bluuebunny/crossref_metadata_2025 huggingface dataset:
Employee voice and lifelong education capabilities in France and Germany: two models of responsibility
Authors: Zimmermann Bénédicte
Published: August 2020

This paper discusses the scope of the employee’s voice in lifelong education decisions, with a focus on qualified assembly‐line workers and professional development schemes allowing their upward mobility out of the assembly line. Using a capability approach, it investigates voice as part of people’s agency. Beyond examining the channels that allow employees to have a say in training matters – weak definition of voice – it addresses voice as a process that participates in the conversion of the available training resources and opportunities into lifelong education achievements – strong definition of voice. Comparing two subsidiaries of a multinational firm, one located in Germany and the other in France, we ask under what institutional and organizational conditions employees are able to express and then achieve what they value. In adopting a multi‐level perspective which integrates qualitative data of an institutional, organizational and individual nature, we show how in France and Germany the worker’s voice in training matters pertains to two different models of responsibility sharing. In Germany the worker’s voice is associated with self‐determination and self‐care as a consequence of the externalization of lifelong education outside the confines of the firm; this results in a weak voice that requires personal or family resources in order to get converted into a strong voice. In France, where national legislation obliges firms to devote a percentage of the gross wage bill to training, companies have historically played an important role in the lifelong education of workers, so that until the country’s last training reforms introducing a personal training account in 2014, the worker’s voice was strongly shaped by organizational factors. Whether this voice is weak or strong depends upon the organizational strategy, processes and involvement in lifelong training.
Cadaveric Penile Prosthesis Workshop training improves surgical confidence levels of urologists: South Asian Society for Sexual Medicine course survey
Authors: Krishnappa Pramod , Srini Vasan S , Shah Rupin , Lentz Aaron C , Garaffa Giulio , Martinez‐Salamanca Juan Ignacio , Moncada Ignacio
Published: August 2020

Objectives

To analyze the impact of South Asia’s first cadaveric hands‐on workshop on urologists’ training in inflatable penile prosthesis surgery.

Methods

A total of 72 urologists/andrologists participated in the 2019 South Asian Society for Sexual Medicine Pre‐congress Penile Prosthesis hands‐on workshop. The workshop included 4 h of lectures and 2 h of hands‐on cadaveric laboratory experience using three‐piece inflatable penile prosthesis. The Shapiro–Wilk test was used on self‐rated procedural confidence levels, which proved the normality. A non‐parametric McNemar test was used to examine the change in the number of correct answers.

Results

Of those who attended the cadaver laboratory, just 45 who answered the survey both before and after the workshop were included for analysis. Significant objective improvements were noted in procedural knowledge test scores (44.30 ± 0.027 vs 72.44 ± 0.024, P < 0.05) and median surgical confidence levels (4 vs 3 and 2, P < 0.001) of the urologists after the completion of the workshop.

Conclusions

Cadaveric hands‐on workshop training improves urologists’ procedural knowledge and surgical confidence levels in carrying out three‐piece inflatable penile prosthesis surgery. The feasibility of such workshops should be considered in increasing the surgical expertise of general urologists in prosthetic urology.
Effect of visitors on the behaviour of three Asian small‐clawed ottersAonyx cinereusat Cattolica Aquarium
Authors: Rossi C. , Accorsi P. A. , Petrulli C. , Florio D. , Gridelli S. , Marliani G.
Published: August 2020

The Asian small‐clawed otterAonyx cinereusis classified as Vulnerable by the International Union for Conservation of Nature Red List. The aim of this study was to evaluate the effects of the presence of visitors on the behavioural repertoire of three Asian small‐clawed otters at Cattolica Aquarium, Italy. Observational data sampling took place over two periods of 11 days each. The first period was in August when the Aquarium was open and there were visitors present (open period = OP). The second period was between September and October, on days when the Aquarium was closed to visitors (closed period = CP). Focal sampling was integrated with behaviour sampling during data collection. To evaluate the significant differences in frequency and duration of behaviours during the OP and CP periods, a Wilcoxon Signed Rank test was performed. The results of this study showed that the absence of visitors stimulated significant differences in frequency and duration of activity (such as ‘locomotion’ and ‘waiting’) and social behaviours (such as ‘play’). The otters also spent significantly more time visible than ‘out of sight’ when there were no visitors present. This preliminary research provides information that may influence the way zoos and aquatic parks manage their otters, and contributes to the improvement of the welfare of animals in human care.
What is required for achieving hepatitis C virus elimination in Singapore? A modeling study
Authors: Chaillon Antoine , Thurairajah Prem Harichander , Hsiang John Chen , Martin Natasha K
Published: August 2020

Background and Aim

The vast majority of hepatitis C virus (HCV) infection in Singapore is among those with a history of injecting drug use (IDU), yet harm reduction is not available and what is required to achieve the World Health Organization (WHO) HCV elimination targets (80% incidence reduction and 65% mortality reduction by 2030) is unknown. We model the intervention scale‐up required to achieve WHO targets in Singapore.

Methods

A dynamic model of HCV transmission and progression among those with a history of IDU was calibrated to Singapore, a setting with declining IDU and no harm reduction (~11 000 people with IDU history in 2017 and 45% HCV seropositive). We projected HCV treatment scale‐up from 2019 required to achieve WHO targets with varying prioritization scenarios, with/without opiate substitution therapy scale‐up (to 40% among people who inject drugs [PWID]).

Results

We estimated 3855 (95% confidence interval: 2635–5446) chronically HCV‐infected individuals with a history of IDU and 148 (87–284) incident HCV cases in Singapore in 2019. Reaching the HCV incidence target requires 272 (187–384) treatments in 2019, totaling 2444 (1683–3452) across 2019–2030. By prioritizing PWID or PWID and cirrhotics, 60% or 30% fewer treatments are required, respectively, whereas the target cannot be achieved with cirrhosis prioritization. Opiate substitution therapy scale‐up reduces treatments required by 21–24%. Achieving both WHO targets requires treating 631 (359–1047) in 2019, totaling 3816 (2664–5423) across 2019–2030.

Conclusions

Hepatitis C virus elimination is achievable in Singapore but even with declining IDU requires immediate treatment scale‐up among PWID. Harm reduction provision reduces treatments required and provides additional benefits.
Improving Measurement in Couple and Family Therapy: An Item Response Theory Primer
Authors: Anderson Shayne R. , Miller Richard B.
Published: August 2020

The valid and reliable assessment of individual and relational functioning relies on high‐quality assessment tools. Most assessments used in the field of couple and family therapy were developed using Classical Test Theory (CTT). An alternate theory for guiding the creation, evaluation, and scoring of assessments is Item Response Theory (IRT). IRT has several advantages over CTT and can be used to improve measurement in the field. For example, the IRT approach creates measures that are significantly more precise, yet uses fewer items, than scales created using CTT. This manuscript provides an overview of how IRT differs from CTT and describes the fundamental concepts and assumptions of IRT. Following this summary, we provide a step‐by‐step example of how IRT can be used to reduce the length of the Marital Disaffection Scale from 21 to 6 items without losing a significant amount of information about the construct.
The Juxtaposition of Revenge and Forgiveness in Peer Conflict Experiences of Youth Exposed to Violence
Authors: Recchia Holly E. , Wainryb Cecilia , Posada Roberto
Published: August 2020

In a sample of 95 urban Colombian mid‐adolescents, this mixed‐method study examined how youths’ retaliatory desires and actions were juxtaposed with forgiveness and nonforgiveness in their narrative accounts of peer conflict. Quantitative analyses examined how retaliatory desire and action were associated with variations in youths’ lifetime exposure to violence (ETV) and recent victimization by peers at school. These measures of violence exposure were related to revenge only in the context of unforgiven harms. Qualitative analyses explored aspects of youths’ narrative accounts that may underlie the observed associations. Overall, findings suggest that ETV may interfere with youths’ capacity to reflect on revenge in ways that recognize their own fallibility and thus open the door to forgiveness.
Improving diagnostic accuracy in neonates with left heart obstruction in a transport setting
Authors: Boyd Stephanie M , Staub Eveline , Browning Carmo Kathryn
Published: August 2020

Aim

Differentiating left heart obstruction (LHO) from other severe illness in the neonatal period is challenging, and important for guiding clinical management. The aim of this study was to identify factors distinguishing LHO from non‐LHO in neonates.

Methods

A retrospective, cohort study of neonates referred to the Newborn and Paediatric Emergency Transport Service, New South Wales, with suspected LHO during the epoch 1996–2016.

Results

A total of 273 neonates were included; 240 with confirmed LHO. Administration of prostaglandin E1 to infants with a structurally normal heart was not associated with impaired acid–base or oxygenation status. Pre‐transport diagnostic accuracy of LHO was 74.4%; sensitivity 84.5%, positive predictive value 86.0%. On multivariable logistic regression, hepatomegaly (odds ratio 2.54; 95% confidence interval 1.05–6.16) was associated with confirmed LHO.

Conclusions

A low threshold for prostaglandin E1 infusion should be maintained in infants with suspected LHO. Hepatomegaly is associated with a diagnosis of LHO and may be more useful than other parameters in predicting the condition.
Dual delivery of platelet‐derived growth factor and bone morphogenetic factor‐6 on titanium surface to enhance the early period of implant osseointegration
Authors: Keceli H. Gencay , Bayram Cem , Celik Ekin , Ercan Nuray , Demirbilek Murat , Nohutcu Rahime Meral
Published: August 2020

Objective

To test the surface properties and in vitro effects of a new sequential release system on MC3T3‐E1 cells for improved osseointegration.

Background

BMP6‐loaded anodized titanium coated with PDGF containing silk fibroin (SF) may improve osseointegration.

Methods

Titanium surfaces were electrochemically anodized, and SF layer was covered via electrospinning. Five experimental groups (unanodized Ti (Ti), anodized Ti (AnTi), anodized + BMP6‐loaded Ti (AnTi‐BMP6), anodized + BMP6 loaded + silk fibroin‐coated Ti (AnTi‐BMP6‐SF), and anodized + BMP6‐loaded + silk fibroin with PDGF‐coated Ti (AnTi‐BMP6‐PDGF‐SF)) were tested. After SEM characterization, contact angle analysis, and FTIR analysis, the amount of released PDGF and BMP6 was detected using ELISA. Cell proliferation (XTT), mineralization, and gene expression (RUNX2 and ALPL) were also evaluated.

Results

After successful anodization and loading of PDGF and BMP6, contact angle measurements showed hydrophobicity for TiO2 and hydrophilicity for protein‐adsorbed surfaces. In FTIR, protein‐containing surfaces exhibited amide‐I, amide‐II, and amide‐III bands at 1600 cm‐1‐1700 cm‐1, 1520 cm‐1‐1540 cm‐1, and 1220 cm‐1‐1300 cm‐1 spectrum levels with a significant peak in BMP6‐ and/or SF‐loaded groups at 1100 cm‐1. PDGF release and BMP6 release were delayed, and relatively slower release was detected in SF‐coated surfaces. Higher MC3T3‐E1 proliferation and mineralization and lower gene expression of RUNX2 and ALPL were detected in AnTi‐BMP6‐PDGF‐SF toward day 28.

Conclusion

The new system revealed a high potential for an improved early osseointegration period by means of a better factor release curve and contribution to the osteoblastic cell proliferation, mineralization, and associated gene expression.
Altered cardiac repolarisation in highlanders with high‐altitude pulmonary hypertension during wakefulness and sleep
Authors: Aeschbacher Sayaka S. , Latshang Tsogyal D. , Sheraliev Ulan , Marazhapov Nuriddin H. , Ulrich Silvia , Sooronbaev Talant M. , Bloch Konrad E. , Furian Michael
Published: August 2020

High‐altitude pulmonary hypertension (HAPH) is an altitude‐related illness associated with hypoxaemia that may promote sympathetic excitation and prolongation of the QT interval. The present case‐control study tests whether QT intervals, markers of malignant cardiac arrhythmias, are prolonged in highlanders with HAPH (HAPH+) compared to healthy highlanders (HH) and healthy lowlanders (LL). The mean pulmonary artery pressure (mPAP) was measured by echocardiography in 18 HAPH+ (mPAP, 34 mmHg) and 18 HH (mPAP, 23 mmHg) at 3,250 m, and 18 LL (mPAP, 18 mmHg) at 760 m, Kyrgyzstan (p < .05 all mPAP comparisons). Groups were matched for age, sex and body mass index. Electrocardiography and pulse oximetry were continuously recorded during nocturnal polysomnography. The heart rate‐adjusted QT interval, QTc, was averaged over consecutive 1‐min periods. Overall, a total of 26,855 averaged 1‐min beat‐by‐beat periods were semi‐automatically analysed. In HAPH+, maximum nocturnal QTc was longer during sleep (median 456 ms) than wakefulness (432 ms, p < .05) and exceeded corresponding values in HH (437 and 419 ms) and LL (430 and 406 ms), p < .05, respectively. The duration of night‐time QTc >440 ms was longer in HAPH+ (median 144 min) than HH and LL (46 and 14 min, p < .05, respectively). HAPH+ had higher night‐time heart rate (median 78 beats/min) than HH and LL (66 and 65 beats/min, p < .05, respectively), lower mean nocturnal oxygen saturation than LL (88% versus 95%, p < .05) and more cyclic oxygen desaturations (median 24/hr) than HH and LL (13 and 3/hr, p < .05, respectively). In conclusion, HAPH was associated with higher night‐time heart rate, hypoxaemia and longer QTc versus HH and LL, and may represent a substrate for increased risk of malignant cardiac arrhythmias.
Educator perceptions on teaching Indigenous health: Racism, privilege and self‐reflexivity
Authors: Vass Alyssa , Adams Karen
Published: August 2020

Introduction

General practitioners (GPs) and family medicine clinicians should respond to Indigenous peoples’ health needs. However, medical graduates feel underprepared for this work. The foundational elements of racism, white privilege and cultural self‐reflexivity remain conspicuously absent from medical education in general practice programmes, despite inclusion in curriculum frameworks. This study explored the perception and experiences of Australian GP educators in teaching this content.

Methods

We undertook a qualitative study that gathered data through semi‐structured interviews with GP educators (n = 12) at a medical school in Victoria, Australia. We utilised the Reflection learning domain of the Aboriginal and Torres Strait Islander Health Curriculum Framework to shape interview questions on racism, white privilege and cultural self‐reflexivity. Data were analysed from constructivist and Critical Indigenous Theory paradigms to formulate key themes.

Results

General practitioner educators were challenged by Reflection content, struggled to articulate a refined pedagogy for provision of anti‐racist, self‐reflexive learning and felt poorly qualified to teach Indigenous health, articulating preference for delegation of teaching to Indigenous peoples. They simultaneously stated the importance of inclusion of Reflection teaching in general practice, alongside expressing beliefs that appeared to devalue its perceived relevance. Students were perceived as being either disinterested or incapable of Reflection learning, or conversely, more engaged than previous generations with these topics.

Discussion

The results call into question how skilled are GP educators to teach elements of Indigenous health education such as racism, white privilege and cultural self‐reflexivity. Unskilled educators can reinforce colonialism in curricula, including through minimisation of content. Stronger anti‐racist pedagogy is urgently required in medical education. Vital to this is active research on educator preparedness, evidence‐based teaching models and accountable curriculum accreditation.
Feeding ecology of the highly threatened common bottlenose dolphin of the Gulf of Ambracia, Greece, through stable isotope analysis
Authors: Borrell Asunción , Vighi Morgana , Genov Tilen , Giovos Ioannis , Gonzalvo Joan
Published: August 2020

The Gulf of Ambracia, in northwestern Greece, hosts a highly threatened community of about 150 common bottlenose dolphins (Tursiops truncatus). Until now, information on their feeding habits was derived exclusively from fish scale samples collected during surface‐feeding events targeting small schooling epipelagic fish. The aim of this study was to determine the diet of bottlenose dolphins living in the Gulf of Ambracia through the application of Bayesian isotopic mixing models. Skin biopsy samples of 16 dolphins were analyzed and no difference related to sex or age‐class was found in δ13C and δ15N values. Results suggested that the dolphin diet was mainly based on Trachurus trachurus, species belonging to the family Sparidae: Diplodus annularis, Lithognathus mormyrus, and Sepia officinalis, which represented together about 42% ± 15% of the biomass ingested, followed by species belonging to the order Clupeiformes (Engraulis encrasicolus, Sardinella aurita, and Sardina pilchardus) and the genus Gobius (37% ± 17%). A better understanding of the feeding habits of these dolphins sheds light on the feeding ecology of this highly threatened population by, for instance, evidencing interactions with artisanal fisheries sharing the same target species, and is key for identifying adequate management measures consistent with an ecosystem‐based approach.
The Integrity of Gareth Moore's Believing in God
Authors: Hinton Timothy
Published: August 2020

In this paper, I defend Gareth Moore from the charge that he espoused some kind of crypto-atheism in Believing in God. I do so by examining the case against Gareth outlined in Howard Robinson's New Blackfriars article “Gareth Moore's Radical Wittgensteinianism”. I examine both the directly textual arguments Robinson presents, as well as his claim that Gareth adhered to a kind of “radical Wittgensteinianism” that involves, among other things, a commitment to materialism. More importantly, I emphasize the true integrity of Believing in God. By this I mean two things: like any worthwhile exercise in philosophy, the book has to be read as forming an integral whole. This requires both an appreciation of Gareth's philosophical and religious motives in writing it and a sense of how it hangs together as a “seamless garment”. In addition, I mean the forthrightness of Gareth's efforts to be faithful to Christianity, not a Christianity of mere – or as he puts it “empty” – belief, but a Christianity that is to be lived out truthfully in thought, word, and deed.
Cerebral embolization associated with parenchymal seeding of the left atrial myxoma: Potential role of interleukin‐6 and matrix metalloproteinases
Authors: Aguilar Cristian , Carbajal Tomas , Beltran Brady E. , Segura Pedro , Muhammad Sajjad , Choque‐Velasquez Joham
Published: August 2020

Systemic embolization has been reported in up to 40% of patients with left atrial myxoma, half of them with cerebral involvement. However, development of intracerebral embolization associated with parenchymal seeding of the myxoma emboli is an extremely rare complication, with only 36 histologically diagnosed cases reported in the published literature. We describe a 69‐year‐old woman who arrived at the emergency service with hemiparesis associated with drug‐resistant epilepsy and a medical history of resection of a left atrial myxoma 10 months previously. Cranial computed tomography revealed multiple large lesions of heterogeneous density and cystic components in the occipital lobes and posterior fossa parenchyma. Histopathological analyses after stereotactic biopsy of the occipital lesion revealed infiltrative myxoma cells with benign histological findings and uniform expression of calretinin similar to that of the primary cardiac myxoma. Additional immunohistochemical studies confirmed brain parenchymal seeding of the myxoma cells with strong expression of interleukin‐6 (IL‐6) and focal expression of matrix metalloproteinases‐2 (MMP‐2). Here, we discuss the clinicopathological features of intracerebral embolization of left atrial myxomas associated with progressive parenchymal seeding of the tumor emboli and the potential pathogenic role of IL‐6 and MMPs.
Duodenal mucosal secretory disturbances in functional dyspepsia
Authors: Puthanmadhom Narayanan Susrutha , Linden David R. , Peters Stephanie A. , Desai Anshuman , Kuwelker Saatchi , O’Brien Daniel , Smyrk Thomas J. , Graham Rondell P. , Grover Madhusudan , Bharucha Adil E.
Published: August 2020

Background

There is increased recognition of duodenal disturbances (inflammation, altered mucosal protein expression, and chemosensitivity) in functional dyspepsia (FD). Besides sensorimotor functions, enteric submucosal neurons also regulate epithelial ion transport. We hypothesized that duodenal mucosal ion transport and expression of associated genes are altered in FD.

Methods

Duodenal mucosal ion transport (basal and acetylcholine‐ and glucose‐evoked changes in short‐circuit current [Isc]) and expression of associated genes and regulatory miRNAs were evaluated in 40 FD patients and 24 healthy controls.

Results

Basal Isc (FD: 88.2 [52.6] μA/cm2vs healthy: 20.3 [50.2] μA/cm2;P ≤ .0001), acetylcholine‐evoked Isc (FD: Emax 50.4 [35.8] μA/cm2vs healthy: 16.6 [15] μA/cm2;P ≤ .001), and glucose‐evoked Isc responses (FD: Emax69.8 [42.1] μA/cm2vs healthy: 40.3 [24.6] μA/cm2;P = .02) were greater in FD than in controls. The Emax for glucose was greater in FD patients on selective serotonin reuptake inhibitors. In FD, the mRNA expression ofSLC4A7andSLC4A4, which transport bicarbonate into cells at the basolateral surface, and the apical anion exchangerSLC26A3were reduced (false discovery rate <0.05), the serotonin receptorHTR4was increased, and the serotonin transporterSLC6A4was decreased. Selected miRNAs (hsa‐miR‐590‐3p, hsa‐miR‐32‐5p) that target genes associated with ionic transport were upregulated in FD.

Conclusions

Compared to controls, FD patients had greater baseline and agonist‐evoked duodenal mucosal secretory responses. These findings may be explained by reduced gene expression, which would be anticipated to reduce luminal bicarbonate secretion. The upregulated miRNAs may partly explain the downregulation of these genes in FD.
The grand sweep of chromosomal evolution in angiosperms
Authors: Escudero Marcial , Wendel Jonathan F.
Published: August 2020

This article is a Commentary on Carta et al. (2020), 228: 1097–1106.
Systematic review of randomised controlled trials to improve dietary intake for the prevention of obesity in infants aged 0–24 months
Authors: Butler Éadaoin M. , Fangupo Louise J. , Cutfield Wayne S. , Taylor Rachael W.
Published: August 2020

Improving dietary intake early in life is a common behavioural target in obesity prevention trials. We undertook a systematic review of randomised controlled trials aiming to improve dietary intake of complementary foods during infancy (0–24 months). PubMed, Cochrane Library, EMBASE, Medline, and PsycInfo were searched for trials focussed on obesity prevention conducted between January 2000 and August 2019 where dietary intake was an outcome. Two reviewers screened studies and extracted data from selected articles. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias 2 tools. The protocol was registered on Open Science Framework (https://osf.io/6srg7/). Seventeen articles from 12 trials were selected for data extraction. Statistically significant group differences in outcomes were observed in 36 of 165 (21.8%) of dietary variables examined. Measurement and analysis of outcomes varied between studies. Overall risk of bias was rated as high, primarily due to missing outcome data. Improving dietary intake at this age appears challenging based on a relatively limited number of studies. Future research could consider dietary pattern analyses, which may provide more meaningful outcomes for this age group. Opportunities exist for further exploration of maternal‐focussed interventions, responsive feeding interventions, and interventions delivered outside of homes.
Common variants of EDA are associated with non‐syndromic hypodontia
Authors: Al‐Ani Azza H. , Antoun Joseph S. , Thomson William M. , Topless Ruth , Merriman Tony R. , Farella Mauro
Published: August 2020

Objective

The aim of this case‐control study was to investigate the association between non‐syndromic hypodontia and nineteen common variants of candidate genes ectodysplasin A (EDA), paired box 9 (PAX9), msh homeobox 1 (MSX1) and axis inhibition protein 2 (AXIN2).

Settings and Sample Population

Sixty‐one hypodontia cases were frequency‐matched to 253 controls with no missing teeth (excluding the third molars).

Material and Methods

Self‐report data and DNA samples were collected from each participant.

Results

The sample had a mean age of 16.6 years (SD = 7.3), with most participants being female (59.6%), and of New Zealand European origin (75.4%). Using multiple logistic regression analysis, it was found that the T‐allele of rs12853659 (EDA) and the G‐allele of rs2428151 (EDA) were both associated with a higher risk of hypodontia (odds ratio, OR = 2.79, 95% CI = 1.11‐7.01; and OR = 2.87, 95% CI = 1.04‐7.94, respectively). The G‐allele of rs2520378 (EDA) showed a protective effect with an OR of 0.61 (95% CI = 0.38‐0.99). The EDA SNP findings were consistent with previous reports included in a meta‐analysis. No associations were found with the PAX9, AXIN2 and MSX1 genes, after adjusting for sex and ethnicity.

Conclusions

Common variants of the EDA genes are associated with specific phenotypes of non‐syndromic hypodontia, thus confirming their role in the regulatory pathways of normal tooth development. However, larger samples are needed to investigate the association further.
Ecosystem size shapes antipredator trait evolution in estuarine threespine stickleback
Authors: Wasserman Ben A. , Paccard Antoine , Apgar Travis M. , Des Roches Simone , Barrett Rowan D. H. , Hendry Andrew P. , Palkovacs Eric P.
Published: August 2020

Ecosystem size is known to influence both community structure and ecosystem processes. Less is known about the evolutionary consequences of ecosystem size. A few studies have shown that ecosystem size shapes the evolution of trophic diversity by shaping habitat heterogeneity, but the effects of ecosystem size on antipredator trait evolution have not been explored. Ecosystem size may impact antipredator trait evolution by shaping predator presence (larger ecosystems have longer food chains) and habitat complexity (larger ecosystems may have more diverse habitat structure). We tested these effects using threespine stickleback from bar‐built estuaries along the Central Coast of California. These stickleback populations are polymorphic forEctodysplasin‐A(Eda), a gene that controls bony lateral plates used as antipredator defense. We inferredEdagenotypes from lateral plate phenotypes and show that the frequency of the complete (C) allele, which is associated with greater number of lateral plates, increases as a function of ecosystem size. Predator presence and habitat complexity are both correlated to ecosystem size. The strongest proximate predictor ofEdaallele frequencies was the presence of predatory fishes (steelhead trout and sculpin). Counter to expectations, habitat complexity did not have a strong modifying effect onEdaallele frequencies. Our results point to the importance of ecosystem size for determining predator presence as being the primary pathway to evolutionary effects. Ecosystem size has received much attention in ecology. Our work shows that it may be an important determinant of adaptive evolution in wild populations.
Comparison of the Pull‐Out Strength between a Novel Micro‐Dynamic Pedicle Screw and a Traditional Pedicle Screw in Lumbar Spine
Authors: Qian Lei , Chen Weidong , Li Peng , Qu Dongbin , Liang Wenjie , Zheng Minghui , Ouyang Jun
Published: August 2020

Objective

This study aimed to investigate the strength of a novel micro‐dynamic pedicle screw by comparing it to the traditional pedicle screw.

Methods

Forty‐five lumbar vertebrae received a traditional pedicle screw on one side and a micro‐dynamic pedicle screw on the other side as follows (traditional group vs micro‐dynamic group): 15 vertebrae underwent instant pull‐out testing; 15 vertebrae underwent 5000‐cyclic fatigue loading testing; and 15 vertebrae underwent 10,000‐cyclic fatigue loading testing and micro‐computed tomography (micro‐CT) scanning. The peek pull‐out force and normalized peek pull‐out force after instant pull‐out testing, 5000‐cyclic and 10,000‐cyclic fatigue loading testing were recorded to estimate the resistance of two types of screws. Bone mineral density was recorded to investigate the strength of the different screws in osteoporotic patients. And the semidiameter of the screw insertion area on micro‐CT images after fatigue were compared to describe the performance between screw and bone surface.

Results

The bone mineral density showed a weak correlation with peek pull‐out force (r = 0.252, P = 0.024). The peek pull‐out force of traditional pedicle screw after 10,000‐cyclic fatigue loading were smaller than that of instant pull‐out test in both osteoporotic (P = 0.017) and healthy group (P = 0.029), the peek pull‐out force of micro‐dynamic pedicle screw after 10,000‐cyclic fatigue loading was smaller than that in instant pull‐out test in osteoporotic group (P = 0.033), but no significant difference in healthy group (P = 0.853). The peek pull‐out force in traditional group and micro‐dynamic group underwent instant pull‐out testing (P = 0.485), and pull‐out testing after 5000‐cyclic fatigue loading testing (P = 0.184) did not show significant difference. However, the peek pull‐out force in micro‐dynamic group underwent pull‐test after 10,000‐cyclic fatigue loading testing was significantly greater than that measured in traditional group (P = 0.005). The normalized peek pull‐out force of traditional groups underwent instant pull‐out testing, pull‐out test after 5000‐cyclic and 10,000‐cyclic fatigue loading testing significantly decreased as the number of cycles increased (P < 0.001); meanwhile, the normalized peek pull‐out force of micro‐dynamic groups remained consistent regardless of the number of cycles (P = 0.133). The semidiameter after the fatigue loading test of the traditional screw insertion area was significantly larger than that of the micro‐dynamic screw insertion area (P = 0.013).

Conclusion

The novel micro‐dynamic pedicle screw provides stronger fixation stability in high‐cyclic fatigue loading and non‐osteoporotic patients versus the traditional pedicle screw, but similar resistance in low‐cycle fatigue testing and osteoporotic group vs the traditional pedicle screw.
Complications of Cryptosporidium infection after pediatric liver transplantation: Diarrhea, rejection, and biliary disease
Authors: Fischer Ryan T. , Day J. Christopher , Wasserkrug Heather , Faseler Megan , Kats Alexander , Daniel James F. , Slowik Voytek , Andrews Walter , Hendrickson Richard J.
Published: August 2020

Background

Cryptosporidium enteritis can be devastating in the immunocompromised host. In pediatric liver transplant recipients, infection may be complicated by prolonged carriage of the parasite, rejection, and biliary tree damage and fibrosis. Herein, we report on six patients and their long‐term outcomes following cryptosporidiosis.

Methods

We reviewed all cases of cryptosporidiosis in a pediatric liver transplant population over a 17‐year period at a single center. Six patients with infection were identified, and their outcomes were analyzed.

Results

Infection was associated with significant diarrhea and dehydration in all cases, and led to hospitalization in one‐half of patients. Four of the six patients developed biopsy‐proven rejection following infection, with three of those patients developing rejection that was recalcitrant to intravenous steroid treatment. Additionally, three patients developed biliary tree abnormalities with similarity to sclerosing cholangitis. In one patient, those biliary changes led to repeated need for biliary drain placement and advancing fibrotic liver allograft changes.

Conclusions

Cryptosporidiosis in pediatric liver transplant recipients may lead to significant complications, including recalcitrant episodes of rejection and detrimental biliary tree changes. We advocate for increased awareness of this cause of diarrheal disease and the allograft injuries that may accompany infection.
A need for trauma informed care in sexually transmitted disease clinics
Authors: Brewer Antonia , Colbert Alison M. , Sekula Kathleen , Bekemeier Betty
Published: August 2020

Objective

This review examines trauma from violence as a risk factor for sexually transmitted diseases (STDs) among women attending STD clinics. The review also aims to suggest trauma informed care (TIC) integrated into STD clinics might more effectively address traumatic effects of violence linked to sexual risk behaviors among this population.

Design and Sample

A systematic literature review was conducted to identify empirical studies examining the relationship between multiple forms of violence and sexual risk behaviors among women attending STD clinics.

Results

All studies found high rates of violence including childhood sexual abuse, intimate partner violence, and/or community violence associated with high rates of sexual risk behaviors among women attending these settings. Researchers recommend screening for multiple forms of violence, interdisciplinary STD clinic services, and more trauma informed sexual risk reduction interventions to address multiple forms of violence found prevalent among this population.

Conclusion

Women attending STD clinics very often experience multiple forms of violence during their lifetime. TIC to address traumatic effects of violence might reduce sexual risk behaviors and sexually transmitted disease rates for improved health outcomes among this population.
The implementation of a dedicated education unit in a public health setting
Authors: Frie Kathryn J. , Prochnow Jenny , Meiers Sonja , Fiedler Tammy , Jones Cynthia , Bergen Silas
Published: August 2020

Introduction

The dedicated education unit (DEU) is an innovative clinical model that prepares preceptors for success in clinical settings with nursing students. Though the DEU is mostly used in acute‐care settings, this project explores the implementation of a DEU in a public health setting.

Objectives

Better preparation of public health nurses and social workers as clinical preceptors for nursing students with the implementation of a DEU in a public health setting.

Design

IRB approved, pre/post survey with participant comments.

Measurements

Clinical Nurse Teacher Survey was assessed pre/post intervention with registered nurses and social work staff (n = 13). Paired t‐tests analysis was used to determine significance. The Clinical Learning Environment and Nurse Teacher (CLES+T) scale completed postimplementation by nursing students (n = 8) after the clinical rotation.

Results

Clinical Nurse Teacher Survey mean scores preintervention was 4.56 and increased postintervention to 4.89, though not statistically significant (p‐value .11). CLES+T showing 100% fully agree or agree that the Public Health DEU is an effective learning environment.

Conclusions

The DEU model in a public health setting is an opportunity to improve lived clinical experiences of preceptors and nursing students, which may increase nursing students’ positive perceptions of, and increase interest in serving as a public health nurse after graduation.
Enkratic Rationality Is Instrumental Rationality*
Authors: Lee Wooram
Published: August 2020

It is widely agreed that there is a rational requirement, “Enkrasia”, which requires that you intend what you believe you ought to do. This paper argues that Enkrasia is not an independent requirement of practical rationality: it is a special case of the requirement to be instrumentally rational. I argue for this view of Enkrasia through an analysis of an all‐things‐considered belief about what you ought to do. Believing, all‐thing‐considered, that you ought toφimplies being settled on a set of options from which to take an option. I argue that this state of being settled on a set of options cannot be a matter of believing. Rather, it should be understood as intending that you do what you ought to do out of that set. If an all‐things‐considered belief implies such an intention, however, satisfying Enkrasia is a matter of satisfying the requirement to intend a necessary means to an end that you intend.
Ectopic expression of common bean ERF transcription factor PvERF35 promotes salt stress tolerance in tobacco
Authors: Kavas M. , Gökdemir G. , Seçgin Z. , Bakhsh A.
Published: August 2020

In the present study, a TINY‐like AP2/ERF gene, PvERF35i, was amplified from common bean (Phaseolus vulgaris L.), cloned and functionally characterized by overexpressing in tobacco cv. Petite havana.

Transgenic plants overexpressing PvERF35 were generated using Agrobacterium‐mediated transformation and used to evaluate the possible roles of the transgene under salt stress conditions. Evaluation of transgenics was completed using both molecular and biochemical analysis.

PCR, Southern blot and RT‐qPCR assays revealed the correct integration and enhanced expression of the transgene. Physiological and biochemical analysis of transgenic plants showed their better performance compared to the wild type in terms of germination and survival rates and root and shoot growth under salt stress treatment (200 mM NaCl). Having a high concentration of proline, APX and POX, the PvERF35 overexpressed plants were physiologically and morphologically less affected by salt stress application. In silico promoter analysis of the PvERF35 gene led to identification of important cis‐regulatory elements, MYB, MYC and TGACG‐motif, annotated with salt response of plants. The protein–protein interaction network showed that there was a strong association between ABC transporter proteins and PvERF35 protein. Salt stress‐related miRNA, miRNA156 and miRNA159, targeting PvERF35 were identified using in silico target finding analysis.

These findings suggest that PvERF35 functions as a stress‐responsive transcription factor in differential modulation of salt stress tolerance and may have applications in the engineering of economically important crops.
Previously unknown ssDNA molecules co‐occurring with CdebDNAV infecting the marine planktonic diatom Chaetoceros debilis
Authors: Tomaru Yuji , Toyoda Kensuke , Kimura Kei
Published: August 2020

Since the first discovery of diatom viruses, more than a dozen species have been identified, and these viruses can significantly affect the dynamics of diatoms in nature. To better understand marine primary productivity, details of the relationship between viruses and their diatom hosts must be elucidated. The marine diatom Chaetoceros debilis is a cosmopolitan species and its blooms are often observed in highly productive areas. To date, only C. debilis DNA virus (CdebDNAV) has been isolated and characterized. In this study, we successfully identified a previously unknown virus‐like particle (VLP) and ssDNA molecules co‐occurring with CdebDNAV. Transmission electron microscopy analysis of the cytoplasm of infected C. debilis revealed particles that were 21 and 36 nm in size, corresponding to the newly identified VLPs and CdebDNAV, respectively. The ssDNA molecules encode a putative capsid protein (CP); however, no proteins related to replication were detected. The estimated molecular weight of the CP is 24.4 kDa, similar to that of VLPs in the protein electrophoresis analysis. Genetic analyses revealed that the CP shows low levels of similarity with uncultured marine ssDNA viruses, but seems to be independent of the known virus genera. Although the relationships between the smaller VLP and ssDNA molecules identified in this study were not fully revealed, it might be a new virus. The finding is important for understanding diatom virus ecology and to promote further characterization of uncultured aquatic ssDNA viruses.
Civil Rights, Social Equity, and Census 2020
Authors: Berry‐James RaJade M. , Gooden Susan T. , Johnson Richard Greggory
Published: August 2020

This article examines Census 2020 relative to civil rights and social equity. Mandated by the U.S. Constitution, the Census is directly related to civil rights as Census totals are used to determine voting representation, and results impact billions of dollars of federal, state, and local funding across multiple areas including education, health care, and housing. Census undercounts impact marginalized communities, and this is a heightened concern for Census 2020 along two core social equity dimensions: (1) race and ethnicity, and (2) immigration and citizenship. The implementation of Census 2020 is the responsibility of public administrators and poses challenges in the areas of social equity, leadership, and administrative infrastructure.

Practitioner Points

Census 2020 matters. Data from the U.S. Census is fundamental to apportioning political power as well as more than $800 billion each year for governmental services.

In each state, population totals will determine the House of Representative seats. Every state will use population totals to redraw legislative districts, allocate resources, and provide public services.

Racial categories and undercounts have been fundamental concerns since the first U.S. Census in 1790. These undercounts pose on‐going challenges to political participation, representation, and resources.

The citizenship question controversy of Census 2020 will likely lead to lower completion levels for noncitizens.

Implementation of Census 2020 is the responsibility of public administrators, and there are important challenges relative to civil rights and social equity.
Use of dentures, receipt of information, quality of life, and oral function following radiotherapy for head and neck cancer
Authors: Abed Hassan , Burke Mary , Fenlon Michael R , Scambler Sasha , Scott Suzanne E
Published: August 2020

Background

Teeth with a poor prognosis are often extracted prior to radiotherapy for head and neck cancer (HNC) in order to help prevent the need for dental treatment after radiotherapy that might in turn lead to the development of osteoradionecrosis. However, the details and impact of replacing missing teeth after radiotherapy for HNC have received little attention, especially from the patients’ perspective.

Aims

This study aimed to assess the use, satisfaction, and impact of denture use following radiotherapy for HNC. The study also sought to determine patients’ satisfaction with information about replacing their missing teeth postradiotherapy. Finally, this study also aimed to assess interest in replacing missing teeth for those who had not done so.

Methods

A structured, validated, and reliable questionnaire was sent to HNC patients who had received radiotherapy and had missing teeth at the time of discharge. In addition to demographic details and self‐reported oral hygiene, the questionnaire included questions on use of (or interest in) dentures, satisfaction with dentures, satisfaction with information about replacing missing teeth, QoL as measured by two questions from the short version of WHOQoL‐BREF, and oral functioning as measured by BCSQ‐H&N. Demographic details and clinical details were extracted from the hospital records.

Results

N = 80 (24%) returned a completed questionnaire. Participants had an average of 12 missing teeth (SD = 8.05). Most (n = 60, 75%) had not replaced their missing teeth. Of these, 35 (58%) were very or extremely interested in doing so. For HNC survivors who wore dentures, there was variable satisfaction and a number of side‐effects of wearing dentures. Satisfaction with information about replacing missing teeth was low. There was no statistical difference in QoL or oral functioning between participants who wore dentures and participants who did not wear dentures. However, those with dentures reported fewer problems with carrying out daily routines as measured by the oral functioning tool.

Conclusions

QoL and oral functioning were similar regardless of denture use, highlighting reduced oral function in both those with and without dentures. In those who had not replaced their missing teeth, there was substantial interest in doing so and thus may be an unmet need. The dental team could offer HNC survivors more support after radiotherapy and following denture provision to improve information about denture use and increase satisfaction with dentures.
On the CO2 gain in on‐line hemodiafiltration
Authors: Marano Marco , Izzo Francesco
Published: August 2020

Background

The dialysis bath holds up to 90 mmHg carbon dioxide (CO2) in order to keep pH low and salts in their soluble forms. CO2 crosses the dialyzer membrane and diffuses to patients. In post‐dilution on‐line hemodiafiltration (HDF) many liters of CO2‐containing dialysis bath – in the form of infusate – are delivered directly to patients bypassing the filtering membrane, but the precise amount of CO2 delivered is unknown.

Methods

To gain insights on this issue 18 outpatients undergoing their regular on‐line HDF were investigated by means of blood gas analysis.

Results

Arterial pre‐dialysis samples show slight hypocapnia (35.40 ± 3.22 mmHg) consistent with the secondary compensatory response to metabolic acidosis. In blood coming back to patients (venous line of extracorporeal circuit) pCO2 doubled, amounting to 69 ± 5.5 mmHg (P < .0001 with respect to pre‐dialysis values) hence in on‐line HDF a CO2 gain does occur. Turning off the infusate flux pump, pCO2 decreased to 63.1 ± 5.8 mmHg (P = .004) meaning that delivery of infusate in post‐dilution mode significantly contributes to CO2 gain, albeit by a small amount.

Conclusion

On‐line HDF is featured by CO2 delivery to patients, in part dragged by the infusate.