrey , Marisaldi Martino , Ullaland Kjetil , Genov Georgi , Yang Shiming , Kochkin Pavlo , Navarro-Gonzalez Javier , Connell Paul H. , Eyles Chris J.
Published: December 2019

Gamma-ray flash from a lightning leader

Terrestrial gamma-ray flashes (TGFs) are millisecond pulses of gamma rays produced by thunderstorms. Neubert
et al.
observed a TGF from above, using instruments on the International Space Station. High-speed photometry in optical, ultraviolet, x-ray, and gamma-ray bands allowed them to determine the sequence of events that produced the TGF. Emission from an intracloud lightning leader was followed within a millisecond by the TGF. The subsequent lightning flash produced an electromagnetic pulse, which induced expanding waves of ultraviolet emission in the ionosphere above the thunderstorm, called an elve. The authors conclude that high electric fields produced within the lightning leader generated the TGF.

Science
, this issue p.
183
Population Pharmacokinetics of Isoniazid, Pyrazinamide, and Ethambutol in Pregnant South African Women with Tuberculosis and HIV
Authors: Abdelwahab Mahmoud Tareq , Leisegang Rory , Dooley Kelly E. , Mathad Jyoti S. , Wiesner Lubbe , McIlleron Helen , Martinson Neil , Waja Ziyaad , Letutu Matebogo , Chaisson Richard E. , Denti Paolo
Published: December 2019

Tuberculosis is an important cause of maternal morbidity, but little is known about the effects of pregnancy on antituberculosis drug concentrations. We developed population pharmacokinetic models to describe drug dispositions of isoniazid, pyrazinamide, and ethambutol in pregnant women with tuberculosis and HIV. HIV-positive pregnant women with tuberculosis receiving standard first-line tuberculosis treatment and participating in Tshepiso, a prospective cohort study in Soweto, South Africa, underwent sparse pharmacokinetic sampling at >36 weeks of gestation and 7 weeks postpartum.
The Invasion Plasmid Antigen J (IpaJ) from
Salmonella
Inhibits NF-κB Activation by Suppressing IκBα Ubiquitination
Authors: Li Qiuchun , Xu Lijuan , Yin Chao , Liu Zijian , Li Yang , Yuan Yu , Hu Yachen , Jiao Xinan
Published: December 2019

Salmonella enterica
serovar Pullorum is the pathogen of pullorum disease, which leads to severe economic losses in many developing countries. In contrast to the strong inflammatory response induced by
Salmonella enterica
serovar Typhimurium and
Salmonella enterica
serovar Enteritidis,
S
. Pullorum causes systemic infection with little inflammation. The effector proteins secreted by
Salmonella
often play a crucial role in modulating host signal transduction and cellular processes to the pathogen’s advantage.
Genome Sequences of Two Strains of the Food Spoilage Mold Aspergillus fischeri
Authors: Zhao Shu , Latgé Jean-Paul , Gibbons John G.
Published: December 2019

Aspergillus fischeri
is a common food spoilage fungus and a close relative of the opportunistic human pathogen
Aspergillus fumigatus
. Here, we sequenced the genomes of two isolates of
A. fischeri
to build resources for comparative genomics and to aid in differentiation between
A. fischeri
subspecies.
Risk of knee osteoarthritis after different types of knee injuries in young adults: a population-based cohort study
Authors: Snoeker Barbara , Turkiewicz Aleksandra , Magnusson Karin , Frobell Richard , Yu Dahai , Peat George , Englund Martin
Published: December 2019

Objectives

To estimate the risk of clinically diagnosed knee osteoarthritis (OA) after different types of knee injuries in young adults.

Methods

In a longitudinal cohort study based on population-based healthcare data from Skåne, Sweden, we included all persons aged 25–34 years in 1998–2007 (n=149 288) with and without diagnoses of knee injuries according to International Classification of Diseases (ICD)-10. We estimated the HR of future diagnosed knee OA in injured and uninjured persons using Cox regression, adjusted for potential confounders. We also explored the impact of type of injury (contusion, fracture, dislocation, meniscal tear, cartilage tear/other injury, collateral ligament tear, cruciate ligament tear and injury to multiple structures) on diagnosed knee OA risk.

Results

We identified 5247 persons (mean (SD) age 29.4 (2.9) years, 67% men) with a knee injury and 142 825 persons (mean (SD) age 30.2 (3.0) years, 45% men) without. We found an adjusted HR of 5.7 (95% CI 5.0 to 6.6) for diagnosed knee OA in injured compared with uninjured persons during the first 11 years of follow-up and 3.4 (95% CI 2.9 to 4.0) during the following 8 years. The corresponding risk difference (RD) after 19 years of follow-up was 8.1% (95% CI 6.7% to 9.4%). Cruciate ligament injury, meniscal tear and fracture of the tibia plateau/patella were associated with greatest increase in risk (RD of 19.6% (95% CI 13.2% to 25.9%), 10.5% (95% CI 6.4% to 14.7%) and 6.6% (95% CI 1.1% to 12.2%), respectively).

Conclusion

In young adults, knee injury increases the risk of future diagnosed knee OA about sixfold with highest risks found after cruciate ligament injury, meniscal tear and intra-articular fracture.
The mixed effects of a package of multilevel interventions on the health and care of pregnant women in Zinder, Niger
Authors: Ouedraogo Cesaire T , Wessells K Ryan , Young Rebecca R , Bamba Ibrahim Foungotin , Faye M Thierno , Banda Ndiaye , Hess Sonja Y
Published: December 2019

Background

Anaemia is prevalent among pregnant women in rural Niger and antenatal care (ANC) attendance is suboptimal. We designed a programmatic intervention including community-based behaviour change communication, provision of essential drugs (including iron folic acid (IFA) supplements) and quality improvement activities at selected integrated health centres (IHCs).

Objective

To assess the impact of the programmatic intervention on: (1) utilisation of ANC, (2) adherence to daily IFA supplementation and (3) prevalence of adequate gestational weight gain (GWG) and anaemia among pregnant women in Zinder, Niger.

Methods

Using a quasi-experimental study design comparing a cohort of women at baseline to another cohort of women at endline, 18 IHCs and surrounding villages were randomly assigned to time of enrolment over 1 year. A baseline survey was implemented among randomly selected pregnant women in 68 village clusters. Subsequently, the intervention was rolled out and an endline survey was implemented 6 months later in the same villages.

Results

Mean age in the baseline (n=1385) and endline (n=922) surveys was 25.8±6.4 years. The percentage of pregnant women who reported attending any number of ANC and an adequate number of ANC for their gestational age, respectively, was not significantly different between the endline and the baseline surveys. Pregnant women in the endline survey were more likely to have received IFA (60.0% vs 45.8%, OR: 2.7 (1.2, 6.1)); and the proportion of pregnant women who reportedly consumed IFA daily in the previous 7 days was significantly higher in the endline than in the baseline survey (46.4% vs 32.8%, OR: 2.8 (1.2, 6.5)). There was no impact on the prevalence of adequate GWG or anaemia.

Conclusions

The programmatic intervention resulted in a modest increase in the number of pregnant women who reported receiving and consuming IFA supplements as recommended, but did not affect ANC attendance and nutritional status.
Learning for Universal Health Coverage
Authors: Meessen Bruno , Akhnif EL Houcine , Kiendrébéogo Joël Arthur , Belghiti Alaoui Abdelali , Bello Kefilath , Bhattacharyya Sanghita , Faich Dini Hannah Sarah , Dkhimi Fahdi , Dossou Jean-Paul , Gamble Kelley Allison , Keugoung Basile , Millimouno Tamba Mina , Pfaffmann Zambruni Jérôme , Rouve Maxime , Sieleunou Isidore , van Heteren Godelieve
Published: December 2019

The journey to universal health coverage (UHC) is full of challenges, which to a great extent are specific to each country. ‘Learning for UHC’ is a central component of countries’ health system strengthening agendas. Our group has been engaged for a decade in facilitating collective learning for UHC through a range of modalities at global, regional and national levels. We present some of our experience and draw lessons for countries and international actors interested in strengthening national systemic learning capacities for UHC. The main lesson is that with appropriate collective intelligence processes, digital tools and facilitation capacities, countries and international agencies can mobilise the many actors with knowledge relevant to the design, implementation and evaluation of UHC policies. However, really building learning health systems will take more time and commitment. Each country will have to invest substantively in developing its specific learning systemic capacities, with an active programme of work addressing supportive leadership, organisational culture and knowledge management processes.
Pragmatic trial evaluating the effectiveness of a patient navigator to decrease emergency room utilisation in transition age youth with chronic conditions: the Transition Navigator Trial protocol
Authors: Samuel Susan , Dimitropoulos Gina , Schraeder Kyleigh , Klarenbach Scott , Nettel-Aguirre Alberto , Guilcher Greg , Pacaud Daniele , Pinzon Jorge , Lang Eddy , Andrew Gail , Zwaigenbaum Lonnie , Scott Shannon , McBrien Kerry , Hamiwka Lorraine , Mackie Andrew
Published: December 2019

Introduction

Transition to adult care is a challenging and complex process for youth with special healthcare needs. We aim to compare effectiveness of a patient navigator service in reducing emergency room (ER) use among adolescents with chronic health conditions transitioning to adult care.

Methods and analysis

Pragmatic randomised controlled trial parallel group design comparing ER visit rates between patients with access to a personalised navigator intervention compared with usual care. Unit of randomisation is the patient. Treatment assignment will not be blinded. Embedded qualitative study to understand navigator’s role and cost analysis attributable to the intervention will be performed. Patients aged 16–21 years, followed within a chronic disease clinic, expected to be transferred to adult care within 12 months and residing in Alberta during study period will be recruited from three tertiary care paediatric hospitals. Sample size will be 300 in each arm. Navigator intervention over 24 months is designed to assist participants in four domains: transition preparation, health system brokering, socioeconomic determinants of health and self-management. Primary outcome is ER visit rate during observation period. Secondary outcomes are ambulatory and inpatient care utilisation measures, as well as Transition Readiness Assessment Questionnaire score, and Short-Form Health Survey 12 (SF-12) score at 6 and 18 months post-randomisation. Poisson regression will compare rates of ER/urgent care visits between navigator and control participants, using intention to treat principle. Cost analysis of the intervention will be conducted. Thematic analysis will be used to identify perceptions of stakeholders regarding the role of navigators.

Ethics and dissemination

Ethics approval was obtained from the University of Calgary Conjoint Health Research Ethics Board (REB #162561) and the University of Alberta Health Research Ethics Board (Pro00077325). Our team is composed of diverse stakeholders who are committed to improving transition of care who will assist with dissemination of results.

Trial registration number

NCT03342495.
Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment
Authors: Faatz Henrik , Farecki Marie-Louise , Rothaus Kai , Gutfleisch Matthias , Pauleikhoff Daniel , Lommatzsch Albrecht
Published: December 2019

Objective

Optical coherence tomography angiography (OCT-A) enables detailed visualisation of the vascular structure of choroidal neovascularisation (CNV). The aim of this study was to determine whether mathematically ascertained OCT-A vascular parameters of type 1 and type 2 CNV in exudative age-related macular degeneration (AMD) change during antivascular endothelial growth factor (anti-VEGF) treatment. The OCT-A vascular parameters were also compared with previously obtained activity parameters (fluid distribution on spectral domain OCT (SD-OCT)) to establish whether they could potentially be used as further ‘activity parameters’ for assessment of anti-VEGF treatment.

Methods and Analysis

We evaluated 27 eyes of 27 patients (mean follow-up 9.8 months) with type 1, type 2 or mixed CNV who had received anti-VEGF treatment (IVAN scheme). The parameters analysed were area (aCNV), total length of all vessels (tlCNV), overall number of vascular segments (nsCNV) and fractal dimension (FD) of the CNV. The changes in each of these parameters were correlated with the central foveal thickness (CFT).

Results

Regression and renewed perfusion of the CNV corresponded with the decrease or increase, respectively, of macular fluid distribution on SD-OCT. The increase and decrease of CFT during anti-VEGF treatment were highly significantly correlated with changes in FD (p<0.00001), aCNV (p<0.00001), tlCNV (p<0.00001) and nsCNV (p<0.00001).

Conclusion

OCT-A enables detailed analysis of AMD with regard to FD, aCNV, tlCNV and nsCNV. As the changes in these parameters correlate closely with changes on SD-OCT, they can be used as new activity parameters, alongside fluid distribution, for assessment of treatment effect and as parameters of stabilisation or the need for repeated treatment.
How are behavioural interventions delivered to children (5–11 years old): a systematic mapping review
Authors: Brigden Amberly , Parslow Roxanne Morin , Linney Catherine , Higson-Sweeney Nina , Read Rebecca , Loades Maria , Davies Anna , Stoll Sarah , Beasant Lucy , Morris Richard , Ye Siyan , Crawley Esther
Published: December 2019

Context

Behavioural interventions are used to prevent, manage and treat a wide variety of conditions including obesity, diabetes, chronic pain, asthma and emotional difficulties. There has been inadequate attention to the delivery of behavioural interventions to younger children (5–11 years old).

Objective

Our objectives were to describe the characteristics of behavioural interventions for children aged 5–11 years.

Data sources

We searched five databases: CINAHL, EMBASE, PsycINFO, MEDLINE and Cochrane Library, from January 2005 to August 2019.

Study selection

The inclusion criteria were (1) children aged 5–11, (2) cognitive and/or behavioural interventions, (3) randomised controlled trials and (4) 2005 onward. Two researchers independently identified studies for inclusion.

Data extraction

Two researchers independently extracted data from eligible papers.

Results

The search identified 10 541 papers. We extracted information on 117 interventions (from 152 papers). Many of the interventions were categorised as complex. This was particularly true for clinical populations; 78.7% were delivered to both the child and parent, and 33.9% took place across multiple settings, typically health and school settings. Most (70.9%) were ‘First Wave’ (behavioural) interventions, and few (4.3%) were ‘Third Wave’ (characterised by metacognition, acceptance and mindfulness). Thirty-nine per cent used interactive techniques (play, arts, story and/or games). Purely digital and paper-based interventions were rare, but around a third used these tools as supplements to face–face delivery. There were differences in interventions for younger (5–7 years) and older (8–11 years) children.

Conclusions

Interventions designed and delivered to children should be developmentally sensitive. This review highlights characteristics of interventions delivered to children 5–11 years old: the involvement of the child’s parent, using behavioural (rather than cognitive) modalities, using interactive techniques and some interventions were delivered across multiple settings.
Norwegian translation, cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow questionnaire
Authors: Fredriksen Hilde , Myklebust Grethe
Published: December 2019

The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire, with 10 items and a total score ranging from zero to 100, provides more clinically relevant information about overhead athletes than other shoulder or upper limb patient-reported outcomes.

Objectives

To translate, cultural adapt and evaluate the measurement properties of the Norwegian version of KJOC shoulder and elbow questionnaire.

Methods

33 overhead athletes (age 18.6±4.2, 10 men/23 women) were included in the analysis of face validity and known-group validity, of whom 15 went through cognitive interviews. An electronic version was developed, and six handball players were interviewed to ensure measurement equivalence between the paper-based and electronic version of the questionnaire. Test–retest reproducibility (1-week interval) and concurrent validity with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was investigated in 36 handball players (age 20.7±3.8, 17 men/19 women).

Results

The translation was conducted, and smaller consensus-based adjustments were made. Athletes found the questionnaire easy to understand, with no differences between paper and electronic based version, and preferred the electronic version. The Norwegian electronic version of the KJOC showed excellent internal consistency (Cronbach's α=0.952) and relative test–retest reliability (Intraclass correlation coefficient, ICC=0.967). SEM, minimal detectable change (MDC) and limits of agreement were 3.1, 8.5 and −9.2 to 7.7, respectively. The concurrent validity versus DASH was moderate (Spearman’s rho=−0.642). However, KJOC had a wider range in scores than DASH, distinguished better between players playing with and without pain and was more sensitive to capture players playing with pain.

Conclusion

This study suggests that the Norwegian version of the KJOC is a reliable and acceptable tool for evaluating shoulder and elbow-related problems in overhead athletes (handball players).
A systematic review of the effectiveness of counselling strategies for modern contraceptive methods: what works and what doesn’t?
Authors: Cavallaro Francesca L , Benova Lenka , Owolabi Onikepe O , Ali Moazzam
Published: December 2019

Aim

The aim of this systematic review was to synthesise the evidence on the comparative effectiveness of different counselling strategies for modern contraception on contraceptive behaviour and satisfaction, and to examine their advantages and disadvantages.

Methods

Six electronic databases (Medline, Embase, Global Health, Popline, CINAHL Plus, and Cochrane Library) were searched to identify publications comparing two or more contraceptive counselling strategies and reporting quantitative results on contraceptive use, uptake, continuation or switching, or client satisfaction. Studies of women or couples from any country, published in English since 1990 were considered.

Results

A total of 63 publications corresponding to 61 studies met the inclusion criteria. There was substantial heterogeneity in study settings, interventions and outcome measures. Interventions targeting women initiating a method (including structured counselling on side effects) tended to show positive effects on contraceptive continuation. In contrast, the majority of studies of provider training and decision-making tools for method choice did not find evidence of an effect. Additional antenatal or postpartum counselling sessions were associated with increased postpartum contraceptive use, regardless of their timing in pregnancy or postpartum. Dedicated pre-abortion contraceptive counselling was associated with increased use only when accompanied by broader contraceptive method provision. Male partner or couples counselling was effective at increasing contraceptive use in two of five studies targeting non-users, women initiating implants or seeking abortion. High-quality evidence is lacking for the majority of intervention types.

Conclusions

The evidence base and quality of studies are limited, and further research is needed to determine the effectiveness of many counselling interventions in different settings.
Sex differences in implantable cardiac defibrillator therapy according to arrhythmia detection times
Authors: Gasparini Maurizio , Kloppe Axel , Lunati Maurizio , Varma Niraj , Martinez-Ferrer Jose B , Hersi Ahmed , Gulaj Marcin , Wijffels Maurits C E F , Arenal Angel , Mangoni di Santo Stefano Lorenza , Proclemer Alessandro
Published: December 2019

Objective

In implantable cardiac defibrillators (ICDs), long-detection times safely reduce unnecessary and inappropriate therapies. We aimed to evaluate ICD treatment of ventricular arrhythmias in women, compared with men, also taking into account ICD detection.

Methods

The Advance III trial randomised patients implanted with an ICD for primary or secondary prevention in two arms—long and nominal ventricular arrhythmias detection times before therapy delivering (number of intervals needed to detect (NID) 30/40 and 18/24, respectively). The main endpoint of this post hoc analysis was the incidence of ICD therapies evaluated through Kaplan-Meier method and univariate Cox regression models.

Results

Overall, 1902 patients (304 women, 65±11 years) were randomised. Women showed a lower risk of ICD therapy (HR 0.63, 95% CI 0.43 to 0.93, p=0.022); this difference was observed only in the long-detection arm (HR 0.37, p=0.013) and not in the short detection arm (HR 0.82, p=0.414). No significant sex differences were observed concerning inappropriate therapies and mortality rate. Long-detection settings significantly reduced overall ICD therapies and appropriate ICD therapies, both in women (overall HR 0.31, p=0.007; appropriate HR 0.33, p=0.033) and in men (overall HR 0.69, p=0.006; appropriate HR 0.73, p=0.048).

Conclusions

In patients with ICDs, the strategy of setting a long-detection time to treat ventricular arrhythmias (NID 30/40) reduces overall delivered therapies, both in women and men, when compared with nominal setting (NID 18/24). The reduction was significantly higher in women. Overall, women were less likely to experience ICD therapies than men; this result was only observed in the long-detection arm.

Clinical trial registration

NCT00617175.
Integrating drawings into health curricula: university educators’ perspectives
Authors: Cheung Melissa Mei Yin , Saini Bandana , Smith Lorraine
Published: December 2019

The literature has identified promising findings regarding the application of arts-based initiatives to enhance healthcare professional (HCP) training. Research shows that drawings offer a window into the authentic, insider view of health and illness, with potential to be a platform for healthcare student and HCP learning. In addition, drawings may also have a place in health communication. Our previous work provides support for the educational application of patients’ drawings in bringing HCPs closer to the patient’s lived experience. Subsequently, this study aimed to explore university educators’ opinions regarding the implementation of drawings as an educational tool for higher education healthcare students. The objective of this study was to explore pathways for using drawings as an art form in an educational context, and provide recommendations for developing curricula and resources for further evaluation. Findings from focus group interviews with nine university educators revealed support for the use of drawings as a novel medium as they offer rich insights into the patient’s perspective while encouraging creative and critical thinking. Key perceived benefits were that drawings foster student appreciation of (1) the holistic impact of illness, (2) the importance of patients’ priorities and (3) the value of learning from the patient. Patients’ drawings of their experiences would offer needed opportunities for students to explicitly reflect about the ‘person’ holistically rather than view the patient as a ‘biomedical problem’. Shifting students’ perspectives and possible assumptions to be better aligned with and appreciative of the patient’s experiences was noted as central to adopting a person-centred approach to healthcare practice. Our findings suggest that incorporating drawings, or indeed other art forms, as educational tools would be a valuable addition to the health curricula.
Firearm violence in the USA: a frank discussion on an American public health crisis—The Kansas City Firearm Violence Symposium
Authors: Winfield Robert D , Crandall Marie , Williams Brian H , Sakran Joseph Victor , Shorr Kathy , Zakrison Tanya L
Published: December 2019

Kansas City is a microcosm for USA. Although Kansas City shows a relatively diverse population, it is one that is segregated along the lines of race and income. This is an inequity that is common to all cities across the country. With this inequity comes unequal opportunity to survive and to thrive. Firearm violence is a core component of this societal inequity. In this article, we present the proceedings of the 2019 Kansas City Firearm Violence Symposium, where distinguished experts in trauma convened to share their experience, evidence and voices of gun violence—directly and indirectly. There were discussions on topics such as the human toll of gun violence, the role of structural violence in its perpetuation, the intersectional nature of race with both violence and medical care, and guidance on measures that could be taken to advocate for the reduction and elimination of gun violence. This was a symposium that started a country-wide conversation between academia, healthcare, survivors and the community on the most pressing public health crisis facing USA today.
Experiences of recent graduates: reframing reflection as purposeful, social activity
Authors: Warman Sheena M
Published: December 2019

Background

During the Royal College of Veterinary Surgeons’ (RCVS) Professional Development Phase, graduates are required to reflect on their progress. Reflection is often conceptualised as a solitary activity, which may contrast with day‐to‐day reflective activities in the workplace. This study drew on cultural‐historical activity theory to understand how recently graduated veterinary surgeons engage in reflective activity.

Methods

Data comprised RCVS documentation and semistructured interviews with 15 recent graduates from one veterinary school. Thematic analysis was used to describe a collective system of reflective activity and to identify contradictions in the system with the potential to limit outcomes of reflective activity.

Results

Two overarching themes of contradictions were identified: ‘social reflection’ and ‘formalising the informal’. Graduates need opportunities for talking and/or writing to progress worries into purposeful reflection, underpinned by a shared understanding of reflective activity with colleagues, and by working practices which prioritise and normalise reflective interaction.

Conclusion

These findings identify potential avenues to better support veterinary graduates as they negotiate the transition to working life, and suggest that reconsideration of the formal expectations of new veterinary graduates and their employers is timely.
Utilizing plane group symmetry to favor noncentrosymmetry in three-dimensional crystals
Authors: Wiscons Ren A. , Matzger Adam J.
Published: December 2019

Materials that lack inversion symmetry (noncentrosymmetric) demonstrate a diversity of desirable optical and electronic properties in bulk such as second harmonic generation, chiral emission, and piezo-, pyro-, and ferro-electricity. Unfortunately, it is challenging to reliably access noncentrosymmetric packing motifs because the closest packing of molecules is often achieved through inversion symmetry operators, leading to the relatively low occurrence of noncentrosymmetry in organic crystals. In this study, the occurrence of noncentrosymmetry in materials that adopt planar packing motifs is investigated because molecular species achieve closest packing in two dimensions through rotations and (or) glides, symmetry operators that do not individually lead to centrosymmetry. It is found that of the 18 crystal structures investigated here adopting planar packing motifs, 13 structures (72%) are noncentrosymmetric showing in-plane polarization. The 13 noncentrosymmetric crystal structures differ from the centrosymmetric structures by directional halogen bonding interactions or steric collisions that align the polarization directions of neighboring layers, leading to bulk structural polarity. The results from this investigation will be of use for designing noncentrosymmetric materials for application in optical and electronic devices.
Climate influences the effect of fungal decay type on regeneration of Picea jezoensis var. hondoensis seedlings on decaying logs
Authors: Fukasawa Yu , Ando Yoko , Suzuki Satoshi N. , Aizawa Mineaki , Sakuma Daisuke
Published: December 2019

Hondo spruce (Picea jezoensis var. hondoensis (Mayr) Rehder)) is separately distributed among several mountainous regions in central Japan as remnant populations of the last glacial period. To identify factors that affect Hondo spruce seedling regeneration on decaying logs, we investigated the relationships between climatic conditions, log properties, including decay type by fungi, and Hondo spruce seedling density on logs using data from seven subalpine Hondo spruce forests in central Japan. The results showed that the presence of soft rot was associated with higher seedling density, and the effect of brown rot in sapwood and white rot in heartwood on the predicted number of spruce seedlings on logs switched from positive to negative with increasing temperature and precipitation. Because soft rot occurs under humid conditions, the use of forest management techniques that increase the number of logs with soft rot in sapwood (e.g., by keeping the forest floor moist) are recommended for the sustainable regeneration of Hondo spruce. However, the relationships between wood decay type and seedling regeneration can also be affected by climate condition and thus are more complex than previously thought.
Mechanisms of NADPH – cytochrome P450 oxidoreductase induction by dexamethasone in the H4IIE rat hepatoma cell line
Authors: Riddick David S. , Mullen Grey Anne K.
Published: December 2019

Expression of NADPH – cytochrome P450 oxidoreductase (POR), electron donor for microsomal P450s, is induced in rat liver by dexamethasone (DEX), an activator of the glucocorticoid receptor (GR) and the pregnane X receptor (PXR). DEX induction of POR in rat liver is primarily PXR-mediated, although GR may contribute to mRNA effects. We examined the role of GR and PXR in the DEX induction of POR mRNA and protein in the H4IIE rat hepatoma cell line. The DEX EC50for a PXR target, CYP3A23, exceeded that for the GR targets tyrosine aminotransferase and PXR as well as POR itself. POR protein levels were induced 3- and 4-fold, respectively, by DEX concentrations activating GR selectively (100 nM) or both GR and PXR (10 μM). POR was induced by triamcinolone acetonide, a selective GR agonist, but not pregnenolone-16α-carbonitrile, a selective PXR agonist. POR induction was blocked by the GR antagonist RU486 but minimally influenced by the PXR antagonist FLB-12. The half-life for POR mRNA was prolonged by DEX at both 100 nM and 10 μM. GR is more important in DEX-induced POR expression in H4IIE cells compared to rat liver in vivo, calling into question the suitability of this cell model for mechanistic studies.