bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous deep sedation and the doctrine of double effect: Do physicians not intend to make the patient unconscious until death if they gradually increase the sedatives?
Authors: Arima Hitoshi
Published: July 2020

Continuous deep sedation (CDS) has the effect of making the patient unconscious until death, and that it has this effect is clearly an undesirable aspect of CDS. However, some authors have recently maintained that many physicians do not intend this effect when practicing CDS. According to these authors, CDS is differentiated into two types; in what is called “gradual” CDS (or CDS as a result of proportionate palliative sedation), physicians start with low doses of sedatives and increase them only gradually, whereas in “rapid” CDS (or palliative sedation to unconsciousness), physicians rapidly administer a heavy dose that clearly induces unconsciousness from the beginning. The claim is that the physicians intend permanent unconsciousness only if they rapidly administer a heavy dose, but they do not intend it when the unconsciousness is the result of a gradual increase of sedatives. This paper attempts to refute these claims based on a close examination of the protocol of gradual CDS. If my argument is valid, the doctrine of double effect would not be useful in justifying most, if not all, cases of CDS.
Human disturbance and the activity patterns and temporal overlap of tapirs and jaguars in reserves of NW Belize
Authors: Monette Victoria D. , Kelly Marcella J. , Buchholz Richard
Published: July 2020

Human disturbance from tourism and other non‐consumptive activities in protected areas may be stressful to wildlife. Animals may move away in space or time to avoid human interaction. For species of particular conservation concern, such as Baird's tapirs (Tapirus bairdii) and jaguars (Panthera onca), a better understanding of how they respond to different levels and types of disturbance is needed in order to manage human visitation to parks in ways that minimize negative outcomes for wildlife. We describe the overlap in activity patterns of tapirs, jaguars, and humans at logged and unlogged sites and at places with low versus high human visitation using camera survey data from protected areas of NW Belize, 2013–2016. Tapirs were nocturnal in all study sites, with > 80% of all tapir detections occurring between 1900 hr and 0500 hr. Their activity patterns were not different in unlogged versus logged sites and did not change with increased human traffic. Jaguars were cathemeral across sites but had more nocturnal activity at the site with the most human impact. Activity pattern overlap between tapirs and jaguars did not differ significantly between logged and unlogged sites, nor between areas with low and high human activity. Human traffic increased from 2013 to 2016 at most of the study locations. In conclusion, this camera trap dataset suggests that non‐consumptive human disturbance does not alter the activity patterns of tapirs and jaguars in protected areas lacking hunting pressure.

Abstract in Spanish is available with online material.
Suburbs and Urban Peripheries in a Global Perspective
Authors: Ren Xuefei
Published: July 2020

Herbert Gans’ classic book, The Levittowners, has inspired generations of urban sociologists studying American suburbs, but it has also confined the field’s focus to studies of the local community. At the same time, however, outside the discipline of American urban sociology, an interdisciplinary field of global suburban studies has flourished. Global suburban studies address a wider range of topics that extends to infrastructural provision, governance, and popular resistance. By introducing the key debates in global suburban studies, this essay argues that it is time for American urban sociologists to broaden their analytical focus beyond community institutions and power relations, and that much can be gained by adopting an international and comparative perspective to learn about urban peripheries elsewhere in the world. A comparative vantage point can help U.S. sociologists better situate socio–spatial transformations in American suburbs among a world of cities (and suburbs), and mine new insights on topics involving poverty, segregation, and community life that have been at the center of suburban research in American sociology.
In vivo demonstration of immunologic cross‐reactivity to octylisothiazolinone in patients primarily and strongly sensitized to methylisothiazolinone
Authors: Russo Juan Pedro , Aerts Olivier
Published: July 2020

Background

Notwithstanding that concomitant exposure to different isothiazolinone derivatives may result in concomitant sensitization, clinical and animal studies have suggested cross‐reactivity between these derivatives, notably between methylisothiazolinone (MI) and octylisothiazolinone (OIT).

Objective

To investigate if patients sensitized to MI show cross‐reactions to OIT and/or to benzisothiazolinone (BIT) by applying the concept of the re‐test method.

Patients And Methods

From March to October 2019 consecutive patients were patch tested with MI 0.2% aqueous in duplicate at the two lower corners of both shoulder blades. Patients sensitized to MI, but not to OIT 0.1% petrolatum (pet.) nor to BIT 0.1% pet., were re‐tested, 2 months later, with the latter two derivatives at the skin sites where the MI reactions had fully disappeared.

Results

Of 116 patients, 15 (13%) were sensitized to MI, eight of these not sensitized to BIT nor to OIT. Of these, seven patients, all (very) strongly sensitized to MI, were re‐tested: five patients showed positive patch test reactions to OIT 0.1% pet.; one patient to OIT 0.1% pet. and BIT 0.1% pet.; and one other patient showed no reactions.

Conclusion

This study suggests that patients primarily and strongly sensitized to MI may show immunologic cross‐reactions to OIT, and to a far lesser extent to BIT.
Provision of dietary advice for people with an ileostomy: a survey in the UK and Ireland
Authors: Mitchell A. , England C. , Atkinson C.
Published: July 2020

Aim

The aim was to explore whether people with an ileostomy in the UK and Ireland receive the dietary advice they require.

Method

An online survey with multiple‐choice questions asked people with an ileostomy about the dietary advice they received and would have preferred to receive. Participants were recruited via websites of the Ileostomy and Internal Pouch Association and Crohn’s and Colitis UK and via social media. People with a current ileostomy, age 16 years or over, and living in the UK or Ireland were eligible for inclusion. Responses were analysed using descriptive statistics.

Results

In all, 291 eligible responses were received and included in the analysis; 201 (69%) received advice on diet for their ileostomy from a healthcare professional or the internet. Of the 90 who did not receive dietary advice, 82 (91%) would have liked advice. Stoma nurses were the most common source of dietary advice (55%), but many other sources were frequently reported. Most (62%) felt that at least some dietary advice they received was conflicting. Over half (55%) felt anxious about managing their diet with a new ileostomy, 39% were confused, and 31% frustrated. Of 291 respondents, 29% received advice from a dietitian compared to 60% who would have preferred advice from a dietitian.

Conclusion

Many people undergoing ileostomy surgery do not receive the dietary advice and support they require. Healthcare professionals working with people with an ileostomy should be mindful they are often anxious about their diet and require clear and consistent dietary advice and support.
Alpha‐1‐antitrypsin deficiency (carrier) as possible risk factor for development of colonic diverticula. A multicentre prospective case–control study: the ALADDIN study
Authors: Rottier S. J. , Dreuning L. C. , van Pelt J. , van Geloven A. A. W. , Beele X. D. Y. , Huisman P. M. , Deurholt W. Y. , Rottier C. A. , van Leeuwen K. , de Boer M. , van Mierlo G. , Boermeester M. A. , Schreurs W. H. ,   for the ALADDIN Collaborative Study Group
Published: July 2020

Aim

Connective tissue changes due to ageing or diseases leading to changes in the colonic wall are one theory for the development of diverticula. Alpha‐1‐antitrypsin (A1AT), a protease inhibitor that protects connective tissue, possibly plays a role in the aetiology of diverticulosis. The aim of this study was to explore associations between the development of diverticula and A1AT deficiency.

Methods

This was a multicentre prospective case–control study. A total of 221 patients aged ≥ 60 years with acute abdominal pain undergoing abdominal CT were included and analysed. Patients with diverticula were defined as the research group, patients without diverticula as controls. Genotype analysis for A1AT deficiency was performed.

Results

Twenty‐six of 221 (11.8%) patients were diagnosed with (being a carrier of) A1AT deficiency. A non‐significant difference in prevalence between patients with and without diverticula was found, 20 (13.9%) of 144 vs 6 (7.8%) of 77, respectively, with a crude OR of 1.9 (95% CI 0.7–5.0; P = 0.186) and after adjustment for confounders an adjusted OR of 1.5 (95% CI 0.5–4.0; P = 0.466). A non‐significant difference in 30‐day mortality rate from acute diverticulitis between A1AT deficient patients (or carriers) and those without was observed: two (22.2%) of nine patients with A1AT deficiency vs 1 (1.8%) of 55 without.

Conclusion

We found no convincing evidence that A1AT deficiency plays a role in the aetiology of diverticulitis, although deficient patients and carriers had a higher mortality when experiencing diverticulitis. Diverticulitis is a multifactorial disease and larger numbers may be needed to explore the role of A1AT deficiency among other contributing factors.
WHY DO MANDATED INTERNATIONAL JOINT VENTURES STILL EXIST?
Authors: Cai Dapeng , Karasawa‐Ohtashiro Yukio
Published: July 2020

It is widely believed that restrictions against foreign direct investment (FDI) should be eliminated altogether. However, local equity requirements (LERs) that effectively mandate multinational enterprises (MNEs) to enter through international joint ventures (IJVs) are still common and are seemingly persistent. We seek to understand why and how governments are motivated to adopt LERs. We demonstrate that LERs can in fact be host governments' optimal choices when regulating the entry of MNEs into domestic markets formerly dominated by public firms. (JEL F13, F23, L32)
The challenging diagnosis of overlapping oral primary/secondary syphilis with nonreactive serology
Authors: Ramírez‐Amador Velia , Anaya‐Saavedra Gabriela , Calva‐Mercado Juan Jose
Published: July 2020

The prevalence of oral syphilis, known as “the great imitator” because of its diagnostic complexity and varied clinical manifestations, is increasing worldwide, particularly in people living with HIV (PLWH), who could present false‐negative serological results. Although some studies have described the variable presentation of oral syphilis in the context of HIV infection, the difficulty in distinguishing between the primary and secondary stages, clinically and histopathologically, underscores the need to describe atypical cases. We report the case of a 28‐year‐old HIV‐positive man presenting with a 3‐month history of painless white/red ulcerated lesion on the soft palate. Physical examination revealed an ulcerated lesion with local signs of inflammation. Initial biopsy revealed a nonspecific inflammatory process and immunohistochemistry (IHC) using anti‐Treponema pallidum antibodies showed negative results. The results of serological tests for syphilis (Venereal Disease Research Laboratory and fluorescent treponemal antibody‐absorption test) were negative on repeated occasions. Nonetheless, polymerase chain reaction (PCR) assay and subsequent IHC for T. pallidum showed positive results, confirming the diagnosis of oral syphilis. This case illustrates that the diagnosis of oral syphilis is challenging in the absence of serological evidence, and specific tests such as PCR and IHC are useful complementary diagnostic tools.
Subverting Process‐Based Controls: Oscillation in Automotive Recalls and a Simulation on Opportunism within a Network
Authors: DuHadway Scott , Narasimhan Ram
Published: July 2020

The increase in the frequency and impact of automotive recalls has had broad reaching economic and social consequences. Recent examples of automotive recalls suggest that some are due to deliberate actions of firms to subvert processes designed to ensure quality. Such controls are dependent on partners acting in good faith in the relationship and abiding by relational norms and so do not recognize the risks of firms lying, falsifying data, or intentionally circumventing process‐based controls. Data on automotive recalls shows that recalls exhibit a statistically significant oscillatory pattern with an estimated period of around 3.6 years. We argue that the cyclical pattern in automotive recalls is due, in part, to opportunistic behavior within a network, which is likely to spread and be reciprocated. To test whether opportunism can lead to similar network effects, we develop an agent‐based simulation to model opportunism within a network of connected firms. The simulation is based on an extension of the prisoner's dilemma where the cooperate/defect decision is based on a dyadic relational model driven by trust, knowledge, and dependence levels within each relationship. The results from the simulation suggest that cyclical patterns, similar to those in automotive recalls, emerge as well as “behavioral clustering” within the network, where connected firms exhibit highly similar behaviors that tend to cycle within small clusters. Therefore, opportunistic behavior in supply networks might be an important, relational determinant of product recalls. Our dynamic modeling approach differs from current perspectives on understanding product recalls, contributing to the current literature.
Fatigue behaviour of the bond interface between carbon fibre‐reinforced polymer sheets and concrete
Authors: Wei Mu‐Wang , Xie Jian‐He , Huang Pei‐Yan , Huang Kun‐Hong
Published: July 2020

Externally bonded carbon fibre‐reinforced polymers (CFRPs) have been applied to retrofit and strengthen civil structures. In this study, four‐point bending beams were manufactured and tested to examine the fatigue behaviour of the CFRP–concrete interface. The results indicated that the specimens exhibited debonding failure in the concrete beneath the adhesive layer under static loading. However, when cyclic loads were imposed on the small beams, debonding failure may occur in the adhesive layer. Moreover, fitting expressions were proposed to predict the shear stress–slip relationship between the CFRP sheets and concrete and the flexural strength of the CFRP‐strengthened beams under static loads, and good agreement with the test data was obtained. Finally, a fatigue life prediction model was also presented to capture the fatigue life of the CFRP–concrete interface under cyclic loads. The calculation results showed that the fatigue strength of the CFRP–concrete bond interface was approximately 65% of the ultimate load capacity.
Efficacy and Contextual (Placebo) Effects of CGRP Antibodies for Migraine: Systematic Review and Meta‐analysis
Authors: Forbes Raeburn B. , McCarron Mark , Cardwell Chris R.
Published: July 2020

Background

CGRP Antibodies are high‐cost newly licensed migraine preventatives.

Objective

To calculate the overall reduction in monthly migraine days and the proportion contextual effect (PCE) using meta‐analysis. The PCE is the ratio between the reduction in Monthly Migraine Days in the placebo group and the reduction in Monthly Migraine Days in the CGRP‐Ab group after 3 months of treatment.

Methods

Meta‐analysis of randomized double‐blind placebo‐controlled trials of anti‐CGRP antibodies in people with episodic migraine (EM) or chronic migraine (CM) in persons aged 18 or over. Non‐randomized trials and trials in persons under 18 years excluded. Search of National Clinical Trials Register 2000‐2019, MEDLINE to September 2019, Hand search of major headache conference abstract books 2012‐2019. Two investigators used standard proforma to reach consensus. Trial quality assessed using Cochrane Collaboration risk of bias tool. PRISMA guidelines followed.

Results

21 completed trials with 13367 participants (8075 EM, 5292 CM). Compared to placebo, pooled reduction in MMD was 1.50 days in 15 EM trials (95%CI 1.16, 1.84; I2 = 69%, Phetereogeneity < .001) and 2.24 days in 7 CM trials (95%CI 1.82, 2.65, I2 = 15%, Phetereogeneity = .320). In EM trials, pooled PCE was 0.66 (95%CI 0.59,0.75; I2 = 64%, Phetereogeneity = .001). In CM trials the PCE was .68 (95%CI 0.61, 0.75; I2 = 20%, Phetereogeneity = .280). Industry funded every study, but risk of bias was low.

Conclusions

CGRPAbs are effective but sixty‐six percent of the benefit is from contextual effects, including placebo effect. Contextual effects merit further scrutiny as a means of improving migraine headache.
Clinical and cost effectiveness of a multi-professional medication reviews in care homes (CAREMED)†
Authors: Desborough James A , Clark Allan , Houghton Julie , Sach Tracey , Shaw Val , Kirthisingha Viveca , Holland Richard C , Wright David J
Published: July 2020

Objectives

With 70% of care home residents experiencing a medication error every day in the UK, better multi-professional working between medical practitioners, pharmacists and care homes was recommended. The aim of this study was to determine the effectiveness (falls reduction) and cost-effectiveness, of a multi-professional medication review (MPMR) service in care homes for older people.

Method

A total of care homes in the East of England were cluster randomised to ‘usual care’ or two multi-professional (General practitioner, clinical pharmacist and care homes staff) medication reviews during the 12-month trial period. Target recruitment was 900 residents with 10% assumed loss to follow-up. Co-primary outcome measures were number of falls and potentially inappropriate prescribing assessed by the Screening Tool of Older Persons Prescriptions.

Key findings

A total of 826 care home residents were recruited with 324 lost to follow-up for at least one primary outcome measure. The mean number of falls per resident per annum was 3.3 for intervention and 3.0 for control (P = 0.947). Each resident was found to be prescribed 0.69 (intervention) and 0.85 (control) potentially inappropriate medicines after 12 months (P = 0.046). No significant difference identified in emergency hospital admissions or deaths. Estimated unadjusted incremental mean cost per resident was £374.26 higher in the intervention group.

Conclusions

In line with other medication review based interventions in care homes, two MPMRs improved medication appropriateness but failed to demonstrate improvements in clinical outcomes. From a health system perspective costs where estimated to increase overall and therefore a different model of medicines management is required.
How COVID‐19 has pushed us into a medical education revolution
Authors: Torda Adrienne
Published: July 2020

The COVID‐19 pandemic has had a profound effect on society and higher education in Australia. In just a few weeks, entire courses have been re‐structured and are now delivered online. The need to adapt rapidly has prompted many innovative changes that will ultimately have long‐term benefits for medical education in Australia and New Zealand.
Creating the data basis to adapt agricultural decision support tools to new environments, land management and climate change—A case study of the RiceAdvice App
Authors: Cotter Marc , Asch Folkard , Abera Bayuh Belay , Andre Chuma Boshuwenda , Senthilkumar Kalimuthu , Rajaona Arisoa , Razafindrazaka Ando , Saito Kazuki , Stuerz Sabine
Published: July 2020

Increasing demand for land to ensure human food security in the future has already impelled agricultural production into marginal areas. The environmental conditions found there have a more pronounced impact on agricultural productivity than in the systems used so far under favourable conditions. In addition to this challenge, climate change is expected to increase the unreliability of weather conditions (through increased variability and occurrence of extremes) for farmers considerably. This unreliability is even more serious in developing countries’ farming system where food security is vulnerable. Current efforts in digitalization offer great possibilities to improve farmers` decision‐making processes. A wide range of online tools and smartphone applications is available to support both agricultural extension services and smallholder farmers alike. These apps are often parameterized and validated to certain environments and are troubled when applied to new geographical locations and different environmental conditions. We have conducted field trials to demonstrate potential methods to close knowledge gaps in the data background for one of these apps, RiceAdvice, concerning three key aspects: shifting of cropping calendar, adjustment of fertilizer management and genotype selection. Sites in Ethiopia, Madagascar and Rwanda were selected to represent altitudinal gradients, with overlapping elevations reflecting differences in temperature to enable cross‐country comparisons. Planting dates were distributed throughout three calendar years, with continuous iterative planting dates taking place in Madagascar, in‐ and off‐season planting dates in Rwanda with different fertilizer applications, and one planting date during each rainy season in Ethiopia with different management options. With these trials, we have been able to identify key data sets needed for the adaptation of agricultural decision support tools to new environments. These include the assessment of climatic constraints on innovations to cropping calendars (e.g. double cropping), informed selection of alternative varieties able to complete crucial parts of their phenological development to avoid temperature‐related stress inducing, for example spikelet sterility in rice in late development stages and the effectivity of potential innovations in fertilizer management strategies.
Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation
Authors: Wändell Per , Carlsson Axel C. , Li Xinjun , Holzmann Martin J. , Sundquist Jan , Sundquist Kristina
Published: July 2020

Congestive heart failure (CHF) is the most important cause of death in patients with atrial fibrillation (AF). We aimed to study the association between cardiovascular drugs in AF patients and incident CHF. The study population included all adults (n = 120 756) aged ≥45 years diagnosed with AF in Sweden diagnosed for the period 1998‐2006. Outcome was incident congestive heart failure (follow‐up 2007‐2015) in AF patients. Associations between treatment with cardiovascular pharmacotherapies and CHF were evaluated using Cox regression to estimate hazard ratios (HRs) with 95% CIs, after adjustment for age, sociodemographic variables, and comorbidities. During a mean 5.3 years (SD 3.0) of follow‐up, there were 28 257 (23.4%) incident cases of CHF. Treatment with beta‐1‐selective and non‐selective beta‐blockers and statins was associated with lower risks of incident CHF in men, HR, (95% CI); 0.90, (0.87‐0.94); 0.90, (0.84‐0.97), and 0.94, (0.90‐0.99), respectively. Only beta‐1‐selective beta‐blockers were protective in women 0.94 (0.91‐0.98). Treatment with loop diuretics, potassium‐saving agents, ACE inhibitors, and angiotensin receptor blockers was associated with a higher risk of CHF. For men, treatment with heart‐active calcium channel blockers also led to a higher risk of CHF. In conclusion, we found that beta‐blockers, in particular, but also statins were associated with lower risk of incident CHF in patients with AF.
Competing Narratives in a Case Biography: A Tale of Two Citadels
Authors: Jones Caroline , Montgomery Jonathan
Published: July 2020

This article is the fourth in a series introducing the reader to methods and theories relevant to advancing socio‐legal research. They are written for the curious rather than the expert reader and provide illustrations of how the theories, methods, and frameworks have been employed and might be used in your work.

This article explores the use of case biography methods for socio‐legal studies. Drawing on ‘paths to justice’ studies, network analysis, and legal archaeology, we develop a case study of AC v.Berkshire West Primary Care Trust. We show how the judicial determination of the case suppressed a transgender rights narrative construction of the dispute in favour of one about health care law. Our case biography analysis explores how competing narratives can be traced not only through legal argument and literature, but also through the personnel involved, in ways that are obscured by formal records. Paying attention to biographical features leads to a richer understanding of cases, including the importance of pre‐ and post‐judicial decision‐making aspects.
Correlation between insulin‐like peptide 3 and appendix testis length in congenital cryptorchidism
Authors: Panagidis Antonios , Kostopoulou Eirini , Rojas Gil Andrea Paola , Sinopidis Xenophon , Kourea Helen , Skiadopoulos Spyros , Georgiou George , Spiliotis Bessie E
Published: July 2020

Aim

The appendix testis (AT) is a vestigial remnant of Müller's paramesonephric duct. Insulin‐like 3 hormone (INSL3) is produced in the Leydig cells of the testis. We investigated the possible correlation between AT length and plasma INSL3 concentrations in patients with congenital cryptorchidism (CCO) and patients with hydrocele, who served as controls.

Methods

A total of 40 patients with CCO and 34 patients with hydrocele and orthotopic testes were investigated. Sixteen patients presented high cryptorchidism and 24 low cryptorchidism. During surgery, AT was identified in 34 patients with CCO (high cryptorchidism:15, low cryptorchidism:19) and 28 controls. Plasma INSL3 levels were measured with a spectrophotometry enzyme immunoassay Elisa sandwich technique.

Results

AT was present in 85.0% of the boys with CCO and 82.4% of the controls. A significant positive correlation was found between the AT length and INSL3 concentrations in CCO patients.

Conclusions

A longer AT may reflect better testicular function in boys with CCO, since it is correlated with higher INSL3 concentrations.
Spinosin protects N2a cells from H2O2-induced neurotoxicity through inactivation of p38MAPK
Authors: Xu Fanxing , Zhang Xiaoying , Wang Jinyu , Li Xu , He Bosai , Xiao Feng , Yan Tingxu , Wu Bo , Jia Ying , Wang Zhenzhong
Published: July 2020

Objectives

Previous studies have suggested that spinosin (SPI) exerted neuroprotective effects through inhibition of oxidative damage, but the underlying mechanisms are still unclear. Herein, the mechanisms underlying the protective effects of SPI against oxidative stress induced by hydrogen peroxide (H2O2) were examined in neuro-2a (N2a) mouse neuroblastoma cells.

Methods

N2a cells were pretreated with H2O2 for 2 h, followed by a 24-h incubation with SPI. Intracellular reactive oxygen species (ROS) production was analysed by flow cytometry. Levels of Aβ1-42 production were determined by ELISA assay. Levels of expression of c-Jun N-terminal kinase (JNK), p-JNK, extracellular signal-regulated kinase (ERK), p-ERK, p38 mitogen-activated protein kinase (p38MAPK), p-p38MAPK, p-Tau (Ser199), p-Tau (Ser202), p-Tau (Ser396), synaptophysin (SYP) and postsynaptic scaffold postsynaptic density-95 (PSD-95) were detected by Western blot analysis.

Key findings

Our results showed that H2O2 treatment enhanced intracellular ROS production in N2a cells. SPI prevented H2O2-induced oxidative damage via inhibiting Aβ1-42 production, decreasing Tau phosphorylation and improving synaptic structural plasticity. Notably, H2O2-increased p38MAPK activation was attenuated by SPI administration, and p38MAPK inhibitor BIRB796 markedly reduced H2O2-induced oxidative damage in N2a cells.

Conclusions

Our findings suggest that SPI protects N2a cells from H2O2-induced oxidative damage through inactivation of p38MAPK.
Inhibition of p90 ribosomal S6 kinase potentiates cisplatin activity in A549 human lung adenocarcinoma cells
Authors: Abdulrahman Nabeel , Siveen Kodappully Sivaraman , Joseph Jensa Mariam , Osman Aisha , Yalcin Huseyin C , Hasan Anwarul , Uddin Shahab , Mraiche Fatima
Published: July 2020

Objective

Cisplatin is a standard treatment approach against lung adenocarcinoma. Resistance to cisplatin and the toxic side effects of cisplatin continue to remain a challenge. Combining drugs with different mechanisms is being investigated as a means to overcome these challenges. In ovarian cancer cells, the knockdown of RSK2 increased the sensitivity of cisplatin. RSK is a downstream mediator of the MAPK pathway that is responsible for cell survival, proliferation and migration.

Methods

Our study examined the effect of cisplatin, BI-D1870 (RSK inhibitor) or their combination on cell migration, apoptosis, autophagy and cell cycle in A549 human lung adenocarcinoma cells.

Key Findings

The combination of cisplatin and BI-D1870 potentiated the antimigration rate, the activation of caspases-3 and was associated with a significant decrease in RSK1 and ERK expression when compared to cisplatin alone. The combination of cisplatin and BI-D1870 also resulted in the inhibition of LC3 II to LC3 I expression when compared to BI-D1870. The combination of cisplatin and BI-D1870 increased the number of cells in the G2/M-phase when compared to cisplatin alone.

Conclusions

These findings suggest that combining cisplatin with agents that target the RSK mediated cell survival pathway, may potentiate the cisplatin effect in lung adenocarcinoma.
Elevated Temperature Affects Phenotypic Plasticity in the Bull Kelp (Nereocystis luetkeana, Phaeophyceae)
Authors: Supratya Varoon P. , Coleman Liam J.M. , Martone Patrick T.
Published: July 2020

The sensitivity of kelps to elevated temperatures has been linked to recent declines in some kelp populations, with cascading impacts on marine communities. However, it remains unclear how thermal stress affects the ability of kelps to respond to other environmental factors, which could influence their vulnerability to climate change. We investigated the effect of thermal stress on the ability of the bull kelp Nereocystis luetkeana to acclimate to its surrounding hydrodynamic environment through tension‐regulated plasticity in blade morphology. We first determined optimal and stressful temperatures for N. luetkeana by measuring growth over nine temperatures from 5°C to 22°C. We then exposed N. luetkeana blades to a factorial combination of temperature (13°C and 20°C) and tension (0.5 N and 2.0 N) simulating different flow conditions, and measured changes in blade length and width after 7 days. The temperature at which N. luetkeana exhibited maximum growth was estimated to be ~11.9°C, though growth was high over a relatively wide temperature range. When thermally stressed, N. luetkeana maintained morphological responses to simulated high flow, but were inhibited from acclimating to low flow, indicated by an inability of blades to widen. Our results suggest that N. luetkeana in sheltered habitats may be particularly vulnerable to climate warming, where an inability to adjust blade morphology to local hydrodynamic conditions could drive declines at sublethal levels of warming. As ecologically important foundation species, declines in sheltered kelp populations could result in major biodiversity loss and disrupt ecosystem function.
Veteran Therapeutics: The Promise of Military Medicine and the Possibilities of Disability in the Post‐9/11 United States
Authors: Wool Zoë H.
Published: July 2020

This article draws on a decade of ethnographic work with injured U.S. soldiers and veterans to show the collateral effects of military medicine's salvific promise. In tracing these effects through recent changes in amputation protocols and less spectacular conditions such as posttraumatic stress disorder, I show that the prevalent model of “veteran therapeutics,” which posits cure as the aim of post‐war, has perverse and cruel effects. Drawing on disability theory, I explore alternative ways to read the frictions that soldiers and veterans experience, stretched between the medical model of veteran therapeutics and an emergent sense that cure may be an impossible goal. Alternatively, the article turns to moments when veterans learn to live with disability, rather than living in anticipation of its end. Though small, such moments contain possibilities for a less cruel mode of inhabiting disability, offering incipient signs of what we might call a crip art of failure.
The determinants of employers’ use of temporary contracts in the frictional labor market
Authors: Masui Makoto
Published: July 2020

This paper focuses on the following two primary reasons that employers use temporary contracts: to flexibly adjust employment and to screen workers. A search‐matching framework is used to not only address employers’ endogenous choices in using temporary contracts, but also numerically identify the situations in which these contracts are likely to be used as a screening tool for permanent positions. This numerical exercise demonstrates that reducing employment protections in permanent jobs, reducing benefits for unemployed workers and raising the conversion probability from temporary to permanent employment will increase the relative proportion of employers who use temporary contracts as a screening device.
Some light amidst the darkness of recent world events
Authors: Eva Kevin W.
Published: July 2020

Our Editor‐in‐chief shares the joy and pain he is feeling as we celebrate exceptional contributions to the field while struggling with world events.
Evidence for validity for the Cognitive Load Inventory for Handoffs
Authors: Young John Q. , John Majnu , Thakker Krima , Friedman Karen , Sugarman Rebekah , Sewell Justin L. , O’Sullivan Patricia S.
Published: July 2020

Context

Patient handovers remain a significant patient safety challenge. Cognitive load theory (CLT) can be used to identify the cognitive mechanisms for handover errors. The ability to measure cognitive load types during handovers could drive the development of more effective curricula and protocols. No such measure currently exists.

Methods

The authors developed the Cognitive Load Inventory for Handoffs (CLIH) using a multi‐step process, including expert interviews to enhance content validity and talk‐alouds to optimise response process validity. The final version contained 28 items. From January to March 2019, we administered a cross‐sectional survey to 1807 residents and fellows from a large health care system in the USA. Participants completed the CLIH following a handover. Exploratory factor analysis of data from one‐third of respondents identified high‐performing items; confirmatory factor analysis of data from the remaining sample assessed model fit. Model fit was evaluated using the comparative fit index (CFI) (>0.90), Tucker‐Lewis index (TFI) (>0.80), standardised root mean square residual (SRMR) (<0.08) and root mean square of error of approximation (RMSEA) (<0.08).

Results

Participants included 693 trainees (38.4%) (231 in the exploratory study and 462 in the confirmatory study). Eleven items were removed during exploratory factor analysis. Confirmatory factor analysis of the 16 remaining items (five for intrinsic load, seven for extraneous load and four for germane load) supported a three‐factor model and met criteria for good model fit: the CFI was 0.95, TFI was 0.93, RMSEA was 0.074 and SRMR was 0.07. The factor structure was comparable for gender and role. Intrinsic, extraneous and germane load scales had high internal consistency. With one exception, scale scores were associated, as hypothesised, with postgraduate level and clinical setting.

Conclusions

The CLIH measures three types of cognitive load during patient handovers. Evidencefor validity is provided for the CLIH's content, response process, internal structure and association with other variables. This instrument can be used to determine the relative drivers of cognitive load during handovers in order to optimize handover instruction and protocols.
Bringing reality to assessment: Lessons from clinical simulation
Authors: Bearman Margaret
Published: July 2020

When simulation doesn't simulate: Bearman uses dissociations between clinical practice and simulation to argue we need constant criticality to prevent assessment from disguising, replacing and altering what it is supposed to represent.
The refiguring of Ancient Rome in Fascist Italy's national imagination
Authors: Fadda Salvatore
Published: July 2020

The relationship between the Italian fascist regime and Roman archaeology was based on an extreme simplification of antiquity, reduced to a set of aesthetic motifs used to exploit their symbolic power. This article aims to examine how the culture of the ruling classes of liberal Italy came to identify its past in ancient Rome and then to highlight the decontextualisation and semantic transformation of certain symbols taken from ancient Roman iconography under the fascist regime which used them for political and nationalistic purposes. Through the analysis of the process of isolation and transformation to which the ruins of ancient Rome have been subjected, the article highlights how the same dynamics were adopted for iconographic elements of antiquity, leading to the creation of modern symbols invested with supposedly ancient values.
Genetic variation of seedling traits responded to brassinosteroid and gibberellin inhibitors in maize (Zea mays) doubled haploid lines
Authors: Hu Kun , Xie Ying , Wu Chenglai , Frei Ursula K. , Lübberstedt Thomas
Published: July 2020

The purpose of this study was to examine the genotypic variation in maize doubled haploid (DH) lines response to brassinosteroid and gibberellin inhibitors. Plant responses to hormone inhibitors were determined in growth chamber experiments using germination paper for three different seedling treatments: application of propiconazole (Pcz), uniconazole (Ucz) or water (control). Mesocotyl length (ML) was more sensitive to hormone inhibitors, especially to the Ucz treatment, than other seedling traits. ML was significantly correlated with other traits in the Ucz treatment. All the seedling traits showed moderate‐to‐high broad sense heritability values, ranging from 0.39 to 0.82. The Euclidian genetic distances of inbred line pairs ranged from 1.27 to 19.94, indicating there was a high level of variability across the maize DH lines used in this study. DH lines with extreme MLs were identified, which can provide valuable breeding resources for improving abiotic stress tolerance, and for further genetic studies.
Prediction of candidate genes associated with resistance to soybean rust (Phakopsora pachyrhizi) in line UG‐5
Authors: Gebremedhn Hailay M. , Msiska Ulemu M. , Weldekidan Miesho B. , Odong Thomas L. , Rubaihayo Patrick , Tukamuhabwa Phinehas
Published: July 2020

Online databases containing genetic information are crucial to extract new candidate genes from existing data and web‐based resources. The objective of this study was, therefore, to predict putative candidate genes associated with resistance to SBR in line UG‐5 and understand their functions using different bioinformatics tools from the online available databases. The physical positions for the flanking markers of the identified putative QTLs were searched on the SoyBase database genome browser based on Glyma 1.01 assembly. The putative candidate genes and annotated functions of the surrounding genes were discovered in the vicinity using SoyBase and Phytozome databases. A total of 18 putative candidate genes were predicted on approximately 482.7 kb region of QTL‐3 (chromosome 18), among which, six putative candidate genes were found to encode leucine‐rich repeat (LRR), Ser/Thr protein phosphatase, leucine‐rich repeat receptor‐like protein kinase (LRR‐RLK) and chitinase‐related proteins, which are associated with plant defence signalling pathways. Moreover, F‐box and leucine‐rich repeat, glycosyltransferase family member and serine/threonine‐protein phosphatase 2A catalytic subunit coding genes were predicted on the novel putative QTL detected on chromosome 9. This information could, therefore, be used for further prediction and annotation of candidate genes from sequenced regions of line UG‐5 as these putative candidate genes were predicted from the Glyma 1.01 assembly.
Doxastic divergence and the problem of comparability. Pragmatism defended further
Authors: Meylan Anne
Published: July 2020

Situations where it is not obvious which of two incompatible actions we ought to perform are commonplace. As has frequently been noted in the contemporary literature, a similar issue seems to arise in the field of beliefs. Cases of doxastic divergence are cases in which the subject seems subject to two divergent oughts to believe: an epistemic and a practical ought to believe. This article supports the moderate pragmatist view according to which subjects ought, all things considered, to hold the practically right belief in, at least, some cases of doxastic divergence. Unlike many defences of pragmatism, this paper does not aim to overcome exclusivism (briefly, the view that only epistemic, but not practical, considerations have an influence on what a subject ought to believe). Another major challenge that pragmatism faces is to show that the epistemic and the practical ought to believe are comparable. This article makes a case for their comparability.
Trust in Nurses Scale: validation of the core elements
Authors: Comparcini Dania , Simonetti Valentina , Tomietto Marco , Radwin Laurel E. , Cicolini Giancarlo
Published: July 2020

Background

The Trust in Nurses Scale (TNS) was developed and psychometrically assessed so that patients’ trust could be accurately and reliably measured. The TNS has been translated, assessed and administered to patients in Europe, Asia and North America.

Aim

This descriptive, cross‐sectional, correlational study aimed to assess the psychometric characteristics of the Italian version of the Trust in Nurses Scale.

Methods

An Italian version of the TNS was developed. We used a forward–backward translation methodology to establish semantic and conceptual equivalence within the Italian context. The scale was then administered to a convenience sample of 200 hospitalised patients in medical, surgical or oncology units. Internal consistency and construct validity were assessed performing Cronbach’s alpha and confirmatory factor analysis (CFA). Both a 4‐item and a 5‐item TNS were assessed.

Results

The 4‐item TNS demonstrated better construct validity than the 5‐item version. Similarly, the internal consistency reliability was better with 4 items than 5 (0.83 and 0.79, respectively).

Conclusion

The Italian version of the scale has acceptable reliability and validity and may be used to assess this aspect of the nurse–patient relationship. Being tested in different settings, it may be used with all patients admitted to hospital. Trust in nurses is critically important to patient outcomes; however, it is rarely measured quantitatively on a wide scale. The use of the Italian validated scale could be useful to increase evidences on this important topic, as it represents a core component of nursing care.
Political Trust and Native American Electoral Participation: An Analysis of Survey Data from Nevada and South Dakota
Authors: Schroedel Jean , Berg Aaron , Dietrich Joseph , Rodriguez Javier M.
Published: July 2020

Objective. This research analyzes the impact of political trust on Native American electoral participation, using survey responses from roughly 1,500 Native Americans living in South Dakota and Nevada.Method. The in‐person survey taking was conducted at locations in Native communities and with the support of tribal leaders, allowing us to overcome many of the methodological issues that have hampered previous studies.Results. We found much higher levels of electoral participation in tribal elections than in non‐tribal elections. Respondents expressed high levels of distrust in nontribal government and voting methods, and this distrust has a surprisingly powerful impact on the decision to participate in nontribal elections.Conclusion. We suggest that historical trauma and ongoing discrimination are the primary causes of distrust among Native Americans and find support for this in the observed differences in levels of trust between South Dakota and Nevada.
Climate Change Communication: Examining the Social and Cognitive Barriers to Productive Environmental Communication
Authors: Merkel Sonia Hélène , Person Angela M. , Peppler Randy A. , Melcher Sarah M.
Published: July 2020

Objectives. This study explores the efficacy of visual appeals that may be used to communicate environmental risk.Methods. To better understand the social and cognitive barriers present in environmental risk communication associated with climate change, we conducted a series of six focus groups. Groups were asked to view images of environmental issues and select the best representation of their feelings out of a range of preselected emotions. While further research is required, preliminary investigation based on the focus groups suggests several themes. Results. First, an individual's familiarity with both an area and an event will decrease the individual's perception of urgency; conversely, the participants expressed greater concern for events that were local and new—in other words, familiarity diminishes urgency, while emergent problems create alacrity. Second, participants expressed a sentiment of tacit blame, in which the participant's own contribution to the issue received less emphasis when ascribing fault. Last, the participants reacted positively toward messages that emphasized a hopeful and solution‐based narrative and were seemingly less motivated by images that relied on fear‐based messaging.
Conclusions.
Preliminary findings suggest that hopeful, solution‐based messaging may be more effective in facilitating pro‐environmental behavior than either fear‐ or guilt‐based appeals.
A Neuroadaptive Cognitive Model for Dealing With Uncertainty in Tracing Pilots' Cognitive State
Authors: Klaproth Oliver W. , Halbrügge Marc , Krol Laurens R. , Vernaleken Christoph , Zander Thorsten O. , Russwinkel Nele
Published: July 2020

A model‐based approach for cognitive assistance is proposed to keep track of pilots' changing demands in dynamic situations. Based on model‐tracing with flight deck interactions and EEG recordings, the model is able to represent individual pilots' behavior in response to flight deck alerts. As a first application of the concept, an ACT‐R cognitive model is created using data from an empirical flight simulator study on neurophysiological signals of missed acoustic alerts. Results show that uncertainty of individual behavior representation can be significantly reduced by combining cognitive modeling with EEG data. Implications for cognitive assistance in aviation are discussed.