bluuebunny/crossref_metadata_2025 huggingface dataset:
The fate of evidence law: Two paths of development
Authors: Wang Zhuhao
Published: June 2020

Evidence law was famously deemed ‘the child of the jury’, its development widely perceived as a by-product of the jury trial. Conventional wisdom tells us that juries, because of their cognitive and epistemic failings, can hardly be trusted and thus need rules of evidence to steer them in the right direction. Therefore, given that jury trials are vanishing in the United States and other common law countries, we must question whether the traditional evidence-law model is sustainable. At the same time that juries have been on the decline, rapid developments in science and technology have led to new forms of evidence, including scientific evidence, electronic evidence and process-based evidence. Presenting these new types of evidence at trials, however, often creates a mismatch with the traditional evidence-law framework. A systematic redesign of 21st-century evidence law to better accommodate the intensified interplay between science, technology and the law seems to be the next natural development. This essay explores these two distinct paths of evidence law—the old, jury-driven model and a new, science-directed model—and argues for preserving the old path while at the same time spending more resources and making greater effort to accommodate these new forms of evidence.
Design and development of a wedge shaped magnetorheological clutch
Authors: Singh Anurag , Kumar Thakur Manish , Sarkar Chiranjit
Published: June 2020

This paper presents a novel drum magnetorheological clutch design having a wedge shaped boundary. The converging film formed due to the direction of motion of the magnetorheological clutch and the inclination of the wedge planes helps to produce the pressure generating mechanism in the magnetorheological grease film. The resistance force developed due to this mechanism in the proposed case exceeds that of the conventional drum clutch. The proposed wedge shaped drum magnetorheological clutch consists of bimetallic discs made up of aluminium and mild steel. Mild steel disc has a certain number of inclined sliders shaped like a wedge at its boundary, which is immersed in the magnetorheological grease. The yield stress of the magnetorheological grease varies as a function of the magnetic field created by electric current passing through the electromagnet. Bingham model has been employed in the present study to analyse theoretically the torque generated by wedge-shaped drum magnetorheological clutch. The proposed magnetorheological drum clutch with wedge shaped boundary and conventional drum clutch have been designed and fabricated with similar material parameters and magnetic circuits. The experiment has been performed for the different current values (0 A, 0.25 A and 0.52 A). Torque results are plotted and compared for both cases. Experimental results suggest that the proposed wedge shaped drum magnetorheological clutch produces more torque than the conventional drum magnetorheological clutch, and thus it has better performance.
Conceptualizing the Active Audience: Rhetoric and Practice in “Engaged Journalism”
Authors: Schmidt Thomas R. , Nelson Jacob L. , Lawrence Regina G.
Published: June 2020

A constellation of journalistic tools, platforms, companies and nonprofit funding has recently emerged, promoting the idea that allowing the audience to contribute to the news agenda is a promising strategy to increase trust in journalism, create new revenue streams and foster community-building. Despite a growing body of research, however, two main issues remain currently unexplored: (1) the extent to which engaged journalism as a practice aligns with engaged journalism as a theoretical construct, and (2) the extent to which the audience assumptions underlying the pursuit of engaged journalism align with actual audience expectations and desires. This paper begins to address both of these issues by comparing how advocates of engaged journalism conceptualize the public’s interest in participating in journalism with observations of actual instances of that participation. We find that there is indeed a gap between engaged journalism theory and practice, which we attribute to a distinction between what engaged journalists believe audiences want from news and how those audiences actually behave. At the same time, we also find that institutional rigidity in newsrooms that leads to some reluctance with regard to making news production more collaborative.
The framing of IMF and World Bank in political reform debates: The role of political orientation and policy fields in the cases of Russia and Ukraine
Authors: Pleines Heiko
Published: June 2020

The article presents a content analysis of assessments of the International Monetary Fund (IMF) and World Bank in parliamentary debates in Russia (1998–2008) and Ukraine (2010–2019) in order to understand the position of domestic actors in cases of conditionality-based international support. Russia and Ukraine offer the opportunity to compare periods with and without an active loan agreement with the IMF for domestic actors across the full political spectrum. In addition, the World Health Organization and the International Labour Organization are included in the analysis to allow a comparison with international organisations not working with financial conditionality. The analysis examines the general image of international organisations and differentiates between political camps and policy fields, with a special focus on social policy.
You can’t eat art! But can arts-based research challenge neighbourhood stigma?
Authors: Warr Deborah , Taylor Gretel , Jacobs Keith
Published: June 2020

We present research findings from an arts-based research (ABR) project that aimed to redress the symbolic effects of negative recognition associated with place-based stigma. Focusing on two prominently stigmatised neighbourhoods in Melbourne and Hobart (Australia), we explain the rationale for the study and how arts-based tactics were used for phenomenological explorations of familiar environments and to generate alternate, faithful and compelling portrayals of neighbourhoods that stemmed from residents’ actual experiences. Our approach to ABR blended sociological concerns with socially engaged practices that emphasised creative and dialogic tactics, provocations and immersive experiences. We explain how art-based tactics were incorporated into artist residency projects that comprised four parts: local induction; excursions to art galleries; a six-week workshop programme; and exhibition events. Following this, interviews were conducted with artist-residents at the conclusion of the projects. Both the artistic outcomes and participants’ reflections provide evidence that blending socially engaged art practices and participatory methods can help residents and researchers navigate the internalised effects of stigma in processes of meaning-making.
Factors associated with self-care behaviours among Koreans with heart failure
Authors: Ryou Choung , Kang Seok-Min , Jang Yeonsoo
Published: June 2020

Background

Self-care behaviours are important to improve health outcomes in patients with heart failure. However, little is known about the factors related to the subdimensions of self-care behaviours in these patients.

Aims

To identify the factors associated with the subdimensions of self-care behaviours among South Korean patients with heart failure.

Methods

The participants in this cross-sectional descriptive study conducted between October 2016 and January 2017 were 178 patients with heart failure. Self-care behaviours were measured using the EHFScB-9, which has three subdimensions: autonomy-based adherence; provider-directed adherence; and consulting behaviours. Demographic characteristics, experience of heart failure education, physical function, patient health questionnaire-9, Pittsburgh sleep quality index and self-care confidence were also measured. Descriptive statistics and multiple linear regression analysis were conducted.

Results

The mean age was 62 ± 12 years, and 37% were women. Younger age (P=0.023), no experience of heart failure education (P=0.039), poor physical function (P=0.003), poor sleep quality (P=0.037) and lower self-care confidence (P=0.001) were significantly associated with poor autonomy-based adherence. Being employed (P=0.042), poor sleep quality (P=0.042) and lower levels of self-care confidence (P=0.001) were associated with poor provider-directed adherence. Younger age (P=0.001) and lower self-care confidence (P=0.001) were associated with lower engagement in consulting behaviours.

Conclusion

The three subdimensions of self-care behaviours were associated with different psychosocial factors, necessitating the development of tailored interventions and educational materials based on unique self-care behaviour patterns in patients with heart failure.
Differences in Substance Use and Sexual Risk by Sexual Orientation and Gender Identity Among University and Community Young Adults in a U.S.-Mexico Border City
Authors: Loza Oralia , Mangadu Thenral , Ferreira-Pinto João B. , Guevara Priscilla
Published: June 2020

Ethnic and sexual minority young adults in El Paso, Texas, are at high risk for substance use, human immunodeficiency virus (HIV), and hepatitis C virus (HCV). In 2014, a Hispanic-serving higher education institution partnered with two community-based organizations to implement integrated substance use interventions and HIV and HCV prevention among young adults on campus and in surrounding communities. Among the 95 young adults, aged 18–24 years, who responded to a needs assessment survey, 91.5% were Hispanic, 53.7% were female, and 27.4% were sexual or gender minorities (SGMs) as defined by behavior and identity. SGMs had significantly higher rates of current smoking, drinking when bored, and of being told they had a drinking problem. Compared with the other young adult survey respondents, SGMs had lower health risk perceptions for tobacco, alcohol, and marijuana use and reported similar or higher rates of lifetime drug use during sex and higher rates of HIV risk behaviors. Study findings have implications for including measures for sexual orientation and gender identity in substance use studies, examining regional and cultural norms that may intersect to shape substance use among SGMs, and incorporating unique risk contexts for SGMs in interventions for substance use.
Erythrocyte Sedimentation Rate Combined With the Probe-to-Bone Test for Fast and Early Diagnosis of Diabetic Foot Osteomyelitis
Authors: Xu Jun , Cheng Fang , Li Yanming , Zhang Jinghang , Feng Shuhong , Wang Penghua
Published: June 2020

This study aimed to investigate the erythrocyte sedimentation rate (ESR) optimal cutoff point in Chinese patients with diabetic foot osteomyelitis (DFO) and to evaluate the screening value of ESR combined with probe-to-bone (PTB) test for a fast diagnosis of DFO in early stage. A total of 204 diabetic inpatients with foot infection were tested for white blood cell count, neutrophil %, C reactive protein, and ESR at admission within 24 hours. All patients were performed PTB test. Patients with DFO (111) were confirmed by bone biopsy, the other patients (86) had only soft tissue infection. Although white blood cell count, neutrophil %, C-reactive protein, and ESR were different between the 2 groups, only area under curve of ESR was 0.832, with the value as a diagnostic indicator. The best cut point of ESR was >43 mm/h; the sensitivity, specificity, positive predictive value (+PV), and negative predictive value (−PV) were 82.9%, 70.5%, 0.78, and 0.77, respectively. ESR combined with PTB test (serial test), the sensitivity, specificity, +PV, −PV, positive likelihood ratio (+LR), and negative LR (−LR) were 63.56%, 98%, 0.97, 0.67, 31.75, and 0.37, respectively. ESR combined with PTB test (parallel test), the sensitivity, specificity, +PV, −PV, +LR, and −LR were 96%, 65.7%, 0.78, 093, 2.8, and 0.06, respectively, combined with PTB test is simple, favorable for application, and can early fast screening patients with DFO in high-risk patients.
Identification of Persistent Aortocaval Fistula Using Ultrasonography in the Outpatient Setting: A Case Report
Authors: Meena Richard A. , Warren Melissa N. , Reeve Thomas E. , Alabi Olamide
Published: June 2020

Aortocaval fistula (ACF) is a rare and life-threatening complication associated with rupture of an abdominal aortic aneurysm (rAAA). Early detection and management of ACF’s during surgical repair of rAAAs is recommended to reduce the risk of future aneurysm-related complications, including mortality. There is a paucity of current literature on the natural history of ACFs postendovascular exclusion. We present a case study describing the detection of a persistent ACF by duplex ultrasonography (DU) postendovascular aortic repair (EVAR).
Convolutional neural network–based person tracking using overhead views
Authors: Ahmad Misbah , Ahmed Imran , Khan Fakhri Alam , Qayum Fawad , Aljuaid Hanan
Published: June 2020

In video surveillance, person tracking is considered as challenging task. Numerous computer vision, machine and deep learning–based techniques have been developed in recent years. Majority of these techniques are based on frontal view images/video sequences. The advancement of convolutional neural network reforms the way of object tracking. The network layers of convolutional neural network models trained on a number of images or video sequences improve speed and accuracy of object tracking. In this work, the generalization performance of existing pre-trained deep learning models have investigated for overhead view person detection and tracking, under different experimental conditions. The object tracking method Generic Object Tracking Using Regression Networks (GOTURN) which has been yielding outstanding tracking results in recent years is explored for person tracking using overhead views. This work mainly focused on overhead view person tracking using Faster region convolutional neural network (Faster-RCNN) in combination with GOTURN architecture. In this way, the person is first identified in overhead view video sequences and then tracked using a GOTURN tracking algorithm. Faster-RCNN detection model achieved the true detection rate ranging from 90% to 93% with a minimum false detection rate up to 0.5%. The GOTURN tracking algorithm achieved similar results with the success rate ranging from 90% to 94%. Finally, the discussion is made on output results along with future direction.
Evolution, the Menstrual Cycle, and Theoretical Overreach
Authors: Kiesner Jeff , Eisenlohr-Moul Tory , Mendle Jane
Published: June 2020

A considerable amount of recent psychological research has attributed a variety of menstrual-cycle-related changes in social behavior to evolutionarily adaptive functions. Although these studies often draw interesting and unusual conclusions about female emotion and behavior within evolutionary theory, their significant limitations have not yet been addressed. In this article, we outline several methodological and conceptual issues related to the menstrual cycle that constitute threats to the internal validity and theoretical integrity of these studies. We recommend specific guidelines to address these issues and emphasize the need to apply more comprehensive and sophisticated theoretical structures when considering menstrual-cycle-related changes in emotion and behavior.
Meritocracy a myth? A multilevel perspective of how social inequality accumulates through work
Authors: van Dijk Hans , Kooij Dorien , Karanika-Murray Maria , De Vos Ans , Meyer Bertolt
Published: June 2020

Work plays a crucial role in rising social inequalities, which refer to unequal opportunities and rewards for different social groups. Whereas the conventional view of workplaces as meritocracies suggests that work is a conduit for social equality, we unveil the ways in which workplaces contribute to the accumulation of social inequality. In our cumulative social inequality in workplaces (CSI-W) model, we outline how initial differences in opportunities and rewards shape performance and/or subsequent opportunities and rewards, such that those who receive more initial opportunities and rewards tend to receive even more over time. These cumulative social inequality dynamics take place via nine different mechanisms spanning four different levels (individual, dyadic, network, and organizational). The CSI-W indicates that the mechanisms interact, such that the social inequality dynamics in workplaces tend to (a) exacerbate social inequalities over time, (b) legitimate social inequalities over time, and (c) manifest themselves through everyday occurrences and behaviors.
Necrocapitalist networks: COVID-19 and the ‘dark side’ of economic geography
Authors: Lawreniuk Sabina
Published: June 2020

The economic fallout from COVID-19 has precipitated a crisis in global supply chains. The lockdown of consumers worldwide has triggered a fall in demand that has so far led to the dismissal of up to one-third of Cambodia’s garment sector workforce. Though the pandemic is exceptional, this is a crisis rooted in the exemplary rather than extraordinary hyper-precarity of workers in global industry. Here, I argue that COVID-19 spotlights the elusive ‘dark sides’ of global production in economic geography, revealing the necrocapitalist logics of supply chains.
Prescribing for moderate or severe unipolar depression in patients under the long-term care of UK adult mental health services
Authors: Paton Carol , Anderson Ian M. , Cowen Philip J. , Delgado Oriana , Barnes Thomas R. E.
Published: June 2020

Background:

A quality improvement programme addressing prescribing practice for depression was initiated by the Prescribing Observatory for Mental Health.

Methods:

A baseline clinical audit against evidence-based practice standards was conducted in UK adult mental health services.

Results:

A total of 55 mental health services submitted data for 2082 patients, under the care of a community psychiatric team (CMHT) for at least a year, with a diagnosis of moderate or severe unipolar depression, 54% of whom had a comorbid psychiatric diagnosis. Selective serotonin reuptake inhibitors were prescribed for 35% of the patients, other newer generation antidepressants for 60%, tricyclic antidepressants for 6% and monoamine oxidase inhibitors for <1%. The most commonly prescribed individual antidepressants were mirtazapine (33%, usually in combination with another antidepressant), venlafaxine (25%) and sertraline (21%). Patients with severe depression were more likely ( p < 0.001) to be co-prescribed an antipsychotic medication, lithium, or to have received electroconvulsive therapy. There was a documented clinical review in the last year in 85%, with a symptom rating scale used in 11%. A documented comprehensive treatment history was accessible for 50% of those prescribed antidepressant medication.

Conclusion:

Patients with moderate or severe depression remaining under the care of a CMHT for longer than a year are clinically complex. The failure to achieve a level of wellness allowing discharge from mental health services may be partly related to the finding that not all patients had the benefit of a systematic approach to clinical assessment and sequential testing of available evidence-based pharmacological interventions.
Influencer Marketing: An Exploratory Study to Identify Antecedents of Consumer Behavior of Millennial
Authors: Chopra Anjali , Avhad Vrushali , Jaju and Sonali
Published: June 2020

Recent marketing trends indicate the rise of influencers as an extension of word of mouth campaigns. As consumers turn to social media platforms, organizations are realizing the power of influencers in affecting a purchase decision. The current study throws light on various aspects of influencer marketing that drive consumer behavior by using the theory of planned behavior (henceforth referred to as TPB) ( Ajzen, 1991 ) and social learning theory by Bandura and Walters (1963) as part of the qualitative research to identify key factors of influencer marketing that impact consumer behavior. The study revealed that both attitude toward influencers and perceived behavior control that allows increase in domain knowledge had a favorable impact on consumer behavior while the influence of peers had no effect. Further additional constructs namely personal relevance, inspiration, and trust had a positive impact on behavior while perceived risk did not have any effect. Product influencer fitment was an important criterion for consumers, as they followed the specific type of influencers for different product categories. Depending on the posts shared by influencers, consumers are impacted at four levels: increase in brand awareness, subject matter expertise, brand preference, and preference. Successful influencer marketing involves identifying the right type of influencer who will offer curated advice, stories, and suggestions to create engagement with the audience.
Immobilization in External Rotation Reduces the Risk of Recurrence After Primary Anterior Shoulder Dislocation: A Meta-analysis
Authors: Shinagawa Kiyotsugu , Sugawara Yumi , Hatta Taku , Yamamoto Nobuyuki , Tsuji Ichiro , Itoi Eiji
Published: June 2020

Background:

The best method for nonsurgical treatment after primary dislocation of the shoulder is not clear. The efficacy of immobilization with the arm in external rotation (ER) compared with internal rotation (IR) remains controversial.

Purpose:

To determine the efficacy of ER immobilization versus IR immobilization on recurrence rate after primary dislocation of the shoulder from the evidence of randomized controlled trials.

Study Design:

Systematic review; Level of evidence, 2.

Methods:

Electronic databases (MEDLINE [Ovid SP], PubMed, Web of Science, EBM reviews, and CINAHL) and available proceedings according to the abstracts of major international meetings related to or including shoulder injuries and trauma were used to search for randomized controlled trials. Two independent investigators determined eligibility and carried out data extraction from the selected studies.

Results:

A total of 9 studies (817 patients) were selected for this meta-analysis. They included 668 male and 149 female patients, with a mean age ranging from 20.3 to 37.5 years. In the 9 pooled studies, the recurrence rate of shoulder dislocation was 21.5% (84/390) in the ER group versus 34.9% (130/373) in the IR group. ER immobilization significantly reduced the recurrence rate compared with IR immobilization (risk ratio, 0.56; P = .007). In the subgroup analysis of those immobilized full-time, ER immobilization was significantly more effective than IR immobilization in reducing the recurrence rate (risk ratio, 0.57; P = .01). In the subgroup analysis of age, ER immobilization was significantly more effective than IR immobilization in those aged 20 to 40 years but not in those younger than 20 years.

Conclusion:

This meta-analysis demonstrates that ER immobilization reduces the recurrence rate after primary shoulder dislocation compared with IR immobilization in patients older than 20 years. When treating a patient with primary shoulder dislocation, the clinician should provide this information to the patient before a treatment method is selected.
Unraveling the role of governance mechanisms in online ratings: The case of Spanish chain-affiliated hotels
Authors: Fernández-Barcala Marta , González-Díaz Manuel , López-Bayón Susana
Published: June 2020

This article studies how the choice of the mechanism of governance affects online ratings of hotels, empirically exploring the conditions under which various governance mechanisms improve (or damage) them. We emphasize that no governance mode is universally superior. However, when the mechanism of governance fits hotel characteristics, online ratings improve. We argue that such characteristics (i.e., hotel category, size, and age) determine the severity of agency problems (e.g., managerial shirking and free-riding) and the performance of governance choice. We test several organizational fit hypotheses on a data set of 2,328 hotels operating in Spain. Our results support the fit argument, because they show the superiority of franchise and management contracts (i.e., hybrids) for enhancing online ratings, as opposed to vertical integration, when category rises and size increases. Furthermore, we find evidence that maintenance does not appear to be a major problem in leasing.

JEL CLASSIFICATION: D23; L25; L83
An Active Learning Approach to Teaching Social Determinants of Health
Authors: Richardson Jeanita W.
Published: June 2020

This active learning exercise is designed to deconstruct the impact of social determinants through the assumption of randomly selected personas. As an active learning exercise, it provides opportunities for discussion, problem solving, writing, and synthesis, while incorporating multiple learning style preferences. Part 1 involves assessing the individual social determinants at work. Part 2 involves exploring ways said determinants can enhance community health through collaboration. Assumption of personas unlike one’s own facilitates an open discussion of social position and ranges of factors influential to health without potentially evoking a sense of defensiveness associated with personal privilege (or the lack thereof).
Practice-Based Teaching Model for Undergraduate Public Health Students: Partnership for Exercise Is Medicine on Campus Initiative
Authors: Kratzke Cynthia , DeLeon Olivia , Rao Satya
Published: June 2020

The practice-based teaching (PBT) pedagogical approach is vital to prepare students to learn collaboratively how to solve real-world complex public health problems. Despite evidence of the new PBT approach in graduate public health courses, little is known about the development of PBT in undergraduate public health courses. The purpose of this article is to describe an undergraduate course design using PBT, offer suggestions for using the effective PBT STEPS (Securing Partnerships, Technology and Training, Engagement and Implementation, Presenting Deliverables, Sizing Up Results) framework, and explain lessons learned. The experiences are based on 4 years of successful implementation of the PBT course project, Exercise Is Medicine on Campus (EIM-OC) initiative. The college campus is a promising setting to promote EIM-OC and physical activity awareness. Undergraduate public health students in the Health Administration of Programs course partnered with the campus Wellness, Alcohol and Violence Education Program for the fall initiative. We used the comprehensive PBT STEPS framework in planning the EIM-OC. The evaluation included the number of participants at the Chancellor Walk and activity stations and student reflective writing papers. The findings suggest the effectiveness of PBT pedagogy for faculty to redesign an existing course. Students gain a deeper understanding of campus health and health topics. Faculty can guide students and empower them for working with partners to think, act, and practice like professionals during academic preparation.
HR4.0: How Should HR Gear Up for Industry 4.0?
Authors: S. Sivakumar , Mohan Uma , Chankarachan Pradeep , Bhaduri Nilanjana
Published: June 2020

This article is based on interviews with industry leaders to get their insights into how the industry-wide disruptions are evolving. Accordingly, they share their views on the transformation journey that HR should undertake, with focus on learning, unlearning and relearning, in order to get ready for its HR4.0 avatar. HR4.0 definitely has a scope to make a bigger impact by designing and influencing talent management and development practices beyond organisational boundaries.
Precursor Lesions of Cholangiocarcinoma: A Clinicopathologic Review
Authors: Geramizadeh Bita
Published: June 2020

Cholangiocarcinoma (CCA) develops through multistep carcinogenesis. During the past decades, 2 precursors have been proved to evolve to CCA. The 2 main precursor lesions of CCA are biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. It is an interesting and relatively novel entity for the hepatobiliary surgeons, radiologists, oncologists, and pathologists. It worth being familiar with these 2 entities for better communication between pathologists, oncologists, and surgeons to improve the treatment and follow-up of these lesions, which can definitely decrease their evolvement to CCA as an aggressive, poor prognostic, and life-threatening cancer. In this narrative review, I collected and discussed all published studies about these 2 precursor lesions of CCA including radiologic, clinical, and pathological manifestation.
Ejaculatory abstinence in semen analysis: does it make any sense?
Authors: Dupesh Shah , Pandiyan Natarajan , Pandiyan Radha , Kartheeswaran Jeeva , Prakash Bhaskar
Published: June 2020

Background:

The precise effect of ejaculatory abstinence on semen parameters is highly debatable, especially among subfertile men. Previous studies on effect of abstinence time on different semen parameters have reported controversial results. The aim of this study was to retrospectively assess the variance of semen parameters with different periods of ejaculatory abstinence among both a population of normozoospermic ( n = 1621) and oligozoospermic ( n = 416) Tamil men, presenting to a fertility clinic for an infertility evaluation ( N = 2037).

Materials and Methods:

A retrospective analysis of 2037 semen analysis reports involved grouping patients based on their ejaculatory abstinence, that is, <24 h, 1 to 2 days, 3 to 7 days, 8 to 15 days, 16 to 30 days, and >30 days. All semen parameters were assessed as per the World Health Organization (WHO, 2010) recommended guidelines. The unpaired two-tailed t-test and Welch’s analysis of variance (ANOVA) combined with Games–Howell post hoc test were used for statistical analysis. A p value <0.05 was considered to be statistically significant.

Result:

A retrospective analysis of data ( N = 2037) identified no statistically significant differences in semen parameters of sperm concentration, percentage of progressively motile sperm, and normal sperm morphology in both normozoospermic and oligozoospermic individuals across different groups of abstinence. Semen volume was the only parameter that showed a statistically significant difference in both groups ( p < 0.0001). In both normozoospermic and oligozoospermic men, the group with <24 h abstinence had the highest mean percentage of progressively motile sperm and normal sperm morphology.

Conclusion:

The findings of this study suggest that ejaculatory abstinence may be highly arbitrary, and the recommendation of a strict 2- to 7-day abstinence per the WHO may be liberalized. In both normozoospermic and oligozoospermic men, semen parameters associated with an abstinence of <24 h were found to be noninferior as compared to longer ejaculatory abstinence intervals. These findings support in eliminating conservative recommendations as far as abstinence is concerned and suggest that patients may be asked to collect a semen sample on the day they present for an infertility evaluation, regardless of abstinence.
Frequency and spectrum of disease-causing variants in 1892 patients with suspected genetic HLH disorders
Authors: Gadoury-Levesque Vanessa , Dong Lei , Su Rui , Chen Jianjun , Zhang Kejian , Risma Kimberly A. , Marsh Rebecca A. , Sun Miao
Published: June 2020

This article explores the distribution and mutation spectrum of potential disease-causing genetic variants in hemophagocytic lymphohistiocytosis (HLH)–associated genes observed in a large tertiary clinical referral laboratory. Samples from 1892 patients submitted for HLH genetic analysis were studied between September 2013 and June 2018 using a targeted next-generation sequencing panel approach. Patients ranged in age from 1 day to 78 years. Analysis included 15 genes associated with HLH. A potentially causal genetic finding was observed in 227 (12.0%) samples in this cohort. A total of 197 patients (10.4%) had a definite genetic diagnosis. Patients with pathogenic variants in familial HLH genes tended to be diagnosed significantly younger compared with other genes. Pathogenic or likely pathogenic variants in the PRF1 gene were the most frequent. However, mutations in genes associated with degranulation defects (STXBP2, UNC13D, RAB27A, LYST, and STX11) were more common than previously appreciated and collectively represented >50% of cases. X-linked conditions (XIAP, SH2D1A, and MAGT1) accounted for 17.8% of the 197 cases. Pathogenic variants in the SLC7A7 gene were the least encountered. These results describe the largest cohort of genetic variation associated with suspected HLH in North America. Merely 10.4% of patients were identified with a clearly genetic cause by this diagnostic approach; other possible etiologies of HLH should be investigated. These results suggest that careful thought should be given regarding whether patients have a clinical phenotype most consistent with HLH vs other clinical and disease phenotypes. The gene panel identified known pathogenic and novel variants in 10 HLH-associated genes.
Risk models for VTE and bleeding in medical inpatients: systematic identification and expert assessment
Authors: Darzi Andrea J. , Karam Samer G. , Spencer Frederick A. , Spyropoulos Alex C. , Mbuagbaw Lawrence , Woller Scott C. , Zakai Neil A. , Streiff Michael B. , Gould Michael K. , Cushman Mary , Charide Rana , Etxeandia-Ikobaltzeta Itziar , Germini Federico , Rigoni Marta , Agarwal Arnav , Morsi Rami Z. , Akl Elie A. , Iorio Alfonso , Schünemann Holger J.
Published: June 2020

Risk assessment models (RAMs) for venous thromboembolism (VTE) and bleeding in hospitalized medical patients inform appropriate use of thromboprophylaxis. Our aim was to use a novel approach for selecting risk factors for VTE and bleeding to be included in RAMs. First, we used the results of a systematic review of all candidate factors. Second, we used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of the evidence for the identified factors. Third, we using a structured approach to select factors to develop the RAMs, by building on clinical and methodological expertise. The expert panel made judgments on whether to include, potentially include, or exclude risk factors, according to domains of the GRADE approach and the Delphi method. The VTE RAM included age >60 years, previous VTE, acute infections, immobility, acute paresis, active malignancy, critical illness, and known thrombophilia. The bleeding RAM included age ≥65 years, renal failure, thrombocytopenia, active gastroduodenal ulcers, hepatic disease, recent bleeding, and critical illness. We identified acute infection as a factor that was not considered in widely used RAMs. Also, we identified factors that require further research to confirm or refute their importance in a VTE RAM (eg, D-dimer). We excluded autoimmune disease which is included in the IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) bleeding RAM. Our results also suggest that sex, malignancy, and use of central venous catheters (factors in the IMPROVE bleeding RAM) require further research. In conclusion, our study presents a novel approach to systematically identifying and assessing risk factors to be included or further explored during RAM development.
Trends in systemic sclerosis and systemic sclerosis-related pulmonary arterial hypertension mortality in the USA
Authors: Ratanawatkul Pailin , Solomon Joshua J. , Kim Darlene , George Marjorie P. , Matarrese McGibbon Lia R. , Demoruelle M. Kristen , Maleki-Fischbach Mehrnaz , Amigues Isabelle , Kastsianok Liudmila , Fernández Pérez Evans R.
Published: June 2020

There are limited data nationwide on the burden of systemic sclerosis (SSc)-related mortality. We aimed to determine recent trends in SSc and SSc-related pulmonary arterial hypertension (PAH) mortality overall and across population subgroups.

Using death certificate data from the National Center for Health Statistics, we computed the age-adjusted mortality rates of SSc and SSc-SSc−PAH, a lethal prevailing complication, across demographic groups, geographic regions and comorbid cardiorespiratory conditions, and used Joinpoint regression analysis to calculate the average annual percentage change (APC) in mortality.

From 2003 to 2016, 25 175 death records contained a code for SSc. Decedents were predominantly female (81%) and white (73%), with an average age of 66±14 years. The age-adjusted mortality rate decreased by 3% per year from 6.6 in 2003 to 4.3 per 1 000 000 population in 2016. Also, a decreasing trend was found when SSc was stratified by age, sex, race and geographic region. The prevalence of PAH was 23%. The odds of PAH were highest in female and black decedents, and in decedents with concomitant pulmonary embolism, cardiomyopathy and interstitial lung disease (ILD). SSc−PAH mortality remained stable from 2003 to 2008 then decreased by 3% per year from 2008 to 2016. In decedents with SSc−PAH, among all concomitant comorbidities, the mortality rate associated with ILD had the highest increase (average APC 6%, 95% CI 2%−10%).

The mortality rate from SSc decreased from 2003 to 2016. Decreases in mortality rates were similar across demographic groups and geographic regions. SSc−PAH-related mortality remained stable. The death rate for SSc−ILD and concomitant PAH increased during this period.
Genetic risk prediction of the plasma triglyceride response to independent supplementations with eicosapentaenoic and docosahexaenoic acids: the ComparED Study
Authors: Vallée Marcotte Bastien , Allaire Janie , Guénard Frédéric , de Toro-Martín Juan , Couture Patrick , Lamarche Benoît , Vohl Marie-Claude
Published: June 2020

Background

We previously built a genetic risk score (GRS) highly predictive of the plasma triglyceride (TG) response to an omega-3 fatty acid (n-3 FA) supplementation from marine sources. The objective of the present study was to test the potential of this GRS to predict the plasma TG responsiveness to supplementation with either eicosapentaenoic (EPA) or docosahexaenoic (DHA) acids in the Comparing EPA to DHA (ComparED) Study.

Methods

The ComparED Study is a double-blind, controlled, crossover trial, with participants randomized to three supplemented phases of 10 weeks each: (1) 2.7 g/day of DHA, (2) 2.7 g/day of EPA, and (3) 3 g/day of corn oil (control), separated by 9-week washouts. The 31 SNPs used to build the previous GRS were genotyped in 122 participants of the ComparED Study using TaqMan technology. The GRS for each participant was computed by summing the number of rare alleles. Ordinal and binary logistic models, adjusted for age, sex, and body mass index, were used to calculate the ability of the GRS to predict TG responsiveness.

Results

The GRS predicted TG responsiveness to EPA supplementation (p = 0.006), and a trend was observed for DHA supplementation (p = 0.08). The exclusion of participants with neutral TG responsiveness clarified the association patterns and the predictive capability of the GRS (EPA, p = 0.0003, DHA p = 0.01).

Conclusion

Results of the present study suggest that the constructed GRS is a good predictor of the plasma TG response to supplementation with either DHA or EPA.

Trial registration

ClinicalTrials.gov, NCT01810003. The study protocol was registered on March 4, 2013.
Genome-wide analysis of proline-rich extension-like receptor protein kinase (PERK) in Brassica rapa and its association with the pollen development
Authors: Chen Guohu , Wang Jian , Wang Hao , Wang Chenggang , Tang Xiaoyan , Li Jie , Zhang Lei , Song Jianghua , Hou Jinfeng , Yuan Lingyun
Published: June 2020

Background

Proline-rich extension-like receptor protein kinases (PERKs) are an important class of receptor kinases located in the plasma membrane, most of which play a vital role in pollen development.

Results

Our study identified 25 putative PERK genes from the whole Brassica rapa genome (AA). Phylogenetic analysis of PERK protein sequences from 16 Brassicaceae species divided them into four subfamilies. The biophysical properties of the BrPERKs were investigated. Gene duplication and synteny analyses and the calculation of Ka/Ks values suggested that all 80 orthologous/paralogous gene pairs between B. rapa and A. thaliana, B. nigra and B. oleracea have experienced strong purifying selection. RNA-Seq data and qRT-PCR analyses showed that several BrPERK genes were expressed in different tissues, while some BrPERKs exhibited high expression levels only in buds. Furthermore, comparative transcriptome analyses from six male-sterile lines of B. rapa indicated that 7 BrPERK genes were downregulated in all six male-sterile lines. Meanwhile, the interaction networks of the BrPERK genes were constructed and 13 PERK coexpressed genes were identified, most of which were downregulated in the male sterile buds.

Conclusion

Combined with interaction networks, coexpression and qRT-PCR analyses, these results demonstrated that two BrPERK genes, Bra001723.1 and Bra037558.1 (the orthologs of AtPERK6 (AT3G18810)), were downregulated beginning in the meiosis II period of male sterile lines and involved in anther development. Overall, this comprehensive analysis of some BrPERK genes elucidated their roles in male sterility.
Impacts of a novel defensive symbiosis on the nematode host microbiome
Authors: Dahan Dylan , Preston Gail M. , Sealey Jordan , King Kayla C.
Published: June 2020

Background

Bacteria adapted to live within animals can protect their hosts against harmful infections. Beyond antagonism with pathogens, a ‘defensive’ bacterial symbiont could engage in additional interactions with other colonizing micro-organisms. A single bacterium might thus have cascading ecological impacts on the whole microbiome that are rarely investigated. Here, we assess the role of a defensive symbiont as a driver of host-associated microbiota composition by using a bacterial species (Enterococcus faecalis) that was previously experimentally adapted to a nematode host model (Caenorhabditis elegans).

Results

An analysis of 16S rRNA data fromC. elegansexposed toE. faecalisand subsequently reared in soil, reveal that symbiont adaptation to host environment or its protective potential had minimal impact on microbiota diversity. Whilst the abundance ofPseudomonaswas higher in the microbiota of hosts with protectiveE.faecalis(and another protective species tested), a few other genera – includingSerratiaandSalinispora –were less abundant in hosts colonized by allE. faecalisstrains. In addition, the protective effect ofE. faecalisagainst virulentStaphylococcus aureuspathogens was maintained despite multi-species interactions within the microbiota.

Conclusions

Our results reveal the degree to which a new, evolving symbiont can colonise and maintain pathogen-resistance with minimal disruption to host microbiota diversity.
Retraction Note to: The role of seed appendage in improving the adaptation of a species in definite seasons: a case study of Atriplex centralasiatica
Authors: Wang Zhaoren , Zhao Yufei , Zhang Yuanyuan , Zhao Baoshan , Yang Zhen’an , Dong Lijia
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Improving design choices in Delphi studies in medicine: the case of an exemplary physician multi-round panel study with 100% response
Authors: Veugelers Rebekka , Gaakeer Menno I. , Patka Peter , Huijsman Robbert
Published: June 2020

Background

A proper application of the Delphi technique is essential for obtaining valid research results. Medical researchers regularly use Delphi studies, but reports often lack detailed information on methodology and controlled feedback: in the medical literature, papers focusing on Delphi methodology issues are rare. Since the introduction of electronic surveys, details on response times remain scarce. We aim to bridge a number of gaps by providing a real world example covering methodological choices and response times in detail.

Methods

The objective of our e(lectronic)-Delphi study was to determine minimum standards for emergency departments (EDs) in the Netherlands. We opted for a two-part design with explicit decision rules. Part 1 focused on gathering and defining items; Part 2 addressed the main research question using an online survey tool. A two-person consensus rule was applied throughout: even after consensus on specific items was reached, panellists could reopen the discussion as long as at least two panellists argued similarly. Per round, the number of reminders sent and individual response times were noted. We also recorded the methodological considerations and evaluations made by the research team prior to as well as during the study.

Results

The study was performed in eight rounds and an additional confirmation round. Response rates were 100% in all rounds, resulting in 100% consensus in Part 1 and 96% consensus in Part 2. Our decision rules proved to be stable and easily applicable. Items with negative advice required more rounds before consensus was reached. Response delays were mostly due to late starts, but once panellists started, they nearly always finished the questionnaire on the same day. Reminders often yielded rapid responses. Intra-individual differences in response time were large, but quick responders remained quick.

Conclusions

We advise those considering Delphi study to follow the CREDES guideline, consider a two-part design, invest in personal commitment of the panellists, set clear decision rules, use a consistent lay-out and send out your reminders early. Adopting this overall approach may assist researchers in future Delphi studies and may help to improve the quality of Delphi designs in terms of improved rigor and higher response rates.