bluuebunny/crossref_metadata_2025 huggingface dataset:
A literature review of school leadership policy reforms
Authors: Pont Beatriz
Published: May 2020

This literature review aims to understand the factors that influence the adoption of school leadership policy reforms and whether there are some common trends that lead to policy changes in this area. The main question driving the study was the following: what are important reasons or contextual factors that have influenced the adoption of school leadership policy reforms? The analysis shows that there is an eclectic set of research that covers school leadership from different perspectives. Each tackle the question of school leadership reform adoption from different angles. A policy perspective associates school leadership reforms to contextual changes in relation to decentralisation, school autonomy, accountability or an increasing emphasis on education outcomes. School improvement perspectives acknowledge the key role of school leadership in education change. The research on school leadership impact has contributed to the adoption of school leadership reforms. The school leadership policy perspective shows that countries have introduced school leadership reforms, with practices varying by country and context. Some have been interpreted as a response to a new public management agenda or to the globalisation of education policies. Findings from this review indicate that whilst there is much research on school leadership, nevertheless, analysis and promotion of policies to support and strengthen school leader roles to support school improvement appears to have received less attention.
Endophyte infection influences arbuscular mycorrhizal fungi communities in rhizosphere soils of host as opposed to non‐host grass
Authors: Liu Hui , Wu Man , Liu Jinming , Gao Yubao , Ren Anzhi
Published: May 2020

Endophytes live asymptomatically within many cool‐season grasses for at least a portion of their life cycle. Although the leaf endophyte effects on the growth and stress resistance of host grasses have been relatively well studied, less attention has been focused on how this relationship may impact soil microbial communities, especially arbuscular mycorrhizal fungi (AMF). We defined endophyte‐infected and endophyte‐free Leymus chinensis as the host grass and neighbouring Stipa krylovii, which was not infected by endophytes, as the non‐host grass. Our objective was to examine the effect of endophyte infection on the colonization rate and composition of AMF communities in both the rhizosphere and bulk soils of their host (L. chinensis) and a neighbouring non‐host (S. krylovii) by a consecutive 2‐year survey. We described AMF communities using high‐throughput DNA sequencing, quantified the proportion of root length colonized by AMF using microscopy, and estimated AMF biomass using a lipid biomarker. Structural equation modelling (SEM) was applied to disentangle the direct and indirect effects (mediated by multiple environmental factors) of an endophyte on AMF. We found that endophyte infection significantly increased colonization rates and rhizosphere soil biomass of AMF but had no significant effect on the bulk soil around the host grass. The endophyte increased the diversity of the rhizosphere soil AMF community by decreasing the abundance of the dominant species Glomus while increasing the abundance of some unidentified AMF. SEM showed that the endophyte effects on AMF biomass in rhizosphere soil were primarily mediated by soil total carbon, total nitrogen and pH. With respect to the non‐host grass, the endophyte infection of host grass did not change the colonization rates or AMF biomass in either the rhizosphere or bulk soil but did cause a shift in the rhizosphere soil AMF community composition, resulting in a decrease in the relative abundance of Septoglomus and an increase in the relative abundance of some unidentified AMF.

Highlights

Effects of endophyte infection on AMF communities in both the rhizosphere and bulk soils were studied.

Endophyte effect was studied not only on the host but also on the non‐host grass.

Endophyte infection significantly increased colonization rates and rhizosphere soil biomass of AMF.

Endophyte effect on AMF biomass in rhizosphere soil was primarily mediated by soil physicochemical properties.
Structural basis for the function and inhibition of dihydroorotate dehydrogenase from Schistosoma mansoni
Authors: de Mori Renan M. , Aleixo Mariana A. A. , Zapata Luana C. C. , Calil Felipe A. , Emery Flávio S. , Nonato M. Cristina
Published: May 2020

Schistosomiasis is a serious public health problem, prevalent in tropical and subtropical areas, especially in poor communities without access to safe drinking water and adequate sanitation. Transmission has been reported in 78 countries, and its control depends on a single drug, praziquantel, which has been used over the past 30 years. Our work is focused on exploiting target‐based drug discovery strategies to develop new therapeutics to treat schistosomiasis. In particular, we are interested in evaluating the enzyme dihydroorotate dehydrogenase (DHODH) as a drug target. DHODH is a flavoenzyme that catalyzes the stereospecific oxidation of (S)‐dihydroorotate (DHO) to orotate during the fourth and only redox step of the de novo pyrimidine nucleotide biosynthetic pathway. Previously, we identified atovaquone, used in the treatment of malaria, and its analogues, as potent and selective inhibitors against Schistosoma mansoni DHODH (SmDHODH). In the present article, we report the first crystal structure of SmDHODH in complex with the atovaquone analogue inhibitor 2‐((4‐fluorophenyl)amino)‐3‐hydroxynaphthalene‐1,4‐dione (QLA). We discuss three major findings: (a) the open conformation of the active site loop and the unveiling of a novel transient druggable pocket for class 2 DHODHs; (b) the presence of a protuberant domain, only present in Schistosoma spp DHODHs, that was found to control and modulate the dynamics of the inhibitor binding site; (c) a detailed description of an unexpected binding mode for the atovaquone analogue to SmDHODH. Our findings contribute to the understanding of the catalytic mechanism performed by class 2 DHODHs and provide the molecular basis for structure‐guided design of SmDHODH inhibitors.

Database

The structural data are available in Protein Data Bank (PDB) database under the accession code number 6UY4.
Marine cyanobacteria tune energy transfer efficiency in their light‐harvesting antennae by modifying pigment coupling
Authors: Kolodny Yuval , Zer Hagit , Propper Mor , Yochelis Shira , Paltiel Yossi , Keren Nir
Published: May 2020

Photosynthetic light harvesting is the first step in harnessing sunlight toward biological productivity. To operate efficiently under a broad and dynamic range of environmental conditions, organisms must tune the harvesting process according to the available irradiance. The marine cyanobacteria Synechococcus WH8102 species is well‐adapted to vertical mixing of the water column. By studying its responses to different light regimes, we identify a new photo‐acclimation strategy. Under low light, the phycobilisome (PBS) is bigger, with extended rods, increasing the absorption cross‐section. In contrast to what was reported in vascular plants and predicted by Forster resonance energy transfer (FRET) calculations, these longer rods transfer energy faster than in the phycobilisomes of cells acclimated to a higher light intensity. Comparison of cultures grown under different blue light intensities, using fluorescence lifetime and emission spectra dependence on temperature at the range of 4–200 K in vivo, indicates that the improved transfer arises from enhanced energetic coupling between the antenna rods' pigments. We suggest two physical models according to which the enhanced coupling strength results either from additional coupled pathways formed by rearranging rod packing or from the coupling becoming non‐classical. In both cases, the energy transfer would be more efficient than standard one‐dimensional FRET process. These findings suggest that coupling control can be a major factor in photosynthetic antenna acclimation to different light conditions.
A breeding strategy to identify modifiers of high genetic risk for methamphetamine intake
Authors: Reed Cheryl , Stafford Alexandra M. , Mootz John R. K. , Baba Harue , Erk Jason , Phillips Tamara J.
Published: May 2020

Trace amine‐associated receptor 1 (Taar1) impacts methamphetamine (MA) intake. A mutant allele (Taar1m1J) derived from the DBA/2J mouse strain codes for a non‐functional receptor, and Taar1m1J/m1J mice consume more MA than mice possessing the reference Taar1+ allele. To study the impact of this mutation in a genetically diverse population, heterogeneous stock‐collaborative cross (HS‐CC) mice, the product of an eight‐way cross of standard and wild‐derived strains, were tested for MA intake. HS‐CC had low MA intake, so an HS‐CC by DBA/2J strain F2 intercross was created to transfer the mutant allele onto the diverse background, and used for selective breeding. To study residual variation in MA intake existing in Taar1m1J/m1J mice, selective breeding for higher (MAH) vs lower (MAL) MA intake was initiated from Taar1m1J/m1J F2 individuals; a control line of Taar1+/+ individuals (MAC) was retained. The lines were also examined for MA‐induced locomotor and thermal responses, and fluid and tastant consumption. Taar1m1J/m1J F2 mice consumed significantly more MA than Taar1+/+ F2 mice. Response to selection was significant by generation 2 and there were corresponding differences in fluid consumed. Fluid consumption was not different in non‐MA drinking studies. Taar1m1J/m1J genotype (MAL or MAH vs MAC mice) was associated with heighted MA locomotor and reduced hypothermic responses. MAL mice exhibited greater sensitization than MAH mice, but the selected lines did not consistently differ for thermal or tastant phenotypes. Residual variation among high‐risk Taar1m1J/m1J mice appears to involve mechanisms associated with neuroadaptation to MA, but not sensitivity to hypothermic effects of MA.
Policy venue preference and relative trust in government in federal systems
Authors: Leland Suzanne , Chattopadhyay Jacqueline , Maestas Cherie , Piatak Jaclyn
Published: May 2020

This article defines a concept of relative trust—the gap between trust in different levels of government in a federalist system—and examines whether it influences public attitudes about which level of government holds authority in specific policy domains. While scholars have explored how trust in government affects political systems from a national perspective, little is known about how trust influences multitiered government systems in which public trust levels differ for national versus subnational governments. This article finds that greater relative trust in the state versus national level of government is associated with support for devolution in several policy areas where governing authority is shared: unemployment, health care, environmental policy, and food safety regulation. The implication is that relative trust shapes public preferences about policy centralization or decentralization and provides an individual‐level mechanism through which windows of opportunity open for changes in the allocation of policy authority.
Evaluation of the Allplex™ H pylori and ClariR PCR Assay for Helicobacter pylori detection on gastric biopsies
Authors: Jehanne Quentin , Bénéjat Lucie , Mégraud Francis , Bessède Emilie , Lehours Philippe
Published: May 2020

Background

The diagnosis of Helicobacter pylori infection can be made by PCR on gastric biopsies. The objective of this study was to evaluate retrospectively the performance of the Allplex™ H pylori and ClariR PCR Assay (Seegene).

Material and Methods

A collection of 180 DNA samples extracted from gastric biopsies was used in this study: 90 DNAs from H pylori‐negative patients and 90 from H pylori‐positive patients. The Allplex™ H pylori and ClariR Assay was performed on a CFX96™ real‐time PCR System and analyzed using the Seegene Viewer software. The real‐time PCR used as the reference was our in‐house H pylori PCR, and discrepant results were tested by the Amplidiag® H pylori + ClariR PCR (Mobidiag).

Results

The performance of the Allplex™ H pylori and ClariR Assay showed 100% sensitivity, 97.6% specificity, 98% PPV, and 100% NPV. Regarding the detection of H pylori in the 90 expected negative samples, eight late amplifications were obtained (Ct > 39). Six of these eight samples were also positive using the Amplidiag® H pylori + ClariR kit and were therefore considered as true positives. For the two remaining cases, non‐pathological evidence of H pylori infection was found. H pylori was detected in all 90 positive samples. Compared with our in‐house H pylori PCR, all H pylori WT cases or mutated cases were correctly detected.

Conclusions

The Allplex™ H pylori and ClariR Assay showed an excellent performance and can be integrated into the armamentarium of diagnostic tests for H pylori infection. This kit has the advantage of differentiating the main mutations associated with macrolide resistance.
Epigenetic regulation of TLR2‐mediated periapical inflammation
Authors: Fernández A. , Veloso P. , Astorga J. , Rodríguez C. , Torres V.A. , Valdés M. , Garrido M. , Gebicke‐Haerter P.J. , Hernández M.
Published: May 2020

Aim

To determine the methylation pattern of TLR2 gene promoter and its association with the transcriptional regulation of periapical inflammatory and angiogenic responses in symptomatic and asymptomatic forms of apical periodontitis.

Methodology

In this cross‐sectional study, apical lesions were obtained from volunteers with asymptomatic apical periodontitis (AAP) (n = 17) and symptomatic apical periodontitis (SAP) (n = 17) scheduled for tooth extraction, and both total RNA and DNA were extracted. DNA was bisulfite‐treated, a region of CpG island within the TLR2 gene was amplified by qPCR and the products were sequenced. Additionally, the mRNA expression of TLR2, TLR4, IL‐6, IL‐12, TNFalpha, IL‐23, IL‐10, TGFbeta, VEGFA and CDH5 was analysed by qPCR. The data were analysed with chi‐square tests, Mann–Whitney or unpaired t‐tests, and Spearman´s correlation; variable adjustments were performed using multiple linear regression (P < 0.05).

Results

TLR2 depicted a hypomethylated DNA profile at the CpG island in SAP when compared with AAP, along with upregulated expression of TLR2, with pro‐inflammatory cytokines IL‐6 and IL‐23, and the angiogenesis marker CDH5 (P < 0.05). TLR2 methylation percentage negatively correlated with mRNA levels of IL‐23 and CDH5 in apical periodontitis. Lower methylation frequencies of single CpG dinucleotides −8 and −10 localized in close proximity to nuclear factor κB (NFκB) binding within the TLR2 promoter were identified in SAP versus AAP (P < 0.05). Finally, unmethylated −10 and −8 single sites demonstrated up‐regulation of IL‐23, IL‐10 and CDH5 transcripts compared to their methylated counterparts (P < 0.05).

Conclusions

TLR2 gene promoter hypomethylation was linked to transcriptional activity of pro‐inflammatory cytokines and angiogenic markers in exacerbated periapical inflammation. Moreover, unmethylated single sites in close proximity to NFκB binding were involved in active transcription of IL‐23, IL‐10 and CDH5.
Impact and production of Non‐HLA‐specific antibodies in solid organ transplantation
Authors: Zhang Xiaohai , Reinsmoen Nancy L.
Published: May 2020

Organ transplantation is an effective way to treat end‐stage organ disease. Extending the graft survival is one of the major goals in the modern era of organ transplantation. However, long‐term graft survival has not significantly improved in recent years despite the improvement of patient management and advancement of immunosuppression regimen. Antibody‐mediated rejection is a major obstacle for long‐term graft survival. Donor human leucocyte antigen (HLA)‐specific antibodies were initially identified as a major cause for antibody‐mediated rejection. Recently, with the development of solid‐phase‐based assay reagents, the contribution of non‐HLA antibodies in organ transplantation starts to be appreciated. Here, we review the role of most studied non‐HLA antibodies, including angiotensin II type 1 receptor (AT1R), K‐α‐tubulin and vimentin antibodies, in the solid organ transplant, and discuss the possible mechanism by which these antibodies are stimulated.
Effectiveness of auricular point therapy for cancer‐related fatigue: A systematic review and meta‐analysis
Authors: Han Qiong , Yang Liu , Huang Shuang‐Yan , Yeung Jerry W.F. , Chen Xiao‐Huan , Xue Hui , Xu Li‐Ping , Suen Lorna K. P.
Published: May 2020

Aims

To systemically review the efficacy and safety of auricular point therapy in patients with cancer‐related fatigue.

Design

A systematic review and meta‐analysis of randomized controlled trials.

Data sources

Eight electronic databases (PubMed, CENTRAL, Embase, CINAHL, Web of Science, China Biology Medicine, China National Knowledge Infrastructure and WanFang Data Knowledge Service Platform) were explored for randomized controlled trials from their inception to 1 December 2018.

Review methods

The risk of bias assessment tool was adopted in accordance with Cochrane Handbook 5.3.0. All included studies reported the effects on cancer‐related fatigue as the primary outcome. Effect size was estimated using relative risk, standardized mean difference or mean difference with a corresponding 95% confidence interval. Review Manager 5.3 was used for meta‐analysis.

Results

Six studies comprising 394 patients were included. The results of meta‐analysis showed that auricular point therapy plus standard care produced more positive effects on cancer‐related fatigue and quality of life than standard care alone. It could significantly improve the role, emotional, cognitive, and social functions of patients with cancer‐related fatigue.

Conclusions

Auricular point therapy may be a safe therapy to relieve cancer‐related fatigue and enhance the quality of life of patients with cancer. However, the evidence was inconclusive due to limitations on the quantity and quality of included studies. Rigorously designed randomized controlled trials should be conducted to verify the results.

Impact

Auricular point therapy is a simple and safe therapeutic approach that may alleviate cancer‐related fatigue of common complications in patients with cancer and it is worth promoting in the community, family, and hospital. Moreover, the research findings can provide suggestions and inspiration for nurses and researchers to implement the proposal, which is conducive to design more rigorous and high‐quality randomized controlled trials.
Differentially expressed genes identified through RNA‐seq with extreme values of principal components for beef fatty acid in Nelore cattle
Authors: Olivieri Bianca Ferreira , Braz Camila Urbano , Brito Lopes Fernando , Peripolli Elisa , Medeiros de Oliveira Silva Rafael , Ruegger Pereira da Silva Corte Rosana , Albuquerque Lucia Galvão de , Pereira Angélica Simone Cravo , Stafuzza Nedenia Bonvino , Baldi Fernando
Published: May 2020

The aim of this study was to identify differentially expressed genes (DEG) in theLongissimus thoracismuscle of Nelore cattle related to fatty acid (FA) profile through RNA sequencing and principal component analysis (PCA). Two groups of 10 animals each were selected containing PC1 and PC2 extreme DEG values (HIGH × LOW) for each FA group. The intramuscular fat (IMF) was compared between cluster groups by ANOVA, and only the sum of monounsaturated FA (MUFA) and ω3 showed significant differences (p < .05). Interestingly, the highest percentage (95%) of phenotypic variation explained by the sum of the first two PC was observed for ω3, which also displayed the lowest number of DEG (n = 1). The lowest percentage (59%) was observed for MUFA, which also revealed the largest number of DEG (n = 66). Since only MUFA and ω3 exhibited significant differences between cluster groups, we can conclude that the differences observed for the remaining groups are not due to the percentage of IMF. Several genes that have been previously associated with meat quality and FA traits were identified as DEG in this study. The functional analysis revealed one KEGG pathway and eight GO terms as significant (p < .05), in which we highlighted the purine metabolism, glycolytic process, adenosine triphosphate binding and bone development. These results strongly contribute to the knowledge of the biological mechanisms involved in meat FA profile of Nelore cattle.
Biogeography of shell morphology in over‐exploited shellfish reveals adaptive trade‐offs on human‐inhabited islands and incipient selectively driven lineage bifurcation
Authors: Hamilton Ashley M. , Selwyn Jason D. , Hamner Rebecca M. , Johnson Hokuala K. , Brown Tia , Springer Shauna K. , Bird Christopher E.
Published: May 2020

Aim

Humans are unintentionally affecting the evolution of fishery species directly through exploitation and indirectly by altering climate. We aim to test for a relationship between biogeographic patterns in the shell phenotypes of an over‐exploited shellfish and the presence of humans to identify human‐mediated adaptive trade‐offs. The implications of these trade‐offs are discussed with respect to the sustainability of the fishery.

Taxon

The endemic Hawaiian intertidal limpet, ‘opihi makaiauli (Patellagastropoda, Nacellidae, Cellana exarata)

Methods

We surveyed phenotypic characters associated with temperature and predation avoidance across the entire species range and tested for differences in the relationship between these characters and latitude, on islands with and without humans.

Results

Among all limpets surveyed, there was a bimodal distribution in shell colour (light, dark) and a parapatric pattern of shell coloration across the archipelago with lighter shells being prevalent on the uninhabited islands and darker, more camouflaged shells being prevalent on the inhabited islands. On the cooler, uninhabited islands, all morphometric characters associated with thermal avoidance (surface area, height and doming) increased with decreasing latitude. On the hotter, inhabited islands, however, shells were flatter, less variable and less adapted for avoiding thermal stress than predation.

Main Conclusions

The biogeographic patterns in shell phenotype and previous genetic studies suggest that the population is beginning to bifurcate in response to disruptive and directional selection as well as geographic isolation between the islands with and without humans. Decreased phenotypic and genetic diversity on the inhabited islands despite much larger populations of ‘opihi suggests a prominent historical bottleneck. The prevalence of maladaptive dark, flat phenotypes for thermal avoidance on the inhabited islands suggests that predation is a stronger selective force, driving adaptive trade‐offs in shape and colour. We propose that this is likely a case of fisheries‐induced evolution and a millennium of harvesting is the most likely selective pressure driving the observed biogeographic patterns in shell morphology. The flatter, darker shells will allow body temperatures to rise higher in direct sunlight, therefore we hypothesize that the thermal niche of ‘opihi is narrower on inhabited islands and will continue to narrow as Earth warms.
The biogeography of ecoregions: Descriptive power across regions and taxa
Authors: Smith Jeffrey R. , Hendershot J. Nicholas , Nova Nicole , Daily Gretchen C.
Published: May 2020

Aim

Biomes, biogeographical realms and ecoregions have become central concepts of biotic organization and biodiversity research. Recent data‐intensive analysis has shown that, while ecoregions do delineate biotic communities, how distinct they are from one another varies considerably across regions and taxa. Given their central importance to global models of the earth system and to the development of conservation plans, it is key to understand in what regions, and for which taxa, ecoregion classification schemes best describe the underlying variability in biological communities.

Location

Global.

Taxa

Plants, animals, fungi.

Methods

In this paper, we integrate ecoregion maps with data on spatially continuous changes in environmental conditions, biodiversity and species traits to quantify the descriptive power of ecoregions around the globe. Capitalizing on the troves of newly available global biodiversity data, we model the abiotic and biotic factors that describe how distinct ecoregions are from one another.

Results

From an abiotic perspective, we report compelling evidence that, first, ecoregions are more distinct in tropical zones with higher temperatures, less temperature seasonality and greater rainfall seasonality. Second, we also find that ecoregions are more distinct in regions with steeper slopes. From a biotic perspective, we find that ecoregions tend to be more distinct for reptiles and amphibians than they are for mammals or birds. Likewise, ecoregions tend to be more distinct for smaller‐bodied species and, to a lesser extent, species at lower trophic levels.

Main conclusions

While ecoregion‐based conservation planning can provide a crucial tool for developing holistic conservation interventions, we show here that the ability to capture and describe communities is not uniform across regions or taxa. In particular, ecoregions tend to best describe communities of small‐bodied species, less vagile and tropical taxa that are typically underrepresented in the scientific literature. While ecoregion classification schemes will continue to provide invaluable conservation guidance, we must think critically about when an ecoregional approach is best suited to informing management.
Internet‐delivered cognitive behavior therapy with minimal therapist support for anxious children and adolescents: predictors of response
Authors: Spence Susan H. , Prosser Samantha J. , March Sonja , Donovan Caroline L.
Published: May 2020

Background

In general, Internet‐delivered cognitive behavior therapy (iCBT) produces significant reductions in child and adolescent anxiety, but a proportion of participants continue to show clinical levels of anxiety after treatment. It is important to identify demographic, clinical, and family factors that predict who is most likely to benefit from iCBT in order to better tailor treatment to individual needs.

Methods

Participants were 175 young people (7–18 years) with an anxiety disorder, and at least one of their parents, who completed an iCBT intervention with minimal therapist support. Multilevel modeling (MLM) examined predictors of response to iCBT as measured by the slope for changes in the primary outcome measures of child‐ and parent‐reported anxiety scores, from pretreatment, to 12‐weeks, 6‐month, and 12‐month follow‐ups, controlling for pretreatment total clinician severity ratings of all anxiety diagnoses.

Results

Child age, gender, father age, parental education, parental mental health, parenting style, and family adaptability and cohesion did not significantly predict changes in anxiety in the multivariate analyses. For child‐reported anxiety, greater reductions were predicted by a separation anxiety disorder diagnosis (SEP) and elevated depression, with lower reductions predicted by poor couple relationship quality. For parent‐reported child anxiety, greater reductions were predicted by higher pretreatment total CSRs, SEP, and lower family income, with lower reductions for children of older mothers. Irrespective of these predictors of change, children in general showed reductions in anxiety to within the normal range.

Conclusions

Overall, children responded well to iCBT irrespective of the demographic, clinical, and family factors examined here. Poor couple relationship quality and older mother age were risk factors for less positive response to iCBT in terms of reductions in anxiety symptoms although still to within the normal range.
COVID‐19 and dermatology: a comprehensive guide for dermatologists
Authors: Fahmy D.H. , El‐Amawy H.S. , El‐Samongy M.A. , Fouda A.A. , Soliman S.H. , El‐Kady A. , Farnetani F. , Conti A. , Zoeir A. , Eissa A. , Eissa R. , Puliatti S. , Sighinolfi M.C. , Rocco B. , Pellacani G.
Published: May 2020

Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e291–e310.
Metastatic melanoma treatment with checkpoint inhibitors in the COVID‐19 era: experience from an Italian Skin Cancer Unit
Authors: Quaglino P. , Fava P. , Brizio M. , Marra E. , Rubatto M. , Agostini A. , Tonella L. , Ribero S. , Fierro M. T.
Published: May 2020

Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e291–e310 .
Warmer temperatures enhance beneficial mutation effects
Authors: Chu Xiao‐Lin , Zhang Da‐Yong , Buckling Angus , Zhang Quan‐Guo
Published: May 2020

Temperature determines the rates of all biochemical and biophysical processes, and is also believed to be a key driver of macroevolutionary patterns. It is suggested that physiological constraints at low temperatures may diminish the fitness advantages of otherwise beneficial mutations; by contrast, relatively high, benign, temperatures allow beneficial mutations to efficiently show their phenotypic effects. To experimentally test this “mutational effects” mechanism, we examined the fitness effects of mutations across a temperature gradient using bacterial genotypes from the early stage of a mutation accumulation experiment withEscherichia coli. While the incidence of beneficial mutations did not significantly change across environmental temperatures, the number of mutations that conferred strong beneficial fitness effects was greater at higher temperatures. The results therefore support the hypothesis that warmer temperatures increase the chance and magnitude of positive selection, with implications for explaining the geographic patterns in evolutionary rates and understanding contemporary evolution under global warming.
When all else fails: The (mis)use of qualitative research in the evaluation of complex interventions
Authors: Rotteau Leahora , Albert Mathieu , Bhattacharyya Onil , Berta Whitney , Webster Fiona
Published: May 2020

Rational, aims, and objectives

Qualitative research has been promoted as an important component of the evaluation of complex interventions to support the scale up and spread of health service interventions, but is currently not being maximized in practice. We aim to identify and explore the sociocultural and structural factors that impact the uses (and misuses) of qualitative research in the evaluation of complex health services interventions.

Methods

We conducted a qualitative analysis of data collected in a multiple case study of the evaluation and scale up and spread of three health service intervention.

Results

Our findings demonstrate the challenges of meaningfully integrating qualitative research in evaluation programmes lead by clinicians with limited qualitative expertise and operating within an environment dominated by biomedical research, even with methodological support.

Conclusions

Based on these findings we encourage ongoing engagement of qualitative researchers in evaluation programmes to begin to refine our methodological understanding, while also suggesting changes to medical education and evaluation funding models to create fertile environments for interdisciplinary collaborations.
Perceived barriers to evidence‐based practice in stroke management among physiotherapists in a developing country
Authors: Ibikunle Peter O. , Onwuakagba Ifeoma U. , Maduka Esther U. , Okoye Emmanuel C. , Umunna Joseph O.
Published: May 2020

Background of Study

Like most healthcare disciplines, the physiotherapy profession has embraced the concept of evidence‐based practice (EBP) worldwide. However, there is a discrepancy between the amount of research evidence that exists and its use in clinical decision making.

Aims

To investigate the barriers physiotherapists in Nigeria encounter in implementing EBP in stroke management.

Methods

This was a cross‐sectional survey involving consecutively recruited 170 physiotherapists (mean age = 29.92 ± 5.72 years) from conveniently sampled centres in the six geopolitical zones in Nigeria. The Practitioner and Organizational Barriers to Evidence‐based Stroke Rehabilitation Questionnaire was used to collect data on EBP among the physiotherapists. Data was summarized using frequency, percentage, mean, and SD and analysed using Spearman rank order, Kruskal‐Wallis and Mann‐Whitney U tests at alpha level of 0.05.

Results

Insufficient time (47.6%), lack of information resources (42.9%), lack of organizational mandate (42.9%), lack of research skills (30.6%), and poor ability to critically appraise literature (29.4%) were the mostly reported barriers. Most participants had received formal training about EBP, had positive attitude and beliefs about EBP, were highly confident in their abilities to implement EBP, were aware of their roles in EBP, and were interested in acquiring and improving the skills necessary to implement EBP. There was unavailability of resources and support to promote evidence‐based practice. EBP uptake was significantly facilitated by having more education on EBP, higher academic degree, less daily workload, more years of experience in stroke rehabilitation, more participation time in research and teaching, and belonging to professional association (P < .05).

Conclusion

Insufficient time, lack of organizational mandates, lack of research skills, poor ability to critically appraise literature and unavailability of resources and organizational support are key barriers to EBP among Nigerian physiotherapists. Nigerian physiotherapists, their regulatory board, and Government need to work in tandem to improve EBP among Nigerian physiotherapists.
Maxillary full‐arch reconstruction using a sequenced digital workflow
Authors: Roberts Matt , Shull Franklin , Schiner Brit
Published: May 2020

Objective

Multi‐staged treatment of a terminal maxillary arch from tooth‐supported provisional to implant‐supported final reconstruction using a fully digital workflow is reported. Each stage of the phased esthetically‐guided reconstruction treatment plan, provisional restorations, and final restoration were executed in a virtual 3D environment prior to clinical treatment, providing CAD/CAM manufactured precision provisionals and final restoration that preserved the natural gingival architecture, function, and esthetics demanded by the patient.

Demonstrate the efficacy of using a digital workflow to fully restore a terminal maxillary arch with a precision implant‐supported final prosthetic by instituting a multi‐phase treatment plan designed to preserve the patient's gingival architecture, facial esthetics, and natural function.

Clinical Considerations

Sophisticated digital tools and software allow the dental team to work in a virtual environment to envision and execute the outcome of each stage of treatment prior to the patient appointment and to deliver an esthetically‐guided precision final prosthesis that replicates the form, function, and occlusion of existing natural teeth.

Conclusions

Digital technologies provide clinicians and dental ceramists with sophisticated tools and software that advance the precision and execution of each phase of maxillary arch reconstruction in fewer patient visits and elevate the patient experience and treatment outcome.

Clinical Significance

Sophisticated digital tools and software allow the dental team to work in a virtual environment to envision and execute the outcome of each stage of treatment prior to the patient appointment and to deliver an esthetically‐guided precision final prosthesis that replicates the form, function, and occlusion of existing natural teeth.
Comparison of endoscopic versus laparoscopic resection for gastric gastrointestinal stromal tumors: A preliminary meta‐analysis
Authors: Zhu Hanlong , Zhao Si , Jiao Ruonan , Zhou Jian , Zhang Chunmei , Miao Lin
Published: May 2020

Background and Aim

For localized disease, complete surgical resection is regarded as the “gold standard” therapeutic modality. With the rapid development of endoscopic techniques, endoscopic resection (ESR) has been confirmed as an efficient and safe alternative for the treatment of gastrointestinal stromal tumors (GISTs) in the stomach. Nevertheless, the management of gastric GISTs remains poorly defined. The purpose of this study is to evaluate the security and effectiveness of ESR with laparoscopic resection (LAR) for gastric GISTs.

Methods

A literature search of online databases was conducted to identify relevant comparative studies of ESR and LAR procedures for gastric GISTs published before April 10, 2020. The cumulative data analysis was also performed utilizing the software STATA.

Results

In total, 10 studies involving 1165 patients met the inclusion criteria for analysis (651 for ESR and 514 for LAR). From the results of meta‐analysis, patients who underwent ESR experienced decreased operative time (P = 0.000), less intraoperative blood loss (P = 0.002), earlier time to diet (P = 0.000), shorter hospital stay (P = 0.000), and lower total charges (P = 0.000) compared with LAR. Moreover, there were no significant differences between these two approaches concerning tumor rupture, conversion rate to other procedure, complete resection rate, postoperative complication rate, recurrence rate, and disease‐free survival.

Conclusions

Endoscopic resection, as an effective alternative treatment strategy with satisfactory outcomes, is acceptable for selective patients with gastric GISTs compared with LAR. Further well‐designed randomized controlled trials with large samples are warranted to corroborate our observations.
Making use of life cycle assessment and environmental product declarations: A survey with practitioners
Authors: Galindro Bruno Menezes , Welling Sebastian , Bey Niki , Olsen Stig Irving , Soares Sebastião Roberto , Ryding Sven‐Olof
Published: May 2020

Life Cycle Assessment (LCA) and Environmental Product Declarations (EPDs) represent important sources of information in applications such as ecodesign and process optimization. However, their use in comparisons and communication is still limited. Therefore, this article aims to understand the use of LCA‐ and EPD‐information from the perspective of the practitioners, that is, professionals with experience in dealing with this type of information. A survey was built consisting of two questionnaires and two webinars, with questions related to core themes: frequency and purpose of use, comparability, and advantages and disadvantages for practical use and reliability of different presentation formats. Also, two suggested benchmarking frameworks were presented and discussed, later being commented upon and evaluated. Out of the 55 respondents, 76% stated that they use both LCA‐ and EPD‐information, primarily to fulfill requirements from customers, in environmental management systems and for marketing purposes. It was also stated that they use LCA (73%)‐ and EPD (56%)‐information to make comparisons but presented different responses and there were no established patterns as to the procedures. Methodological limitations and the need for harmonization of Product Category Rules (PCRs) were mentioned as limiting factors for comparisons between studies. Regarding the benchmarking frameworks, both were indicated to be potentially applicable in communication with consumers and between companies. It is concluded that LCA‐ and EPD‐information is used by the practitioners in different applications and that there may be a need to increase standardization efforts of benchmarking procedures in order to improve communication with nonspecialist audiences.
“Y, what do you think about what X just said?” Conversation analysis of stance‐eliciting questions in open dialogue network meetings
Authors: Rossen Camilla Blach , Schriver Karen Nissen , Tarber Christel , Nordahl Dorthe Vedel , Thygesen Rasmussen Grethe , Ong Ben , Buus Niels
Published: May 2020

Open dialogue is a resource‐oriented approach to mental health, which aims to help those involved in a crisis situation support each other and engage in dialogue. While language use in open dialogue is generally characterized as being open‐ended, nondirective, and nonevaluating on the professionals' side, little is known about the specific conversational features. The aim of this study was to analyze the interactional functions of a stance‐eliciting question of the form: “Y, what do you think about what X just said?” We used conversation analysis (CA) to examine this in eight video‐recorded Danish open dialogue network meetings. In CA, stance involves expressions of attitude, affect, or judgments about people or events. We describe the interactional functions of these stance‐eliciting questions and discuss how clinicians used them as a tool for accomplishing neutrality. The findings can be used to gain a more nuanced understanding of open dialogue psychotherapeutic practices.
An Academic Midwifery Fellowship: Addressing a Need for Junior Faculty Development and Interprofessional Education
Authors: Nacht Amy , Martin Julia
Published: May 2020

The University of Colorado College of Nursing crafted a midwifery fellowship to address a local need to recruit junior faculty into a large practice caring primarily for an underserved, at‐risk population. Additional goals for the fellowship included promoting retention and development of interprofessional education teams. The curriculum design drew heavily from 2 national initiatives: (1) the Institute of Medicine's call for nursing residencies to support the transition to advanced practice and build expertise in navigating health systems and caring for patients with complex needs and (2) the American College of Obstetricians and Gynecologists and American College of Nurse‐Midwives collaboration to address maternity care workforce shortages by building clinically‐based interprofessional teams. The fellowship uses Melei's transitions theory and Jean Watson's Theory of Human Caring as frameworks to understand the fellows experience in the 12‐month program. Fellow competencies concentrate on 7 core components: clinical, professional, intrapersonal, mentorship, interprofessional, low‐resource setting, and leadership. Program evaluation is in process with the aim of understanding if the fellowship improves confidence and competence for the newly graduated nurse‐midwife, and a change in attitude toward interprofessional teams. Of the 5 fellows who completed the midwifery fellowship over 4 years, 2 now have faculty positions within the practice and 4 of the 5 were offered positions. Common themes from the fellows’ reflection journals and mentorship meetings include the importance of mentorship in clinical and professional growth. Further program evaluation is needed to better understand the efficacy of program components in meeting the objectives to recruit and retain faculty and promote interprofessional education. Academic midwifery fellowships with interprofessional components may be an innovative recruitment technique for clinical faculty.
Considering Labor After Cesarean in a Woman with Class 3 Obesity
Authors: Ledbetter Ann
Published: May 2020

Because of the high cesarean rate in the United States, perinatal care providers are increasingly called upon to counsel women considering labor after cesarean. This counseling can be more complicated for women with class 3 obesity, defined as a body mass index at or exceeding 40. Although labor after cesarean may be less likely to result in successful vaginal birth after cesarean (VBAC) for this population, the risks of repeat cesarean are also higher for these women. This case report describes the benefits and risks of labor after cesarean, the chance of successful VBAC, and clinical recommendations to aid women in achieving VBAC when class 3 obesity is present.
Efficacy of a collagen hydrolysate and antioxidants‐containing nutraceutical on metrics of skin health in Indian women
Authors: Motwani Meghna S. , Khan Kaynat , Pai Akshay , Joshi Rajiv
Published: May 2020

Background

The skin’s aging process involves a decreased biosynthesis of extracellular matrix proteins (predominantly collagen) compounded by damage from environmental and intrinsic stressors. The Indian population is susceptible to skin damage given its geography and increasing urbanization or a genetic disposition. Previous studies have investigated nutrients such as collagen peptides, vitamins and phytonutrient‐rich botanical extracts for their individual benefits on skin.

Aims

This study examined the collective effect of a proprietary blend of these nutrients (in Nutrova Collagen+Antioxidants; NCA) on skin parameters, which has not been previously studied, especially in an Indian context.

Patients/Methods

34 healthy, Indian women (mean age = 39.5 years) were given a placebo daily for 30 days to establish a baseline, followed by NCA for two intervals of 30 days. 3D image reconstruction allowed the analysis of skin topography and blemishes. Instrumental measurements also included skin firmness, elasticity, hydration, and transepidermal water loss. Clinical evaluation was used to grade blemishes, wrinkles and periorbital hyperpigmentation.

Results

Based on instrumental evaluation, NCA significantly reduced wrinkle width, open pores, skin roughness, and the colour of hyperpigmented blemishes, while improving skin hydration, firmness and barrier function from baseline to Day 30 and Day 60. NCA also increased elasticity at Day 30. Clinical evaluation showed that periorbital hyperpigmentation and wrinkles reduced significantly.

Conclusion

NCA is effective for improving overall skin health in Indian women. These results show that targeted nutrient supplementation can improve skin health and further research over extended durations is merited.
Immune tolerance at the maternal‐placental interface in healthy pregnancy and pre‐eclampsia
Authors: Valencia‐Ortega Jorge , Saucedo Renata , Peña‐Cano María I. , Hernández‐Valencia Marcelino , Cruz‐Durán José G.
Published: May 2020

Aim

The objective of this review is to describe the immunological mechanisms which facilitate maternal tolerance at the maternal‐placental interface, and to discuss how these mechanisms are disrupted in pre‐eclampsia.

Methods

A literature review was performed based on the analysis of papers available on PubMed. The most important and relevant studies regarding the immunological mechanisms which facilitate maternal tolerance in healthy pregnancy and pre‐eclampsia are presented in this article.

Results

The maternal‐placental interface is the site where the immune tolerance begins and develops. Within the innate immunity, natural killer cells, macrophages and dendritic cells play a pivotal role in tolerance through regulation of inflammation. On the other hand, within the adaptive immunity, the correct increase of regulatory T cells is crucial for ensuring immune tolerance toward placental cells. Disturbances in maternal tolerance can lead to the appearance of pregnancy complications such as pre‐eclampsia, which has a considerable impact on perinatal morbidity and mortality.

Conclusion

Our partial knowledge of immunological mechanisms involved in tolerance at the maternal‐placental interface indicates that pre‐eclampsia is characterized by alterations of this maternal immune tolerance, which could represent the origin of the disease.