bluuebunny/crossref_metadata_2025 huggingface dataset:
Cosmic ray feedback in the FIRE simulations: constraining cosmic ray propagation with GeV γ-ray emission
Authors: Chan T K , Kereš D , Hopkins P F , Quataert E , Su K-Y , Hayward C C , Faucher-Giguère C-A
Published: July 2019

We present the implementation and the first results of cosmic ray (CR) feedback in the Feedback In Realistic Environments (FIRE) simulations. We investigate CR feedback in non-cosmological simulations of dwarf, sub-L⋆ starburst, and L⋆ galaxies with different propagation models, including advection, isotropic, and anisotropic diffusion, and streaming along field lines with different transport coefficients. We simulate CR diffusion and streaming simultaneously in galaxies with high resolution, using a two-moment method. We forward-model and compare to observations of γ-ray emission from nearby and starburst galaxies. We reproduce the γ-ray observations of dwarf and L⋆ galaxies with constant isotropic diffusion coefficient $\kappa \sim 3\times 10^{29}\, {\rm cm^{2}\, s^{-1}}$. Advection-only and streaming-only models produce order of magnitude too large γ-ray luminosities in dwarf and L⋆ galaxies. We show that in models that match the γ-ray observations, most CRs escape low-gas-density galaxies (e.g. dwarfs) before significant collisional losses, while starburst galaxies are CR proton calorimeters. While adiabatic losses can be significant, they occur only after CRs escape galaxies, so they are only of secondary importance for γ-ray emissivities. Models where CRs are ‘trapped’ in the star-forming disc have lower star formation efficiency, but these models are ruled out by γ-ray observations. For models with constant κ that match the γ-ray observations, CRs form extended haloes with scale heights of several kpc to several tens of kpc.
Current Low-Cost Video-Based Motion Analysis Options for Clinical Rehabilitation: A Systematic Review
Authors: Parks Melissa T , Wang Zhuo , Siu Ka-Chun
Published: July 2019

Background

Physical therapists, as clinical human movement experts, must qualitatively evaluate patients’ functional and biomechanical impairments. There are now low-cost 2- and 3-dimensional video measurement systems that can be used to increase the precision and reliability of these qualitative clinical assessments.

Purpose

The purpose of this study was to systematically review current low-cost video-based methods for motion analysis compared with gold-standard 3-dimensional biomechanical methods.

Data Sources

Electronic searches were conducted until January 2018 within the following databases: MEDLINE via PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Scopus, and the Institute of Electrical and Electronics Engineers.

Study Selection

Studies designed to evaluate criterion-referenced validity and/or reliability of video-based motion analysis technologies within the last 20 years were included. English-language articles dealing with human rehabilitation were considered.

Data Extraction

Data extraction was independently completed by 3 reviewers, and methodological quality was assessed using the 2018 Consensus-Based Standards for the Selection of Health Measurement Instruments checklist. Articles were organized for analysis on the basis of type of motion analyzed and category of each low-cost technology used.

Data Synthesis

With 20 articles meeting selection criteria, 10 low-cost motion analysis platforms were presented, each examining different functional movement-dependent variables. Overall article quality was “low” or “very low” on the basis of Consensus-Based Standards for the Selection of Health Measurement Instruments scoring. Correlations between low-cost and 3-dimensional gold standard systems ranged widely from “poor” agreement (r = 0.025) to “strong” agreement (r = 0.992). Spatiotemporal gait parameters consistently outperformed planar joint angle data. Reliability was better measured than concurrent validity. A summary table was developed to assist clinicians in choosing which motions could potentially be measured accurately by each low-cost platform on the basis of current findings.

Limitations

Databases available to researchers were more clinical/medical in nature, and this review was written from that clinically based perspective. Lack of standardized protocols and methodology within included studies was common, making generalizability difficult.

Conclusions

Research attempting to validate newer low-cost movement analysis systems is limited in quality. Measurement of only certain variables should be considered when these tools are used. Further research is warranted, because these devices still have potential clinical utility for supplementing qualitative movement assessment with objective outcome measures.
A hard-earned draw: phylogeny-based revision of the deep-sea shrimp Bentheogennema (Decapoda: Benthesicymidae) transfers two species to other genera and reveals two new species
Authors: Lunina Anastasia A , Kulagin Dmitry N , Vereshchaka Alexander L
Published: July 2019

The phylogenetic study of the deep-sea genus Bentheogennema is based on four molecular markers and 79 morphological characters. All four previously recognized species and two new species of Bentheogennema, representatives of all other genera and species groups of Benthesicymidae, and three outgroups were included in the analyses. We have examined and coded six major groups of morphological characters related to the carapace (three characters), the pleon and the telson (14), the mouthparts (nine), the armature of the pereopods (five), the thelycum (27) and the petasma (21). Results of morphological and molecular analyses were similar. Two species were transferred from Bentheogennema to other genera (for one of them a new genus was erected) and two new species of Bentheogennema were described. Three pelagic genera (Gennadas, Bentheogennema and a new genus) created a robust clade. The divergence of this clade is linked to ‘smoothening’ of the body (reduction of the branchiostegal spine on the carapace, reduction and loss of the dorsolateral spines and the end-piece on the telson) and elaboration of the copulatory structures. We provide amended diagnoses of these three pelagic genera and key to species of Bentheogennema.
Prevalence of Acidovorax citrulli in Commercial Cucurbit Seedlots During 2010–2018 in China
Authors: Tian Yanli , Zhao Yuqiang , Zhou Jiaju , Sun Ting , Luo Xue , Kurowski Chet , Gong Weirong , Hu Baishi , Walcott Ron R.
Published: July 2019

Acidovorax citrulli is the causal agent of bacterial fruit blotch (BFB), a serious threat to cucurbit fruit and seed production worldwide. In recent years, the BFB has spread to many areas of China, mainly via the inadvertent distribution of contaminated commercial seeds. To assess the prevalence of seedborne A. citrulli in commercial watermelon and other cucurbitaceous seedlots in China, a 9-year survey was conducted between 2010 and 2018. A total of 4,839 seedlots of watermelon and other cucurbitaceous species were collected from 13 major seed production areas of China and tested by a semiselective media-based colony PCR technique for A. citrulli. Overall, A. citrulli was detected in 18.00% (871/4,839) of all cucurbitaceous seedlots. The bacterium was detected in 21.59% (38/176), 19.19% (33/172), 23.44% (214/913), 40.76% (247/606), 13.28% (85/640), 15.40% (95/617), 13.25% (73/551), 8.03% (48/598), and 6.71% (38/566) of all commercial seedlots tested from the 2010, 2011, 2012, 2013, 2014, 2015, 2016, 2017, and 2018 growing seasons, respectively. Additionally, the prevalence of A. citrulli in cucurbit seedlots was determined for different seed production areas. The prevalence of A. citrulli in cucurbitaceous seedlots produced in Xinjiang, Gansu, Ningxia, Inner Mongolia, and 9 other provinces was 18.76% (582/3103), 26.34% (103/391), 21.47% (82/382), 11.11% (14/126), and 10.75% (90/837), respectively. This is the first survey for A. citrulli in commercial cucurbit seeds in China, and the relatively high prevalence suggests that commercial seeds represent a substantial source of primary inoculum that can threaten cucurbit seed and fruit production in China.
Emergence of Stemphylium Leaf Blight of Onion in New York Associated With Fungicide Resistance
Authors: Hay Frank S. , Sharma Sandeep , Hoepting Christy , Strickland David , Luong Karen , Pethybridge Sarah J.
Published: July 2019

A complex of foliar diseases affects onion production in New York, including Botrytis leaf blight (Botrytis squamosa), purple blotch (Alternaria porri), Stemphylium leaf blight (SLB; Stemphylium vesicarium), and downy mildew (Peronospora destructor). Surveys were conducted in 2015 and 2016 to evaluate the cause of severe premature foliar dieback in New York onion fields. SLB was the most prevalent disease among fields with the greatest incidence, surpassing downy mildew, purple blotch, and Botrytis leaf blight. Sequencing of the internal transcribed spacer region of ribosomal DNA and the glyceraldedyhe-3-phosphate dehydrogenase and calmodulin genes identified S. vesicarium as the species most commonly associated with SLB. S. vesicarium was typically associated with a broad range of necrotic symptoms but, most commonly, dieback of leaf tips and asymmetric lesions that often extended over the entire leaf. Because of the intensive use of fungicides for foliar disease control in onion crops in New York, the sensitivity of S. vesicarium populations to various fungicides with site-specific modes of action was evaluated. Sensitivity of S. vesicarium isolates collected in 2016 to the quinone outside inhibitor (QoI) fungicide, azoxystrobin, was tested using a conidial germination assay. Isolates representing a broad range of QoI sensitivities were selected for sequencing of the cytochrome b gene to evaluate the presence of point mutations associated with insensitivity to azoxystrobin. The G143A mutation was detected in all 74 S. vesicarium isolates with an azoxystrobin-insensitive phenotype (effective concentrations reducing conidial germination by 50%, EC50 = 0.2 to 46.7 µg of active ingredient [a.i.]/ml) and was not detected in all 31 isolates with an azoxystrobin-sensitive phenotype (EC50 = 0.01 to 0.16 µg a.i./ml). The G143A mutation was also associated with insensitivity to another QoI fungicide, pyraclostrobin. Sensitivity to other selected fungicides commonly used in onion production in New York was evaluated using a mycelial growth assay and identified isolates with insensitivity to boscalid, cyprodinil, and pyrimethanil, but not difenoconazole. The frequency of isolates sensitive to iprodione, fluxapyroxad, and fluopyram was high (93.5 to 93.6%). This article discusses the emergence of SLB as dominant in the foliar disease complex affecting onion in New York and the complexities of management posed by resistance to fungicides with different modes of action.
Serum Concentrations and Pharmacokinetics of Tranexamic Acid after Two Means of Topical Administration in Massive Weight Loss Skin-Reducing Surgery
Authors: Ausen Kjersti , Pleym Hilde , Liu Jiayin , Hegstad Solfrid , Nordgård Håvard Bersås , Pavlovic Ivan , Spigset Olav
Published: July 2019

Background:

Topical administration of tranexamic acid to reduce bleeding is receiving increasing attention, as it is inexpensive, simple, and possibly beneficial in most surgery. Concerns regarding potential systemic adverse effects such as thromboembolic events and seizures may prevent general use of tranexamic acid. Although serum concentrations after topical application are assumed to be low, proper pharmacokinetic studies of tranexamic acid after topical application are lacking.

Methods:

The authors have investigated systemic absorption of tranexamic acid after two means of topical administration in patients undergoing abdominoplasty after massive weight loss: a bolus of 200 ml of 5 mg/ml into the wound cavity versus moistening the wound surface with 20 ml of 25 mg/ml. Twelve patients were recruited in each group. Serum concentrations achieved were compared with those after administration of 1 g as an intravenous bolus to arthroplasty patients. Serial blood samples for tranexamic acid analysis were obtained for up to 24 hours.

Results:

After intravenous administration, the peak serum concentration was 66.1 ± 13.0 µg/ml after 6 ± 2 minutes. Peak serum concentration after topical moistening was 5.2 ± 2.6 µg/ml after 80 ± 33 minutes, and in the topical bolus group, it was 4.9 ± 1.8 µg/ml after 359 ± 70 minutes. Topical moistening resulted in homogenous and predictable absorption across the individuals included, whereas topical bolus administration caused variable and unpredictable serum concentrations.

Conclusion:

Topical administration of tranexamic acid in patients undergoing abdominoplasty results in low serum concentrations, which are highly unlikely to cause systemic effects.
Supercharged Jejunal Interposition: A Reliable Esophageal Replacement in Pediatric Patients
Authors: Firriolo Joseph M. , Nuzzi Laura C. , Ganske Ingrid M. , Hamilton Thomas E. , Smithers C. Jason , Ganor Oren , Upton Joseph , Taghinia Amir H. , Jennings Russell W. , Labow Brian I.
Published: July 2019

Background:

There is no consensus for esophageal reconstruction in the pediatric population. Long defects are commonly repaired with gastric pull-up or colonic interposition; however, jejunal interposition offers several potential advantages in children. One historical concern with jejunal interposition has been the risk of flap infarction following transposition. The use of neck and intrathoracic vessels to “supercharge” the jejunum has been reported in adults. This study reports outcomes of supercharged jejunal interposition in pediatric and young adult patients with long esophageal defects.

Methods:

The authors reviewed the medical records of patients who underwent supercharged jejunal interposition for esophageal reconstruction at their institution from 2013 to 2017. The authors collected data pertaining to patient characteristics, operative technique, and postoperative outcomes.

Results:

Twenty patients, 10 female and 10 male, aged 1.4 to 23.8 years, underwent esophageal reconstruction with supercharged jejunal interposition and were followed for a median of 1.4 years. Seventeen patients had a primary diagnosis of long-gap esophageal atresia, and three required reconstruction following caustic ingestion. Eighty percent of patients had undergone prior attempts at surgical reconstruction. Postoperatively, all conduits demonstrated coordinated peristalsis, and no flap losses were noted. Major complications occurred in seven patients, stricture dilation was performed in four patients, and there was no mortality.

Conclusions:

Jejunal interposition with supercharging can be safely performed for management of long esophageal gaps in the pediatric setting; it is useful where the stomach or colon has been used previously or is unavailable. Long-term outcome studies are required to determine whether jejunal interposition provides a more durable and safe conduit than gastric pull-up or colonic interposition over time.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Factors influencing people’s continuous watching intention and consumption intention in live streaming
Authors: Hou Fangfang , Guan Zhengzhi , Li Boying , Chong Alain Yee Loong
Published: July 2019

Purpose

The purpose of this paper is to investigate what factors can affect people’s continuous watching and consumption intentions in live streaming.

Design/methodology/approach

This research conducted a mixed-methods study. The semi-structured interview was deployed to develop a research model and a live streaming typology. A survey was then used for quantitative assessment of the research model. Survey data were analyzed using partial least squares-structural equation modeling.

Findings

The results suggest that sex and humor appeals, social status display and interactivity play considerable roles in the viewer’s behavioral intentions in live streaming and their effects vary across different live streaming types.

Research limitations/implications

This research is conducted in the Chinese context. Future research can test the research model in other cultural contexts. This study can also be extended by incorporating the roles of viewer gender and price sensitivity in the future.

Practical implications

This study provides managerial insights into how live streaming platforms and streamers can improve their popularity and profitability.

Originality/value

The paper introduces a novel form of social media and a new business model. It illustrates what will affect people’s behavioral intentions in such a new context.
The sex‐determination pattern in crocodilians: A systematic review of three decades of research
Authors: González Edgar J. , Martínez‐López Marcela , Morales‐Garduza Marco Antonio , García‐Morales Rodrigo , Charruau Pierre , Gallardo‐Cruz José Alberto
Published: July 2019

Sex in crocodilians is not determined by chromosomes, but by egg incubation temperature, where different temperatures produce different clutch sex ratios. Two patterns have been proposed to describe these changes in sex ratios: a 100% female proportion at low and high temperatures with male predominance at intermediate ones (FMF) or a simpler pattern with a single female‐to‐male transition (FM). Over the last three decades, researchers have provided empirical information to support either of these two patterns in different species; however, no consensus has been reached partly because data have not been analysed as a whole.

Here, we aimed at gathering the existing data on these patterns to provide models of temperature‐dependent sex determination in those crocodilians studied so far.

Potentially relevant publications were searched on Web of Knowledge, Scopus, Scielo and Science Direct. Studies that reported results on the sexual identity of crocodilian hatchlings obtained from constant temperature incubation treatments were considered. Using statistical models varying in their underlying assumptions, we evaluated which sex‐determination pattern was best supported for the studied crocodilians and constructed species‐specific and latitude‐specific models.

Based on the 8,458 sexed hatchlings studied throughout 31 studies, we show that the evidence supports a shared FMF pattern in all the crocodilian species for which enough data are available. We find that such pattern changes between species and at different latitudes.

These results suggest a lability of the FMF crocodilian sex‐determination pattern, a key feature under the present climate change scenario.
Evaluation of habitat use and ecological carrying capacity for the reintroduced Eastern black rhinoceros (Diceros bicornis michaeli) in Ruma National Park, Kenya
Authors: Oginah Susan Anyango , Ang’ienda Paul O. , Onyango Patrick O.
Published: July 2019

We carried out a postrelease evaluation to determine predictors of habitat use and carrying capacity for the black rhinoceros (Diceros bicornis michaeli), which are critical for monitoring how the Ruma National Park sub‐population may contribute to Kenya's meta‐population strategy. We determined whether level of elevation, rockiness, shade, distance to fence, roads, and human settlements predict habitat use, differences in habitat and diet preference between female and male black rhinoceros, and the ecological carrying capacity (CC) of black rhinoceros in the park. We used standard ecological methods to collect data on predictors of habitat use, habitat preference and to estimate CC. Results show, first, that none of the environmental and anthropogenic factors evaluated predicted habitat use by black rhinoceros in the park. Second, although there was no significant difference in habitat preference between the sexes (U = 16.50,p = 0.306), there was a 60% difference in Jaccard's dissimilarity in diet selection between the sexes. Third, the park can support 65 black rhinoceros. Altogether, the findings suggest that the park has potential to support other sub‐populations in Kenya. We recommend that future similar studies should incorporate population viability analysis and a community‐based approach to forecast the species health and extinction risk.
Significant reduction in heart rate variability is a feature of acute decompensation of cirrhosis and predicts 90‐day mortality
Authors: Jansen Christian , Chatterjee Devnandan Amor , Thomsen Karen Louise , Al‐Kassou Baravan , Sawhney Rohit , Jones Helen , Gallego‐Leon Angela , Lehmann Jennifer , Pohlmann Alessandra , Nickenig Georg , Strassburg Christian P. , Andrié René , Jalan Rajiv , Linhart Markus , Trebicka Jonel , Mookerjee Rajeshwar P.
Published: July 2019

Background

Heart rate variability (HRV) is reduced in cirrhosis and in conditions of systemic inflammation. Whether HRV is associated with cirrhosis decompensation and development of acute‐on‐chronic liver failure (ACLF) is unknown.

Aims

To (a) validate wireless remote HRV monitoring in cirrhosis decompensation; (b) determine if severely reduced HRV is a surrogate for inflammation and progression of cirrhosis decompensation; (c) assess if measuring HRV determines prognosis in cirrhosis decompensation.

Methods

One hundred and eleven patients at risk of cirrhosis decompensation at two clinical sites were monitored for HRV. Standard deviation of all normal beat‐beat intervals (SDNN) reflecting HRV was assessed using remote monitoring (Isansys Lifetouch) and/or Holter ECG recording. Clinical outcomes and major prognostic scores were recorded during 90‐day follow‐up.

Results

Reduced HRV denoted by lower baseline SDNN, correlated with severity of decompensation (median 14 (IQR 11‐23) vs 33 (25‐42); P < 0.001, decompensated patients vs stable outpatient cirrhosis). Furthermore, SDNN was significantly lower in patients developing ACLF compared to those with only decompensation (median 10 (IQR9‐12) vs 16 (11‐24); P = 0.02), and correlated inversely with MELD and Child‐Pugh scores, and C‐reactive protein (all P < 0.0001) and white cell count (P < 0.001). SDNN predicted disease progression on repeat measures and appeared an independent predictor of 90‐day mortality (12 patients). An SDNN cut‐off of 13.25 ms had a 98% negative predictive value.

Conclusions

This study demonstrates that remote wireless HRV monitoring identifies cirrhosis patients at high risk of developing ACLF and death, and suggests such monitoring might guide the need for early intervention in such patients. Clinical Trial number: NIHR clinical research network CPMS ID 4949.
Psychosis screening in schools: Considerations and implementation strategies
Authors: Meyer Monet S. , Rosenthal Adi , Bolden Khalima A. , Loewy Rachel L. , Savill Mark , Shim Ruth , Rodriguez Jacqueline , Flores Victoria , Pavao Earl , Niendam Tara A.
Published: July 2019

Aim

Duration of untreated psychosis, or the time between onset of psychosis symptoms and accurate diagnosis and treatment, is a significant predictor of both initial treatment response and long‐term outcomes. As such, efforts to improve rapid identification are key. Because early signs of psychosis commonly emerge in adolescence, schools have the potential to play an important role in the identification of psychosis‐spectrum disorders.

Methods

To illustrate the potential role of schools in this effort, the current paper describes implementation of a psychosis screening tool as part of a larger study focused on reducing the duration of untreated psychosis in Sacramento, CA.

Results

Clinical considerations related to screening for psychosis in schools, including ethical concerns, logistics, screening population and stigma are addressed. Implementation strategies to address these concerns are suggested.

Conclusions

Early psychosis screening in the school system could improve early identification, reduce stigma and may represent an important further step towards an integrative system of mental health.
Effectiveness of agri‐environmental management on pollinators is moderated more by ecological contrast than by landscape structure or land‐use intensity
Authors: Marja Riho , Kleijn David , Tscharntke Teja , Klein Alexandra‐Maria , Frank Thomas , Batáry Péter
Published: July 2019

Agri‐environment management (AEM) started in the 1980s in Europe to mitigate biodiversity decline, but the effectiveness of AEM has been questioned. We hypothesize that this is caused by a lack of a large enough ecological contrast between AEM and non‐treated control sites. The effectiveness of AEM may be moderated by landscape structure and land‐use intensity. Here, we examined the influence of local ecological contrast, landscape structure and regional land‐use intensity on AEM effectiveness in a meta‐analysis of 62 European pollinator studies. We found that ecological contrast was most important in determining the effectiveness of AEM, but landscape structure and regional land‐use intensity played also a role. In conclusion, the most successful way to enhance AEM effectiveness for pollinators is to implement measures that result in a large ecological improvement at a local scale, which exhibit a strong contrast to conventional practices in simple landscapes of intensive land‐use regions.
Educational leadership: Producing docile bodies? A Foucauldian perspective on Higher Education
Authors: Beattie Liana
Published: July 2019

The aim of this paper is to contribute to a long‐standing critical tradition in the educational leadership literature through an analytical examination of the idiosyncrasies of leadership in Higher Education institutions (based on the UK example). It applies a postmodern way of thinking to the educational leadership phenomenon to problematise and challenge the traditional views on the trajectories of power in Higher Education institutions, utilising Foucault’s key theoretical units of discipline, governmentality and biopolitics as a toolbox for dissecting the implications of neoliberal ideology on the leadership praxes. Significantly, the paper demonstrates how the engagement with Foucault’s three modes of objectification—dividing practices, scientific classification and self‐subjection—can expose the ways, in which the roles of educational leaders become re‐configured into economic‐rational individuals or subjects, who are compliant with the imposed requisites of the government’s neoliberal agendas. The paper concludes that Foucault’s theoretical perspectives could be used as a methodological template for a deeper critical analysis of leadership practices, equipping academics with additional tools for critiquing the existing boundaries of neoliberalism and intervening in the transformation of the social order by undertaking an investigation into the practices of governmentality, as suggested by Foucault.
How patient and community involvement in diabetes research influences health outcomes: A realist review
Authors: Harris Janet , Haltbakk Johannes , Dunning Trisha , Austrheim Gunhild , Kirkevold Marit , Johnson Maxine , Graue Marit
Published: July 2019

Background

Patient and public involvement in diabetes research is an international requirement, but little is known about the relationship between the process of involvement and health outcomes.

Objective

This realist review identifies who benefits from different types of involvement across different contexts and circumstances. Search strategies Medline, CINAHL and EMBASE were searched to identify interventions using targeted, embedded or collaborative involvement to reduce risk and promote self‐management of diabetes. People at risk/with diabetes, providers and community organizations with an interest in addressing diabetes were included. There were no limitations on date, language or study type.

Data extraction and synthesis

Data were extracted from 29 projects using elements from involvement frameworks. A conceptual analysis of involvement types was used to complete the synthesis.

Main results

Projects used targeted (4), embedded (8) and collaborative (17) involvement. Productive interaction facilitated over a sufficient period of time enabled people to set priorities for research. Partnerships that committed to collaboration increased awareness of diabetes risk and mobilized people to co‐design and co‐deliver diabetes interventions. Cultural adaptation increased relevance and acceptance of the intervention because they trusted local delivery approaches. Local implementation produced high levels of recruitment and retention, which project teams associated with achieving diabetes health outcomes.

Discussion and Conclusions

Achieving understanding of community context, developing trusting relationships across sectors and developing productive partnerships were prerequisites for designing research that was feasible and locally relevant. The proportion of diabetes studies incorporating these elements is surprisingly low. Barriers to resourcing partnerships need to be systematically addressed.
TLR‐2, TLR‐4 and MyD88 genes expression in renal transplant acute and chronic rejections
Authors: Sharbafi Mohammad Hossein , Assadiasl Sara , Pour‐reza‐gholi Fatemeh , Barzegari Saeed , Mohammadi Torbati Peyman , Samavat Shiva , Nicknam Mohammad Hossein , Amirzargar Aliakbar
Published: July 2019

Background

Graft rejection due to alloreactivity is still the main obstacle to successful renal transplantation. Toll‐like receptors (TLRs), which are significantly involved in initiating inflammation, triggering innate immunity, occurrence of ischaemia reperfusion injury (IRI) and subsequent deterioration of allograft function, are of interest in molecular diagnosis of graft rejection.

Methods

In present research, we have evaluated the mRNA expressions of TLR‐4, TLR‐2 and myeloid differentiation primary response gene 88 (MyD88) in peripheral blood mononuclear cells (PBMCs) and biopsy samples of 26 stable graft function (SGF), 14 acute T‐cell‐mediated rejection (ACMR), six acute antibody‐mediated rejection (AAMR), 10 chronic T‐cell‐mediated rejection (CCMR) and four chronic antibody‐mediated rejection (CAMR) cases of renal transplant recipients, using TaqMan detector real‐time polymerase chain reaction (RT‐PCR).

Results

It was found that TLR4 mRNA level was significantly elevated in PBMCs of both ACMR (P.v: 0.025) and CCMR (P.v: 0.007) cases, while TLR2 gene was upregulated only in PBMCs of ACMR (P.v: 0.024). Moreover, MyD88 expression was increased in biopsy samples of all rejection groups AAMR (P.v: 0.032), ACMR (P.v: 0.002), CAMR (P.v: 0.038) and CCMR (P.v: 0.013) and could distinguish them from stable grafts with AUC (area under curve) of 0.81, 0.80, 0.83 and 0.77, respectively.

Conclusion

These data showed that MyD88 gene upregulation in renal tissue could have diagnostic value and increased level of TLR4 mRNA in PBMCs could be suggestive of cell‐mediated rejections. Therefore, monitoring the expression level of inflammatory signalling genes might be useful in predicting allograft rejection.
Selecting and quantifying low‐value nursing care in clinical practice: A questionnaire survey
Authors: Osorio Dimelza , Zuriguel‐Pérez Esperanza , Romea‐Lecumberri Soledad , Tiñena‐Amorós Montserrat , Martínez‐Muñoz Montserrat , Barba‐Flores Ángeles
Published: July 2019

Aims and objectives

To evaluate the opinion of hospital nurses on a group of recommendations aimed at reducing low‐value nursing care and, based on these results, to detect low‐value practices probably existing in the hospital.

Background

Low‐value nursing care refers to clinical practices with poor or no benefit for patients that may be harmful and a waste of resources. Detecting these practices and understanding nurses' perceptions are essential to developing effective interventions to reduce them.

Methods

We conducted a survey in a tertiary hospital. STROBE guidelines were followed. The questionnaire appraised nurses' agreement, subjective adherence and perception of usefulness of a group of recommendations to reduce low‐value nursing care from Choosing Wisely and other initiatives. Practices described in recommendations with an agreement over 70% and a subjective adherence under 70% were categorised as low‐value practices probably existing in the hospital.

Results

A total of 265 nurses from eight areas of care participated in the survey. The response rate by area ranged between 2%–55%. From the 38 recommendations evaluated, agreement was 96% (95% confidence interval [95%CI], 95%–97%), median subjective adherence was 80% (95%CI, 80%–85%), and usefulness was 90% (95%CI, 89%–92%). Based on these results, we detected seven (0–15) low‐value practices probably existing in our hospital, mostly on general practice, pregnancy care and wound care.

Conclusions

We found a great understanding of low‐value care between nurses, given the high agreement to recommendations and perception of usefulness. However, several low‐value practices may be present in nursing care, requiring actions to reduce them, for instance, reviewing institutional protocols and involving patients in de‐implementation.

Relevance to clinical practice

Hospitals and other settings should be aware of low‐value practices and take actions to identify and reduce them. A survey may be a simple and helpful way to start this process.
Self‐exercise programmes and occlusal splints in the treatment of TMD‐related myalgia—Evidence‐based medicine?
Authors: Eliassen Morten , Hjortsjö Carl , Olsen‐Bergem Heming , Bjørnland Tore
Published: July 2019

Background

The low‐cost and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, stretching exercises, manual therapy, acrylic splints and cognitive behavioural therapy.

Objective

The aim of this study was to evaluate the evidence behind the use of self‐exercising programmes and occlusal splints in the treatment of myofascial pain.

Methods

We conducted a thorough search of five databases, using four cardinal search terms in combination with twelve supporting terms. We also assessed the evidence quality, using GRADEpro software.

Results

The search resulted in 4967 individual studies. 18 studies met the inclusion criteria and were re‐evaluated.

Conclusion

The selected studies were in favour of a self‐care or an occlusal splint treatment of myalgia. However, a GRADE assessment showed that 14 of the 18 selected studies had low or very low evidence quality. Studies also showed weaknesses with regard to nomenclature and reproducibility. Hence, it is our professional opinion that the evidence level for prescribing self‐exercises and occlusal splints in the treatment of myalgia is low.
Lytic transglycosylases RlpA and MltC assist in Vibrio cholerae daughter cell separation
Authors: Weaver Anna I. , Jiménez‐Ruiz Valeria , Tallavajhala Srikar R. , Ransegnola Brett P. , Wong Kimberly Q. , Dörr Tobias
Published: July 2019

The cell wall is a crucial structural feature in the vast majority of bacteria and comprises a covalently closed network of peptidoglycan (PG) strands. While PG synthesis is important for survival under many conditions, the cell wall is also a dynamic structure, undergoing degradation and remodeling by ‘autolysins’, enzymes that break down PG. Cell division, for example, requires extensive PG remodeling, especially during separation of daughter cells, which depends heavily upon the activity of amidases. However, in Vibrio cholerae, we demonstrate that amidase activity alone is insufficient for daughter cell separation and that lytic transglycosylases RlpA and MltC both contribute to this process. MltC and RlpA both localize to the septum and are functionally redundant under normal laboratory conditions; however, only RlpA can support normal cell separation in low‐salt media. The division‐specific activity of lytic transglycosylases has implications for the local structure of septal PG, suggesting that there may be glycan bridges between daughter cells that cannot be resolved by amidases. We propose that lytic transglycosylases at the septum cleave PG strands that are crosslinked beyond the reach of the highly regulated activity of the amidase and clear PG debris that may block the completion of outer membrane invagination.
The role of ‘mediators’ of communication in health professionals' intersectoral collaboration: An ethnographically inspired study
Authors: Andersen Anne Bendix , Beedholm Kirsten , Kolbæk Raymond , Frederiksen Kirsten
Published: July 2019

Several studies describe intersectoral collaboration in Western healthcare as hampered by lack of coordination of care and treatment and incoherent patient pathways. We performed an ethnographic study following elderly patients from admission to an emergency unit (EMU) to discharge and further treatment and care at other facilities in the healthcare system. The aim was to explore how health professionals work together across sectors in the Danish healthcare system and how they create patient pathways for elderly patients (+65) with multiple chronic illnesses. Intersectoral collaboration was identified as distant relations between large numbers of health professionals, where communication was conveyed by electronic health record (EHR) formats which promoted information delivery that focused on patients’ immediate symptoms. Other significant ‘mediators’ of communication were the telephone that seemed to resemble face‐to‐face communication and the patient who delivered information from one professional to another. We suggest that the communication among professionals at various facilities interacts with the format and functionalities of the EHRs, which typically fall short in delivery of information across sectors, because the often complex needs of patients with multimorbidity do not fit in with the available functionalities of the EHR.
An in vitro study of coagulation properties in refrigerated whole blood and reconstituted whole blood
Authors: Wang Shujun , Zhao Guangchao , Li Na , Hou Tao , Shao Xiaobao , Tang Wen , Wang Fei , Luan Jianfeng , Zhu Peiyuan
Published: July 2019

Objective

Fresh whole blood (WB) has been used in military applications and cardiac surgery. We undertook a study of the coagulation properties of refrigerated WB stored for 21 days and compared them with the properties of reconstituted WB.

Study design and methods

Ten WB units were obtained from healthy volunteer donors and stored at 4 ± 2°C. Samples were obtained on Days 1, 2, 4, 6, 8, 10, 14 and 21 from the WB units. Ten units of reconstituted WB were prepared with a ratio of red cells, platelets and plasma of 1:1:1. Tests included complete blood count, electrolyte, routine coagulation, blood coagulation factor and thromboelastography.

Results

There was a progressive decline in Hb, WBC, PLT, sodium and coagulation factors but a progressive increase in APTT, PT and potassium in WB. The concentrations of factor (F)V and FVIII as well as FII and FX of WB were higher before Days 4, 2, 8 and 14, respectively, compared with the concentrations of reconstituted WB. The concentrations of FVII, FIX, FXI and FXII in WB were found to be equal to or higher than those in reconstituted WB throughout the course of 21 days. TEG variables in all WB units were normal throughout the course of 10 days. The mean PT and APTT of WB were lower than those of reconstituted WB before Days 14 and 10, respectively.

Conclusion

This study suggests that the coagulation properties of refrigerated WB were equal to or superior to those of reconstituted WB for a minimum of 10 days.
Immunomodulatory potential of Nisin A with application in wound healing
Authors: Mouritzen Michelle V. , Andrea Athina , Qvist Katrine , Poulsen Steen S. , Jenssen Håvard
Published: July 2019

Antimicrobial peptides can have a dual role with both antimicrobial activity against a broad range of bacteria and immunomodulatory effect, making them attractive as therapeutic treatment of difficult wounds. Nisin A is widely known for its antimicrobial activity, and a preliminary study demonstrated that it increased wound closure, but the mechanism behind its effect is unknown. The aim of this study is to elucidate the wound healing potential of Nisin A and the mechanism behind. First, an epithelial and endothelial cell line, human keratinocyte (HaCaT) and human umbilical vein endothelial cell, were used to demonstrate migration and proliferation effects in vitro. From HaCaT cells and peripheral blood mononuclear cell, changes in cytokine levels were shown by quantitative polymerase chain reaction and enzyme‐linked immunosorbent assay. Second, the ex vivo porcine wound healing model was used to investigate the re‐epithelization potential of Nisin A. Finally, the model Galleria mellonella was used to confirm antimicrobial activity and to investigate potential immunomodulatory effects in vivo. Here, we demonstrated that Nisin A affected migration significantly of both human umbilical vein endothelial cell and HaCaT cells (p < 0.05) but not proliferation, potentially by decreasing the levels of proinflammatory cytokines tumor necrosis factor‐α, interleukin‐6, and interleukin‐8 (p < 0.001). Furthermore, Nisin A treatment diminished lipopolysaccharide‐induced tumor necrosis factor‐α levels from peripheral blood mononuclear cells and monocyte chemoattractant protein‐1 from HaCaT cells (p < 0.001). Furthermore, Nisin A did not affect proliferation ex vivo either but increased re‐epithelization of the porcine skin. Nisin A improved survival of G. mellonella significantly from Staphylococcus epidermidis (p < 0.001) but not from Escherichia coli, indicating that Nisin A did not help the larvae to survive the infection in a different than direct antimicrobial way. All together this makes Nisin A a potential treatment to use in wound healing, as it increases the mobility of skin cells, dampens the effect of lipopolysaccharide and proinflammatory cytokines, and decreases bacterial growth.
A Data-Driven Methodology to Construct Customer Choice Sets Using Online Data and Customer Reviews
Authors: Suryadi Dedy , Kim Harrison M.
Published: July 2019

The recent development in engineering design has incorporated customer preferences by involving a choice model. In generating a choice model to produce a good quality estimate of parameters related to product attributes, a high-quality choice set is essential. However, the choice set data are often not available. This research proposes a methodology that utilizes online data and customer reviews to construct customer choice sets in the absence of both the actual choice set and the customer sociodemographic data. The methodology consists of three main parts, i.e., clustering the products based on their attributes, clustering the customers based on their reviews, and constructing the choice sets based on a sampling probability scenario that relies on product and customer clusters. The proposed scenario is called Normalized, which multiplies the product cluster and customer cluster fractions to obtain the probability sampling distribution. There are two utility functions proposed, i.e., a linear combination of product attributes only and a function that includes the interactions of product attributes and customer reviews. The methodology is implemented to a data set of laptops. The Normalized scenario performs significantly better than the baseline, Random, in predicting the test set data. Moreover, the inclusion of customer reviews into the utility function also significantly increases the predictive ability of the model. The research shows that using the product attribute data and customer reviews to construct choice sets generates choice models with higher predictive ability than randomly constructed choice sets.
Measurement of Hysteresis Energy Using Digital Image Correlation With Application to Energy-Based Fatigue Life Prediction
Authors: Celli Dino , Herman Shen M.-H. , Holycross Casey , Scott-Emuakpor Onome , George Tommy
Published: July 2019

A modified experimental method using digital image correlation (DIC), a noncontact optical method for measuring full-field displacements and strains, is used to interrogate accumulated fatigue damage for low and high cycle fatigue at continuum scales. Previous energy-based fatigue life prediction methods have shown that cyclic strain energy dissipated during fatigue acts as a key damage parameter for accurate determination of total and remaining fatigue life. DIC enables the collection of accurate strain energy measurements or damaging energy of complex geometries that would otherwise be exceedingly difficult and time consuming using traditional strain measurement techniques. Thus, the use of DIC to obtain strain energy measurements of gas turbine engine (GTE) components is highly advantageous for energy-based fatigue life prediction methods. Presented in this study is the experimental characterization of the cyclic strain energy dissipation as a means of predicting fatigue performance and assessment of damage progression of Aluminum 6061 subjected to fully reversed axial fatigue loading utilizing DIC. Validation of total and cyclic strain energy dissipation DIC measurements is accomplished with the simultaneous use of axial extensometery for direct comparison and implementation to strain energy-based life prediction methods.
Effects of acoustic nonlinearities on the ultrasonic backscatter coefficient estimation
Authors: Coila Andres , Oelze Michael L.
Published: July 2019

The backscatter coefficient (BSC) is a fundamental property of tissues and can be used to classify tissues. Two BSC calibration methods are the planar reflector method and the reference phantom method. In both methods, linear acoustic propagation is assumed. In this study, the calibration methods were evaluated when acoustic nonlinear distortion was present. Radio frequency data were acquired from two physical phantoms using a 5 MHz single-element transducer and low power (one excitation level) and high power (six increasing excitation levels) excitation signals. BSCs estimated from the high power settings were compared to the BSCs estimated using the low power by calculating the root mean square error (RMSE). The BSCs were parameterized by fitting the BSC curve to a power law and estimating the power law exponent and by estimating the effective scatterer diameter (ESD). When using the planar reflector method, estimates of the exponent were observed to monotonically increase in value versus increasing excitation level and the ESD decreased with increasing excitation level. The RMSE increased monotonically versus excitation level using the planar reflector method but did not increase using the reference phantom method. The results suggest that the effects of nonlinear distortion are minimized using the reference phantom method.
Short-term cellular memory tunes the signaling responses of the chemokine receptor CXCR4
Authors: Spinosa Phillip C. , Humphries Brock A. , Lewin Mejia Daniela , Buschhaus Johanna M. , Linderman Jennifer J. , Luker Gary D. , Luker Kathryn E.
Published: July 2019

Recent signaling events determine how CXCR4 activates its downstream effector kinases.