bluuebunny/crossref_metadata_2025 huggingface dataset:
A QSAR modeling approach for predicting myeloid antimicrobial peptides with high sequence similarity
Authors: Waghu Faiza Hanif , Gawde Ulka , Gomatam Anish , Coutinho Evans , Idicula‐Thomas Susan
Published: June 2020

Microbial resistance to conventional antibiotics has led to a surge in antimicrobial peptide (AMP) rational design initiatives that rely heavily on algorithms with good prediction accuracy and sensitivity. We present a quantitative structure‐activity relationship (QSAR) approach for predicting activity of cathelicidins, an AMP family with broad‐spectrum activity. The best multiple linear regression model built against Escherichia coli ATCC 25922 could accurately predict activity of three rationally designed peptides CP, DP, and Mapcon, having high sequence similarity. On further experimental validation of the rationally designed peptides, CP was found to exhibit high antimicrobial activity with negligible hemolysis. Here, we provide CP, an AMP with potential therapeutic applications and a family‐based QSAR model for AMP prediction.
Developments in the Social Meaning Underlying Accent‐ and Dialect‐Based Social Preferences
Authors: Imuta Kana , Spence Jessica L.
Published: June 2020

From infancy, children display robust preferences for native‐accented and local‐dialect speakers over foreign or nonlocal counterparts. These accent‐ and dialect‐based preferences continue to manifest in children’s friendship choices and intergroup behaviors across childhood, resulting ultimately in prejudice and discrimination in various settings in adulthood. In this article, we begin with a review of the burgeoning literature on infants’ and children’s accent‐ and dialect‐based social preferences. We then adapt Bigler and Liben’s (2007) theory to discuss how developments in children’s perceptual discrimination, social categorization, and intergroup attitudes lead to shifts in the social meaning children attach to accents and dialects to guide their social preferences across childhood. We conclude by suggesting avenues for research that can inform efforts to reduce accent‐ and dialect‐based prejudice and discrimination.
Improved gait recognition through gait energy image partitioning
Authors: Premalatha G. , V Chandramani Premanand
Published: June 2020

Recently, human gait pattern has turned into an essential biometric feature to recognize an individual remotely. Gait as a feature becomes challenging owing to variation in appearance under different covariate conditions (eg, shoe, surface, haul, viewpoint and attire). The covariates may alter few fragment of gait while other fragment stay unaltered, leading to lower the probability of correct identification. To overcome such variation, an improved gait recognition strategy is proposed in this article by gait energy image partitioning and selection processing. Our method involves pre‐processing of raw video for silhouette extraction, gait cycle detection, segmentation into different regions, and histogram of gradients feature extraction from selected segments. In this way, the specific features across complete gait cycles are extracted precisely. Finally, recognition is done by using K‐NN. The proposed strategy has been assessed using the CASIA B gait database. Our outcomes shows a particular proposed strategy accomplishes high recognition rate and outperforms the advanced gait recognition mechanism.
False‐negative ultrasound‐guided fine‐needle aspiration of axillary lymph nodes in breast cancer patients
Authors: Iwamoto Naoko , Aruga Tomoyuki , Asami Hidekazu , Horiguchi Shin‐ichiro
Published: June 2020

Introduction

The purpose of this study was to clarify the clinicopathological features of patients with false‐negative fine needle aspiration cytology (FNAC) and to determine the factors associated with negative FNAC.

Methods

Patients with negative FNAC from January 2010 to December 2019 were included. The patients with positive sentinel nodes (SN) were divided into two groups: micrometastasis (≤2 mm) group and macrometastasis (>2 mm) group. The clinicopathological characteristics were compared between the two groups using the χ2 test.

Results

A total of 165 patients with negative FNAC were included; 52 (31.5%) had positive SNs. Of the 52 patients, 13 (25%) had micrometastasis and the remaining 39 (75%) had macrometastasis. Of the 113 patients with negative SNs, none had metastases found in non‐SNs. No significant differences were observed in age, cT stage or subtype, and preoperative ultrasound findings between the two groups.

Conclusions

The false‐negative rate of FNAC was high (31.5%). Micrometastatic disease was seen in patients with negative FNAC, and this might be the cause of false‐negative FNAC results.
Pastoral leadership as creativity and resilience
Authors: R. Nelson Derek
Published: June 2020

Contemporary trends in American culture like the de‐centering of the church from public consciousness and the weakening of institutions in general provide an occasion to reflect on a new theology of pastoral leadership. This article proposes that pastors function best as community leaders when they are maximally creative in seeing possibilities, rather than functioning as spokespersons for an institution. God's creative activity involves both foresight and improvisation, and therefore a pastoral theology modeled on God's creative work must also include those elements.
The New Progressivism and its implications for institutional theories of development
Authors: Rosevear Evan , Trebilcock Michael , Mota Prado Mariana
Published: June 2020

Context

A growing body of literature argues that the world is better off now than it ever has been and that things will only get better. This trend, long identified in advanced economies, has more recently manifest in low‐ and middle‐income countries and is attributed to the rapid diffusion of technological innovation through global trade, investment, communications, research and educational networks.

Purpose

We label this literature “New Progressivism”, mapping its main claims and examining its limitations. New Progressivists pay insufficient attention to the interaction between technological innovation and institutional capacity. More specifically, we show that the New Progressivists fail to explain existing patterns of stagnation and regression, and suggest a modified approach.

Approach and Methods

Accounting for the significance of institutional pre‐ and co‐requisites in facilitating the uptake of innovation, we analyze the different interactions between technological innovations and institutional capacities. We then provide illustrative examples of these relationships drawn from the areas of health, education, and financial development.

Findings

Technological innovation has vastly improved human well‐being in many countries in recent decades, but understanding why innovation had been adopted in some jurisdictions but not others and why it has not always proven beneficial if adopted requires an account of jurisdiction‐specific institutional landscapes.

Policy Implications

In many contexts technological innovations will not achieve their full potential without attention being paid to their institutional pre‐ or co‐requisites. Technological innovation, by itself, provides no easy escape from the often admittedly daunting challenge of reforming dysfunctional institutions in low‐ and middle‐income countries.
An Alternative Multiple‐Choice Question Format to Guide Feedback Using Student Self‐Assessment of Knowledge
Authors: Collignon Stéphane E. , Chacko Josey , Wydick Martin Megan
Published: June 2020

Management science professors who teach large classes often assess students with multiple‐choice questions (MCQs) because it is efficient. However, traditional MCQ formats are ill‐fitted for constructive feedback. We propose the reward for omission with confidence in knowledge (ROCK) format as an original formative assessment technique to help guide feedback associated with MCQs in an introductory undergraduate management science course. Our study contributes to theory by empirically showing that students can self‐assess their state of knowledge, signal it to the professor, and use proper answering options. In practice, ROCK is an easily implementable MCQ format that allows professors to gain information on student learning based on answers selected. ROCK identifies lack of knowledge or misinformation at both individual and collective levels thus providing opportunities for better feedback in class and during office hours. Limitations of the application of ROCK are also discussed.
Striatal cholinergic interneurons exert inhibition on competing default behaviours controlled by the nucleus accumbens and dorsolateral striatum
Authors: Ashkenazi Sivan Lian , Polis Baruh , David Orit , Morris Genela
Published: June 2020

With repeated practice, learned actions become more skilled, and eventually highly stereotypical. This transition is accompanied by a shift in striatal control over behaviour from ventral and dorsomedial striatum to dorsolateral striatum. The cholinergic interneurons (CINs) in the striatum are central to striatal computation. Yet, their role in the transition from motivated to stereotypic behaviour is still unclear. In this study, we examined whether CINs contribute to the competition between both control systems. We selectively lesioned CINs in the nucleus accumbens (NAc) or in the dorsolateral striatum (DLS) of rats trained in a cued maze task. After obtaining skilled performance, we manipulated the motivation for reward. While sparing task acquisition, selective lesions of the CINs had a marked dissociable impact on the sensitivity to motivation in the highly skilled state. Selective lesions of CINs increased automaticity of behaviour when performed in the DLS, but increased sensitivity to motivation in the NAc. These findings indicate a central role of CINs in regulating motivational impact on striatally controlled behaviours.
Assessing metacommunity processes through signatures in spatiotemporal turnover of community composition
Authors: Jabot Franck , Laroche Fabien , Massol François , Arthaud Florent , Crabot Julie , Dubart Maxime , Blanchet Simon , Munoz François , David Patrice , Datry Thibault
Published: June 2020

Although metacommunity ecology has been a major field of research in the last decades, with both conceptual and empirical outputs, the analysis of the temporal dynamics of metacommunities has only emerged recently and consists mostly of repeated static analyses. Here we propose a novel analytical framework to assess metacommunity processes using path analyses of spatial and temporal diversity turnovers. We detail the principles and practical aspects of this framework and apply it to simulated datasets to illustrate its ability to decipher the respective contributions of entangled drivers of metacommunity dynamics. We then apply it to four empirical datasets. Empirical results support the view that metacommunity dynamics may be generally shaped by multiple ecological processes acting in concert, with environmental filtering being variable across both space and time. These results reinforce our call to go beyond static analyses of metacommunities that are blind to the temporal part of environmental variability.
Reducing dispersal limitation via seed addition increases species richness but not above‐ground biomass
Authors: Ladouceur Emma , Stanley Harpole W. , Blowes Shane A. , Roscher Christiane , Auge Harald , Seabloom Eric W. , Chase Jonathan M.
Published: June 2020

Seed dispersal limitation, which can be exacerbated by a number of anthropogenic causes, can result in local communities having fewer species than they might potentially support, representing a potential diversity deficit. The link between processes that shape natural variation in diversity, such as dispersal limitation, and the consequent effects on productivity is less well known. Here, we synthesised data from 12 seed addition experiments in grassland communities to examine the influence of reducing seed dispersal limitation (from 1 to 60 species added across experiments) on species richness and productivity. For every 10 species of seed added, we found that species richness increased by about two species. However, the increase in species richness by overcoming seed limitation did not lead to a concomitant increase in above‐ground biomass production. This highlights the need to consider the relationship between biodiversity and ecosystem functioning in a pluralistic way that considers both the processes that shape diversity and productivity simultaneously in naturally assembled communities.
Money Management and Gender Equality: An Analysis of Dual‐Earner Couples in Western Europe
Authors: Çineli Beyda
Published: June 2020

Objective

To explore the conditions under which couples use different money management systems.

Background

Both joint and individualized money management systems are associated more with gender egalitarian values than with the traditional “breadwinner” system. However, prior research has not fully examined the differences between these systems in terms of power relation attributes amongst couples, such as couples' relative income, age difference, and the associations with gender egalitarian values.

Method

The International Social Survey Program “Family and Changing Gender Roles” 2012 module (N = 2,520) was used to estimate multinomial logistic regression models predicting the likelihood of using different money management systems.

Results

The probability of using individualized or joint money management systems was much higher than traditional system for those who have more gender egalitarian beliefs. This probability was significantly higher for the individualized system. For a couple with income homogamy, the probability of using either the joint or the individualized system was higher. For relationships in which the males were older or earned significantly more money than their partners, the likelihood of using nontraditional systems (joint/individualized) was lower.

Conclusion

Couples who appeared relatively more traditional on characteristics such as individual gender role attitudes, relative income, and age difference are also more likely to use more traditional strategy. The individualized system, which is a newer method couples use to manage their money, is the most closely associated with gender egalitarian values.

Implications

Policymakers who focus on poverty and income inequalities should avoid treating the household as a single unit but rather take into consideration within‐household inequalities and gender differences. Furthermore, couple education and couple therapy–oriented policies can incorporate sessions about household money management into counselling programs for couples.
Effect of the grass Leersia hexandra on the dispersal, seed germination, and establishment of Pachira aquatica seedlings
Authors: Vázquez‐Benavides Judith , Moreno‐Casasola Patricia , López‐Rosas Hugo
Published: June 2020

In wetlands, hydrochory is one of the main mechanisms of seed dispersal and there is often synchrony between propagule production and the flood season. Different sources of disturbance can prevent seed dispersal to suitable sites, and if environmental conditions are not adequate for germination and seedling establishment, recruitment will be limited, affecting succession.

We worked in a disturbed tropical freshwater swamp where the native grass Leersia hexandra has dominated open areas, creating a grass matrix that surrounds patches of swamp forest. Leersia grows vigorously, forming cushions of dry matter that cover the soil, forming a potential obstacle to seed dispersal. We asked whether the vegetative growth of this grass prevents the entry and dispersal of seeds of the tropical swamp tree Pachira aquatica, thwarting seed germination and seedling establishment, and arresting succession. We set up transects in the grass matrix in two zones: close to the river (R) and bordering the tree patches or fragments (F). We quantified tree seed and seedling presence, survival and growth in situ and experimentally introduced seeds and seedlings in the field and monitored seed germination and the survival and growth of their seedlings, as well as that of transplanted seedlings.

There was a negative relationship between the number of seeds and established seedlings, and the distance to river or fragment (r = −0.86, p < 0.001 for zone R; and r = −0.77, p < 0.001 for zone F) and with the grass cushion (r = −0.68, p = 0.005 for zone R; and r = −0.66, p = 0.007 for zone F); the grass creating a barrier to dispersal. When seeds were sown after clearing the grass cushion, germination success was high, so this stage is not limited. The transplanted seedlings had better survival and a greater final height than the seedlings of the sown seeds. Grass cover had a negative effect on both types of seedlings. Seedling survival rates were inversely related to grass cover, showing that seedlings overgrown by grass had low survival rates. Flooding is a stress factor for seedlings and produced mortality, in addition to the effects of the grass.

Together, the field survey and the experiment show that succession is being arrested in two ways: (1) by limiting seed dispersal because the grass cushion slows the dispersal and penetration of seeds into the vegetation; and (2) by limiting seedling establishment because the grass competes for space and light. Our results show that even where the grass is native, slower growing, seed‐dependent species may struggle to compete and establish. If grass cover is increasing, these swamps are very vulnerable to a decrease in area because it is very difficult for them to regenerate naturally.
Untangling the importance of niche breadth and niche position as drivers of tree species abundance and occupancy across biogeographic regions
Authors: Vela Díaz Dilys M. , Blundo Cecilia , Cayola Leslie , Fuentes Alfredo F. , Malizia Lucio R. , Myers Jonathan A.
Published: June 2020

Aim

Ecological niches shape species commonness and rarity, yet, the relative importance of different niche mechanisms within and across ecosystems remains unresolved. We tested the influence of niche breadth (range of environmental conditions where species occur) and niche position (marginality of a species’ environmental distribution relative to the mean environmental conditions of a region) on tree‐species abundance and occupancy across three biogeographic regions.

Location

Argentinian Andes; Bolivian Amazon; Missouri Ozarks.

Time period

2002–2010.

Major taxa studied

Trees.

Methods

We calculated abiotic‐niche breadths and abiotic‐niche positions using 16 climate, soil and topographic variables. For each region, we used model selection to test the relative influence of niche breadth and niche position on local abundance and occupancy in regional‐scale networks of 0.1‐ha forest plots. To account for species–environment associations caused by other mechanisms (e.g., dispersal), we used null models that randomized associations between species occurrences and environmental variables.

Results

We found strong support for the niche‐position hypothesis. In all regions, species with higher local abundance and occupancy occurred in non‐marginal environments. Observed relationships between occupancy and niche position also differed from random species–environment associations in all regions. Surprisingly, we found little support for the niche‐breadth hypothesis. Observed relationships between both local abundance and niche breadth, and occupancy and niche breadth, did not differ from random species–environment associations.

Main conclusion

Niche position was more important than niche breadth in shaping species commonness and rarity across temperate, sub‐tropical and tropical forests. In all forests, tree species with widespread geographic distributions were associated with environmental conditions commonly found throughout the region, suggesting that niche position has similar effects on species occupancy across contrasting biogeographic regions. Our findings imply that conservation efforts aimed at protecting populations of common and rare tree species should prioritize conservation of both common and rare habitats.
Geriatric Nutritional Risk Index can predict postoperative delirium and hospital length of stay in elderly patients undergoing non‐cardiac surgery
Authors: Zhao Yanli , Xia Xin , Xie Dongmei , Liao Yulin , Wang Yanyan , Chen Ling , Ge Ning , Yue Jirong
Published: June 2020

Aim

Malnutrition is common in older patients and is associated with adverse outcomes. The Geriatric Nutritional Risk Index (GNRI) has been developed as an objective index to assess nutritional risk in these patients. However, there is limited evidence regarding the association between GNRI and postoperative delirium (POD) as well as length of stay (LOS) in surgical older patients. Therefore, our goal was to examine the impact of poor nutrition, evaluated by the GNRI, on POD and length of stay in older patients undergoing non‐cardiac surgery.

Methods

In this prospective cohort study, older patients undergoing non‐cardiac surgery from April to June of 2015 were included. Preoperative nutritional status was assessed by the GNRI within the first 48 h after hospital admission. The outcomes were POD and LOS. Multivariable logistic regression and linear regression analyses were used to assess the role of GNRI in predicting these outcomes.

Results

In the whole sample (N = 288), the prevalence of severe/moderate (GNRI <92) and low (GNRI 92–98) nutritional risk was 15.6% and 29.5%, respectively. The median length of hospital stay was 14 days. Delirium was present in 49 patients (17%). A linear regression analysis showed that low (β = 4.56, 95% confidence interval [CI]: 2.18–6.94) and severe/moderate (β = 3.70, 95% CI: 0.74–6.65) nutritional risk were associated with prolonged LOS. Moreover, a multivariate analysis revealed that patients with severe/moderate nutritional risk were more likely to develop POD compared with those without (odds ratio = 2.56, 95% CI: 1.11–5.89).

Conclusion

Preoperative malnutrition, as assessed using the GNRI, predicted LOS and the development of POD in elderly non‐cardiac surgical patients. Geriatr Gerontol Int 2020; 20: 759–764.
Spatio‐temporal dynamics of technical efficiency in China’s specialized markets: A stochastic frontier analysis approach
Authors: Zhang Xuliang , Hu Xiaohui , Xu Wei
Published: June 2020

China’s specialized markets as a special form of bottom‐up capital agglomeration have played a key role in fostering regional development. It once exhibited positive externalities with high efficiencies. However, given the rapid proliferation of specialized markets and the penetration of E‐commerce, their advantages may have shifted and the understanding of this shift is limited. The paper explores the spatio‐temporal dynamics of China’s specialized markets in terms of technical efficiency. Based on turnover data from Statistical Yearbooks of China Commodity Exchange Market from 2000 to 2016, technical efficiencies in specialized markets are measured by a Stochastic Frontier Analysis (SFA) approach using panel data. The results show that (a) the technical efficiencies in China’s specialized markets are significantly divergent in space over time; (b) labor input has notable effect on efficiency increase, while capital input has no significant effect; (c) informatization level, cluster size, and degree of market openness are identified to have a positive effect on specialized market’s technical efficiency. This paper argues that specialized markets should be taken seriously in the cluster evolution research. The role of proximity and the bounded links between specialized markets and their local clusters is the key to understanding their changing forms, performances, and trajectories.
Screening on platelet LncRNA expression profile discloses novel residual platelet reactivity biomarker
Authors: Yan Shaodi , Liu Xiaojing , Ke Xiao , Xian Zhanchao , Peng Changnong , Wang Xiaoqing , Chen Mao
Published: June 2020

Introduction

Double antiplatelet therapy (DAPT) has wide inter‐individual variabilities in coronary heart disease (CHD) patients’ responses, which undermines the prognosis effect in clinical practice. Long noncoding RNAs (lncRNAs) have been reported to be widely existed in platelets, albeit their potential roles in platelet responses to DAPT largely remains in the realm of the unknown. This study aims to screen differentially expressed lncRNAs responsible for high residual platelet reactivities under DAPT.

Methods

We enrolled 144 CHD patients that received DAPT and assigned them to high platelet reactivity (HPR) group and baseline group according to their residual platelet reactivities. Statistical analysis and a series of experiments including microarray analysis, platelet reactivity screening, RNA isolation and lncRNA microarray analysis were explored to the research.

Results

We detected a total of 22,424 kinds of co‐expressed lncRNAs in three pairs of patients between the HPR and baseline groups. We identified twenty differentially expressed lncRNAs and successfully validated three of them in the 144 patients. Ultimately, the expression of ensemble transcript ENST00000433442 was demonstrated as significantly correlated with high platelet reactivity (OR = 0.487, P = .035) by logistic regression analysis.

Conclusion

There is a considerable amount of lncRNAs in platelets, and the downregulated expression of ENST00000433442 is an independent risk factor for high residual platelet reactivity in CHD patients under DAPT.
Constructing nurses' professional identity through group performance
Authors: Willetts Georgina , Garvey Loretta
Published: June 2020

Aims

The aim of this study was to examine professional identity through the group performances of nurses within a specific work environment.

Background

Professional identity and social identity are closely linked. Nurses undertake clinical practice usually within a social group environment. The literature is limited on the development of professional identity within the context of nurses' daily work.

Design

An integrated ethnographic case context design was adopted, consisting of two clinical wards in one acute health‐care facility in Australia. The application of the social identity theory (SIT) was used to study two specific professional activities to describe the group performance of nurses within this organizational cultural context and how this influenced nurses' professional identity.

Method

The research was undertaken between 2012 and 2014. Data collection included observation, interviews and fieldnotes of a convenience sample of nurses and allied health‐care professionals who undertook two professional activities in their normal work environment.

Findings

The development of group efficacy contributed to the development of the professional identity in the homogenous handover activity. Self‐efficacy was demonstrated in the heterogenous multidisciplinary activity.

Conclusion

The results indicated the importance of recognizing core identity‐building activities and understanding the value of these activities to professional identity development.
Student Access to Apprenticeships: Evidence from a Vignette Experiment
Authors: Tobback Ilse , Verhaest Dieter , Baert Stijn
Published: June 2020

We identify the causal effects of student characteristics on the likelihood of being hired for an apprenticeship and explore the mechanisms underlying the employer’s decision. To this end, we perform a vignette experiment among human resources professionals in Belgium, focusing on less‐qualified youth. Our results indicate that students with favorable educational records and students revealing being motivated are more likely to obtain an apprenticeship. Furthermore, we find that these characteristics are used by human resources professionals as signals of trainability, employability, and quit intentions.
The impact of negative‐pressure wound therapy with instillation on wounds requiring operative debridement: Pilot randomised, controlled trial
Authors: Kim Paul J. , Lavery Lawrence A. , Galiano Robert D. , Salgado Christopher J. , Orgill Dennis P. , Kovach Stephen J. , Bernstein Brent H. , Attinger Christopher E.
Published: June 2020

Presence of bacteria in wounds can delay healing. Addition of a regularly instilled topical solution over the wound during negative‐pressure wound therapy (NPWT) may reduce bioburden levels compared with standard NPWT alone. We performed a prospective, randomised, multi‐centre, post‐market trial to compare effects of NPWT with instillation and dwell of polyhexamethylene biguanide solution vs NPWT without instillation therapy in wounds requiring operative debridement. Results showed a significantly greater mean decrease in total bacterial counts from time of initial surgical debridement to first dressing change in NPWT plus instillation (n = 69) subjects compared with standard NPWT (n = 63) subjects (−0.18 vs 0.6 log10 CFU/g, respectively). There was no significant difference between the groups in the primary endpoint of required inpatient operating room debridements after initial debridement. Time to readiness for wound closure/coverage, proportion of wounds closed, and incidence of wound complications were similar. NPWT subjects had 3.1 times the risk of re‐hospitalisation compared with NPWT plus instillation subjects. This study provides a basis for exploring research options to understand the impact of NPWT with instillation on wound healing.
Carboxypeptidase A6 was identified and validated as a novel potential biomarker for predicting the occurrence of active ulcerative colitis
Authors: Wang Haizhou , Zhang Meng , Zhang Mengna , Wang Fan , Liu Jing , Zhao Qiu
Published: June 2020

Ulcerative colitis (UC) is a chronic, highly heterogeneous intestinal inflammation with changes in epithelial function and tissue damage. However, the pathogenesis is still unclear between active UC and inactive UC. Herein, weighted gene co‐expression network analysis was applied to explore the gene modules related to active UC. Gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA) were used to further investigate the underlying mechanism of selected genes. We found that in the blue module (r = −.72), carboxypeptidase A6 (CPA6) was chosen to validate because of its high intra‐modular connectivity and module membership. In the test sets, the expression level of CPA6 was down‐regulated in active UC compared with inactive UC and normal colon. Furthermore, CPA6 expression was decreased primarily in the descending colon and only in mucosa affected by active UC. The receiver operating characteristic curve indicated that CPA6 expression had a performed well in diagnosing active UC from inactive UC (area under the curve = 0.99). Importantly, anti‐tumour necrosis factor (TNF) treatment (infliximab and golimumab) significantly increased the CPA6 expression. Finally, GSEA and GSVA found that extracellular matrix receptor, inflammatory response and epithelial‐mesenchymal transition were highly enriched in active UC with low CPA6 expression. In conclusion, CPA6 was identified and validated as a novel potential biomarker for predicting the occurrence of active UC, probably through regulating extracellular matrix or immune response.
Ablation of Gadd45β ameliorates the inflammation and renal fibrosis caused by unilateral ureteral obstruction
Authors: Moon Sung‐Je , Kim Jae‐Hoon , Choi Young‐Keun , Lee Chul‐Ho , Hwang Jung Hwan
Published: June 2020

The growth arrest and DNA damage‐inducible beta (Gadd45β) protein have been associated with various cellular functions, but its role in progressive renal disease is currently unknown. Here, we examined the effect of Gadd45β deletion on cell proliferation and apoptosis, inflammation, and renal fibrosis in an early chronic kidney disease (CKD) mouse model following unilateral ureteral obstruction (UUO). Wild‐type (WT) and Gadd45β‐knockout (KO) mice underwent either a sham operation or UUO and the kidneys were sampled eight days later. A histological assay revealed that ablation of Gadd45β ameliorated UUO‐induced renal injury. Cell proliferation was higher in Gadd45β KO mouse kidneys, but apoptosis was similar in both genotypes after UUO. Expression of pro‐inflammatory cytokines after UUO was down‐regulated in the kidneys from Gadd45β KO mice, whereas UUO‐mediated immune cell infiltration remained unchanged. The expression of pro‐inflammatory cytokines in response to LPS stimulation decreased in bone marrow‐derived macrophages from Gadd45β KO mice compared with that in WT mice. Importantly, UUO‐induced renal fibrosis was ameliorated in Gadd45β KO mice unlike in WT mice. Gadd45β was involved in TGF‐β signalling pathway regulation in kidney fibroblasts. Our findings demonstrate that Gadd45β plays a crucial role in renal injury and may be a therapeutic target for the treatment of CKD.
The clinical and inflammatory relationships between periodontitis and chronic obstructive pulmonary disease
Authors: Sapey Elizabeth , Yonel Zehra , Edgar Ross , Parmar Sabrina , Hobbins Stephanie , Newby Paul , Crossley Diana , Usher Adam , Johnson Sarah , Walton Georgia M. , McGuinness Adam , Chapple Iain , Stockley Robert
Published: June 2020

Aim

To investigate associations between periodontitis and chronic obstructive pulmonary disease (COPD) with and without alpha‐1 antitrypsin deficiency (AATD), including neutrophil functions implicated in tissue damage.

Methods

The presence and severity of periodontitis (using two international criteria) and lung disease were assessed in 156 COPD patients with and without AATD accounting for common confounding factors. Saliva and systemic inflammatory markers were measured by ELISA together with neutrophil migration.

Results

COPD and AATD patients exhibited higher prevalence of periodontitis (COPD 95%; AATD 88%) than reported in unselected community‐dwelling populations even when risk factors (age, smoking history, socio‐economic status and dental habits) were considered. Periodontitis severity associated with lung disease severity (AATD, periodontitis versus no periodontitis; FEV1 = 56% versus 99% predicted; TLCO = 59% versus 81% predicted, p < .0001 for both). Neutrophil migratory accuracy declined in stage II–IV periodontitis patients with COPD or AATD compared to COPD or AATD with no or stage I periodontitis. Improved dental habits appeared to be associated with a reduction in exacerbation frequency in COPD.

Conclusion

The results support shared pathophysiology between periodontitis and COPD, especially when associated with AATD. This may reflect an amplification of neutrophilic inflammation and altered neutrophil functions, already described in periodontitis, COPD and AATD.
Persons with type 2 diabetes and high insulin persistence were associated with a lower risk of mortality: A nationwide retrospective cohort study
Authors: Yen Fu‐Shun , Wei James Cheng‐Chung , Liu Jia‐Sin , Hsu Chih‐Cheng , Hwu Chii‐Min
Published: June 2020

Aims/Introduction

Studies assessing the long‐term outcomes of insulin persistence are scant. We compared the risk of all‐cause mortality among patients with different degrees of insulin persistence.

Materials and Methods

In total, 293,210 patients with type 2 diabetes mellitus undergoing insulin therapy were enrolled during 2002–2014. Insulin persistence was defined as continual insulin treatment without a 90‐day gap of discontinuation in the 2‐year observation period. Mortality rates were compared between 111,220 patients with ≥90% insulin persistence and 111,220 matched patients with <90% insulin persistence during the observational period.

Results

During the mean 5.37‐year follow‐up period, the mortality rates were 58.26 and 73.21 per 1,000 person‐years for patients with ≥90% and <90% of insulin persistence. The adjusted hazard ratio for mortality was 0.80 (95% confidence interval 0.79–0.81, P < 0.001). Patients with high insulin persistence had significantly lower risks than did those with low insulin persistence of death due to hypertension, diabetes, cardiovascular disease, liver disease, kidney disease, respiratory disease, sepsis and cancer.

Conclusions

This study showed that patients with ≥90% insulin persistence were associated with lower risks of all‐cause mortality than did patients with <90% insulin persistence.
The predictive and prognostic significance of cell‐free DNA concentration in melanoma
Authors: Váraljai R. , Elouali S. , Lueong S.S. , Wistuba‐Hamprecht K. , Seremet T. , Siveke J.T. , Becker J.C. , Sucker A. , Paschen A. , Horn P.A. , Neyns B. , Weide B. , Schadendorf D. , Roesch A.
Published: June 2020

Background

Melanoma is the leading cause of skin cancer‐related deaths worldwide. While there have been significant improvements in the treatment of advanced melanoma in the past decade, biomarker development lagged behind.

Objectives

The majority of liquid biopsy biomarkers rely on the analyses of oncogenic mutations; however, about 20% of melanoma patients are wild type. Therefore, validation of universal predictive and prognostic biomarkers is urgently needed.

Methods

We analysed plasma samples in a discovery cohort (n = 20) and expansion cohort (n = 166) of metastatic melanoma patients and healthy donors (n = 116). Total plasma circulating cell‐free DNA (cfDNA) concentrations were measured on the Qubit®platform using assays for single‐(ss) and double (ds)‐stranded DNA, DNA spectrophotometry and RNase P qPCR. We explored the diagnostic, predictive and prognostic potential of cfDNA concentration by bio‐statistical methods and established a cfDNA threshold for risk stratification.

Results

Our selected best method was Qubit®dsDNA assay which quantified higher plasma cfDNA concentrations in melanoma patients than in healthy controls (AUC 72%). Measurement of baseline cfDNA concentration revealed that high cfDNA was associated with presence of metastases and higher AJCC stage (P < 0.05). Furthermore, high baseline cfDNA was an indicator of shorter overall survival in patients with oncogenic mutations (HR 2.12,P = 0.0008), and in wild‐type patients (HR 5.55,P < 0.0001).

Conclusions

We provide evidence that total cfDNA can be used as a biomarker for melanoma irrespective of the tumour genotype and can provide information on tumour load, risk of progression and risk of death.
Hybrid Context, Management Practices and Organizational Performance: A Configurational Approach
Authors: White Leroy , Lockett Andy , Currie Graeme , Hayton James
Published: June 2020

Employing a configurational approach we explore how ‘hybrid context’ shapes organizations’ adoption, and performance implications, of management practice. We do because hybrid contexts have been a policy aim of many governments seeking to blurr the distinction between the public, private and not‐for‐profit sectors. To conceptualize hybrid contexts we employ the dimensions of market authority and (the multiple) political authority. Employing data from UK care homes, our findings suggest that: (i) the adoption, and performance effects, of management practices are conditioned by dimensions of hybrid context; (ii) there is significant variation across the configurations in terms of the mix of management practices that lead to high and low performance; and (iii) there is a high degree of symmetry between high and low performance, with good management practices being a necessary condition for high performing as compared to low performing organizations.
Fabrication of Custom Post‐And‐Core Using a Directly Fabricated Silicone Pattern and Digital Workflow
Authors: Farah Ra'fat I. , Aloraini Abdullah S. , Al‐Haj Ali Sanaa N.
Published: June 2020

This report introduces an alternative clinical and laboratory technique for the direct fabrication of a custom post‐and‐core pattern using poly (vinyl siloxane) (PVS) occlusal registration material, followed by a digital workflow. This technique decreases chairside time, eliminates the risk of locking the pattern into the postspace and improves accuracy of the custom post‐and‐core.
Global consensus on nutritional rickets: Implications for Australia
Authors: Siafarikas Aris , Simm Peter , Zacharin Margaret , Jefferies Craig , Lafferty Antony R , Wheeler Benjamin J , Tham Elaine , Brown Justin , Biggin Andrew , Hofman Paul , Woodhead Helen , Rodda Christine , Jensen Diane , Brookes Denise , Munns Craig F ,   the APEG Bone and Mineral Working Group
Published: June 2020

In 2016, a global consensus on the prevention, diagnosis and management of nutritional rickets was published. The bone and mineral working group of the Australasian Paediatric Endocrine Group provides a summary and highlights differences to previous Australian and New Zealand (ANZ) guidelines on vitamin D deficiency and their implications for clinicians. Key points are: (i) The International Consensus document is focused on nutritional rickets, whereas the ANZ guidelines were focused on vitamin D deficiency. (ii) Definitions for the interpretation of 25‐hydroxy vitamin D (25OHD) levels do not differ between statements. (iii) The global consensus recommends that routine 25OHD screening should not be performed in healthy children and recommendations for vitamin D supplementation are not based solely on 25OHD levels. The Australasian Paediatric Endocrine Group bone and mineral working group supports that screening for vitamin D deficiency should be restricted to populations at risk. (iv) Recommendations from the global consensus for vitamin D dosages for the therapy of nutritional rickets (diagnosed based on history, physical examination, biochemical testing and a confirmation by X‐rays) are higher than in ANZ publications. (v) The global consensus recommends the implementation of public health strategies such as universal supplementation with vitamin D from birth to 1 year of age and food fortification. We conclude that updated global recommendations for therapy of nutritional rickets complement previously published position statements for Australia and New Zealand. Screening, management and the implementation of public health strategies need to be further explored for Australia.
Protecting children from iatrogenic harm during COVID19 pandemic
Authors: Camporesi Anna , Díaz‐Rubio Franco , Carroll Christopher L , González‐Dambrauskas Sebastián
Published: June 2020

Critical care management of patients with COVID‐19 has been influenced by a mixture of public, media and societal pressure, as well as clinical and anecdotal observations from many prominent researchers and key opinion leaders. These factors may have affected the principles of evidence‐based medicine and encouraged the widespread use of non‐tested pharmacological and aggressive respiratory support therapies, even in intensive care units (ICUs). The COVID‐19 pandemic has predominantly affected adult populations, while children appear to be relatively spared of severe disease. Notwithstanding, paediatric intensive care (PICU) clinicians may already have been influenced by changes in practices of adult ICUs, and these changes may pose unintended consequences to the vulnerable population in the PICU. In this article, we analyse several potential iatrogenic causes of the detrimental effects of the current pandemic to children and highlight the risks underlying a sudden change of clinical practice.
Academic detailing program for rheumatoid arthritis: a contribution to Brazilian public health system sustainability
Authors: Carvalho Borin Marcus , Kakehasi Adriana Maria , Dartnell Jonathan , Gomes Ribeiro Junior Nelio , Acurcio Francisco de Assis , Guerra Junior Augusto Afonso , Alvares-Teodoro Juliana
Published: June 2020

Objectives

In Brazil, specialty medicines for rheumatoid arthritis (RA) treatment are provided by the national health system (NHS) according to mandatory protocols. Knowing the rules for prescription of these biological agents is crucial to ensuring patient access to treatment. This study aims to evaluate the feasibility of an academic detailing strategy to promote the quality use of the medicines available in NHS among prescribers.

Methods

Forty-three specialists and general practitioners were visited by researchers to perform an academic detailing of the Clinical Protocols and Therapeutic Guidelines (PCDT) for RA adopted by NHS. After the visits, a survey was performed with prescribers to measure their perception in terms of satisfaction and information reliability with the academic visits. At the end, we perform a cost analysis to permit comparisons of this strategy with other educational activities.

Key findings

From 43 physicians that were visited, 28 responded to the telephone survey. Of these, 68% were very satisfied with the visit, 50% rated the content of the visit relevant to their practice, 64.3% agreed the duration of the visit did not affect their work, 60.7% agreed the distributed material would be useful for their professional practice, and 57.1% agreed that the visits added to their knowledge. A total of USDPPP 162.96 per prescriber (USDPPP 7,007.20, BRL14,185.00) were spent on the program.

Conclusion

The prescribers visited represent a large number of deferrals for the Specialized Component of Pharmaceutical Care (CEAF) drug applications. Therefore, the total amount spent on the implementation of this program and its potential for improving access to these medicines has the possibility to have a positive impact on the targeting of public expenditures and avoiding litigation against NHS. Academic detailing has the capability to become an effective strategy for PCDT dissemination and implementation.
Districtwide Evaluation of RTI Implementation: Success, Challenges, and Self‐Efficacy
Authors: Thomas Elizabeth R. , Conoyer Sarah J. , Lembke Erica S.
Published: June 2020

The purpose of this study was to examine the role descriptive factors played in the perceptions of response to intervention (RTI) implementation success, challenges, and self‐efficacy in a large Midwestern school district. District staff were surveyed as part of an evaluation of RTI implementation. Factors analyzed included teacher descriptive information, RTI essential elements, and teacher self‐efficacy. Findings suggested that staff in elementary buildings rated overall success of RTI implementation higher on average than did staff in secondary buildings. This difference could be attributed to additional challenges to implementation presented by secondary building needs. In addition, no difference was found in overall elementary versus secondary staff perceptions of RTI implementation difficulty; there were, however, differences in the elements that were considered more or less difficult.
Narrative beyond postmodernism: Scenes from Paul Auster's Sunset Park
Authors: Torkamaneh Pouria , Maleki Nasser
Published: June 2020

This essay examines the way Paul Auster's Sunset Park (2010) moves beyond postmodern conceptions of narrative by treating it as a liberating phenomenon and a strategy of survival. It argues that the characters' thoughts and decisions, which value construction and communication, represent an underlying motive to transcend the generic postmodern incredulity toward narrative to reveal. Although the novel offers disjointed narratives as part of an attempt to deny unification and coherence, it also conveys a longing for connection—regardless of its possibility—to move beyond the postmodern mood of disbelief and skepticism. To clarify its argument, this essay draws on the theories of Irmtraud Huber about contemporary fiction and how new aesthetic shifts have sidelined postmodern maxim of deconstruction in favor of a more constructive approach. Therefore, by analyzing scenes from Sunset Park that display such a sensibility, this research attempts to examine this new understanding of the interplay between narrative and knowledge as a larger experiment beyond postmodern principles.