bluuebunny/crossref_metadata_2025 huggingface dataset:
How citizen journalists impact the agendas of traditional media and the government policymaking process in China
Authors: Luo Yumeng , Harrison Teresa M.
Published: March 2019

“Citizen journalism” is a term used to refer to ordinary individuals who act as journalists during some part of the process of creating content for mainstream journalism coverage. In China, besides ordinary citizen journalists, some professional journalists have been regarded as citizen journalists if they write stories online that would otherwise not be publishable in traditional media. Unfortunately, since the real name registration system was launched on the Internet in 2012, the activities of both professionals and average citizens in China are frequently limited. So, is citizen journalism a role that can only be practiced in very limited ways in China? This article adopts a broader definition of citizen journalism, in which, through the use of social media to discuss and comment on news and social issues, ordinary citizens in China act as collective citizen journalists, which insulates them against individually targeted criticism for their opinions. We applied agenda-setting theory to explain citizen journalist contributions to the content of traditional media and the policymaking process in China. Using several forms of Chinese media and rank-order cross-lagged correlations, we found that online public opinions in social media influenced the agenda of traditional commercially oriented media, but not the agenda of traditional government-sponsored media. The policy agenda was partially influenced by the online public. The online public acted collectively to influence and contribute to the content of the traditional media and policies the government considers, thus changing the nature of journalism and public sphere.
Financial Efficiency Evaluation of Indian Scheduled Commercial Banks
Authors: Bhatia Aparna , Mahendru Megha
Published: March 2019

The main objective of the article is to analyze and evaluate cost, revenue and profit efficiency scores of Indian scheduled commercial banks (SCBs) in India during 1991–1992 till 2012–2013 by the application of data envelopment analysis (DEA)—a nonparametric approach. The results show that Indian SCBs have profit, revenue and cost efficiency of less than 1 during both the reformatory as well as post-reformatory era depicting that banks are not able to maximize their revenues and minimize their costs simultaneously in order to enhance their net effect. During reformatory and post-reformatory era, SCBs are more efficient in generating revenues and profits rather than in using their resources efficiently reflecting a high level of cost inefficiency. Overall, the results depict that Indian SCBs exhibit higher efficiency scores in reformatory era than in post-reformatory era.
HIV Vaccine Preparedness among Men Who Have Sex with Men in Taiwan: Sociocultural and Behavioral Factors
Authors: Chuang Deng-Min , Newman Peter Adam , Weaver James
Published: March 2019

In Taiwan, men who have sex with men (MSM) are at disproportionate risk of HIV infection. We examined awareness and acceptability of future HIV vaccines. From July to August 2014, we conducted a cross-sectional survey with MSM recruited through community-based organizations (CBOs) in 2 cities. Among 200 participants (mean age, 27.6 years), half reported multiple partners and one-third condomless anal sex (past 3 months); 12% were HIV-positive. Traditional Chinese medicine (TCM) use was reported by 42.7%. Over two-thirds (69.0%) were aware of HIV vaccine research, but less than half (43.8%) would accept an HIV vaccine if available. In multivariable analysis, higher educational attainment, >5 sex partners, and TCM use were positively associated with HIV vaccine awareness. Culturally informed HIV vaccine preparedness in Taiwan may be supported by a complementary approach to TCM and HIV prevention technologies, tailoring information for MSM with lower education and targeting those at high risk through gay-identified CBOs.
In-Clinic Adolescent Peer Group Support for Engagement in Sub-Saharan Africa: A Feasibility and Acceptability Trial
Authors: Barker David , Enimil Anthony , Galárraga Omar , Bosomtwe Dennis , Mensah Nicholas , Thamotharan Sneha , Henebeng Esther , Brown Larry , Kwara Awewura
Published: March 2019

Holding support groups with the same cohort of adolescents during clinic visits promises to increase engagement in care. Participants (N = 35 patients, aged 12-18, 50% female, from an adolescent HIV clinic in Kumasi, Ghana, were divided into 5 teams. Clinic visits were coordinated for members of each team. Team members participated in group discussions and activities while waiting to meet with their medical team. Teams met quarterly for 1 year. Participants reported benefits from talking with peers about the challenges of managing HIV. Clinic attendance improved from the preceding year (54% versus 84%). There were reductions in perceived internal stigma, perceived external stigma, worries about unintended disclosure from taking antiretroviral therapy (ART), and reduced ART concerns. The program demonstrated the feasibility, safety, and acceptability of facilitating increased interaction among adolescents living with HIV during clinic visits. Improvements in clinic attendance, perceived stigma, and concern about medications suggest that the intervention is a promising candidate for additional study.
Incidence, Mechanisms, and Severity of Game-Related High School Football Injuries Across Artificial Turf Systems of Various Infill Weights
Authors: Meyers Michael C.
Published: March 2019

Background:

Artificial turf surfaces are developed to duplicate playing characteristics of natural grass. With the newer generations of sand and rubber infill systems, the infill is a common component that varies between fields and is a critical factor that could influence the player-surface interaction. Because the influence of infill weight on sport trauma is unknown, this study quantified football trauma in high schools in the United States across artificial turf systems of various infill weights.

Hypothesis:

Athletes would not experience differences in game-related injuries across artificial turf systems of various infill weights.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Artificial turf systems were divided into 4 sand/rubber infill weight groups by pounds per square foot: ≥9.0, 6.0-8.9, 3.0-5.9, and 0.0-2.9. A total of 57 high schools in 4 states participated over the course of 5 seasons. Outcomes of interest included injury severity, as a function of infill weight, across head, knee, and shoulder traumas; injury category; primary type of injury; tissue type; specific body location of injury; cleat design; environmental factors; and turf age. Data were subject to multivariate analyses of variance (MANOVAs) and Wilks λ criteria through use of general linear model procedures.

Results:

Of 1837 games documented, 528 games were played on infill weights of ≥9.0 lb/ft2, 521 on 6.0-8.9 lb/ft2, 525 on 3.0-5.9 lb/ft2, and 263 on 0.0-2.9 lb/ft2, with 4655 total injuries reported. MANOVAs indicated significant infill weight effects across injury severity ( F2,4648 = 5.087; P = .0001), with significant main effects also observed by injury category, tissue injured, lower extremity joint and muscle, cleat design, environmental factors, and turf age. Post hoc analyses indicated significantly lower ( P < .05 to .0001) total and substantial traumas, concussions, shoe-surface interaction during contact trauma, surface impacts, muscle-tendon overload, cleat design influence, adverse weather trauma, lower extremity injuries, and turf age effect while athletes were competing on the 6.0 to ≥9.0 lb/ft2 infill weight systems compared with the lighter infill weight systems.

Conclusion:

As infill surface weight decreased, football trauma significantly increased across numerous playing conditions. Based on findings, high school football fields should minimally contain 6.0 pounds of infill per square foot.
Rehabilitation Variability After Elbow Ulnar Collateral Ligament Reconstruction
Authors: Lightsey Harry M. , Trofa David P. , Sonnenfeld Julian J. , Swindell Hasani W. , Makhni Eric C. , Ahmad Christopher S.
Published: March 2019

Background:

Investigations specifically delineating the safest and most efficacious components of physical therapy after ulnar collateral ligament (UCL) reconstruction of the elbow are lacking. As such, while a number of recommendations regarding postoperative therapy have been published, no validated rehabilitation guidelines currently exist.

Purpose:

To assess the variability of rehabilitation protocols utilized by orthopaedic residency programs in the United States (US) and those described in the scientific literature.

Study Design:

Cross-sectional study.

Methods:

Online UCL reconstruction rehabilitation protocols from US orthopaedic programs and from the scientific literature were reviewed. A comprehensive scoring rubric was developed to assess each protocol for the presence of various rehabilitation components as well as the timing of their introduction.

Results:

Overall, 22 protocols (14%) from 155 US Electronic Residency Application Service (ERAS) orthopaedic programs and 8 protocols published in the scientific literature detailing UCL reconstruction postoperative rehabilitation were identified and reviewed. After reconstruction, the majority of ERAS and review article protocols (77% and 88%, respectively) advised immediate splinting at 90° of elbow flexion. The mean time to splint discontinuation across all protocols was 2.0 weeks (range, 1-3 weeks). There was considerable variability in elbow range of motion recommendations; however, most protocols detailed goals for full extension and full flexion (>130°) at a mean 5.3 weeks (range, 4-6 weeks) and 5.5 weeks (range, 4-6 weeks), respectively. Significant diversity in the inclusion and timing of strengthening, proprioceptive, and throwing exercises was also apparent. Thirteen ERAS (59%) and 7 review article (88%) protocols specifically mentioned return to competition as an endpoint. ERAS protocols permitted return to competition significantly earlier than review article protocols (29.6 vs 39.0 weeks, respectively; P = .042).

Conclusion:

There is notable variability in both the composition and timing of rehabilitation components across a small number of protocols available online. While our understanding of postoperative rehabilitation for UCL reconstruction evolves, outcome-based studies focused on identifying clinically beneficial modalities and metrics are necessary to enable meaningful standardization.
Relationship-Centered Advising in a Medical School Learning Community
Authors: Frosch Emily , Goldstein Mitchell
Published: March 2019

Background:

Medical schools are required to have formal advising structures; however, there are limited data on how to optimally meet that mandate. Learning communities (LC), with their emphasis on longitudinal relationships, offer a unique scaffold for advising.

Program description:

The Johns Hopkins School of Medicine (JHSOM) LC focuses on curricular and extracurricular longitudinal connections between students and advisors. A core component of the LC is a relationship-centered advising (RCA) model drawing from best practices in physician–patient relationships, life coaching, and social contract theories. The key elements of the model include dyadic and small group advising, while the LC structure allows for faculty development in these domains. Relationship-centered advising approaches the collaborative advising work between students and advisors through explicit valuing of personal experiences, mutual respect, and earned trust. Framing the advising relationship in this way allows it to grow with the student along their medical school journey.

Program evaluation & results:

Student and faculty satisfaction with this model is high. Data from annual, anonymous student evaluations consistently indicate high degree of trust in and satisfaction from these relationships.

Discussion:

Relationship-centered advising aims to create a relationally anchored platform on which students can develop their personal and professional identities. This LC-based advising model is adaptable across schools regardless of structure and resources.
Soluble urokinase plasminogen activator receptor for the prediction of ventilator-associated pneumonia
Authors: van Oort Pouline M. , Bos Lieuwe D. , Póvoa Pedro , Ramirez Paula , Torres Antoni , Artigas Antonio , Schultz Marcus J. , Martin-Loeches Ignacio
Published: March 2019

Introduction

Diagnosing ventilator-associated pneumonia (VAP) remains challenging. Soluble urokinase plasminogen activator receptor (suPAR) has prognostic value in critically ill patients with systemic infection. We hypothesised that plasma suPAR levels accurately predict development of VAP.

Methods

This observational, multicentre, prospective cohort study compared patients at risk for VAP with a control group. Plasma and tracheal aspirate samples were collected. Plasma suPAR levels were measured on the day of diagnosis and 3 days before diagnosis.

Results

The study included 24 VAP patients and 19 control patients. The suPAR concentration measured 3 days before diagnosis was significantly increased in VAP patientsversusmatched samples of control patients (area under the receiver operating characteristic curve (AUC) 0.68, 95% CI 0.52–1.00; p=0.04). Similar results were found on the day of diagnosis (AUC 0.77, 95% CI 0.6–0.93; p=0.01). Plasma suPAR was significantly higher in deceased patients (AUC 0.79, 95% CI 0.57–1.00; p<0.001). Combining suPAR with the Clinical Pulmonary Infection Score, C-reactive protein and/or procalcitonin led to a significantly increased discriminative accuracy for predicting VAP and an increased specificity.

Conclusions

suPAR can be used to diagnose VAP with a fair diagnostic accuracy and has a moderate prognostic accuracy to be used in critically ill intensive care unit patients. Its performance improves when added to other clinically available biomarkers (C-reactive protein and procalcitonin) or scoring systems (Clinical Pulmonary Infection Score and Sepsis-related Organ Failure Assessment).
Personalised anti-inflammatory therapy for bronchiectasis and cystic fibrosis: selecting patients for controlled trials of neutrophil elastase inhibition
Authors: Keir Holly R. , Fong Christopher J. , Crichton Megan L. , Barth Philip , Chevalier Eric , Brady Gill , Kennedy Gwen , Zimmermann Johann , Bruijnzeel Piet L.B. , Dicker Alison J. , Chalmers James D.
Published: March 2019

Background

Neutrophil elastase (NE) has been linked to lung neutrophil dysfunction in bronchiectasis and cystic fibrosis (CF), making NE inhibition a potential therapeutic target. NE inhibitor trials have given mixed result perhaps because not all patients have elevated airway NE activity.

Methods

We tested whether a single baseline sputum NE measurement or a combination of clinical parameters could enrich patient populations with elevated NE activity for “personalised medicine”. Intra- and interindividual variations of total and active NE levels in induced sputum from patients with CF or bronchiectasis were monitored over 14 days. Patients with established CF and bronchiectasis (n=5 per group) were recruited. NE was measured using three different methods: one total and two active NE assays. Subsequently, we analysed the association between clinical parameters and NE from a large bronchiectasis cohort study (n=381).

Results

All three assays showed a high degree of day-to-day variability (0–233% over 14 days). There were strong correlations found between all assays (p<0.0001). Despite high day-to-day variability, patients could be stratified into “high” or “low” groups based on moderate cut-off levels. In the bronchiectasis cohort study, factors most associated with high sputum NE levels were:Pseudomonas aeruginosainfection (β-estimate 11.5, 95% CI −6.0–29.0), sputum colour (β-estimate 10.4, 95% CI 4.3–16.6), Medical Research Council dyspnoea score (β-estimate 6.4, 95% CI 1.4–11.4) and exacerbation history (β-estimate 3.4, 95% CI 1.4–5.3). Collectively,P. aeruginosainfection, sputum colour and exacerbation frequency provided the greatest specificity for “high” NE (98.7%, 95% CI 7.0–99.6%).

Conclusion

These results show that patients with bronchiectasis and CF can be effectively divided into “high” or “low” groups, based on sputum NE assays or clinical inclusion criteria.
Challenges, Opportunities, and Priorities for Advancing Breast Cancer Control in Zambia: A Consultative Meeting on Breast Cancer Control
Authors: Cabanes Anna , Kapambwe Sharon , Citonje-Msadabwe Susan , Parham Groesbeck P. , Lishimpi Kennedy , Cruz Tauane A. , Shastri Surendra
Published: March 2019

In 2016, the Zambian government made cancer control a national priority and released a National Cancer Control Strategic Plan for 2016 to 2021, which focuses on malignancies of the breast, cervix, and prostate, and retinoblastoma. The plan calls for a collective reduction in the cancer burden by 50%. In support of this vision, Susan G. Komen sponsored a consultative meeting in Lusaka, Zambia, in September 2017 to bring together the country’s main breast cancer stakeholders and identify opportunities to improve breast cancer control. The recommendations generated during the discussions are presented. There was general agreement that the first step toward breast cancer mortality reduction should consist of implementation of early detection service platforms focused on women who are symptomatic. Participants also agreed that the management of all components of the national breast cancer control program should be integrated and led by the Ministry of Health. As much as possible, early detection and treatment services presently offered by the Cervical Cancer Prevention Program of Zambia and Cancer Diseases Hospital should be leveraged. Efforts are under way through multiple stakeholders to implement the following recommendations: development of national guidelines for the early diagnosis of breast cancer, training of breast surgeons, implementation of early detection and surgical treatment service platforms at the district-hospital level, and epidemiologic research, including the improvement of electronic recording mechanisms.
Efficacy of Pharmacological Therapies for the Prevention of Fractures in Postmenopausal Women: A Network Meta-Analysis
Authors: Barrionuevo Patricia , Kapoor Ekta , Asi Noor , Alahdab Fares , Mohammed Khaled , Benkhadra Khalid , Almasri Jehad , Farah Wigdan , Sarigianni Maria , Muthusamy Kalpana , Al Nofal Alaa , Haydour Qusay , Wang Zhen , Murad Mohammad Hassan
Published: March 2019

Background

Osteoporosis and osteopenia are associated with increased fracture incidence in postmenopausal women. We aimed to determine the comparative effectiveness of various available pharmacological therapies.

Methods

We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science, and Scopus for randomized controlled trials that enrolled postmenopausal women with primary osteoporosis and evaluated the risk of hip, vertebral, or nonvertebral fractures. A network meta-analysis was conducted using the multivariate random effects method.

Results

We included 107 trials (193,987 postmenopausal women; mean age, 66 years; 55% white; median follow-up, 28 months). A significant reduction in hip fractures was observed with romosozumab, alendronate, zoledronate, risedronate, denosumab, estrogen with progesterone, and calcium in combination with vitamin D. A significant reduction in nonvertebral fractures was observed with abaloparatide, romosozumab, denosumab, teriparatide, alendronate, risedronate, zoledronate, lasofoxifene, tibolone, estrogen with progesterone, and vitamin D. A significant reduction in vertebral fractures was observed with abaloparatide, teriparatide, parathyroid hormone 1-84, romosozumab, strontium ranelate, denosumab, zoledronate, risedronate, alendronate, ibandronate, raloxifene, bazedoxifene, lasofoxifene, estrogen with progesterone, tibolone, and calcitonin. Teriparatide, abaloparatide, denosumab, and romosozumab were associated with the highest relative risk reductions, whereas ibandronate and selective estrogen receptor modulators had lower efficacy. The evidence for the treatment of fractures with vitamin D and calcium remains limited despite numerous large trials.

Conclusions

This network meta-analysis provides comparative effective estimates for the various available treatments to reduce the risk of fragility fractures in postmenopausal women.
Comparison of Collapsibility of the Human Upper Airway During Anesthesia and During Sleep
Authors: Maddison Kathleen J. , Walsh Jennifer H. , Shepherd Kelly L. , Bharat Chrianna , Lawther Bradley K. , Platt Peter R. , Eastwood Peter R. , Hillman David R.
Published: March 2019

BACKGROUND:

The propensities for the upper airway to collapse during anesthesia and sleep are related, although much of our understanding of this relationship has been inferred from clinical observation and indirect measures such as the apnea–hypopnea index. The aim of this study was to use an identical, rigorous, direct measure of upper airway collapsibility (critical closing pressure of the upper airway) under both conditions to allow the magnitude of upper airway collapsibility in each state to be precisely compared.

METHODS:

Ten subjects (8 men and 2 women; mean ± SD: age, 40.4 ± 12.1 years; body mass index, 28.5 ± 4.0 kg/m2) were studied. Critical closing pressure of the upper airway was measured in each subject on separate days during (1) propofol anesthesia and (2) sleep.

RESULTS:

Critical closing pressure of the upper airway measurements were obtained in all 10 subjects during nonrapid eye movement sleep and, in 4 of these 10 subjects, also during rapid eye movement sleep. Critical closing pressure of the upper airway during anesthesia was linearly related to critical closing pressure of the upper airway during nonrapid eye movement sleep (r = 0.64 [95% CI, 0.02–0.91]; n = 10; P = .046) with a similar tendency in rapid eye movement sleep (r = 0.80 [95% CI, −0.70 to 0.99]; n = 4; P = .200). However, critical closing pressure of the upper airway during anesthesia was systematically greater (indicating increased collapsibility) than during nonrapid eye movement sleep (2.1 ± 2.2 vs −2.0 ± 3.2 cm H2O, respectively, n = 10; within-subject mean difference, 4.1 cm H2O [95% CI, 2.32–5.87]; P < .001) with a similar tendency during rapid eye movement sleep (1.6 ± 2.4 vs −1.9 ± 4.3 cm H2O, respectively, n = 4; unadjusted difference, 3.5 cm H2O [95% CI, −0.95 to 7.96]; P = .087).

CONCLUSIONS:

These results demonstrate that the magnitude of upper airway collapsibility during anesthesia and sleep is directly related. However, the upper airway is systematically more collapsible during anesthesia than sleep, suggesting greater vulnerability to upper airway obstruction in the anesthetized state.
Prospective Investigation of the Operating Room Time-Out Process
Authors: Freundlich Robert E. , Bulka Catherine M. , Wanderer Jonathan P. , Rothman Brian S. , Sandberg Warren S. , Ehrenfeld Jesse M.
Published: March 2019

BACKGROUND:

Although the surgical pause or time-out is a required part of most hospitals’ standard operating procedures, little is known about the quality of execution of the time-out in routine clinical practice. An interactive electronic time-out was implemented to increase surgical team compliance with the time-out procedure and to improve communication among team members in the operating room. We sought to identify nonroutine events that occur during the time-out procedure in the operating room, including distractions and interruptions, deviations from protocol, and the problem-solving strategies used by operating room team members to mitigate them.

METHODS:

Direct observations of surgical time-outs were performed on 166 nonemergent surgeries in 2016. For each time-out, the observers recorded compliance with each step, any nonroutine events that may have occurred, and whether any operating room team members were distracted.

RESULTS:

The time-out procedure was performed before the first incision in 100% of cases. An announcement was made to indicate the start of the time-out procedure in 163 of 166 observed surgeries. Most observed time-outs were completed in <1 minute. Most time-outs were completed without interruption (92.8%). The most common reason for an interruption was to verify patient information. Ten time-out procedures were stopped due to a safety concern. At least 1 member of the operating room team was actively distracted in 10.2% of the time-out procedures observed.

CONCLUSIONS:

Compliance with preincision time-outs is high at our institution, and nonroutine events are a rare occurrence. It is common for ≥1 member of the operating room team to be actively distracted during time-out procedures, even though most time-outs are completed in under 1 minute. Despite distractions, there were no wrong-site or wrong-person surgeries reported at our hospital during the study period. We conclude that the simple act of performing a preprocedure checklist may be completed quickly, but that distractions are common.
Remote Ischemic Preconditioning Prevents Postoperative Acute Kidney Injury After Open Total Aortic Arch Replacement: A Double-Blind, Randomized, Sham-Controlled Trial
Authors: Zhou Hui , Yang Lijing , Wang Guyan , Zhang Congya , Fang Zhongrong , Lei Guiyu , Shi Sheng , Li Jun
Published: March 2019

BACKGROUND:

Acute kidney injury is a common complication after open total aortic arch replacement but lacks effective preventive strategies. Remote ischemic preconditioning has controversial results of its benefit to the kidney and may perform better in high-risk patients of acute kidney injury. We investigated whether remote ischemic preconditioning would prevent postoperative acute kidney injury after open total aortic arch replacement.

METHODS:

We enrolled 130 patients scheduled for open total aortic arch replacement and randomized them to receive either remote ischemic preconditioning (4 cycles of 5-minute right upper limb ischemia and 5-minute reperfusion) or sham preconditioning (4 cycles of 5-minute right upper limb pseudo ischemia and 5-minute reperfusion), both via blood pressure cuff inflation and deflation. The primary end point was the incidence of acute kidney injury within 7 days after the surgery defined by the Kidney Disease: Improving Global Outcomes criteria. Secondary end point included short-term clinical outcomes.

RESULTS:

Significantly fewer patients developed postoperative acute kidney injury with remote ischemic preconditioning compared with sham (55.4% vs 73.8%; absolute risk reduction, 18.5%; 95% CI, 2.3%–34.6%; P = .028). Remote ischemic preconditioning significantly reduced acute kidney injury stage II–III (10.8% vs 35.4%; P = .001). Remote ischemic preconditioning shortened the mechanical ventilation duration (18 hours [interquartile range, 14–33] versus 25 hours [interquartile range, 17–48]; P = .01), whereas no significant differences were observed between groups in other secondary outcomes.

CONCLUSIONS:

Remote ischemic preconditioning prevented acute kidney injury after open total aortic arch replacement, especially severe acute kidney injury and shortened mechanical ventilation duration. The observed renoprotective effects of remote ischemic preconditioning require further investigation in both clinical research and the underlying mechanism.
Transient localization of the Arp2/3 complex initiates neuronal dendrite branching in vivo
Authors: Stürner Tomke , Tatarnikova Anastasia , Mueller Jan , Schaffran Barbara , Cuntz Hermann , Zhang Yun , Nemethova Maria , Bogdan Sven , Small Vic , Tavosanis Gaia
Published: March 2019

The formation of neuronal dendrite branches is fundamental for the wiring and function of the nervous system. Indeed, dendrite branching enhances the coverage of the neuron's receptive field and modulates the initial processing of incoming stimuli. Complex dendrite patterns are achieved in vivo through a dynamic process of de novo branch formation, branch extension and retraction. The first step towards branch formation is the generation of a dynamic filopodium-like branchlet. The mechanisms underlying the initiation of dendrite branchlets are therefore crucial to the shaping of dendrites. Through in vivo time-lapse imaging of the subcellular localization of actin during the process of branching of Drosophila larva sensory neurons, combined with genetic analysis and electron tomography, we have identified the Actin-related protein (Arp) 2/3 complex as the major actin nucleator involved in the initiation of dendrite branchlet formation, under the control of the activator WAVE and of the small GTPase Rac1. Transient recruitment of an Arp2/3 component marks the site of branchlet initiation in vivo. These data position the activation of Arp2/3 as an early hub for the initiation of branchlet formation.
Novel functions of the ubiquitin-independent proteasome system in regulatingXenopusgermline development
Authors: Hwang Hyojeong , Jin Zhigang , Krishnamurthy Vishnu Vardhan , Saha Anumita , Klein Peter S. , Garcia Benjamin , Mei Wenyan , King Mary Lou , Zhang Kai , Yang Jing
Published: March 2019

In most species, early germline development occurs in the absence of transcription with germline determinants subject to complex translational and post-translational regulations. Here we report for the first time, that early germline development is influenced by dynamic regulation of the proteasome system, previously thought to be ubiquitously expressed and to serve “house-keeping” roles in controlling protein homeostasis. We show that proteasomes are present in a gradient with highest levels in the animal hemisphere but extending into the vegetal hemisphere of Xenopus oocytes. This distribution changes dramatically during the oocyte-to-embryo transition, with proteasomes becoming enriched in and restricted to the animal hemisphere and therefore separated from vegetally localized germline determinants. We identify Dead-end1 (Dnd1), a master regulator of vertebrate germline development, as a novel substrate of the ubiquitin-independent proteasomes. In the oocyte, ubiquitin-independent proteasomal degradation acts together with translational repression to prevent premature accumulation of Dnd1 protein. In the embryo, artificially increasing ubiquitin-independent proteasomal degradation in the vegetal pole interferes with germline development. Our work thus reveals novel inhibitory functions and spatial regulation of the ubiquitin-independent proteasome during vertebrate germline development.
Individual components of the SWI/SNF chromatin remodelling complex have distinct roles in memory neurons of theDrosophilamushroom body
Authors: Chubak Melissa C. , Nixon Kevin C. J. , Stone Max H. , Raun Nicholas , Rice Shelby L. , Sarikahya Mohammed , Jones Spencer G. , Lyons Taylor A. , Jakub Taryn E. , Mainland Roslyn L. M. , Knip Maria J. , Edwards Tara N. , Kramer Jamie M.
Published: March 2019

Technology has led to rapid progress in the identification of genes involved in neurodevelopmental disorders such as intellectual disability (ID), but our functional understanding of the causative genes is lagging. Here, we show that the SWI/SNF chromatin remodelling complex is one of the most over-represented cellular components disrupted in ID. We investigated the role of individual subunits of this large protein complex using targeted RNA interference in post-mitotic memory-forming neurons of the Drosophila mushroom body (MB). Knockdown flies were tested for defects in MB morphology, short-term memory and long-term memory. Using this approach, we identified distinct roles for individual subunits of the Drosophila SWI/SNF complex. Bap60, Snr1 and E(y)3 are required for pruning of the MBγ neurons during pupal morphogenesis, while Brm and Osa are required for survival of MBγ axons during ageing. We used the courtship conditioning assay to test the effect of MB-specific SWI/SNF knockdown on short- and long-term memory. Several subunits, including Brm, Bap60, Snr1 and E(y)3, were required in the MB for both short- and long-term memory. In contrast, Osa knockdown only reduced long-term memory. Our results suggest that individual components of the SWI/SNF complex have different roles in the regulation of structural plasticity, survival and functionality of post-mitotic MB neurons. This study highlights the many possible processes that might be disrupted in SWI/SNF-related ID disorders. Our broad phenotypic characterization provides a starting point for understanding SWI/SNF-mediated gene regulatory mechanisms that are important for development and function of post-mitotic neurons.
CD28null CD4 T-cell expansions in autoimmune disease suggest a link with cytomegalovirus infection
Authors: Bano Aalia , Pera Alejandra , Almoukayed Ahmad , Clarke Thomas H.S. , Kirmani Sukaina , Davies Kevin A. , Kern Florian
Published: March 2019

Immunosenescence is thought to contribute to the increase of autoimmune diseases in older people. Immunosenescence is often associated with the presence of an expanded population of CD4 T cells lacking expression of CD28 (CD28null). These highly cytotoxic CD4 T cells were isolated from disease-affected tissues in patients with rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, or other chronic inflammatory diseases and their numbers appeared to be linked to disease severity. However, we recently demonstrated that the common herpes virus, cytomegalovirus (CMV), not ageing, is the major driver of this subset of cytotoxic T cells. In this review, we discuss how CMV might potentiate and exacerbate autoimmune disease through the expansion of CD28nullCD4 T cells.
Advancing understanding, diagnosis, and therapies for cutaneous lupus erythematosus within the broader context of systemic lupus erythematosus
Authors: Chen Kristen L. , Krain Rebecca L. , Werth Victoria P.
Published: March 2019

Cutaneous lupus erythematosus (CLE) is an autoimmune disease that can be associated with systemic lupus erythematosus (SLE) symptoms. The pathogenesis of both CLE and SLE is multifactorial, involving genetic susceptibility, environmental factors, and innate and adaptive immune responses. Despite the efficacy of current medications, many patients remain refractory, highlighting the necessity for new treatment options. Unfortunately, owing to challenges related in part to trial design and disease heterogeneity, only one new biologic in the last 50 years has been approved by the US Food and Drug Administration for the treatment of SLE. Thus, although SLE and CLE have a similar pathogenesis, patients with CLE who do not meet criteria for SLE cannot benefit from this advancement. This article discusses the recent trials and emphasizes the need to include patients with single-organ lupus, such as CLE, in SLE trials.
Growth evaluation of several types of energy crops from tropical shrubs species
Authors: Susanto Dwi , Auliana Auliana , Amirta Rudianto
Published: March 2019

Background:Few species of tropical shrubs potentially produce biomass to replace fossil fuels for heat production and electricity. The aims of this study were to determine the growth and nutrient status of leaves of several types of energy crops from tropical shrub species with NPK fertilizer application.

Methods:Randomized block design was used with ten replications of four levels of fertilizer treatment: T0 = 40 g, T1 = 80 g, T2 = 120 g and T4 = 160 g per plant.

Results:The results indicated that fertilization increased plant growth and the quantity of nutrients in leaves. The plants accumulated a lot of potassium, followed by nitrogen and phosphorus. The species of tropical shrubs with the best growth wereVernonia amygdalina,Calliandra calothyrsus and Gliricidia sepium,which are all potentially cultivated as sustainable energy crops.

Conclusions:Serious attention must be paid to the availability of soil nutrients in order to sustain the cultivation of these plants.
The common patterns of abundance: the log series and Zipf's law
Authors: Frank Steven A.
Published: March 2019

In a language corpus, the probability that a word occurs n times is often proportional to 1/n2. Assigning rank, s, to words according to their abundance, log s vs log n typically has a slope of minus one. That simple Zipf's law pattern also arises in the population sizes of cities, the sizes of corporations, and other patterns of abundance. By contrast, for the abundances of different biological species, the probability of a population of size n is typically proportional to 1/n, declining exponentially for larger n, the log series pattern.

This article shows that the differing patterns of Zipf's law and the log series arise as the opposing endpoints of a more general theory. The general theory follows from the generic form of all probability patterns as a consequence of conserved average values and the associated invariances of scale.

To understand the common patterns of abundance, the generic form of probability distributions plus the conserved average abundance is sufficient. The general theory includes cases that are between the Zipf and log series endpoints, providing a broad framework for analyzing widely observed abundance patterns.
The idea of sobornost and its artistic realization in the novel “And Quiet Flows the Don” by M.A. Sholokhov
Authors: Стюфляева Наталья , Styuflyaeva Natal'ya
Published: March 2019

The monograph studies one of the magnum opuses of the XXth century within the context of the national spiritual tradition. It states the problem of sobornost as an author's ideal in the novel “And Quiet Flows the Don”. This idea defines the analysis of the agon, narrative structure, distinction of style, motive organization, Don landscape symbols. Referring to a complex religio-cultural, literary and philosophical context of “And Quiet Flows the Don” contributes to holistic understanding of the novel, writer’s historical concept, his attitude and aesthetics.
The book is written for students-philologists, university professors, as well as all who are interested in the problems of national literature, history and culture.
Will extra training improve care of service users with learning disabilities or autism?
Authors: Glasper Alan
Published: March 2019

Emeritus Professor Alan Glasper, University of Southampton, discusses a new initiative for additional training for health professionals in England. An open consultation is inviting nurses and others to comment on the proposals
Testicular pain as an atypical presentation of sarcoidosis
Authors: Chierigo F , Alnajjar HM , Haider A , Walkden M , Shaikh T , Muneer A
Published: March 2019

Sarcoidosis is a systemic granulomatous disease, with genitourinary tract involvement being very rare (0.2% of all sarcoidosis cases). Genitourinary sarcoidosis may present with a scrotal mass with or without testicular pain, often mimicking epididymo-orchitis or malignancy. Only 8 cases of genitourinary sarcoidosis have been reported in the literature in the last 14 years. We describe the case of a 25-year-old man who was referred with testicular pain. Scrotal ultrasonography demonstrated multiple bilateral hypoechoic testicular lesions that were of similar size and distributed unusually throughout the testicular parenchyma. Computed tomography detected a nodule in the middle lobe of the right lung, multiple small volume nodes in the retrocaval and left para-aortic regions, and enlarged bilateral external iliac and inguinal nodes, similar to those found in metastatic testicular cancer. Following ultrasound guided excision of one of the lesions, histopathological examination confirmed granulomatous inflammation consistent with sarcoidosis.
Policy spotlight
Authors: Davies John
Published: March 2019

This regular feature aims to provide key political news in relation to dentistry and an update of the Faculty’s policy activities. You can find out more in the Government Relations and Media Centre sections of the FDS website.
Updated clinical guidelines on the oral management of oncology patients
Authors: Kumar Navdeep
Published: March 2019

As the rate of dentists treating children and adults who present before and after cancer treatment increases, appropriate preventive regimens, timely oral care and improved dental services are crucial for improving patients’ quality of life.

https://www.rcseng.ac.uk/dental-faculties/fds/publications-guidelines/clinical-guidelines/
Stability of hematological parameters of canine blood samples stored with citrate phosphate dextrose adenine-1 anticoagulated plastic vacutainers
Authors: Nnamdi Okereke Henry , Ijeoma Udegbunam Rita , Okaforx Nnaji Theophilus
Published: March 2019

Aim: The effect of citrate phosphate dextrose adenine-1 on the hematological parameters of stored Nigerian indigenous dog's blood with plastic vacutainer was investigated. This was done in view of determining the viability and stability of the studied parameters for blood banking purpose. Till date, there is no literature on the stability of whole blood of Nigerian indigenous dogs for blood banking purposes. Materials and Methods: A total of six apparently adult healthy dogs were sampled, and their blood was stored at 4°C and analyzed for their packed cell volume (PCV), hemoglobin (Hgb) concentration, red blood cell (RBC) count, total and differential white blood cell (WBC) count, platelet count (PC), mean corpuscular values (mean corpuscular Hgb [MCH], MCH concentration, and mean corpuscular volume [MCV]), blood potency of hydrogen (pH), and erythrocyte sedimentation rate (ESR) over a period of 14 days. Results: Significant changes were observed in some of the studied parameters. Of the 14 days' study period, PCV, Hgb concentration, total WBC count, PC, and neutrophil count showed no significant (p≥0.05) difference until day 2 post-storage (PS), while RBC count, ESR, MCV, and lymphocyte count showed no significant (p≥0.05) variation up until day 3 PS. Blood pH showed no significant (p≥0.05) variation within 24-h PS but was significantly (p≤0.05) higher than obtained values on days 1, 3, 7, 10, and 14 PS. Conclusion: Based on our finding, we could suggest that hematological laboratories and hemotherapists could use canine blood stored in a plastic vacutainer for 2-3 days.
Adapting an Exposure and Response Prevention Manual To Treat Youth Obsessive-Compulsive Disorder and Comorbid Anxiety Disorder: The Case of "Daniel"
Authors: Tice Alexander M.B.
Published: March 2019

Exposure and Response Prevention (E/RP) is an evidenced-based, short-term (12-20 sessions) treatment for Obsessive-Compulsive Disorder (OCD). This treatment has been shown to be effective in randomized control trials (RCTs), including pediatric samples (Franklin et al., 2011). Despite the strong evidence supporting the effectiveness of E/RP, the current E/RP literature remains wanting in terms of clinical process research to support novice clinicians in the adaptation of the principles, techniques, and interventions with such a complex and heterogeneous disorder, as well as with youth suffering from comorbid disorders. Thus, the present study aims to provide a detailed account of the course of a 25-session E/RP treatment and its outcomes with a 14-year-old called by the pseudonym "Daniel," to protect his identity. Guided by the Pragmatic Case Study Method (Fishman, 1999, 2005, 2013), as the therapist I examined this case in systematic qualitative detail and also gathered and analyzed data from standardized quantitative assessment measures. The study concludes with an analysis of the process used in meeting Daniel’s positive treatment goals as well as a discussion of the importance of adaptations made to the E/RP manualized protocol to address the entire range of Daniels’s symptoms.
Forests and Trees: Commentary on the Case of "Daniel"
Authors: Franklin Martin E.
Published: March 2019

The Case of "Daniel" (Tice, 2019) provides an in-depth look at the implementation of an empirically supported psychotherapy, Exposure and Response Prevention (E/RP), in the treatment of a boy with a severe and complex symptom presentation. The discussion begins with explication of guiding theory pertaining both to the disorders that were targeted, Obsessive-Compulsive Disorder (OCD) and generalized anxiety disorder (GAD), as well as their cognitive-behavioral treatment. The assessment and hierarchy-development aspects of the case are presented, and treatment targets identified. Implementation of E/RP followed a specific treatment manual, but the discussion of case material goes beyond the manual in addressing the interpersonal context of therapy, challenges met and overcome along the way, and the importance of using positive reinforcement for effort in keeping a child moving successfully towards more and more challenging tasks. The role of the therapist’s own interpersonal style is also addressed in how this factor may facilitate and complicate treatment delivery, and therapists are encouraged to examine how this may affect what they do and do not do even in the context of protocol-driven treatment.
When Psychological Comorbidities Demand Flexibility: Treatment Adaptations for Youth Anxiety Disorders
Authors: Pincus Liza E. , Quinn Andrea
Published: March 2019

The first author (LEP) is a third year clinical psychology doctoral student at the Graduate School of Applied and Professional Psychology (GSAPP) at Rutgers University, working under the supervision of the second author (AQ) at GSAPP’s Anxiety Disorders Clinic, which the second author directs. As a fellow student clinician, the first author had a particular appreciation for Dr. Alexander Tice’s treatment of "Daniel" (2019), a client with a complex clinical presentation who appears to have greatly benefited from his treatment with Tice, under the supervision of Dr. Martin Franklin. Much of Tice’s experience applying theoretical principles to treating specific disorders, as well as finding a delicate balance between manual-based treatment and real-world clinical application of those manuals, reflects the experiences of the first author (LEP) as a cognitive-behavioral therapist working at a graduate student training clinic.
The Case of "Daniel": Flexibly Delivering an Inherently Challenging Treatment in the Face of a Complex Presentation
Authors: Tice Alexander M.B.
Published: March 2019

In this article, I respond to commentaries by Martin Franklin (2019) and by Liza Pincus and Andrea Quinn (2019) about my case study of "Daniel" (Tice, 2019), a 14-year-old young man presenting to therapy with Obsessive Compulsive Disorder (OCD) and Generalized Anxiety Disorder (GAD). I treated Daniel with a manual-based, 25-session treatment centered around the cognitive-behavioral approach of Exposure and Response Prevention (E/RP). A major theme running through my case study and the two commentaries is the need for flexibility in adapting the manual to be responsive to a variety of factors associated with Daniel’s disorder, such as his personality, interests, life situation, attitude towards his symptoms, and his way of relating to the therapist. In the context of the commentaries, I review a variety of the specific ways in which I learned to be flexible. Some of these included (a) focusing on nonspecific factors in developing a strong therapeutic alliance and rapport; (b) paying particular attention to how I communicated relevant psychoeducational concepts to Daniel, particularly by the use of metaphors, in preparing him for the E/RP procedures and in encouraging his participation; and (c) focusing on the process of making decisions at important clinical choice points.