bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphology and molecular phylogeny of a poorly known species—Erysiphe bulbouncinula (Erysiphaceae) on Koelreuteria paniculata
Authors: Liu Li , Tang Shu‐Rong , Takamatsu Susumu , Braun Uwe , Li Yu , Liu Shu‐Yan
Published: July 2020

Erysiphe bulbouncinula (≡ Bulbouncinula bulbosa) on Koelreuteria paniculata is a powdery mildew native and endemic in China. Fresh samples of this species were collected on K. paniculata in Sichuan Province, China, in 2018. This is the fourth confirmed identification of this species. The original description in 1932 was based on one specimen from Hangzhou and then was described in Nanjing in 1990 and in Taiwan in 1993. The morphology of the new collections of this species is described and illustrated in detail, and agrees well with the original description of the type specimen except for the number of asci (8–16 asci per chasmothecia versus 7–9 asci in the type specimen). To explore the phylogenetic position of this poorly known species, three separate phylogenetic analyses, using partial 28S rDNA and the combination of internal transcribed spacer (ITS) and 28S rDNA sequences, were conducted. The results clearly showed that E. bulbouncinula form a monophyletic clade with strong bootstrap (BS) support (MP = 100%) constituting a sister clade to E. gracilis s. lat., form a subclade with Erysiphe sect. Californiomyces and then form a big group with sect. Typhulochaeta and sect. Uncinula. Phylogenetic results confirm that E. bulbouncinula is more closely allied to Erysiphe than to Phyllactinia. Thus, this species can be maintained in Erysiphe in its current circumscription, confirming Bulbouncinula as a synonym of Erysiphe.
Idealism and illusions
Authors: Smithson Robert
Published: July 2020

According to the idealist, facts about phenomenal experience determine facts about the physical world. Any such view must account for illusions: cases where there is a discrepancy between the physical world and our experiences of it. In this article, I critique some recent idealist treatments of illusions before presenting my own preferred account. I then argue that, initial impressions notwithstanding, it is actually the realist who has difficulties properly accounting for illusions.
A meta‐analysis of global avian survival across species and latitude
Authors: Scholer Micah N. , Strimas‐Mackey Matthew , Jankowski Jill E.
Published: July 2020

Tropical birds are purported to be longer lived than their temperate counterparts, but it has not been shown whether avian survival rates covary with latitude worldwide. Here, we perform a global‐scale meta‐analysis of 949 estimates from 204 studies of avian survival and demonstrate that a latitudinal survival gradient exists in the northern hemisphere, is dampened or absent for southern hemisphere species, and that differences between passerines and nonpasserines largely drive these trends. We also show that while extrinsic factors related to climate were poor predictors of apparent survival compared to latitude alone, the relationship between apparent survival and latitude is strongly mediated by intrinsic traits – large‐bodied species and species with smaller clutch size had the highest apparent survival. Our findings reveal that differences among intrinsic traits and whether species were passerines or nonpasserines surpass latitude and its underlying climatic factors in explaining global patterns of apparent avian survival.
Pulse pressure variability is associated with unfavorable outcomes in acute ischaemic stroke patients treated with intravenous thrombolysis
Authors: Katsanos A. H. , Alexandrov A. V. , Mandava P. , Köhrmann M. , Soinne L. , Barreto A. D. , Sharma V. K. , Mikulik R. , Muir K. W. , Rothlisberger T. , Grotta J. C. , Levi C. R. , Molina C. A. , Saqqur M. , Palaiodimou L. , Psaltopoulou T. , Vosko M. R. , Moreira T. , Fiebach J. B. , Rubiera M. , Sandset E. C. , de Havenon A. , Kent T. A. , Alexandrov A. W. , Schellinger P. D. , Tsivgoulis G. ,   for the CLOTBUST‐ER Trial Investigators
Published: July 2020

Background and purpose

Blood pressure (BP) variability has been associated with worse neurological outcomes in acute ischaemic stroke (AIS) patients receiving treatment with intravenous thrombolysis (IVT). However, no study to date has investigated whether pulse pressure (PP) variability may be a superior indicator of the total cardiovascular risk, as measured by clinical outcomes.

Methods

Pulse pressure variability was calculated from 24‐h PP measurements following tissue plasminogen activator bolus in AIS patients enrolled in the Combined Lysis of Thrombus using Ultrasound and Systemic Tissue Plasminogen Activator for Emergent Revascularization (CLOTBUST‐ER) trial. The outcomes of interest were the pre‐specified efficacy and safety end‐points of CLOTBUST‐ER. All associations were adjusted for potential confounders in multivariable regression models.

Results

Data from 674 participants was analyzed. PP variability was identified as the BP parameter with the most parsimonious fit in multivariable models of all outcomes, and was independently associated (P < 0.001) with lower likelihood of both 24‐h neurological improvement and 90‐day independent functional outcome. PP variability was also independently related to increased odds of any intracranial bleeding (P = 0.011) and 90‐day mortality (P < 0.001). Every 5‐mmHg increase in the 24‐h PP variability was independently associated with a 36% decrease in the likelihood of 90‐day independent functional outcome (adjusted odds ratio 0.64, 95% confidence interval 0.52–0.80) and a 60% increase in the odds of 90‐day mortality (adjusted odds ratio 1.60, 95% confidence interval 1.23–2.07). PP variability was not associated with symptomatic intracranial bleeding at either 24 or 36 h after IVT administration.

Conclusions

Increased PP variability appears to be independently associated with adverse short‐term and long‐term functional outcomes of AIS patients treated with IVT.
Increased greenhouse gas emissions intensity of major croplands in China: Implications for food security and climate change mitigation
Authors: Zhang Jingting , Tian Hanqin , Shi Hao , Zhang Jingfang , Wang Xiaoke , Pan Shufen , Yang Jia
Published: July 2020

Balancing crop production and greenhouse gas (GHG) emissions from agriculture soil requires a better understanding and quantification of crop GHG emissions intensity, a measure of GHG emissions per unit crop production. Here we conduct a state‐of‐the‐art estimate of the spatial‐temporal variability of GHG emissions intensities for wheat, maize, and rice in China from 1949 to 2012 using an improved agricultural ecosystem model (Dynamic Land Ecosystem Model‐Agriculture Version 2.0) and meta‐analysis covering 172 field‐GHG emissions experiments. The results show that the GHG emissions intensities of these croplands from 1949 to 2012, on average, were 0.10–1.31 kg CO2‐eq/kg, with a significant increase rate of 1.84–3.58 × 10–3 kg CO2‐eq kg−1 year−1. Nitrogen fertilizer was the dominant factor contributing to the increase in GHG emissions intensity in northern China and increased its impact in southern China in the 2000s. Increasing GHG emissions intensity implies that excessive fertilizer failed to markedly stimulate crop yield increase in China but still exacerbated soil GHG emissions. This study found that overfertilization of more than 60% was mainly located in the winter wheat–summer maize rotation systems in the North China Plain, the winter wheat–rice rotation systems in the middle and lower reaches of the Yangtze River and southwest China, and most of the double rice systems in the South. Our simulations suggest that roughly a one‐third reduction in the current N fertilizer application level over these “overfertilization” regions would not significantly influence crop yield but decrease soil GHG emissions by 29.60%–32.50% and GHG emissions intensity by 0.13–0.25 kg CO2‐eq/kg. This reduction is about 29% and 5% of total agricultural soil GHG emissions in China and the world, respectively. This study suggests that improving nitrogen use efficiency would be an effective strategy to mitigate GHG emissions and sustain China's food security.
21st‐century biogeochemical modeling: Challenges for Century‐based models and where do we go from here?
Authors: Berardi Danielle , Brzostek Edward , Blanc‐Betes Elena , Davison Brian , DeLucia Evan H. , Hartman Melannie D. , Kent Jeffrey , Parton William J. , Saha Debasish , Hudiburg Tara W.
Published: July 2020

21st‐century modeling of greenhouse gas (GHG) emissions from bioenergy crops is necessary to quantify the extent to which bioenergy production can mitigate climate change. For over 30 years, the Century‐based biogeochemical models have provided the preeminent framework for belowground carbon and nitrogen cycling in ecosystem and earth system models. While monthly Century and the daily time‐step version of Century (DayCent) have advanced our ability to predict the sustainability of bioenergy crop production, new advances in feedstock generation, and our empirical understanding of sources and sinks of GHGs in soils call for a re‐visitation of DayCent's core model structures. Here, we evaluate current challenges with modeling soil carbon dynamics, trace gas fluxes, and drought and age‐related impacts on bioenergy crop productivity. We propose coupling a microbial process‐based soil organic carbon and nitrogen model with DayCent to improve soil carbon dynamics. We describe recent improvements to DayCent for simulating unique plant structural and physiological attributes of perennial bioenergy grasses. Finally, we propose a method for using machine learning to identify key parameters for simulating N2O emissions. Our efforts are focused on meeting the needs for modeling bioenergy crops; however, many updates reviewed and suggested to DayCent will be broadly applicable to other systems.
STAGING FAILURE? BERTA LASK'S THOMAS MÜNZER (1925) AND THE 400TH ANNIVERSARY OF THE GERMAN PEASANTS’ WAR
Authors: Smale Catherine
Published: July 2020

This article examines Berta Lask's drama Thomas Münzer (1925), which was commissioned by the Kommunistische Partei Deutschlands (KPD) and staged in Eisleben to mark the 400th anniversary of the German Peasants’ War (1524–5) and the execution of Thomas Müntzer. Drawing on cultural memory theory and reading the play as a multi‐layered lieu de mémoire, it argues that Lask attempts to recuperate the revolutionary potential of the failed Peasants’ War and harness it to the agenda of the KPD of the 1920s. The article begins by situating Lask's play in a tradition of leftist writing about the Peasants’ War dating back to the mid‐nineteenth century. It then considers the ways in which Lask uses historical analogy to create connections between the sixteenth‐century uprising and events in post‐World War I German political history. Finally, the article explores the techniques used by Lask to create a sense of revolutionary community among her actors and audience.
ANNIVERSARIES, THE PUBLIC, AND ACADEMIA
Authors: Williams Seán M.
Published: July 2020

Anniversaries have been much problematised in scholarship, not least in the present special number. But pragmatically, they are also a tried‐and‐tested way of engaging with diverse publics. In contemporary British Higher Education, such work is incentivised through the impact agenda of the Research Excellence Framework. The following contribution brings together three British‐based colleagues in German Studies, who each reflect on their own practical experiences of capitalising on anniversaries. Henrike Lähnemann discusses commemorative activities and events 500 years after the Reformation, in which she uses translating, printing, and singing as historic impact‐style activities to engage audiences in Oxford and beyond. Seán Williams turns to mainstream media, arguing that anniversaries are a useful hook for bringing German Studies content to wider audiences – even if the commemorative occasions seem, on the face of it, less relevant to those of us working in increasingly marginal disciplines in Great Britain. Stefan Manz is concerned with remembering the forgotten ‘collateral’ victims of the First World War during the centenary, particularly those Germans who were interned in camps throughout the British Empire. Manz shows that it is possible to connect the stories of the marginalised to large‐scale anniversaries in order to challenge dominant narratives. Here, as in all cases, the key to success is cross‐sector collaboration and adaptation to non‐academic needs and contexts.
Primary intra‐abdominal melanoma arising in association with extracutaneous blue naevus: a report of two cases
Authors: Shah Kabeer , Folpe Andrew L , Miller Michael , Morgan Jeffrey A , Raut Chandrajit P , Doyle Leona A
Published: July 2020

Aims

Blue naevi are uncommon dermal melanocytic neoplasms characterised by GNAQ/GNA11 mutations, which very rarely progress to melanoma. Such melanomas also often have BAP1 mutations, and lack genetic events associated with conventional melanoma. Exceptionally, blue naevi arise in extracutaneous locations; one melanoma arising in this setting has been reported. We report the clinicopathological, immunohistochemical and molecular genetic features of two cases of melanoma arising in extracutaneous blue naevus.

Methods and results

Both arose in males, aged 25 and 63 years, with no history of other melanocytic lesions, and presented as large, painful intra‐abdominal masses. The tumours were dark‐brown/black, multilobulated, involved small intestinal mesentery and consisted of a predominantly fascicular and spindled, but occasionally nested and epithelioid, proliferation of variably pigmented, relatively monotonous cells with pale cytoplasm and ovoid nuclei with mild to moderate atypia. Mitotic activity was variable but generally low. Both cases showed areas of conventional and cellular blue naevus. Recurrent tumour in one case showed predominantly epithelioid morphology and greater cytological atypia and mitotic activity. One case expressed Melan‐A, SOX10 and CD117, with absent expression of S100 protein and DOG1; the other expressed Melan‐A, HMB45 and S100 protein. Next‐generation sequencing identified GNAQ and BAP1 mutations in one case and GNA11 mutation in the other. Both patients developed widespread metastatic disease.

Conclusion

Exceptionally rare, aggressive melanomas arising in extracutaneous blue naevi should be distinguished from metastatic melanoma, gastrointestinal stromal tumour and malignant melanotic nerve sheath tumour, especially given the significant therapeutic and prognostic differences between these different entities.
Design of a novel low vision questionnaire to evaluate the quality of life and independence
Authors: Almpanidou Stavroula , Almaliotis Diamantis , Labiris Georgios , Topouzis Fotis , Dardavesi Theodoros , Karampatakis Vasileios
Published: July 2020

Purpose

To develop a novel vision‐ related quality‐ of‐ life questionnaire for patients with low vision.

Methods

The content for questionnaire items was determined through personal interview with patients facing various ocular diseases (aAge‐ rRelated mMacular dDegeneration, dDiabetic rRetinopathy, etc.) and with bBest cCorrected vVisual aAcuity (BCVA) ranging from light perception to 0.2 logMAR. Patients were asked to define the most important activities in their everyday lives and difficulties due to their visual impairment. Analysis following interview identified groups of items which formed the questionnaire's scales and subscales that were evaluated for internal consistency. All eligible persons had to be 18 years or older and cognitively able to give informed consent for participation.

Results

Fifty patients with a mean (standard deviation, SD) age of 54.6 (29.9) years were studied. Items that were internally inconsistent, unreliable or not relevant were excluded, resulting in the 50‐item quality‐ of‐ life and independence assessment questionnaire. Items were distributed into 7 different functional visual domains: mobility under various luminance conditions, self‐care, shopping, communication, social life, technology and education–‐work life. There were no significant differences among patients regarding their general health (p = 0.444). The questionnaire was proved to have a good internal consistency (Cronbach's alpha > 0.8). The average score of patients with low vision was significantly lower (p < 0.001) than the average score of those with BCVA > 0.5 logMAR and significantly higher (p < 0.001) than those with BCVA < 1.3 logMAR.

Conclusions

There is preliminary evidence that questionnaire has good internal consistency (alpha > 0.8, n = 50). Results also suggest that the questionnaire seems to be sensitive to subgroup differences by measuring the vision‐ related quality of life and independence. The instrument is going to be further refined following this pilot study.
The prevalence of despair in intractable conflicts: Direct messages of hope and despair affect leftists, but not rightists
Authors: Cohen‐Chen Smadar , Lang Ofir , Ran Shira , Halperin Eran
Published: July 2020

In contexts of long‐term conflict, it often seems easier to spread despair than to instill hope. The prevalence of despair, an emotion that promotes apathy, in contexts that so desperately need hope, an emotion that promotes conciliation, calls for further investigation. One possibility is that messages of hope and despair have different effects on people based on their political ideology. In the present research we examined the effect of direct despair‐ and hope‐inducing messages (compared to a control condition involving a neutral message) on participants' experience of hope for peace, their sense of urgency to resolve the conflict, and subsequently their support for concession‐making as a function of political orientation. Two samples of Jewish‐Israelis were collected. Study 1 was collected using snowball methods, while Study 2 replicated and enhanced findings with a more representative sample of Jewish‐Israeli society collected using an online survey platform. In both studies, messages of hope or despair yielded no influence on Rightists, whose baseline of hope is inherently low. However, for Leftists (experiencing higher levels of hope for peace) the despair manipulation significantly decreased support for concession‐making through decreased hope for peace and sense of urgency to resolve the conflict, providing an explanation to the prevalence of despair over hope in conflict.
Exploring the thinking, reasoning and clinical approach of expert child psychiatric nurses
Authors: Delaney Kathleen R. , McIntosh Diana
Published: July 2020

Background

Expert nurses are characterized by their deep knowledge of patient situations and understanding of patients in the context of their total situation. We know of no studies that have focused on the expert practice of child/adolescent (C/A) psychiatric mental health (PMH) advanced practice nurse.

Objective

The purpose of this study was to gather information on how expert C/A advanced practice psychiatric nurses (APPNs) view their role and assess/treat children and adolescents with complex mental health issues.

Method

Expert C/A APPNs were interviewed by one of the two investigators using a semi‐structured interview guide. All interviews were audiotaped and transcribed. This was a qualitative descriptive study and in line with that method, interview content was open‐coded and examined for themes that were collapsed into categories.

Results

Fifteen C/A PMH APPNs were interviewed. Initial categories that were distilled included descriptions of their commitment to the population, development of families as partners, an expanded approach to medication management, and how they demonstrate expertise.

Conclusion

Expert nurses adopt an invaluable approach to children and families—inherently patient and family‐centered. They view the child/teen in terms of the multiple contexts of their lives.
A murine cellular model of necroinflammation displays RAGE‐dependent cytokine induction that connects to hepatoma cell injury
Authors: Bachmann Malte , Lamprecht Laura , Gonther Sina , Pfeilschifter Josef , Mühl Heiko
Published: July 2020

Unresolved inflammation maintained by release of danger‐associated molecular patterns, particularly high‐mobility group box‐1 (HMGB1), is crucial for hepatocellular carcinoma (HCC) pathogenesis. To further characterize interactions between leucocytes and necrotic cancerous tissue, a cellular model of necroinflammation was studied in which murine Raw 264.7 macrophages or primary splenocytes were exposed to necrotic lysates (N‐lys) of murine hepatoma cells or primary hepatocytes. In comparison to those derived from primary hepatocytes, N‐lys from hepatoma cells were highly active—inducing in macrophages efficient expression of inflammatory cytokines like C‐X‐C motif ligand‐2 , tumor necrosis factor‐α, interleukin (IL)‐6 and IL‐23‐p19. This activity associated with higher levels of HMGB1 in hepatoma cells and was curbed by pharmacological blockage of the receptor for advanced glycation end product (RAGE)/HMGB1 axis or the mitogen‐activated protein kinases ERK1/2 pathway. Analysis of murine splenocytes furthermore demonstrated that N‐lys did not comprise of functionally relevant amounts of TLR4 agonists. Finally, N‐lys derived from hepatoma cells supported inflammatory splenic Th17 and Th1 polarization as detected by IL‐17, IL‐22 or interferon‐γ production. Altogether, a straightforward applicable model was established which allows for biochemical characterization of immunoregulation by HCC necrosis in cell culture. Data presented indicate a remarkably inflammatory capacity of necrotic hepatoma cells that, at least partly, depends on the RAGE/HMGB1 axis and may shape immunological properties of the HCC microenvironment.
Parent Work‐to‐Family Conflict and Child Psychological Well‐Being: Moderating Role of Grandparent Coresidence
Authors: Mustillo Sarah , Li Miao , Wang Weidong
Published: July 2020

Objective

This study examines how grandparental coresidence influences the daily crossover of parent work‐to‐family conflict (WTFC) to child psychological well‐being.

Background

A small but growing literature reports high levels of daily fluctuations in WTFC and its health implications for individuals, but little is known about the intergenerational crossover of WTFC in the context of multigenerational living.

Method

Using propensity score methods, we matched 129 three‐generation households with 133 two‐generation households in Zhengzhou, China based on multiple characteristics, including family member demographics, family socioeconomic status, migration status, and potential need for parenting assistance. Participants completed a daily questionnaire for 15 consecutive days. Fixed effects models estimate the association between parent WTFC and child next‐day negative affect on the two‐generation and three‐generation households, separately. Post‐estimation Wald tests for the predicted marginal effects across subgroups were performed to test whether the coefficients for parental WTFC were significantly different across groups.

Results

We found substantial daily fluctuations in parent WTFC. After adjusting for parent daily mood, hostile parenting, parent/child physical symptoms, and parent/child previous night sleep deficiency, parent daily WTFC was positively associated with child next‐day negative affect, but only among two‐generation families.

Conclusion

Coresiding grandparent(s) could be an important source of social support that buffers the negative crossover of parent WTFC. Future studies are needed to identify mechanisms through which coresiding grandparent(s) help mitigate the intergenerational crossover of WTFC.
Using School Climate to Improve Attendance and Grades: Understanding the Importance of School Satisfaction Among Middle and High School Students
Authors: Daily Shay M. , Smith Megan L. , Lilly Christa L. , Davidov Danielle M. , Mann Michael J. , Kristjansson Alfgeir L.
Published: July 2020

BACKGROUND

Students with chronic absences tend to struggle academically and may not benefit fully from all school has to offer. A positive school climate has been shown to reduce absenteeism and promote academic success. In this study, we explored how a positive school climate and high satisfaction with school may influence absences and academic performance.

METHODS

We used mediated path analysis to describe relationships involving school climate, school satisfaction, absences, and grades among 6839 middle school (49% female, 82% white) and 7470 high school (51% female, 85.0% white) students from 26 West Virginia schools.

RESULTS

In the middle and high school samples, we found that a positive school climate and high satisfaction with school reduces school absenteeism. Findings also suggest students with more absences tend to perform less well academically; a positive school climate and school satisfaction may promote good grades.

CONCLUSIONS

Missing a substantial amount of school days for any reason may hinder students academic success, but “skipping” may require added attention. Improving school climate and student satisfaction with school may contribute to better attendance and grades.
Cost‐Effectiveness of 2 Support Models for a Healthy School Initiative*
Authors: Finster Matthew P. , Feldman Jill
Published: July 2020

BACKGROUND

In school year (SY) 2014‐2015, 128 schools in 24 districts and 14 states were randomly assigned to receive either onsite or online support to implement a school‐based wellness program. The objective of this study was to assess the cost‐effectiveness (CE) of the 2 models of implementation support: onsite and online.

METHODS

We adapted the “ingredients method” for the CE analysis. Using expenditure data, we tabulated the costs of relevant expense categories and allocated the appropriate proportion to determine the total costs of providing each type of support for 4 years (SY 2014‐2015 through SY 2017‐2018). We divided the average cost per school by the average change in school wellness policies and practices, using assessment data provided by the program provider, to calculate a CE ratio for schools in each group.

RESULTS

Findings indicate that when the program is implemented as intended, online support is, on average, approximately 1.3 times more cost‐effective than onsite support at the end of 4 years.

CONCLUSIONS

By demonstrating the relative CE of 2 approaches to supporting the implementation of a school health program, this study provides further insight on more efficient interventions for improving overall school wellness.
Depression in High School: Lesbian, Gay, and Bisexual Identity as a Moderator of Sexual Assault
Authors: Zeglin Robert J. , Terrell Kassie R. , Barr Elissa M. , Moore Michele J.
Published: July 2020

BACKGROUND

Depression continues to be a public health crisis for young adults. For high school students, past research has identified trauma as a significant predictor of depression. Congruent with the theory of cumulative stress, the present study hypothesized that the effect of sexual assault on depression would be stronger among lesbian, gay, and bisexual (LGB) students than among their straight peers.

METHODS

Using the Youth Risk Behavior Survey completed by students attending Duval County Public Schools in Florida (N = 3053), this study used secondary data analysis to conduct 2 regression analyses, one for boys and one for girls.

RESULTS

LGB status was associated with 3‐fold increase in the odds of reporting depression for both boys and girls. History of sexual assault was associated with a significant increase in reporting depression. There was also a significant interaction effect between sexual orientation and history of sexual assault among male students only (p < .05). Contrary to the hypothesis, the effect was stronger among straight boys than among LGB boys.

CONCLUSION

Minority students continue to evidence greater risks for depression. Opportunities for systemic changes to address these include training teachers, banning conversion therapy, and implementing comprehensive sex education.
Health expenditure and health services utilization comparison of patients with type 2 diabetes on sodium–glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors: evidence from 2015 to 2016 medical expenditure panel survey
Authors: Patel Pranav M , Vaidya Varun
Published: July 2020

Objectives

Primary objective of this study was to compare the overall health expenditures of patients with type 2 diabetes on sodium–glucose cotransporter-2 (SGLT2) inhibitors versus dipeptidyl peptidase-4 (DPP4) inhibitors.

Methods

Two cohorts of type 2 diabetes patients receiving either SGLT2 inhibitor with metformin or DPP4 inhibitor with metformin were identified from 2015 to 2016 Medical Expenditure Panel Survey (MEPS) data. Propensity score matching was used to balance cohorts based on socio-economic status, insulin utilization status, and the Charlson comorbidity score. Patients in SGLT2 inhibitor cohort were matched with patients in DPP4 inhibitor cohort using 1 : 2 ratio on the logit of propensity score using caliper width of 0.1 of the standard deviation of the logit of the propensity score. Expenditure variables were analysed using a generalized linear model with log link function and gamma distribution and adjusted for socio-economic variables. Unadjusted means were obtained using bootstrap.

Results

After propensity score matching, 240 patients were left in the sample with 80 patients in SGLT2 inhibitor cohort and 160 patients in DPP4 inhibitor cohort. Unadjusted average annual total health expenditure was significantly higher in the SGLT2 inhibitor cohort versus DPP4 inhibitor cohort ($17,325 versus $15,702; P value <0.0001). After adjusting for socio-economic factors, overall health expenditure (β = −0.3516; P = 0.0038) was significantly lower in DPP4 inhibitor cohort compared to SGLT2 inhibitor.

Conclusion

SGLT2 inhibitors were associated with significantly higher overall and prescription expenditures compared to DPP4 inhibitors during the study period evaluated. Future studies need to utilize administrative claims data to assess current comparativeness effectiveness trends.
Retrospectively analysed tooth loss in periodontally compromised patients: Long‐term results 10 years after active periodontal therapy—Patient‐related outcomes
Authors: Petsos Hari , Schacher Beate , Ramich Tatjana , Nickles Katrin , Dannewitz Bettina , Arendt Susanne , Seidel Kathrin , Eickholz Peter
Published: July 2020

Background and Objective

Long‐term tooth retention is the ultimate goal of periodontal therapy. Aim of this study was to evaluate tooth loss (TL) during 10 years of supportive periodontal therapy (SPT) in periodontal compromised patients and to identify factors influencing TL on patient level.

Material and Methods

Patients were re‐examined 120 ± 12 months after active periodontal therapy. TL and risk factors [smoking, initial diagnosis, SPT adherence, interleukin‐1 polymorphism, cardiovascular diseases, age at baseline, bleeding on probing (BOP), change of practitioner, insurance status, number of SPT, marital and educational status] influencing TL on patient level were assessed.

Results

One‐hundred patients (52 female, mean age 65.6 ± 11 years) lost 121 of 2428 teeth (1.21 teeth/patient; 0.12 teeth/patient/y) during 10 years of SPT. Forty‐two of these were lost for periodontal reasons (0.42 teeth/patient; 0.04 teeth/patient/y). Significantly more teeth were lost due to other reasons (P < .001). Smoking, baseline severity of periodontitis, non‐adherent SPT, positive interleukin‐1 polymorphism, marital and educational status, private insurance, older age at baseline and BOP, small number of SPT were identified as patient‐related risk factors for TL (P < .05).

Conclusion

During 120 ± 12 months of SPT, only a small number of teeth was lost in periodontally compromised patients showing the positive effect of a well‐established periodontal treatment concept. The remaining risk for TL should be considered using risk‐adopted SPT allocation.
Rural‐Urban Differences in Dental Service Utilization and Dental Service Procedures Received Among US Adults: Results From the 2016 Medical Expenditure Panel Survey
Authors: Luo Huabin , Wu Qiang , Bell Ronny A. , Wright Wanda , Quandt Sara A. , Basu Rashmita , Moss Mark E.
Published: July 2020

Purpose

To assess rural‐urban differences in dental service use and procedures and to explore the interaction effects of individual‐ and county‐level factors on having dental service use and procedures.

Methods

Data were from the 2016 Medical Expenditure Panel Survey (MEPS). We assessed rural‐urban differences in 3 outcome variables: number of dental visits (1, 2, or 3+ visits), preventive care procedures (Yes/No), and treatment procedures (Yes/No). The study sample included 8,199 adults ≥ 18 years of age who reported at least 1 dental visit in the past year. Sampling weights embedded in MEPS were incorporated into all the analyses.

Findings

A significant interaction between residential location and race/ethnicity (P = .030) suggested limited access to dental visits for minority groups, especially for blacks in the more rural areas. Adults from a more rural area were less likely to have received a preventive procedure (AOR = 0.55, 95% CI: 0.35‐0.87) than those from an urban area. Adults of racial/ethnic minority groups, with lower SES, and without dental insurance were less likely to have received a preventive procedure (all P < .01) but were more likely to have received a treatment procedure (all P < .05).

Conclusions

The study showed rural adults were less likely to have received preventive dental procedures than their urban counterparts. Racial/ethnic minority groups living in a more rural area had even more limited access to dental services. Innovative service delivery models that integrate telehealth and community‐based case management may contribute to addressing these gaps in rural communities.
The acculturation effect and eyewitness memory reports among migrants
Authors: Anakwah Nkansah , Horselenberg Robert , Hope Lorraine , Amankwah‐Poku Margaret , van Koppen Peter J.
Published: July 2020

Purpose

When people migrate to new cultures, they adapt to their new culture while at the same time retaining the norms of their original culture. The phenomenon whereby migrants adapt to the cultural norms of a host culture has been referred to as acculturation. Using a mock witness paradigm, we examined the acculturation effect in the eyewitness memory reports of sub‐Saharan African migrants in Western Europe.

Methods

We sampled sub‐Saharan African migrants in Western Europe, as well as sub‐Saharan Africans living in Africa as a control group (total N = 107). The mock witnesses were shown stimuli scenes of crimes in African and Western European settings and provided free and cued recall reports about what they had seen.

Results

Central details were reported more than contextual details by both groups of sub‐Saharan Africans. Relative to the control group of sub‐Saharan Africans living in Africa, sub‐Saharan African migrants in Western Europe provided more correct central details in free recall. The longer migrants had resided in Western Europe, the less collectivistic they become. Migrants also provided more elaborate reports the longer their duration of residence in Western Europe.

Conclusion

The findings of the current research suggest the new cultural environment of migrants impact their cultural norms, which may have implications for their eyewitness memory reports.
Change is never easy: How management theories can help operationalise change in medical education
Authors: Gordon Lisi , Cleland Jennifer A.
Published: July 2020

Context

Medical education is neither simple nor stable, and is highly contextualised. Hence, ways of perceiving multiple connections and complexity are fundamental when seeking to describe, understand and address concerns and questions related to change.

Proposal

In response to calls in the literature, we introduce three examples of contemporary organisational theory which can be used to understand and operationalise change within medical education. These theories, institutional logics, paradox theory and complexity leadership theory, respectively, are relatively unknown in medical education. However, they provide a way of making sense of the complexity of change creatively. Specifically, they cross‐cut different levels of analysis and allow us to ‘zoom in’ to micro levels, as well as to ‘zoom out’ and connect what is happening at the individual level (the micro level) to what happens at a wider institutional and even national or international level (the macro level), thereby providing a means of understanding the interactions among individuals, teams, organisations and systems. We highlight the potential value of these theories, provide a brief discussion of the few studies that have used them in medical education, and then briefly critique each theory.

Conclusions

We hope that by drawing the attention of readers to the potential of these management theories, we can unlock some of the complexity of change in medical education, support new ways of thinking and open new avenues for research.
PHILOSOPHY AS ART IN ARISTOTLE’S PROTREPTICUS
Authors: Güremen Refik
Published: July 2020

Observing certain affinities with Plato’s Alcibiades, this paper argues that a distinction between care (epimeleia) of the soul and philosophy as its art (technê) is reflected in Aristotle’s Protrepticus. On the basis of this distinction, it claims that two notions of philosophy can be distinguished in the Protrepticus: philosophy as epistêmê and philosophy as technê. The former has the function of contemplating the truth of nature, and Aristotle praises it as the natural telos of human beings; whereas philosophy as technê helps nature to accomplish the end it designed for human beings. It emerges that according to Aristotle in the Protrepticus philosophy is the art of making oneself coincide with one’s nature as a human being.
Fleas infesting cats and dogs in Great Britain: spatial distribution of infestation risk and its relation to treatment
Authors: Cooper A‐R. , Nixon E. , Rose Vineer H. , Abdullah S. , Newbury H. , Wall R.
Published: July 2020

The spatial pattern of flea (Siphonaptera: Pulicidae) infestation risk in cats and dogs across Great Britain is quantified, using data collected from a national survey undertaken in 2018, with particular attention given to the association between insecticidal treatment and infestation risk. Flea infestation risk declined significantly from south to north. None of the factors: pet breed, sex, neutered status or whether the pet had been abroad, showed any relationship with the underlying geographic distribution, which is most likely to be associated with climatic factors. However, overall, only 23.6% of the cats and 35% of the dogs inspected had been treated with identifiable flea products that were still ‘in date’ at the point of inspection. The percentage of owners treating their pet broadly followed infestation risk. The insecticide fipronil is a common active in a wide range of flea treatments and was the most frequently applied insecticide class, particularly in cats. However, 62% of cats and 45% of dogs that had been treated with a fipronil‐based product that was ‘in date’ at the point of inspection still had fleas. Persistent flea infestation is likely to be due to a range of factors, including compliance and application failure, but the data provide strong inferential evidence for a lack of efficacy of fipronil‐based products. Given the ubiquity of flea infestation, this finding and the relatively low‐level of treatment compliance, highlight a clear need for greater owner education about the importance of flea management and a better understanding of the efficacy of different products.
Neurofibrillary changes undergoing morphological and biochemical changes – How does tau with the profile shift of from four repeat to three repeat spread in Alzheimer brain?
Authors: Uchihara Toshiki
Published: July 2020

The concept of the hierarchal spread of neurofibrillary tangles (NFTs) from the hippocampus to the cortex in Alzheimer's disease (AD)/aging brains, initially proposed by Braak and Braak, revolutionized our understanding by putatively explaining that tau lesions are being unidirectionally extended along neural connections. Because pathological misfolding of tau can serve as a seed to induce identical misfolding on normal tau, this prion‐like property is considered to represent a molecular mechanism that may explain such lesion spread. However, double labeling studies for three repeat (3R) and four repeat (4R) tau demonstrated a profile shift in these tau isoforms along chronological change: initially positive only for 4R in early pretangles, gradual involvement of 3R in mature NFTs, and finally replaced by 3R in advanced ghost tangles. This profile shift is hardly explained by aggregation of a single tau molecule. Surprisingly, this profile shift from 4R to 3R tau is shared with the hierarchal spread of NFT around the hippocampus, which is hardly explained by a simple mechanism such as propagation of a single tau molecule. Some molecules other than tau or non‐materialist influences such as neuronal activity may be candidate mechanisms to explain this regional profile shift if it is mediated by neural connections. Because this profile shift is shared with brainstem NFTs, it may instead represent a cell autonomous phenomenon, tightly linked with progression of AD but not necessarily linked with prion‐like propagation along neural connections. In addition, we recently clarified that posttranslational deamidation of 4R tau at asparagine 279 to aspartate is a marker for AD, distinct from progressive supranuclear palsy (PSP)/corticobasal degeneration (CBD). This may provide another axis to see how AD‐NFTs develop and how their 4R tau is distinct from 4R tau of PSP/CBD. Because tau species and their distributions are disease‐specific, molecular homogenization, such as “tauopathy” to encompass AD, PSP/CBD and Pick body disease, is just an oversimplification that may obscure fundamental distinctions between human diseases. Careful reference to the realities of human brain disease may provide a solid and fruitful basis to improve diagnostic and therapeutic strategies to tackle these intractable diseases.
His bundle lead placement: Is His bundle captured?
Authors: Chokesuwattanaskul Ronpichai , Jongnarangsin Krit
Published: July 2020

A 59‐year‐old female underwent a dual‐chamber pacemaker implantation for intermittent complete heart block. A baseline electrocardiogram showed normal sinus rhythm with first‐degree atrioventricular (AV) block and right bundle branch block. A His bundle lead placement was attempted. An intracardiac electrogram from the His bundle lead demonstrated atrial‐His, and His‐ventricular intervals were 186 and 110 ms, respectively. Pacing was performed from the His bundle lead with a decremental pacing output to assess for the His bundle capture threshold. However, there were no significant QRS morphology changes during the pacing. Is the His bundle captured? The tracing evaluation demonstrated the fascinating physiology of activation wavefront in His Purkinje system that could be applied in the use of conducting system pacing technologies.
Distribution and genetic diversity of Dothistroma septosporum in Pinus brutia forests of south‐western Turkey
Authors: Oskay Funda , Tunalı Zeynep , Lehtijärvi Asko T. , Doğmuş‐Lehtijärvi Hatice Tuğba , Woodward Steve , Mullett Martin
Published: July 2020

Dothistroma needle blight (DNB) is a serious disease of the Pinaceae, mainly Pinus species, caused by the fungi Dothistroma septosporum and D. pini. Both species are regarded as invasive forest pathogens worldwide, with rising incidence in central and northern Europe over the last three decades. In this work, 29 sites were investigated between 2013 and 2015 in south‐western Turkey. Morphological examination of needles confirmed DNB infection (i.e., Dothistroma conidiospores observed) at 18 sites, and a total of 108 Dothistroma sp. isolates were obtained from 11 of the sites. Host age seemed to be an important factor in both occurrence and severity of DNB in Pinus brutia forests. Continuous rainy days, especially in December, may increase severity of disease; however, extreme rain events may reduce available conidiospores on plant tissues or in the air. Species‐specific mating type primers showed that all isolates were D. septosporum; D. pini was not detected. The mating type ratio was close to 1:1, indicating sexual recombination was occurring. Eleven microsatellite markers revealed 59 unique multilocus haplotypes (MLHs) among the 73 isolates originating from different conidiomata. The majority of MLHs were represented by a single isolate (n = 52) and only one MLH was shared between two localities. Analyses showed high genetic diversity, isolation‐by‐distance, and clear population clusters. These findings suggest that D. septosporum is well established in south‐western Turkey and is probably not a recent introduction.
B cell helper T cells and type 1 diabetes
Authors: Vandamme Céline , Kinnunen Tuure
Published: July 2020

Type 1 diabetes is an autoimmune disease typically starting in childhood that culminates in the destruction of insulin‐producing beta cells in the pancreas. Although type 1 diabetes is considered to be a primarily T cell–mediated disease, B cells clearly participate in the autoimmune process, as autoantibodies recognizing pancreatic islet antigen commonly appear in circulation before the onset of the disease. T cells providing helper functions to B cells have recently been shown to be involved in the pathogenesis of a wide range of antibody‐associated immune disorders. These T cells include CXCR5‐positive follicular T helper (Tfh) cells, and a recently described closely related CXCR5‐negative subset coined peripheral T helper (Tph) cells. Here, we review the current state of knowledge on different B cell helper T cell subsets, focusing on their potential involvement in the development of type 1 diabetes.
Current knowledge on autoantigens and autoantibodies in psoriasis
Authors: ten Bergen Lisa Lynn , Petrovic Aleksandra , Aarebrot Anders Krogh , Appel Silke
Published: July 2020

In the past decades, clinical and experimental evidence has demonstrated that psoriasis is an immune‐mediated inflammatory disease of the skin that occurs in genetically susceptible individuals. Psoriasis also shows clear autoimmune pathomechanisms, but specific cellular targets for the onset and maintenance of psoriatic lesions were not established until 2014. Since then, four psoriasis autoantigens were discovered, namely cathelicidin LL‐37, melanocytic ADAMTSL5, lipid antigen PLA2G4D and keratin 17. Autoreactive T cells against these autoantigens were found in a number of patients with moderate‐to‐severe plaque psoriasis. Moreover, the discovery of autoantibodies against LL‐37 and ADAMTSL5 and their strong association with psoriatic arthritis (PsA) suggest a potential role of these autoantibodies in the pathogenesis of PsA. This review discusses the current studies on psoriatic autoantigens and the associated circulating autoantibodies and their mechanisms involved in the development and maintenance of psoriatic plaques. Recent autoimmune evidence fuelled the discussion on psoriasis as an autoimmune skin disorder and has the potential to develop new treatment strategies with protective and therapeutic antigen‐targeted methods.