bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring group boundaries and conflicts: a social identity theory perspective
Authors: Bochatay Naike , Bajwa Nadia M , Blondon Katherine S , Junod Perron Noëlle , Cullati Stéphane , Nendaz Mathieu R
Published: April 2019

Context

In the clinical environment, health care professionals self‐categorise into different groups towards which they develop positive attitudes, whereas they view other groups less favourably. Social identity theory purports that these attitudes influence group processes and may foster conflicts that impede collaborative practice, although this relationship is poorly understood. This study used concepts from social identity theory to examine the interplay between group processes and conflicts, as well as the consequences of these conflicts, with the goal of identifying educational strategies to favour teamwork.

Methods

Semi‐structured interviews with 82 randomly selected physicians and nursing professionals working at a Swiss academic medical centre explored participants’ experiences of conflicts. Data analysis was informed by social identity theory and focused on interviews where group processes were highlighted by participants. The analysis sought to uncover how group processes were intertwined with conflicts and how they affected health care professionals.

Results

A total of 42 participants out of the initial pool of 82 interviews shared 52 stories of conflicts involving group processes. Most of these stories were shared by physicians and involved groups of physicians at different hierarchical levels. Conflicts and group processes were linked in two ways: (i) through processes of group membership when individuals struggled to join a relevant group, and (ii) through intergroup boundaries, such as when participants perceived that power differentials disadvantaged their own groups. Conflicts could lead to difficult experiences for clinicians who questioned their abilities, became disillusioned with their professional ideals and developed negative perceptions of other groups.

Conclusions

This study suggests that conflicts involving group processes may lead to stronger intergroup boundaries, challenging current educational efforts to favour teamwork in health care. Taking steps to create more inclusive groups and to encourage perspective taking may help manage intergroup conflict.
Commentary: expert responses in script concordance tests: a response process validity investigation
Authors: Wan Siu Hong , Tor Elina , Hudson Judith N
Published: April 2019

The authors outline why a ‘de‐constructed’ approach to validation offers a very positive trend to shed light on the many grey areas surrounding the validity of SCT scores.
The role of C‐terminal extensions in controlling ECF σ factor activity in the widely conserved groups ECF41 and ECF42
Authors: Wu Hao , Liu Qiang , Casas‐Pastor Delia , Dürr Franziska , Mascher Thorsten , Fritz Georg
Published: April 2019

The activity of extracytoplasmic function σ‐factors (ECFs) is typically regulated by anti‐σ factors. In a number of highly abundant ECF groups, including ECF41 and ECF42, σ‐factors contain fused C‐terminal protein domains, which provide the necessary regulatory function instead. Here, we identified the contact interface between the C‐terminal extension and the core σ‐factor regions required for controlling ECF activity. We applied direct coupling analysis (DCA) to infer evolutionary covariation between contacting amino acid residues for groups ECF41 and ECF42. Mapping the predicted interactions to a recently solved ECF41 structure demonstrated that DCA faithfully identified an important contact interface between the SnoaL‐like extension and the linker between the σ2 and σ4 domains. Systematic alanine substitutions of contacting residues support this model and suggest that this interface stabilizes a compact conformation of ECF41 with low transcriptional activity. For group ECF42, DCA supports a structural homology model for their C‐terminal tetratricopeptide repeat (TPR) domains and predicts an intimate contact between the first TPR‐helix and the σ4 domain. Mutational analyses demonstrate the essentiality of the predicted interactions for ECF42 activity. These results indicate that C‐terminal extensions indeed bind and regulate the core ECF regions, illustrating the potential of DCA for discovering regulatory motifs in the ECF subfamily.
Factors associated with nutritional status and motor development among young children
Authors: Wang Peipei , Hao Ming , Han Wei , Yamauchi Taro
Published: April 2019

This study was conducted to investigate the nutritional status and gross motor development of children in a suburban area of northeast China and the factors influencing these issues. A total of 189 children aged 1–3 years and their mothers participated. Child and maternal length/height and weight were measured. Information was collected on basic characteristics, household monthly income, child's age at achievement of six gross motor milestones, and feeding practices by interviewing the mothers/caregivers. The prevalence of overweight (using World Health Organization growth standards) and delayed achievement of walking alone among the children was 27% and 12.7%, respectively. The independent predictors of increased odds for being overweight were middle household income and high dietary diversity score. Exclusive breastfeeding was associated with lower odds of children being overweight. Delayed solid feeding initiation was associated with increased odds of delay in walking alone for the children. Breastfeeding predicted reduced odds of this issue. These findings suggest that nutritional intervention and childcare education, such as breastfeeding promotion, improved diet quality, and the timely introduction of solid food, could improve growth and development among young children in suburban northeast China.
Jasminum honghoense sp. nov. (Oleaceae), from the dry‐hot Yuanjiang valley in Yunnan, China
Authors: Zhang Kai , Yuan Shuai , Pan Bo , Zeng Gui , Li Xiaojuan , Zhang Dianxiang
Published: April 2019

Jasminum honghoense (Oleaceae), a new species from the dry‐hot Yuanjiang valley in southern central Yunnan, China, is described and illustrated. Differences between J. honghoense and two morphologically similar species are presented. Moreover, the pollen morphology of J. honghoense is reported.
Sparing of the nipple‐areola complex by capillary malformations: Vascular variant of the Bork–Baykal phenomenon
Authors: Knöpfel Nicole , Theiler Martin , Rodríguez‐Jiménez Pedro , Happle Rudolf , Weibel Lisa , Torrelo Antonio
Published: April 2019

The“Bork‐Baykal phenomenon” refers to the sparing of the nipple‐areola complex in large congenital melanocytic nevi involving the breast. So far, this finding has not been reported in vascular anomalies. We present four patients with an extensive capillary malformation (CM) involving the breast that was found to exhibit a similar sparing of the nipple and areola. All of these capillary nevi were associated with asymmetric overgrowth.
The effects of stakeholder integration on firm‐level product innovativeness: insights from small and medium‐sized enterprises in Ghana
Authors: Adomako Samuel , Amankwah‐Amoah Joseph , Danso Albert
Published: April 2019

In spite of growing research on the influence of external stakeholders on firm outcomes, there is a paucity of research on how they influence innovation in emerging economies. In addition, the specific environmental factors that may influence the effect of stakeholder integration (SI) on firm innovation is less understood. Using data collected from 248 small‐ and medium‐sized enterprises in Ghana, this paper develops and tests a model that examines the relationship between SI and firm‐level product innovativeness. The findings from the study indicate SI positively relates to product innovativeness. Moreover, under conditions of higher competitor pressure and greater customer expectations, the effect of SI on product innovativeness is amplified. Contributions for theory and practice are discussed.
Azithromycin reduces airway inflammation induced by human rhinovirus in lung allograft recipients
Authors: Ling Kak‐Ming , Hillas Jessica , Lavender Melanie A. , Wrobel Jeremy P. , Musk Michael , Stick Stephen M. , Kicic Anthony
Published: April 2019

Background and objective

Human rhinovirus (RV) is a common upper and lower respiratory pathogen in lung allograft recipients causing respiratory tract exacerbation and contributing towards allograft dysfunction and long‐term lung decline. In this study, we tested the hypothesis that RV could infect both the small and large airways, resulting in significant inflammation.

Methods

Matched large and small airway epithelial cells (AEC) were obtained from five lung allograft recipients. Primary cultures were established, and monolayers were infected with RV1b over time with varying viral titre. Cell viability, receptor expression, viral copy number, apoptotic induction and inflammatory cytokine production were also assessed at each region. Finally, the effect of azithromycin on viral replication, induction of apoptosis and inflammation was investigated.

Results

RV infection caused significant cytotoxicity in both large AEC (LAEC) and small AEC (SAEC), and induced a similar apoptotic response in both regions. There was a significant increase in receptor expression in the LAEC only post viral infection. Viral replication was elevated in both LAEC and SAEC, but was not significantly different. Prophylactic treatment of azithromycin reduced viral replication and dampened the production of inflammatory cytokines post‐infection.

Conclusion

Our data illustrate that RV infection is capable of infecting upper and lower AEC, driving cell death and inflammation. Prophylactic treatment with azithromycin was found to mitigate some of the detrimental responses. Findings provide further support for the prophylactic prescription of azithromycin to minimize the impact of RV infection.
Characterization of oral health in a Portuguese population with mild intellectual disability
Authors: Couto Patrícia , Pereira Paulo Almeida , Nunes Manuel , Mendes Rui Amaral
Published: April 2019

Aims

This study aims to characterize the hygiene habits, the self‐perception of the need for treatment and the oral condition of a population with a disability.

Methods and Results

This research is part of an observational, cross‐sectional epidemiological study on oral health and quality of life of people with mild intellectual disabilities living in (or attending) institutions of the Central Region of Portugal that were affiliated with HUMANITAS (Portuguese Federation for Mental Disability) in 2016. A sociodemographic and oral health questionnaire, applied on the form of an interview to 240 individuals aged between 18 and 64 years, was used. Statistical analyses were performed using SPSS version 22.0. It was verified that 32.9% of the individuals had less than 20 teeth. Only 15% of all individuals used removable prosthesis. About 21% didn't do oral hygiene daily. Only 28.4% of the sample visited the dentist in the last 6 months. Note that 75.2% of the sample stated their need for dental treatment and less than half (37.4%) described their oral condition as good or superior.

Conclusion

Dental care among adults with intellectual disability is one of the most unattended health needs. Evidence suggests that inadequate oral health habits are more prevalent in the studied population than in the Portuguese population.
Transvaginal laparoscopic ovariectomy in 60 dogs: Description of the technique and comparison with 2‐portal‐access laparoscopic ovariectomy
Authors: Arntz Geert‐Jan H. M.
Published: April 2019

Objective

To describe a transvaginal laparoscopic ovariectomy (TLOVE) in dogs and compare duration and perioperative complications between TLOVE and 2‐portal‐access laparoscopic OVE (LapOVE).

Study design

Retrospective study.

Animals

Female client‐owned dogs (60 in TLOVE group and 202 in LapOVE group) between 6 and 103 months of age with body weights between 10 and 33 kg.

Methods

Ovariectomy was performed either through a transvaginal approach (TLOVE) or 2‐portal‐access laparoscopy (LapOVE). Dog characteristics (breed, weight, body condition score, age), surgical procedure time, and perioperative complications were compared between groups.

Results

The time required to complete TLOVE (34.3 ± 9.9 minutes) was longer than that for LapOVE (22.3 ± 3.2 minutes, P < .001). Intraoperative complications were encountered in 3 of 60 dogs undergoing TLOVE and 0 of 202 in the LapOVE group. Postoperative complications were not present in the TLOVE group. Suture dehiscence due to early removal of the Elizabethan collar occurred in 4 dogs after LapOVE.

Conclusion

Transvaginal laparoscopic OVE was completed without postoperative complications in all dogs of this study although TLOVE took about 15 minutes longer to complete than LapOVE.

Clinical significance

Transvaginal laparoscopic OVE provides a minimally invasive surgical alternative for OVE in dogs weighing 10‐33 kg and aged 6‐103 months, eliminating incisions through the abdominal wall, placement of suture material, and application of an Elizabethan collar.
Influence of multiple herbicide resistance on growth in Amaranthus tuberculatus
Authors: Jones E A L , Owen M D K , Leon R G
Published: April 2019

Plant defence traits, such as herbicide resistance mutations, may incur a fitness cost to plants that become evident when the trait is not needed. However, individuals with multiple herbicide resistance traits may decrease fitness beyond that of plants with a single herbicide resistance mutation. Multiple herbicide‐resistant (MHR) Amaranthus tuberculatus populations are becoming more prevalent in Midwest United States agroecosystems. The objective was to determine whether selected MHR A. tuberculatus populations express differential development when grown in a herbicide‐free environment. The hypothesis was that MHR A. tuberculatus populations become increasingly less fit when additional herbicide resistances evolve. Multiple herbicide‐resistant and herbicide‐susceptible A. tuberculatus populations were grown in a herbicide‐free field for 20 weeks for two seasons. Differences (P < 0.001) in apical growth were detected 5 and 7 weeks after transplanting for all populations in 2016 and 2017 respectively. Gender and population influenced (P < 0.001) flowering date, with males flowering up to 1.5 weeks earlier than females, but did not cause pollination asynchrony. Shoot biomass was not different (P = 0.84) across A. tuberculatus populations, but there were differences (P < 0.001) for gender and year. Seed production was different amongst A. tuberculatus populations (P = 0.001), but was not influenced by the number of MHR traits. Conversely, a negative quadratic relationship between seed mass and the number of MHR traits was observed (r2 = 0.32; P < 0.001). The experiment results demonstrate that MHR in A. tuberculatus populations is not incurring a fitness penalty that will remove the populations in the immediate future.
Reduction in field emergence and seedbank density of Galinsoga quadriradiata and other weeds after contrasting false seedbed strategies in organic vegetable fields
Authors: De Cauwer B , De Cuypere T , De Ryck S , Delanote L , DeWaele K , Willekens K , Reheul D
Published: April 2019

Mechanical weed control in low competitive, organic vegetable production systems is challenging, particularly in fields with large populations of Galinsoga spp. (Asteraceae). Various false seedbed techniques are used prior to crop planting or sowing to prevent weed emergence, albeit with variable success. This study investigated the impact of machinery type (flamer, hoe and harrow), number of passes (2 and 4), tillage depth (1–4 cm) and intensity (double and single hoeing, and hoeing with or without additional harrowing) on weed emergence and seedbank density in 0–5 cm topsoil of organic vegetable fields. False seedbed machinery that did not or minimally disturb the soil was most appropriate for preventive control of Galinsoga quadriradiata (Hairy galinsoga) and total weed seeds, with reductions in seedling emergence up to 99% and 73%, respectively, for flaming, and 74% and 67%, respectively, for 1 cm deep hoeing, 1 month after false seedbed creation. Compared with 1 cm deep hoeing, 1 cm deep harrowing was 16% less effective in the control of emerged seedlings, while flaming was highly effective in preventing weed seedling emergence, even after a low number of passes. Tillage intensity was less important than tillage depth for the reduction in weed emergence and seedbank density. Overall, tillage was more effective for seedbank reduction than flaming.
Construction of a high cell density human corneal endothelial equivalent and its transplantation in primate models
Authors: Zhao Jun , Fan Tingjun , Ma Xiya , Hu Xiuzhong
Published: April 2019

Background

Recently, many patients with corneal blindness caused by endothelial dysfunction have no opportunity to receive keratoplasty therapy because of the extremely limited number of donor corneas. Corneal tissue engineering opens a new path for in vitro reconstruction of tissue‐engineered HCE which will cure the corneal endotheliopathy by clinical corneal transplantation. In this study, we construct a human corneal endothelium (HCE) equivalent with non‐transfected monoclonal HCE (mcHCE) cells and modified denuded amniotic membrane (mdAM), and evaluate its functions in monkey models.

Methods

Tissue‐engineered HCE (TE‐HCE) was constructed by culturing DiI‐labeled mcHCE cells on mdAMs in 20% fetal bovine serum‐containing DMEM/Ham’s Nutrient Mixture F12 (1:1) medium and 5% CO2 at 37°C on a 24‐well culture plate. The constructed TE‐HCE was transplanted into monkey corneas via penetrating keratoplasty with Descemet’s membrane and endothelium stripped. The corneal transparency, thickness, and intraocular pressure were monitored in vivo, and the corneal morphology and histological structure were examined ex vivo 181 days after surgery.

Results

The constructed TE‐HCE, with an average density of 3602.22 ± 45.22 cells/mm2, mimicked its natural counterpart both in morphology and histological structure. In vivo, corneal transparency was maintained, and the corneal thickness gradually decreased to 567.33 ± 72.77 μm at day 181 after TE‐HCE transplanted into monkey eyes, while intense corneal edema and turbid were found in mdAM‐transplanted eyes with their corneal thicknesses maintained over 1000 μm during the monitoring period. Ex vivo, a monolayer of corneal endothelium, consisting of mcHCE cells at a density of 2795.65 ± 156.83 cells/mm2, was reconstructed in transplanted monkey eyes. The cells in the transplanted area had the hexagonal or polygonal morphology and normal ultrastructure, and established plenty of cell‐cell and cell‐stromal matrix junctions. Besides, huge membrane‐bounded flat stacks with electric dense inclusions were found in mcHCE cells beneath the plasma membrane at the stromal side.

Conclusions

The constructed TE‐HCE has normal histological property and functions well in monkey models. The TE‐HCE could be used as a promising HCE equivalent in therapy of corneal endothelium dysfunction and corneal regenerative medicine.
Justification of specific genetic modifications in pigs for clinical organ xenotransplantation
Authors: Cooper David K. C. , Hara Hidetaka , Iwase Hayato , Yamamoto Takayuki , Li Qi , Ezzelarab Mohamed , Federzoni Elena , Dandro Amy , Ayares David
Published: April 2019

Xenotransplantation research has made considerable progress in recent years, largely through the increasing availability of pigs with multiple genetic modifications. We suggest that a pig with nine genetic modifications (ie, currently available) will provide organs (initially kidneys and hearts) that would function for a clinically valuable period of time, for example, >12 months, after transplantation into patients with end‐stage organ failure. The national regulatory authorities, however, will likely require evidence, based on in vitro and/or in vivo experimental data, to justify the inclusion of each individual genetic modification in the pig. We provide data both from our own experience and that of others on the advantages of pigs in which (a) all three known carbohydrate xenoantigens have been deleted (triple‐knockout pigs), (b) two human complement‐regulatory proteins (CD46, CD55) and two human coagulation‐regulatory proteins (thrombomodulin, endothelial cell protein C receptor) are expressed, (c) the anti‐apoptotic and “anti‐inflammatory” molecule, human hemeoxygenase‐1 is expressed, and (d) human CD47 is expressed to suppress elements of the macrophage and T‐cell responses. Although many alternative genetic modifications could be made to an organ‐source pig, we suggest that the genetic manipulations we identify above will all contribute to the success of the initial clinical pig kidney or heart transplants, and that the beneficial contribution of each individual manipulation is supported by considerable experimental evidence.
A NONLINEAR FINITE ELEMENT ANALYSIS OF PRECAST INDUSTRIALISED BUILDING SYSTEM BEAM UNDER FLEXURAL TEST
Authors: Yip Chun-Chieh , Wong Jing-Ying , Hor Ka-Wai
Published: April 2019

Software simulation enables design engineers to have a better picture of possible structural failure behaviour and determine the accuracy of a design before the actual structural component is fabricated. Finite element analysis is used to simulate the behaviour of the reinforced concrete beam under the flexural test. During the flexural test, results are recorded for both simulation and experimental tests. By comparing the results, beam displacement, crack patterns, and failure modes can be studied with better accuracy. The accuracy percentage for yield load and ultimate load between the two tests results were 94.12 % and 95.79 %, respectively, whereas the accuracy percentage for elastic gradient before the yielding stage was 81.08 %. The behaviour between simulation and laboratory models described is based on crack pattern and failure mode. The progression of von Mises (VM) stresses highlighted the critical areas of the reinforced concrete beam and correlation between the experimental specimen, in terms of flexural cracks, shear cracks, yielding of tension reinforcement, and the crushing of concrete due to compressive stress. This paper concludes that simulation can achieve a significant accuracy in terms of loads and failure behaviour compared to the experimental model.
PEAT SOIL STABILIZATION IN RAWA PENING SALATIGA CENTRAL JAVA USING SYNTHETIC GYPSUM AND SALT
Authors: Silmi Surjandari Niken , Djarwanti Noegroho , Prasetyo Gunawan , Erianto Febby
Published: April 2019

Peat is known as a problematic soil due to its low bearing capacity as well as its high and long settlement process. Necessary treatment is needed to improve peat soil capability. One of the methods to improve peat soil characteristics is by adding mixed materials. In this study the added materials are synthetic gypsum (CaSO4.2H20) and salt (NaCl). The research was conducted in a Soil Mechanics Laboratory using a consolidation test and direct shear tests. This research aims to find out the effect of CaSO4.2H20 and NaCl on consolidation and shear strength parameters. The soil samples taken for consolidation and direct shear tests were original and treated peat soil. The gypsum synthesis doses varied between 10%, 15%, and 20%, whereas the salt varied between 2%, 4%, and 6%, calculated from the dry weight of peat soil. The mixing of soil and the added materials was carried out under optimum water conditions of Standard Proctor compaction results. After the consolidation and direct shear tests were completed, the Scanning Electron Microscope (SEM) test was performed on the soil samples to determine the components of the peat soil on micron size. The addition of synthetic gypsum and salt resulted in the smallest Cc value of 0.0302 at 4% salt + 20% gypsum and the highest Cv value of 0.130 cm2/s at 6% salt + 20% gypsum. The addition of synthetic gypsum and salt mixture resulted in the highest cohesion, c value of 61,55 kPa at 6% salt + 15% gypsum and the greatest friction angle, ϕ value of 52.24° at 4% salt + 20% gypsum. NaCl gave better results than Gypsum in improving shear strength. A composition of 4%-6% of NaCl and 15%-20% of Gypsum is recommended, if NaCl and gypsum were to be applied simultaneously to improve shear strength.
POLYMERIC MIXED MATRIX MEMBRANES INCORPORATED WITH GRAPHENE OXIDE FOR H2/CO2 SEPARATION
Authors: Rohani Rosiah , Milani Kalkhoran Hannaneh , Tao Chung Ying
Published: April 2019

Biohydrogen is a potential alternative for fossil fuels and it can be produced from POME fermentation. Membrane technology has been a prominent separation approach for H2 purification. However, membranes yield weakness in tradeoff between permeability and selectivity. The main objective of this project is to develop mixed matrix membrane with different polymeric bases of Polysulfone (PSF) and Polyimide (PI) with graphene oxide (GO) incorporation as inorganic filler for H2/CO2 separation. Gas permeability and selectivity results indicated that PI/GO membrane with 1 wt% of GO has the highest H2 and CO2 permeability at 501 GPU and 595 GPU at 1 bar, respectively, H2/CO2 selectivity of 1.01 at 5 bar and highest H2 purity of 83 %. FESEM analysis indicated changes in the pore size and top layer of membranes due to the presence of GO. Zeta potential analysis proved that PI/GO 1wt% membranes is highly negative-charged (-56 mV). Contact angle results showed a decrease in contact angle value with the addition of GO. It can be concluded that PI/GO 1 wt% membranes demonstrated better results in the aspects of permselectivity and physicochemical properties compared to PSF membranes.
Compressible flow simulations of voiced speech using rigid vocal tract geometries acquired by MRI
Authors: Schickhofer Lukas , Malinen Jarmo , Mihaescu Mihai
Published: April 2019

Voiced speech consists mainly of the source signal that is frequency weighted by the acoustic filtering of the upper airways and vortex-induced sound through perturbation in the flow field. This study investigates the flow instabilities leading to vortex shedding and the importance of coherent structures in the supraglottal region downstream of the vocal folds for the far-field sound signal. Large eddy simulations of the compressible airflow through the glottal constriction are performed in realistic geometries obtained from three-dimensional magnetic resonance imaging data. Intermittent flow separation through the glottis is shown to introduce unsteady surface pressure through impingement of vortices. Additionally, dominant flow instabilities develop in the shear layer associated with the glottal jet. The aerodynamic perturbations in the near field and the acoustic signal in the far field are examined by means of spatial and temporal Fourier analysis. Furthermore, the acoustic sources due to the unsteady supraglottal flow are identified with the aid of surface spectra, and critical regions of amplification of the dominant frequencies of the investigated vowel geometries are identified.
Repeated Impacts Diminish the Impact Performance of Equestrian Helmets
Authors: Mattacola Carl G. , Quintana Carolina , Crots Jed , Tumlin Kimberly I. , Bonin Stephanie
Published: April 2019

Context: During thoroughbred races, jockeys are placed in potentially injurious situations, often with inadequate safety equipment. Jockeys frequently sustain head injuries; therefore, it is important that they wear appropriately certified helmets. Objective: The goals of this study are (1) to perform impact attenuation testing according to ASTM F1163-15 on a sample of equestrian helmets commonly used by jockeys in the United States and (2) to quantify headform acceleration and residual crush after repeat impacts at the same location. Participants and Design: Seven helmet models underwent impact attenuation testing according to ASTM F1163-15. A second sample of each helmet model underwent repeat impacts at the crown location for a total of 4 impacts. Setting: Laboratory. Intervention: Each helmet was impacted against a flat and equestrian hazard anvil. Main Outcome Measures: Headform acceleration was recorded during all impact and computed tomography scans were performed preimpact and after impacts 1 and 4 on the crown to quantify liner thickness. Results: Four helmets had 1 impact that exceeded the limit of 300g. During the repeated crown impacts, acceleration remained below 300g for the first and second impacts for all helmets, while only one helmet remained below 300g for all impacts. Foam liner thickness was reduced between 5% and 39% after the first crown impact and between 33% and 70% after the fourth crown impact. Conclusions: All riders should wear a certified helmet and replace it after sustaining a head impact. Following an impact, expanded polystyrene liners compress, and their ability to attenuate head acceleration during subsequent impacts to the same location is reduced. Replacing an impacted helmet may reduce a rider’s head injury risk.
Phosphotyrosine-dependent interaction between the kinases PKCθ and Zap70 promotes proximal TCR signaling
Authors: Xie Jiji , Han Xuemei , Zhao Chensi , Canonigo-Balancio Ann J. , Yates John R. , Li Yingqiu , Lillemeier Björn F. , Altman Amnon
Published: April 2019

The phosphotyrosine-binding domain of PKCθ interacts with the kinase Zap70 and is required for early TCR signaling.
Cardiomyocyte glucocorticoid and mineralocorticoid receptors directly and antagonistically regulate heart disease in mice
Authors: Oakley Robert H. , Cruz-Topete Diana , He Bo , Foley Julie F. , Myers Page H. , Xu Xiaojiang , Gomez-Sanchez Celso E. , Chambon Pierre , Willis Monte S. , Cidlowski John A.
Published: April 2019

Skewing glucocorticoid signaling to favor mineralocorticoid receptor activation is detrimental to the heart.
Corticosteroid receptor balance regulates life and death in cardiomyocytes
Authors: Chapman Karen E.
Published: April 2019

Corticosteroid receptor signaling can be beneficial or detrimental to the heart (Oakley
et al.
, in 16 April 2019 issue).
New Zealand White Rabbits Effectively Clear Borrelia burgdorferi B31 despite the Bacterium’s FunctionalvlsEAntigenic Variation System
Authors: Batool Maliha , Hillhouse Andrew E. , Ionov Yurij , Kochan Kelli J. , Mohebbi Fatemeh , Stoica George , Threadgill David W. , Zelikovsky Alex , Waghela Suryakant D. , Wiener Dominique J. , Rogovskyy Artem S.
Published: April 2019

Borrelia burgdorferiis a tick-borne bacterium responsible for approximately 300,000 annual cases of Lyme disease (LD) in the United States, with increasing incidences in other parts of the world. The debilitating nature of LD is mainly attributed to the ability ofB. burgdorferito persist in patients for many years despite strong anti-Borreliaantibody responses.
Petrogenesis of the southern Qiangtang mafic dykes, Tibet: Link to a late Paleozoic mantle plume on the northern margin of Gondwana?
Authors: Wang Ming , Li Cai , Zeng Xiao-Wen , Li Hang , Fan Jian-Jun , Xie Chao-Ming , Hao Yu-Jie
Published: April 2019

This study presents 13 new U-Pb zircon ages obtained by laser ablation–inductively coupled plasma–mass spectrometry (LA-ICP-MS) together with whole-rock geochemical, Sr-Nd isotopic and zircon Hf isotopic data for a mafic dike swarm in the southern Qiangtang area of Tibet. These data provide the basis for a new model of the late Paleozoic evolution of the Tethys. Combined with the results of previous zircon U-Pb dating, the magmatic zircon grains extracted from mafic dikes yield latest Carboniferous to Early Permian ages (317–279 Ma). The geochemistry of the southern Qiangtang mafic rocks indicates the presence of low-Ti (QLT) and high-Ti (QHT) suites. The magmas that formed the QLT suite underwent higher degrees of partial melting (>5%) and display evidence of crustal contamination, whereas the QHT suite was derived from magmas generated by low-degree (1%–5%) partial melting of a garnet-bearing mantle source, with a greater extent of fractional crystallization than the QLT suite, and no evidence of crustal contamination. We propose that the QHT and QLT suites may have been derived from magmas from different parts of a single mantle plume. The formation of the southern Qiangtang mafic dikes (latest Carboniferous to Early Permian; 317–279 Ma) may have been related to the northward drift of the Cimmerian continent from the northern Gondwana margin, which resulted in the opening of the Meso-Tethys Ocean.
A structural model for the South Tibetan detachment system in northwestern Bhutan from integration of temperature, fabric, strain, and kinematic data
Authors: Long Sean P. , Mullady Connor L. , Starnes Jesslyn K. , Gordon Stacia M. , Larson Kyle P. , Pianowski Laura S. , Miller Robert B. , Soignard Emmanuel
Published: April 2019

Despite playing a fundamental role in all models of Himalayan tectonics, minimal data constraining the structural evolution, metamorphic history, and offset magnitude of the South Tibetan detachment system (STDS) are available. Here, we integrate petrofabric, finite strain, and kinematic data with metamorphic and deformation temperatures to generate a structural model for the STDS in northwestern Bhutan. We divide the STDS into an ∼2-km-thick lower level that accommodated ∼6–13 km of thinning via ≥30–76 km of simple shear-dominant displacement within Greater Himalayan rocks, and an ∼3-km-thick upper level that accommodated ≥21 km of displacement via an upward decrease (from 44% to 2%) in transport-parallel lengthening within Tethyan Himalayan rocks. Peak metamorphic temperatures in the lower level are ∼650–750 °C, and two distinct intervals of telescoped isotherms in the upper level define a cumulative upward decrease from ∼700 to ∼325 °C. These intervals are separated by an abrupt upward increase from ∼450 to ∼620 °C, which we interpret as the result of post-STDS thrust repetition. Above the upper telescoped interval, temperatures gradually decrease upward from ∼325 to ∼250 °C through a 7-km-thick section of overlying Tethyan Himalayan rocks. Telescoped isotherms lie entirely above the high-strain lower level of the STDS zone, which we attribute to progressive elevation of isotherms during protracted intrusion of granite sills. This study demonstrates the utility of using gradients in fabric intensity and thin section-scale finite strain to delineate shear zone boundaries when field criteria for delineating strain gradients are not apparent.
Dysautonomia and hyponatraemia as harbingers of Guillain-Barre syndrome
Authors: Shah Preet Mukesh , Dhakre Vijay Waman , Veerasuri Ramya , Bhabhor Anand
Published: April 2019

A 56-year-old woman with a medical history of hypertension presented to our hospital with back pain, abdominal pain, vomiting and elevated blood pressure. The laboratory parameters including evaluation for secondary hypertension were within normal ranges at the time of presentation. During her hospitalisation, fluctuations in her blood pressure and pulse were observed which were attributed to autonomic disturbances, the cause of which was unknown. On the seventh day after presentation to the hospital, the patient developed focal seizures and slurred speech which was believed to be secondary to hyponatraemia detected at that time. Hyponatraemia improved with hypertonic saline and she experienced no further seizures. On the eighth day of her admission, she developed acute flaccid paralysis of all her limbs and respiratory distress. We concluded this to be secondary to Guillain-Barre syndrome (GBS). She responded to plasmapheresis.

The presence of dysautonomia and hyponatraemia before the onset of paralysis makes this a rare presentation of GBS.
Doubles trouble-85 cases of ocular trauma in badminton: clinical features and prevention
Authors: Yu Jie , Chen Yan , Miao Jingpeng , Zhao Meng , Keng Caixia , Wang Xiaojie , Guo Jianjun , Liu Yi
Published: April 2019

Objectives

To describe ocular injuries caused by badminton and to explore the implications for future prevention strategies.

Methods

We enrolled 85 patients with ocular trauma caused by badminton. Information collected from patients included type of game, instigator, instrument of injury and lessons in badminton from a professional, and ocular trauma information such as type of injury, treatment and final outcomes.

Results

The 85 patients (52 men, 33 women) were aged 15–65 years with an average age of 42.9 (±10.7) years. In 60 cases the player was hit by a shuttlecock and in 25 the player was hit by a racquet. 73 cases occurred in doubles matches and 10 in singles matches. In 31 cases the trauma was caused by an opponent and in 52 cases by a partner; 2 cases involved bystanders, not players. About 70% (43/61) of the injured and 82% (40/49) of the instigators had not received badminton lessons from a professional. 80 injuries were non-penetrating and 5 were penetrating. There were 58 cases with hyphaema, 36 with secondary glaucoma, 23 with lens subluxation and 2 with retinal detachment. Surgery comprised phacoemulsification or lensectomy and vitrectomy in 16 cases, silicone oil tamponade in 2 cases, trabeculectomy in 3 cases and direct cyclopexy in 5 cases.

Conclusion

The vast majority of the badminton related eye injuries occurred among doubles players and were instigated by the injured person’s partner. Non-penetrating injury was more frequent; penetrating injury was usually more serious. We recommend that badminton players use protective eyewear and receive safety education and professional coaching/instruction on techniques to protect against serious eye injuries.
Diabetes in pregnancy in associations with perinatal and postneonatal mortality in First Nations and non-Indigenous populations in Quebec, Canada: population-based linked birth cohort study
Authors: Chen Lu , Wang Wen-Juan , Auger Nathalie , Xiao Lin , Torrie Jill , McHugh Nancy Gros-Louis , Luo Zhong-Cheng
Published: April 2019

Objective

Both pregestational and gestational diabetes mellitus (PGDM, GDM) occur more frequently in First Nations (North American Indians) pregnant women than their non-Indigenous counterparts in Canada. We assessed whether the impacts of PGDM and GDM on perinatal and postneonatal mortality may differ in First Nations versus non-Indigenous populations.

Design

A population-based linked birth cohort study.

Setting and participants

17 090 First Nations and 217 760 non-Indigenous singleton births in 1996–2010, Quebec, Canada.

Main outcome measures

Relative risks (RR) of perinatal and postneonatal death. Perinatal deaths included stillbirths and neonatal (0–27 days of postnatal life) deaths; postneonatal deaths included infant deaths during 28–364 days of life.

Results

PGDM and GDM occurred much more frequently in First Nations (3.9% and 10.7%, respectively) versus non-Indigenous (1.1% and 4.8%, respectively) pregnant women. PGDM was associated with an increased risk of perinatal death to a much greater extent in First Nations (RR=5.08[95% CI 2.99 to 8.62], p<0.001; absolute risk (AR)=21.6 [8.6–34.6] per 1000) than in non-Indigenous populations (RR=1.76[1.17, 2.66], p=0.003; AR=4.2[0.2, 8.1] per 1000). PGDM was associated with an increased risk of postneonatal death in non-Indigenous (RR=3.46[1.71, 6.99], p<0.001; AR=2.4[0.1, 4.8] per 1000) but not First Nations (RR=1.16[0.28, 4.77], p=0.35) infants. Adjusting for maternal and pregnancy characteristics, the associations were similar. GDM was not associated with perinatal or postneonatal death in both groups.

Conclusions

The study is the first to reveal that PGDM may increase the risk of perinatal death to a much greater extent in First Nations versus non-Indigenous populations, but may substantially increase the risk of postneonatal death in non-Indigenous infants only. The underlying causes are unclear and deserve further studies. We speculate that population differences in the quality of glycaemic control in diabetic pregnancies and/or genetic vulnerability to hyperglycaemia’s fetal toxicity may be contributing factors.
Quantitative examination of the bone health status of older adults with intellectual and developmental disability in Ireland: a cross-sectional nationwide study
Authors: Burke Éilish , Carroll Rachael , O’Dwyer Máire , Walsh James Bernard , McCallion Philip , McCarron Mary
Published: April 2019

Objectives

(1) To investigate the prevalence of osteopenia and osteoporosis among adults with intellectual disabilities (IDs) and (2) to examine alternative optimal bone screening techniques.

Design

Observational cross-sectional study.

Setting

Wave 2 (2013–2106) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing.

Participants

A national representative sample of 604 male and female persons with ID aged 43 years and over. In total, 575 participants completed quantitative ultrasound (QUS) measurements for one or both feet.

Outcome measures

Participants underwent health assessments consisting of eight objective health measures including the standardised QUS of the calcaneus bone using a GE Lunar Achilles. A preinterview questionnaire and face-to-face interview were also completed.

Results

Objectively QUS identified poorer rates of bone health in people with ID overall with 74% indicating evidence of osteopenia (33.2%) or osteoporosis (41%). Females scored lower than males in the QUS t-scores −2.208 (±1.77) versus −1.78(±1.734). Bone status was stratified by gender (p=0.114), age (p=0.003), level of ID (p<0.0001) and living circumstance (p<0.0001).

Conclusions

This study has shown the prevalence of poor bone health in people with ID is substantial implying an increased risk of fracture due to reduced skeletal integrity. QUS screening has been shown to be useful when combined with clinical risk factors.
Using near-miss events to improve MRI safety in a large academic centre
Authors: Goolsarran Nirvani , Martinez Jose , Garcia Christine
Published: April 2019

Near-miss events represent an opportunity to identify and correct errors that jeopardise patient safety. The MRI environment poses potential safety threats and is frequently associated with near misses or adverse events related to improper safety screening for presence of cardiac pacemakers and other potential contraindications. At our institution, MRI safety screening lacked a formalised structure and standardisation; the process relied on a single-step safety screening process. As a result, we observed a significant number of near misses associated with improper MRI screening that resulted in ‘close calls’ in patients with incompatible metals implants. The purpose of this project was to use a quality improvement approach to analyse the near-miss pattern and create a multistep intervention to decrease the number of near misses associated with MRI screening and to ultimately decrease the potential for patient harm. Using the Plan-Do-Study-Act model, we decreased the number of MRI near misses from 22 to zero near misses in 1 year after implementation. The project demonstrates successful transformation of near misses to a never event: a reportable event that should never happen. The project also demonstrates the importance in targeting and prioritising a pattern of near misses, which are unplanned events that do not result in injury but had great potential to do so.
Chest radiograph reading panel performance in a Bangladesh pneumococcal vaccine effectiveness study
Authors: McCollum Eric D , Ahmed Salahuddin , Chowdhury Nabidul H , Rizvi Syed J R , Khan Ahad M , Roy Arun D , Hanif Abu AM , Pervaiz Farhan , Ahmed ASM Nawshad U , Farrukee Ehteshamul H , Monowara Mahmuda , Hossain Mohammad M , Doza Fatema , Tanim Bidoura , Alam Farzana , Simmons Nicole , Reller Megan E , Harrison Meagan , Schuh Holly B , Quaiyum Abdul , Saha Samir K , Begum Nazma , Santosham Mathuram , Moulton Lawrence H , Checkley William , Baqui Abdullah H
Published: April 2019

Introduction

To evaluate WHO chest radiograph interpretation processes during a pneumococcal vaccine effectiveness study of children aged 3–35 months with suspected pneumonia in Sylhet, Bangladesh.

Methods

Eight physicians masked to all data were standardised to WHO methodology and interpreted chest radiographs between 2015 and 2017. Each radiograph was randomly assigned to two primary readers. If the primary readers were discordant for image interpretability or the presence or absence of primary endpoint pneumonia (PEP), then another randomly selected, masked reader adjudicated the image (arbitrator). If the arbitrator disagreed with both primary readers, or concluded no PEP, then a masked expert reader finalised the interpretation. The expert reader also conducted blinded quality control (QC) for 20% of randomly selected images. We evaluated agreement between primary readers and between the expert QC reading and the final panel interpretation using per cent agreement, unadjusted Cohen’s kappa, and a prevalence and bias-adjusted kappa.

Results

Among 9723 images, the panel classified 21.3% as PEP, 77.6% no PEP and 1.1% uninterpretable. Two primary readers agreed on interpretability for 98% of images (kappa, 0.25; prevalence and bias-adjusted kappa, 0.97). Among interpretable radiographs, primary readers agreed on the presence or absence of PEP in 79% of images (kappa, 0.35; adjusted kappa, 0.57). Expert QC readings agreed with final panel conclusions on the presence or absence of PEP for 92.9% of 1652 interpretable images (kappa, 0.75; adjusted kappa, 0.85).

Conclusion

Primary reader performance and QC results suggest the panel effectively applied the WHO chest radiograph criteria for pneumonia.
Suicide rates in Zhejiang Province, China, from 2006 to 2016: a population-based study
Authors: Fei Fangrong , Liu Huixin , I Leuba Sequoia , Li Yichong , Hu Ruying , Yu Min , Pan Jin , Zhong Jieming
Published: April 2019

Background

We investigated the current temporal trends of suicide in Zhejiang, China, from 2006 to 2016 to determine possible health disparities in order to establish priorities for intervention.

Methods

We collected mortality surveillance data from 2006 to 2016 from the Zhejiang Chronic Disease Surveillance Information and Management System from the Zhejiang Provincial Centre for Disease Control and Prevention. We estimated region-specific and gender-specific suicide rates using joinpoint regression analyses to determine the average annual percentage change (AAPC) and its 95% CI.

Results

The crude suicide rate declined from 9.64 per 100 000 people in 2006 to 4.86 per 100 000 in 2016, and the age-adjusted suicide rate decreased from 9.74 per 100 000 in 2006 to 4.14 per 100 000 in 2016. During 2006–2013, rural males had the highest suicide rate, followed by rural females, urban males, and urban females, while after 2013, urban males suicide rates surpassed rural female suicide rates, and became the second highest suicide rate subgroup. The rate of suicide declined in all region-specific and/or gender-specific subgroups except among urban males between 20 and 34 years of age. Their age-adjusted suicide rate AAPC greatly increased to 28.39 starting in 2013 compared with an AAPC of −13.47 from 2006 to 2013.

Conclusions

The suicide rate among young urban males has been alarmingly increasing since 2013, and thus, researchers must develop targeted effective strategies to mitigate this escalating loss of life.