bluuebunny/crossref_metadata_2025 huggingface dataset:
Duetting correlates with territory quality and reproductive success in a suboscine bird with low extra-pair paternity
Authors: Diniz Pedro , Macedo Regina H , Webster Michael S
Published: June 2019

Duetting has been intensively studied, but we still have little consensus about its fitness consequences. Some studies suggest that duetting functions in acoustic mate guarding to prevent cuckoldry (acoustic paternity guarding hypothesis), whereas other studies argue that duetting is a cooperative behavior to defend common resources (territory defense hypothesis). We tested these 2 hypotheses by investigating the relationships among song traits, extra-pair paternity, territory quality and reproductive success in the Rufous Hornero (Furnarius rufus), a Neotropical, socially monogamous bird. We found a low rate of extra-pair paternity (3.33% of 120 offspring and 6.52% of 46 broods), which suggests that acoustic paternity guarding is probably not a primary function of duetting behavior in this species. Female song output was positively correlated with territory quality, measured as the availability of territory foraging patches. The number of young that survived post-fledging was positively correlated with duet duration, but not with territory features. Our results support the territory defense hypothesis, suggesting that female song in duets might be used in the defense of food resources within territories. Our study provides the first evidence that song traits correlate with both territory features and reproductive success in a duetting species.
Are commonly used metrics of bird song complexity concordant?
Authors: Benedict Lauryn , Najar Nadje A
Published: June 2019

Researchers studying the evolution of animal communication often ask what generates and maintains signal complexity, but they define and measure complexity in different ways. If different metrics are not concordant, then studies using them are probably not comparable. In this study, we asked whether 7 metrics of bird song complexity vary in tandem among individuals of a single species, the Rock Wren (Salpinctes obsoletus). The included metrics were chosen because they are regularly used by researchers in the field to test hypotheses within the literature. Results indicated that none of the metrics positively correlated with any others, suggesting that bird songs are not under general selective pressures favoring increased complexity across multiple features. If metrics of signal complexity are not correlated, then care should be taken when designing analyses and comparing results. Researchers should always clearly define the “complexity” under investigation and verify that it has significance to the study species. Contradictory outcomes among existing research into signal “complexity” may result from the fact that this single word is used to represent multiple independent traits.
Investigation of the geographic origin of burrowing owl fleas with implications for the ecology of plague
Authors: Navock Kara A , Johnson David H , Evans Samantha , Kohn Matthew J , Belthoff James R
Published: June 2019

Host-parasite relationships between Western Burrowing Owls (Athene cunicularia hypugaea) and the fleas (Pulex irritans, Siphonaptera:Pulicidae) they harbor were studied to understand the extent to which migratory Burrowing Owls translocated fleas from wintering grounds to breeding grounds. This has implications for host-parasite relationships in Burrowing Owls and also potentially for the dynamics of plague, as Burrowing Owl distributions overlap plague foci, owls inhabit fossorial mammal colonies where epizootic outbreaks of plague occur, and owls may harbor species of flea that are competent plague vectors. We used hydrogen stable isotope analysis to help elucidate geographic origins of fleas collected from adults and nestlings in 2 migratory populations of Burrowing Owls in Idaho and Oregon, USA. For adults, we posited that bird-mediated dispersal would impart flea isotopic compositions representative of southern latitudes and be similar to owl toenail tissue recently grown on wintering grounds, but they would differ from contour feathers presumably grown on breeding grounds the previous year. We assumed nestling feathers and toenails would have isotopic compositions representative of the breeding grounds. We analyzed contour feathers and toenails from adults collected shortly after they arrived in breeding grounds following spring migration and from nestlings later in the breeding season, to which we compared isotopic compositions in fleas collected from individuals of both age classes. Fleas on nestlings in both populations had isotopic compositions that did not differ from nestling feathers and toenails, suggesting that nestling fleas had breeding ground origins. Fleas on adults in one population (Oregon) had breeding ground isotopic signatures, as flea compositions did not differ from nestling feathers or toenails. Adult owls in Idaho had fleas that similarly did not express a wintering ground signature, but they were enriched in the heavy isotope (deuterium) relative to nestling feathers and toenails. Therefore, we discuss the possibility that adult owls in Idaho acquired fleas at migratory stopover sites. While the latter indicates that Burrowing Owls have the potential to disperse fleas, there was no evidence of continent-wide movement of fleas by owls from wintering grounds to breeding grounds.
Rabbits and Bergmann’s rule: how cold was Portugal during the last glaciation?
Authors: Davis Simon J M
Published: June 2019

Osteometric data from > 450 modern wild rabbits, mostly from Portugal, Spain and France, show an inverse correlation between their size and the temperature of the environment, in accordance with Bergmann’s rule. Similar measurements made on some 1660 rabbit bones from 14 Portuguese late Pleistocene and Holocene archaeological sites indicate that rabbits became considerably smaller at the Pleistocene–Holocene boundary. Thus, rabbit size varies or varied with temperature both today and in the past. A direct temperature–size relationship was assumed, and the regression of modern rabbit bone size on temperature was then used to calibrate the temperature equivalent for the change of size of rabbit bones in the past. The result indicates a Last Glacial Maximum to present-day difference, Δt°, of 7 or 8 °C. An alternative interpretation that does not assume a direct temperature–size relationship would indicate that the environment in Portugal 15 000–30 000 years ago was similar to that in northern France today.
Aligning Perspectives?—Comparison of Top and Middle-Level Managers’ Views on How Organization Influences Implementation of evidence-based practice
Authors: Bäck Annika , von Thiele Schwarz Ulrica , Hasson Henna , Richter Anne
Published: June 2019

A supportive organizational context is important for successfully implementing evidence-based practice (EBP). Managers have an important role in creating organizational prerequisites for EBP. The present study compared how top- and middle-level managers describe the process of implementing EBP and the factors influencing this process. Data were collected through interviews with twenty-two managers in social services, and analysed with thematic deductive analysis based on the Theoretical Domains Framework (TDF) and the COM-B model. Findings showed that top-level managers focused more on strategic- and system-level issues, e.g. external comparisons, dialogue with authorities and creating support systems, while the middle managers focused on the operative implementation at staff level, i.e. motivating and involving staff. Furthermore, the two groups had different understandings of EBP. To conclude, there needs to be an alignment in the understanding of, and support for, EBP between the different levels of managers. To create a mutual understanding of what EBP entails and to clearly communicate how the organization applies the different steps of the EBP process could be crucial steps in enabling the implementation of EBP, and needs to be done in dialogue between middle- and top-level managers.
Screening and identification of potential tyrosinase inhibitors from Semen Oroxyli extract by ultrafiltration LC-MS and in silico molecular docking
Authors: Yin Xing-shuo , Zhang Xue-qin , Yin Jin-tuo , Kong De-zhi , Li De-qiang
Published: June 2019

There is an increasing interest in screening and developing natural tyrosinase inhibitors widely applied in medicinal and cosmetic products, as well as in the food industry. In this study, an approach by ultrafiltration LC-MS and molecular docking was used to screen and identify tyrosinase inhibitors from Semen Oroxyli extract. The samples were first incubated with the tyrosinase to select the optimal binding conditions including tyrosinase concentration, incubation time and the molecular weight of ultrafiltration membrane. By comparison of the chromatographic profiles of the extracts after ultrafiltration with activated and inactivated tyrosinase, the potential inhibitors were obtained and then identified by LC-MS. The relative binding affinities of the potential inhibitors were also calculated based on the decrease of peak areas of those. As a result, seven compounds were fished out as tyrosinase inhibitors by this assay. Among them, oroxin A and baicalein showed higher tyrosinase inhibitory than resveratrol as positive drug, and their binding mode with enzyme was further verified via the molecular docking analysis. The test results showed that the proposed method was a simple, rapid, effective, and reliable method for the discovery of natural bioactive compounds, and it can be extended to screen other bioactive compounds from traditional Chinese medicines.
Invariant Natural Killer T-cell Dynamics in Human Immunodeficiency Virus–associated Tuberculosis
Authors: Walker Naomi F , Opondo Charles , Meintjes Graeme , Jhilmeet Nishtha , Friedland Jon S , Elkington Paul T , Wilkinson Robert J , Wilkinson Katalin A
Published: June 2019

Background

Tuberculosis (TB) is the leading cause of mortality and morbidity in people living with human immunodeficiency virus (HIV) infection (PLWH). PLWH with TB disease are at risk of the paradoxical TB-associated immune reconstitution inflammatory syndrome (TB-IRIS) when they commence antiretroviral therapy. However, the pathophysiology is incompletely understood and specific therapy is lacking. We investigated the hypothesis that invariant natural killer T (iNKT) cells contribute to innate immune dysfunction associated with TB-IRIS.

Methods

In a cross-sectional study of 101 PLWH and HIV-uninfected South African patients with active TB and controls, iNKT cells were enumerated using α-galactosylceramide-loaded CD1d tetramers and subsequently functionally characterized by flow cytometry. In a second study of 49 people with HIV type 1 (HIV-1) and active TB commencing antiretroviral therapy, iNKT cells in TB-IRIS patients and non-IRIS controls were compared longitudinally.

Results

Circulating iNKT cells were reduced in HIV-1 infection, most significantly the CD4+ subset, which was inversely associated with HIV-1 viral load. iNKT cells in HIV-associated TB had increased surface CD107a expression, indicating cytotoxic degranulation. Relatively increased iNKT cell frequency in patients with HIV-1 infection and active TB was associated with development of TB-IRIS following antiretroviral therapy initiation. iNKT cells in TB-IRIS were CD4+CD8– subset depleted and degranulated around the time of TB-IRIS onset.

Conclusions

Reduced iNKT cell CD4+ subsets as a result of HIV-1 infection may skew iNKT cell functionality toward cytotoxicity. Increased CD4– cytotoxic iNKT cells may contribute to immunopathology in TB-IRIS.
PICEAdatabase: a web database for Picea omics and phenotypic information
Authors: Lu Nan , Zhu Tianqing , Ouyang Fangqun , Xia Yan , Li Qingfen , Jia Zirui , Hu Jiwen , Ling Juanjuan , Ma Wenjun , Yang Guijuan , Zhang Hanguo , Kong Lisheng , Wang Junhui
Published: June 2019

Picea belongs to the Pinaceae family and is a famous commercial tree species because of its straight trunk and excellent timber traits. Recently, omics have been widely used for fundamental and mechanism studies on Picea plants. To improve the accessibility to omics and phenotypic data and facilitate further studies, we compiled the sequences of 2 chloroplast genomes (Picea crassifolia and Picea asperata) and 32 complete omics data sets, including 20 transcriptomes, 4 proteomes, 2 degradomes and 6 microRNAs from P. crassifolia, P. asperata, Picea balfouriana and Picea abies tissues under different treatments, in PICEAdatabase. In addition, phenotypic data on plant growth and wood property traits were collected from two field trials of P. crassifolia. PICEAdatabase also includes useful analysis tools, such as BLAST, DESeq2 and JBrowse, to assist with analyses.
High-resolution computational modeling of immune responses in the gut
Authors: Verma Meghna , Bassaganya-Riera Josep , Leber Andrew , Tubau-Juni Nuria , Hoops Stefan , Abedi Vida , Chen Xi , Hontecillas Raquel
Published: June 2019

Background

Helicobacter pylori causes gastric cancer in 1–2% of cases but is also beneficial for protection against allergies and gastroesophageal diseases. An estimated 85% of H. pylori–colonized individuals experience no detrimental effects. To study the mechanisms promoting host tolerance to the bacterium in the gastrointestinal mucosa and systemic regulatory effects, we investigated the dynamics of immunoregulatory mechanisms triggered by H. pylori using a high-performance computing–driven ENteric Immunity SImulator multiscale model. Immune responses were simulated by integrating an agent-based model, ordinary, and partial differential equations.

Results

The outputs were analyzed using 2 sequential stages: the first used a partial rank correlation coefficient regression–based and the second a metamodel-based global sensitivity analysis. The influential parameters screened from the first stage were selected to be varied for the second stage. The outputs from both stages were combined as a training dataset to build a spatiotemporal metamodel. The Sobol indices measured time-varying impact of input parameters during initiation, peak, and chronic phases of infection. The study identified epithelial cell proliferation and epithelial cell death as key parameters that control infection outcomes. In silico validation showed that colonization with H. pylori decreased with a decrease in epithelial cell proliferation, which was linked to regulatory macrophages and tolerogenic dendritic cells.

Conclusions

The hybrid model of H. pylori infection identified epithelial cell proliferation as a key factor for successful colonization of the gastric niche and highlighted the role of tolerogenic dendritic cells and regulatory macrophages in modulating the host responses and shaping infection outcomes.
Feeding the Australian family: challenges for mothers, nutrition and equity
Authors: Mehta Kaye , Booth Sue , Coveney John , Strazdins Lyndall
Published: June 2019

Australian women shoulder the bulk of household duties including family food provisioning, despite increasing participation in the workforce. This research aimed to understand employed mothers’ daily-lived experience of family food provisioning, in particular, the intersection between family food provisioning, gender inequality and nutritional guidelines as they impact women’s time and health. Semi-structured interviews were conducted with 22 employed mothers in South Australia. Participants had at least one child aged less than 13 years. Qualitative data was analysed using a thematic content approach. Time-scarcity was common and associated with stress in relation to family food provisioning; this relationship was particularly apparent among employed mothers who were also studying. Most mothers valued nutrition and strove to provide nutritious meals, although they tended to work from their own nutritional understandings, not the national nutrition guidelines; they saw the nutrition guidelines as unhelpful because of the time demands that were implied. The study invites policy makers, practitioners and researchers to consider time for family food provisioning as a social determinant of family as well as women’s health, and structural strategies to address this health inequity for women.
Extending the Geometric Approach for Studying Biomechanical Motions
Authors: Martinez C M , Wainwright P C
Published: June 2019

Whether it is swimming, walking, eating, or jumping, motions are a fundamental way in which organisms interact with their environment. Understanding how morphology contributes to motion is a primary focus of kinematic research and is necessary for gaining insights into the evolution of functional systems. However, an element that is largely missing from traditional analyses of motion is the spatial context in which they occur. We explore an application of geometric morphometrics (GM) for analyzing and comparing motions to evaluate the outputs of biomechanical linkage models. We focus on a common model for oral jaw mechanics of perciform fishes, the fourbar linkage, using GM to summarize motion as a trajectory of shape change. Two traits derived from trajectories capture the total kinesis generated by a linkage (trajectory length) and the kinematic asynchrony (KA) of its mobile components (trajectory nonlinearity). Oral jaw fourbar data from two subfamilies of Malagasy cichlids were used to generate form–function landscapes, describing broad features of kinematic diversity. Our results suggest that kinesis and KA have complex relationships with fourbar morphology, each displaying a pattern in which different shapes possess equivalent kinematic trait values, known as many-to-one mapping of form-to-function. Additionally, we highlight the observation that KA captures temporal differences in the activation of motion components, a feature of kinesis that has long been appreciated but was difficult to measure. The methods used here to study fourbar linkages can also be applied to more complex biomechanical models and broadly to motions of live organisms. We suggest that they provide a suitable alternative to traditional approaches for evaluating linkage function and kinematics.
Health systems’ use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions
Authors: Vest Joshua R , Unruh Mark Aaron , Freedman Seth , Simon Kosali
Published: June 2019

Objective

Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions.

Materials and Methods

The association between unplanned 30-day readmissions among adult patients and adoption of enterprise HIE or a single vendor environment was measured in a panel of 211 system-member hospitals from 2010 through 2014 using fixed-effects regression models. Sample hospitals were members of health systems in 7 states. Enterprise HIE was defined as self-reported ability to exchange information with other members of the same health system who used different EHR vendors. A single EHR vendor environment reported exchanging information with other health system members, but all using the same EHR vendor.

Results

Enterprise HIE adoption was more common among the study sample than EHR (75% vs 24%). However, adoption of a single EHR vendor environment was associated with a 0.8% reduction in the probability of a readmission within 30 days of discharge. The estimated impact of adopting an enterprise HIE strategy on readmissions was smaller and not statically significant.

Conclusion

Reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggests that HIE technologies can better support the aim of higher quality care. Additionally, health systems may benefit more from a single vendor environment approach than attempting to foster exchange across multiple EHR vendors.
Perceptual Range, Targeting Ability, and Visual Habitat Detection by Greater Fritillary Butterflies Speyeria cybele (Lepidoptera: Nymphalidae) and Speyeria atlantis
Authors: MacDonald Zachary G , Acorn John H , Zhang Jian , Nielsen Scott E
Published: June 2019

Butterflies are widely invoked as model organisms in studies of metapopulation and dispersal processes. Integral to such investigations are understandings of perceptual range; the maximum distance at which organisms are able to detect patches of suitable habitat. To infer perceptual range, researchers have released butterflies at varying distances from habitat patches and observed their subsequent flight behaviors. It is often assumed that butterflies rely on visual senses for habitat detection; however, this assumption has not been explicitly investigated. Here, we assess the extent and sensory determinants of perceptual range for the great spangled fritillary (Speyeria cybele (Fabricius, 1775)) and Atlantis fritillary (Speyeria atlantis (W.H. Edwards, 1862)). This was achieved by experimentally releasing butterflies over open water at various distances from a lake island, representing an isolated habitat patch in a dichotomous habitat-matrix landscape. To infer whether butterflies rely on vision for habitat detection, we exposed a subset of butterflies to a series of intense light flashes before release to induce flash blindness (bleaching of photoreceptive rhodopsins) without affecting olfaction. Flashed individuals were 30.1 times less likely to successfully navigate to the target island after release, suggesting butterflies rely primarily on visual senses to navigate fragmented landscapes. For unflashed butterflies, the likelihood of successful navigation decreased by a factor of 2.1 for every 10 m increase in release distance. However, no specific distance threshold for perceptual range was observed. We therefore suggest that perceptual range is best viewed as a continuum of probabilities (targeting ability), reflecting the likelihood of habitat detection across a range of distances.
Scrotal Dartos-Fascio-Myo-Cutaneous flaps for penis reconstruction after iatrogenic skin shaft sub-amputation
Authors: Moussa Mohamad , Abou Chakra Mohamed
Published: June 2019

Penile amputation is an uncommon genital injury, the causes of penile trauma are varied; it can be iatrogenic or caused by traffic accidents, burns, circumcision, animal bites, gunshots or self‐mutilation. The type and extent of penile trauma vary from mild to severe injuries, sometimes even with total amputation. A wide variety of surgical options exist for penile reconstruction. Often, not only the surgical but also psychological aspects of treatment will determine the success or failure of therapy. Regardless of the method of reconstruction, the goals of surgery remain the same; these include creating a functional and esthetic phallus. We present a case of 49-year-old male diabetic presented for penile reconstruction after iatrogenic skin shaft sub-amputation post penile implant surgery complications done 1 year ago in a country where technical experts for this surgery are absent. Dartos Fascio-Myo-Cutaneous Flaps for penile skin loss is used with satisfactory results.
Observable features of GW170817 kilonova afterglow
Authors: Kathirgamaraju Adithan , Giannios Dimitrios , Beniamini Paz
Published: June 2019

The neutron star merger, GW170817, was followed by an optical-infrared transient (a kilonova) which indicated that a substantial ejection of mass at trans-relativistic velocities occurred during the merger. Modelling of the kilonova is able to constrain the kinetic energy of the ejecta and its characteristic velocity but, not the high-velocity distribution of the ejecta. Yet, this distribution contains crucial information on the merger dynamics. In this work, we assume a power-law distribution of the form E(> βΓ) ∝ (βΓ)−α for the energy of the kilonova ejecta and calculate the non-thermal signatures produced by the interaction of the ejecta with the ambient gas. We find that ejecta with minimum velocity β0 ≃ 0.3 and energy E ∼ 1051 erg, as inferred from kilonova modelling, has a detectable radio, and possibly X-ray, afterglow for a broad range of parameter space. This afterglow component is expected to dominate the observed emission on a time-scale of a few years post-merger and peak around a decade later. Its light curve can be used to determine properties of the kilonova ejecta and, in particular, the ejecta velocity distribution α, the minimum velocity β0, and its total kinetic energy E. We also predict that an afterglow rebrightening, that is associated with the kilonova component, will be accompanied by a shift of the centroid of the radio source towards the initial position of the explosion.
The hidden giant: discovery of an enormous Galactic dwarf satellite in Gaia DR2
Authors: Torrealba G , Belokurov V , Koposov S E , Li T S , Walker M G , Sanders J L , Geringer-Sameth A , Zucker D B , Kuehn K , Evans N W , Dehnen W
Published: June 2019

We report the discovery of a Milky Way satellite in the constellation of Antlia. The Antlia 2 dwarf galaxy is located behind the Galactic disc at a latitude of b ∼ 11° and spans 1.26°, which corresponds to ∼2.9 kpc at its distance of 130 kpc. While similar in spatial extent to the Large Magellanic Cloud, Antlia 2 is orders of magnitude fainter at MV = −9 mag, making it by far the lowest surface brightness system known (at ∼31.9 mag arcsec−2), ∼100 times more diffuse than the so-called ultra diffuse galaxies. The satellite was identified using a combination of astrometry, photometry, and variability data from Gaia Data Release 2, and its nature confirmed with deep archival DECam imaging, which revealed a conspicuous BHB signal. We have also obtained follow-up spectroscopy using AAOmega on the AAT, identifying 159 member stars, and we used them to measure the dwarf’s systemic velocity, 290.9 ± 0.5 km s−1, its velocity dispersion, 5.7 ± 1.1 km s−1, and mean metallicity, [Fe/H] = −1.4. From these properties we conclude that Antlia 2 inhabits one of the least dense dark matter (DM) haloes probed to date. Dynamical modelling and tidal-disruption simulations suggest that a combination of a cored DM profile and strong tidal stripping may explain the observed properties of this satellite. The origin of this core may be consistent with aggressive feedback, or may even require alternatives to cold dark matter (such as ultra-light bosons).
Inquiring into the nature of the Abell 2667 brightest cluster galaxy: physical properties from MUSE
Authors: Iani E , Rodighiero G , Fritz J , Cresci G , Mancini C , Tozzi P , Rodríguez-Muñoz L , Rosati P , Caminha G B , Zanella A , Berta S , Cassata P , Concas A , Enia A , Fadda D , Franceschini A , Liu A , Mercurio A , Morselli L , Pérez-González P G , Popesso P , Sabatini G , Vernet J , van Weeren R J
Published: June 2019

Based on HST and MUSE data, we probe the stellar and gas properties (i.e. kinematics, stellar mass, star formation rate) of the radio-loud brightest cluster galaxy (BCG) located at the centre of the X-ray-luminous cool-core cluster Abell 2667 (z = 0.2343). The bi-dimensional modelling of the BCG surface brightness profile reveals the presence of a complex system of substructures extending all around the galaxy. Clumps of different size and shape plunged into a more diffuse component constitute these substructures, whose intense ‘blue’ optical colour hints at the presence of a young stellar population. Our results depict the BCG as a massive (M⋆ ≃ 1.38 × 1011 M⊙) dispersion-supported spheroid (Δv⋆ ≤ 150 km s−1, σ0 ∼ 216 km s−1) hosting an active supermassive black hole (MSMBH ≃ 3.8 × 109 M⊙) whose optical features are typical of low-ionization nuclear emission line regions. Although the velocity pattern of the stars in the BCG is irregular, the stellar kinematics in the regions of the clumps show a positive velocity of ∼100 km s−1, similarly to the gas component. An analysis of the mechanism giving rise to the observed lines in the clumps through empirical diagnostic diagrams points out that the emission is composite, suggesting contribution from both star formation and an active galactic nucleus. We conclude our analysis describing how scenarios of both chaotic cold accretion and merging with a gas-rich disc galaxy can efficaciously explain the phenomena the BCG is undergoing.
Adrenal adaptation in potassium-depleted men: role of progesterone?
Authors: Blanchard Anne , Brailly Tabard Sylvie , Lamaziere Antonin , Bergerot Damien , Zhygalina Valentina , Lorthioir Aurélien , Jacques Antoine , Hourton Delphine , Azizi Michel , Crambert Gilles
Published: June 2019

Background

In rodents, the stimulation of adrenal progesterone is necessary for renal adaptation under potassium depletion. Here, we sought to determine the role of progesterone in adrenal adaptation in potassium-depleted healthy human volunteers and compared our findings with data collected in patients with Gitelman syndrome (GS), a salt-losing tubulopathy.

Methods

Twelve healthy young men were given a potassium-depleted diet for 7 days at a tertiary referral medical centre (NCT02297048). We measured by liquid chromatography coupled to tandem mass spectroscopy plasma steroid concentrations at Days 0 and 7 before and 30 min after treatment with tetracosactide. We compared these data with data collected in 10 GS patients submitted to tetracosactide test.

Results

The potassium-depleted diet decreased plasma potassium in healthy subjects by 0.3 ± 0.1 mmol/L, decreased plasma aldosterone concentration by 50% (P = 0.0332) and increased plasma 17-hydroxypregnenolone concentration by 45% (P = 0.0232) without affecting other steroids. CYP17 activity, as assessed by 17-hydroxypregnenolone/pregnenolone ratio, increased by 60% (P = 0.0389). As compared with healthy subjects, GS patients had 3-fold higher plasma concentrations of aldosterone, 11-deoxycortisol (+30%) and delta 4-androstenedione (+14%). Their post-tetracosactide progesterone concentration was 2-fold higher than that of healthy subjects and better correlated to plasma potassium than to plasma renin.

Conclusion

The increase in 17-hydroxypregnenolone concentration after mild potassium depletion in otherwise healthy human subjects suggests that 17 hydroxylation of pregnenolone prevents the increase in progesterone observed in potassium-depleted mice. The unexpected over-response of non-mineralocorticoid steroids to tetracosactide in GS subjects suggests that the adrenal system not only adapts to sodium depletion but may also respond to hypokalaemia.
A Bibliometric Analysis of Neurosurgical Practice Guidelines
Authors: Lepard Jacob R , Walters Beverly C
Published: June 2019

BACKGROUND

In the last 20 yr, the rate of neurosurgical guideline publication has increased. However, despite the higher volume and increasing emphasis on quality there remains no reliable means of measuring the overall impact of clinical practice guidelines (CPGs).

OBJECTIVE

To utilize citation analysis to evaluate the dispersion of neurosurgical CPGs.

METHODS

A list of neurosurgical guidelines was compiled by performing electronic searches using the Scopus (Elsevier, Amsterdam, Netherlands) and National Guideline Clearinghouse databases. The Scopus database was queried to obtain current publication and citation data for all included documents and categorized based upon recognized neurosurgical specialties. The h-index, R-index, h2
-index, i10-index, and dissemination index (D-Index) were manually calculated for each subspecialty.

RESULTS

After applying screening criteria the search yielded 372 neurosurgical CPGs, which were included for bibliometric analysis. The overall calculated h-index for neurosurgery was 56. When broken down by subspecialty trauma/critical care had the highest value at 35, followed by spine and peripheral nerve at 30, cerebrovascular at 28, tumor at 16, pediatrics at 14, miscellaneous at 11, and functional/stereotactic/pain at 6. Cerebrovascular neurosurgery was noted to have the highest D-Index at 3.4.

CONCLUSION

A comprehensive framework is useful for guideline impact analysis. Bibliometric data provides a novel and adequate means of evaluating the successful dissemination of neurosurgical guidelines. There remains a paucity of data regarding implementation and clinical outcomes of individual guidelines.
The Law Commissions: Constitutional Arrangements and the Rule of Law†
Authors: Kenny Susan
Published: June 2019

This review article considers two publications concerning the Law Commissions created under the Law Commissions Act 1965: Fifty Years of the Law Commissions: The Dynamics of Law Reform, a collection of essays edited by Dyson, Lee and Wilson Stark, and Wilson Stark’s monograph, The Work of the British Law Commissions: Law Reform … Now? The writers demonstrate how the Commissions’ law reform work has made a unique contribution to the improved operation of the legal system and how they must continue to adapt to changes in the constitutional arrangements within which they discharge their statutory duties. The review article focuses on key issues identified in Wilson Stark’s separate study—codification, project selection and legislative implementation, and the scope of judicial law reform. Attention is also drawn to the need for the Commissions to have effective capacity to discharge their rule of law function by promoting fair, intelligible, accessible and up-to-date law.
Chasing after flavor symmetries of quarks from the bottom up
Authors: Kawamura Yoshiharu
Published: June 2019

We explore a flavor structure of quarks in the standard model under the assumption that flavor symmetries exist in a theory beyond the standard model, and seek their properties, using a bottom-up approach. We reacknowledge that a flavor-symmetric part of the Yukawa coupling matrix can be realized by a rank-one matrix, and a democratic-type matrix occupies a special position, based on Dirac’s naturalness.
Best teaching practices in the first year of the pilot implementation of the project DrIVE-MATH
Authors: Pinto Carla , Nicola Susana , Mendonça Jorge , Velichová Daniela
Published: June 2019

The Fourth Industrial Revolution era has arrived, according to the World Economic Forum. Everything is changing (viz., artificial intelligence, automation, intelligent robots, self-driving cars and genetic editing) and exciting opportunities accompanied with major challenges come to the surface. On the other hand, major difficulties may also rise, namely technological unemployment and poverty. How can governments, educators and parents prepare the present and future generations to thrive in this increasingly changing world? What is the Education of the Fourth Industrial Revolution age? The education of the new era must transform itself to be able to provide students with the scientific and soft skills needed in the 21st century. Students must actively apply and update their knowledge, must be critical thinkers, problem solvers, curious, imaginative, collaborative, communicators. As Alvin Toffler says in his book Future Shock (1970) ‘The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.’ DrIVE-MATH—Development of Innovative Mathematical Teaching Strategies in European Engineering Degrees’ virtual team was designed to develop a novel and integrated framework to teach math classes in engineering courses, at the university level. Its major goal is to apply novel teaching methodologies to teach math courses to future engineers. DrIVE-MATH emerged from the need to prepare and develop essential competences in engineering students, key to their success in the rapidly changing and dynamic workplace. The teachers involved in the project strongly believe that the implemented active-learning methodologies provide better scientific and soft skills support to the future engineers. In this paper, we present the results of the first year (pilot) implementation of the project DrIVE-MATH at the School of Engineering of the Polytechnic of Porto.
A Symbiotic Virus Facilitates Aphid Adaptation to Host Plants by Suppressing Jasmonic Acid Responses
Authors: Lu Hong , Zhu Junjie , Yu Jinting , Chen Xiaofang , Kang Le , Cui Feng
Published: June 2019

Symbiotic viruses exist in many insects; however, their functions in host insects are not well understood. In this study, we explored the role of acyrthosiphon pisum virus (APV) in the interaction of its host aphid Acyrthosiphon pisum with plants. APV is primarily located in aphid salivary glands and gut and propagated in the insect. APV is horizontally transmitted to host plants during aphid feeding, but the virus does not replicate in the host plant. When the pea host race of aphids colonized two low-fitness plants, Medicago truncatula and Vicia villosa, the virus titers in both the aphids and plants significantly increased. Furthermore, APV infection strongly promoted the survival rate of the pea host race on V. villosa. Transcriptomic analysis showed that only 0.85% of aphid genes responded to APV infection when aphids fed on V. villosa, with a fold change in transcript levels of no more than fourfold. The improved survival due to APV infection was apparently related to the inhibitory effect of the virus on levels of phytohormone jasmonic acid (JA) and JA-isoleucine. Our data suggest a benefit of the symbiotic virus to its aphid host and demonstrate a novel case of symbiotic virus-mediated three-species interaction.
Can Copper Be Used to Treat FoliarPhytophthoraInfections inPinus radiata?
Authors: Rolando Carol , Somchit Chanatda , Bader Martin K-F. , Fraser Stuart , Williams Nari
Published: June 2019

Red needle cast is a significant foliar disease of commercial stands of Pinus radiata caused by Phytophthora pluvialis in New Zealand. The effect of copper, applied as a foliar spray of cuprous oxide at a range of doses between 0 and 1.72 kg ha−1, was investigated in two controlled trials with potted plants and in an operational trial with mature P. radiata. In all trials, lesions formed on needles after artificial exposure to the infecting propagules (zoospores) of P. pluvialis were used to determine treatment efficacy, with the number and/or length of lesions as the dependent variable. Results across all trials indicated that cuprous oxide was highly effective at reducing infection of P. radiata with P. pluvialis. Application rates equivalent to ≥0.65 kg ha−1significantly reduced infection levels relative to a control treatment, with foliar surface copper levels as low as 13 to 26 mg kg−1of needle tissue preventing infection. Greater copper content was associated with a reduction in the proportion of needles with P. pluvialis lesions, with the probability of lesions developing decreasing approximately 1% for every 1 unit (in milligrams per kilogram) increase in copper content. Over a 90-day period, surface copper content declined to 30% of that originally applied, indicating an approximate period of treatment efficacy of 3 months. Our findings highlight the potential of cuprous oxide for the control of red needle cast in P. radiata stands. Further information about the optimal field dose, timing, and the frequency of foliar cuprous oxide application is key to prevent infection and also reduce the build up of inoculum during severe outbreaks of this pathogen.
Simulation to Predict Effect of Citywide Events on Emergency Department Operations
Authors: Ferraro Nicole M. , Day Theodore Eugene
Published: June 2019

Medical emergency preparedness has been an issue of medical relevance since the advent of hospital care. Studies have simulated emergency department (ED) overcrowding but not yet characterized effects of large-scale, planned events that drastically alter a city’s demography, such as in Philadelphia, Pennsylvania during the 2015 World Meeting of Families. A discrete event simulation of the ED at the Children’s Hospital of Philadelphia was designed and validated using past data. The model was used to predict the patient length of stay (LOS) and number of admitted patients if the arrival stream to the ED were to change by 50% from typical arrivals in either direction. We compared the model’s estimations with data produced during the papal visit that had 39.65% fewer patient arrivals. For validation, the simulated mean LOS was 226.1 ± 173.3 minutes (mean ± SD) for all patients and 352.1 ± 170.3 minutes for admitted patients. Real-world mean LOSs for the fiscal year 2014 were 230.6 ± 134.8 for all patients and 345.0 ± 147.7 for admitted patients. For the estimation of the World Meeting of Families, the simulation accurately estimated the LOS of both patients overall and admitted patients within 10%. These results show that it is possible to use simulations to project the patient flow effects in EDs in case of large-scale events. Providing efficient care is essential to emergency operations, and projections of demand are crucial for targeting appropriate changes during large-scale events. Analysis of validated computer simulations allows for evidence-based decision making in a complex clinical environment.
Impact of a Pressure Injury Prevention Bundle in the Solutions for Patient Safety Network
Authors: Frank Gary , Walsh Kathleen E. , Wooton Sharyl , Bost Jim , Dong Wei , Keller Leah , Miller Michelle , Zieker Karen , Brilli Richard J.
Published: June 2019

Background:

Our objective was to describe changes in pressure injury (PI) rates in pediatric hospitals after implementation of an active surveillance and prevention bundle and to assess the impact of bundle elements.

Methods:

The Children’s Hospitals Solutions for Patient Safety (SPS) Network is a learning collaborative working together to eliminate harm to hospitalized children. SPS used a 3-pronged approach to prevent pressure injuries: (1) active surveillance, (2) implementing and measuring compliance with the prevention bundle, and (3) deploying a wound ostomy team. Among hospitals participating since 2011 (phase 1), we used negative binomial analyses to assess change in PI rates. Only phase 1 hospitals had a baseline period before any prevention bundle intervention. Among all hospitals participating in 2013 (phases 1 and 2), we used funnel charts to assess the association between reliable bundle implementation and PI rates.

Results:

Among the 33 hospitals that participated in SPS from 2011 to 2013 (phase 1), the rate of stage 3 pressure injuries declined from 0.06 to 0.03 per 1,000 patient-days (P < 0.001). Stage 4 pressure injuries declined from 0.01 to 0.004 per 1,000 patient-days (P = 0.02). Among all 78 hospitals in phases 1 and 2, the cohort that adopted each bundle element, measured compliance, and achieved 80% prevention bundle compliance had significantly lower PI rates compared with all hospitals.

Conclusions:

SPS hospitals saw a significant reduction in stage 3 and 4 PIs over a 2-year period. Reliable implementation of each element of a prevention bundle was associated with lower PI rates.
Variation in Gentamicin Dosing and Monitoring in Pediatric Units across New South Wales
Authors: Saddi Vishal , Preddy John , Dalton Sarah , Connors John , Patterson Sarah
Published: June 2019

Introduction:

Gentamicin is an aminoglycoside antibiotic with broad-spectrum bactericidal activity and is widely used in pediatric units to treat infection with susceptible organisms. This study aimed to describe the dosage regimen for gentamicin and approach to its therapeutic drug monitoring (TDM) among the pediatric units within the state of New South Wales (NSW).

Methods:

A questionnaire was sent electronically to representatives of 40 pediatric units in NSW, requesting details of each unit’s gentamicin dosing and TDM policy.

Results:

A total of 35 units responded to the survey. The majority (63%) of the units used a dose of 7.5 mg/kg of gentamicin in patients with normal renal function. More than half of the units (54%) did not have a local gentamicin dosing protocol and relied on other sources for dosing regimens. Dosing responses varied from a dose of 6 mg/kg once daily for patients more than 10 years of age to 7 mg/kg once daily on day 1, followed by 5 mg/kg once daily for patients over 10 years of age. For TDM of gentamicin, 63% of units indicated use of trough levels and 23% units used the Hartford Nomogram.

Conclusions:

A significant variation exists in clinical practice among pediatric units in NSW on gentamicin dosing and TDM guidelines. There is an urgent need for collaboration among nursing, medical, and pharmacy experts to achieve consensus to develop and adopt statewide uniform guidelines on gentamicin dosing and TDM.
Improving Apparent Cause Analysis Reliability: A Quality Improvement Initiative
Authors: Crandall Kristen M. , Sten May-Britt , Almuhanna Ahmed , Fahey Lisbeth , Shah Rahul K.
Published: June 2019

Introduction:

Apparent cause analysis (ACA) is a process in quality improvement used to examine events. A baseline assessment of completed ACAs at a tertiary care free-standing pediatric academic hospital revealed they were ineffective due to low-quality analysis, unreliable action plans, and poor spread, leading to error recurrence. The goal of this project was to increase ACA action plan reliability scores while maintaining or decreasing turnaround time.

Methods:

The Model for Improvement served as the framework for this quality improvement initiative. We developed a key driver diagram, established measures, tested interventions using plan- do-study-act cycles, and implemented the effective interventions. To measure reliability, we created a high reliability toolkit that links each action item/intervention to a level of reliability and scored each ACA action plan to determine overall reliability score. Action plans scored as low level of reliability required revision before implementation.

Results:

Average ACA action plan reliability scores increased from 86.4% to 96.1%. ACA turnaround time decreased from a baseline of 13 days to 8.6 days. Stakeholders reported a subjective increase in satisfaction with the revamped ACA process.

Conclusions:

Incorporating high reliability principles into ACA action plan development increased the effectiveness of ACA while decreasing turnaround time. The high reliability toolkit was instrumental in providing an organizational resource for approaching this subset of cause analyses. The toolkit provides a way for safety/quality leaders to connect with stakeholders to design highly reliable solutions that improve safety for patients, families, and staff.