bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence, progression and risk factors of age‐related cataract in Malays: The Singapore Malay Eye Study
Authors: Tan Ava Grace , Tham Yih Chung , Chee Miao Li , Mitchell Paul , Cumming Robert G. , Sabanayagam Charumathi , Wong Tien Y. , Wang Jie Jin , Cheng Ching‐Yu
Published: April 2020

Importance

Long‐term data on age‐related cataract, a leading cause of blindness and visual impairment, is scarce in Asian populations.

Background

We report the 6‐year incidence and progression of age‐related cataract and associated risk factors in Malay adults living in Singapore.

Design

Population‐based cohort study.

Participants

A total of 3280 Malays aged 40+ years participated in baseline examinations of the Singapore Malay Eye Study (2004‐2006). Six years later, 1901 (72.1% of eligible) baseline participants were re‐examined.

Methods

Cataract was assessed using lens photos, taken during eye examinations, following the Wisconsin Cataract Grading System.

Main Outcomes and Measures

Incidence and progression of cortical, nuclear and posterior subcapsular (PSC) cataract. Poisson regression models and generalized estimating equations models (with Poisson link) were used to assess factors associated with cataract incidence and progression, respectively, adjusting for age, sex and other risk factors.

Results

Age‐adjusted 6‐year incidence of cortical, nuclear and PSC cataract was 14.1%, 13.6% and 8.7%, respectively, and was strongly age‐related (P for trend <.001 for all types). Diabetes (relative risk [RR], 1.97; 95% confidence intervals [CI], 1.46‐2.67) was associated with incident cortical cataract, hypertension was associated with PSC cataract incidence (RR, 2.09; 95% CI, 1.22‐3.61), after multivariable adjustment. Progression occurred in 20.4%, 5.9% and 40.6% of baseline cortical, nuclear and PSC cataract cases, respectively.

Conclusions and Relevance

Similar to other elderly populations, incidence and progression of cataract were common in this Malay population. Diabetes and hypertension were important modifiable risk factors for cataract, highlighting the importance of systemic health on eye disease.
Electronic participation‐focused care planning support for families: a pilot study
Authors: Jarvis Jessica M , Kaelin Vera C , Anaby Dana , Teplicky Rachel , Khetani Mary A
Published: April 2020

Aim

To evaluate the feasibility, acceptability, and preliminary effects of Participation and Environment Measure‐Plus (PEM+) 2.0, an optimized version of a web‐based, participation‐focused, care‐planning tool.

Method

Twenty‐two caregivers of children aged 0 to 5 years receiving rehabilitation services, who reported dissatisfaction with their child’s participation, had internet access, and could read and write English, were recruited for this 2‐week, single‐arm pilot trial. Feasibility was assessed through retention rates, completion time, percentage of care plans developed relative to caregiver reported need, and independent completion of PEM+ 2.0. Acceptability was assessed by the Usefulness, Satisfaction, and Ease of Use Questionnaire. Preliminary effects were assessed by two items on caregiver reported impact of PEM+ 2.0 on confidence for addressing their child’s participation.

Results

Eighteen caregivers completed at least one iteration of PEM+ 2.0; of those, 17 were female and 15 were 30 to 39 years old. The median completion time was 12.99 minutes (quartile 1, 6.30; quartile 3, 17.33), mean care plan creation relative to need was 50% (standard deviation [SD] 31), and 17 completed PEM+ 2.0 independently. Mean acceptability scores were 3.80 to 4.97 (SD 1.25–1.97) and mean preliminary effect scores were 4.61 to 4.72 (SD 1.85–2.24), out of 7.0. There were strong and significant positive associations between two of the three estimates of PEM+ 2.0 acceptability and caregiver confidence (r=0.577–0.793, p<0.01).

Interpretation

Electronic health tools have the potential for facilitating family‐centered care in pediatric rehabilitation. PEM+ 2.0 is a feasible tool within pediatric rehabilitation and has potential to be an acceptable tool for improving caregiver confidence for promoting their child’s participation in valued activities.

What this paper adds

Participation and Environment Measure‐Plus (PEM+) 2.0 is feasible for collaboratively engaging caregivers in the care‐planning process.

Caregivers perceived PEM+ 2.0 as helpful for thinking about their child’s participation and what can be done to improve it.

Feasibility and acceptability results will inform PEM+ 2.0 optimizations.
ReMindCare, an app for daily clinical practice in patients with first episode psychosis: A pragmatic real‐world study protocol
Authors: Bonet Lucia , Torous John , Arce David , Blanquer Ignacio , Sanjuán Julio
Published: April 2020

Aim

Despite the potential benefits of e‐health interventions for patients with psychosis, the integration of these applications into the clinical workflow and analysis of their long‐term effects still face significant challenges. To address these issues, we developed the ReMindCare app. This app aims to improve the treatment quality for patients with psychosis. We chose to study the app in real world and pragmatic manner to ensure results will be generalizable.

Methods

This is a naturalistic empirical study of patients in a first episode of psychosis programme. The app was purpose‐designed based on two previous studies, and it offers the following assessments: (a) three daily questions regarding anxiety, sadness and irritability; and (b) 18 weekly questions about medication adherence, medication side effects, medication attitudes and prodromal symptoms. The app offers preset alerts, reminders and the ability for patients to reach out to their clinicians. Data captured by the app are linked to the electronic medical record of the patient. Patients will use the app as part of their ongoing care for a maximum period of 5 years, and assessments will occur at baseline and at the end of the first, second and fifth years of app use.

Results

Recruitment started in October 2018 and is still ongoing.

Conclusions

The ReMindCare app represents early real‐world use of digital mental health tools that offer direct integration into clinical care. High retention and compliance rates are expected, and this will in turn lead to improved quality of assessments and communication between patients and clinicians.
How to compare sampling designs for mapping?
Authors: Wadoux Alexandre M.J.‐C. , Brus Dick J.
Published: April 2020

If a map is constructed through prediction with a statistical or non‐statistical model, the sampling design used for selecting the sample on which the model is fitted plays a key role in the final map accuracy. Several sampling designs are available for selecting these calibration samples. Commonly, sampling designs for mapping are compared in real‐world case studies by selecting just one sample for each of the sampling designs under study. In this study, we show that sampling designs for mapping are better compared on the basis of the distribution of the map quality indices over repeated selection of the calibration sample. In practice this is only feasible by subsampling a large dataset representing the population of interest, or by selecting calibration samples from a map depicting the study variable. This is illustrated with two real‐world case studies. In the first case study a quantitative variable, soil organic carbon, is mapped by kriging with an external drift in France, whereas in the second case a categorical variable, land cover, is mapped by random forest in a region in France. The performance of two sampling designs for mapping are compared: simple random sampling and conditioned Latin hypercube sampling, at various sample sizes. We show that in both case studies the sampling distributions of map quality indices obtained with the two sampling design types, for a given sample size, show large variation and largely overlap. This shows that when comparing sampling designs for mapping on the basis of a single sample selected per design, there is a serious risk of an incidental result.

Highlights

We provide a method to compare sampling designs for mapping.

Random designs for selecting calibration samples should be compared on the basis of the sampling distribution of the map quality indices.
Quantifying the relative importance of variation in predation and the environment for species coexistence
Authors: Shoemaker Lauren G. , Barner Allison K. , Bittleston Leonora S. , Teufel Ashley I.
Published: April 2020

Coexistence and food web theory are two cornerstones of the long‐standing effort to understand how species coexist. Although competition and predation are known to act simultaneously in communities, theory and empirical study of these processes continue to be developed largely independently. Here, we integrate modern coexistence theory and food web theory to simultaneously quantify the relative importance of predation and environmental fluctuations for species coexistence. We first examine coexistence in a theoretical, multitrophic model, adding complexity to the food web using machine learning approaches. We then apply our framework to a stochastic model of the rocky intertidal food web, partitioning empirical coexistence dynamics. We find the main effects of both environmental fluctuations and variation in predator abundances contribute substantially to species coexistence. Unexpectedly, their interaction tends to destabilise coexistence, leading to new insights about the role of bottom‐up vs. top‐down forces in both theory and the rocky intertidal ecosystem.
Sumoylation on its 25th anniversary: mechanisms, pathology, and emerging concepts
Authors: Celen Arda B. , Sahin Umut
Published: April 2020

Sumoylation is an essential post‐translational modification intimately involved in a diverse range of eukaryotic cellular mechanisms. Small ubiquitin‐like modifier (SUMO) protein isoforms can be reversibly linked to lysine residues that reside within specific motifs on thousands of target substrates, leading to modulations in stability, solubility, localization, and interactor profile. Since its initial discovery almost 25 years ago, SUMO has been described as a key regulator of genomic stability, cell proliferation, and infection among other processes. In this review, we trace the exciting developments in the history of this critical modifier, highlighting SUMO’s roles in pathogenesis as well as its potential for the development of targeted therapies for numerous diseases.
Glycolysis – a key player in the inflammatory response
Authors: Soto‐Heredero Gonzalo , Gómez de las Heras Manuel M. , Gabandé‐Rodríguez Enrique , Oller Jorge , Mittelbrunn María
Published: April 2020

The inflammatory response involves the activation of several cell types to fight insults caused by a plethora of agents, and to maintain the tissue homoeostasis. On the one hand, cells involved in the pro‐inflammatory response, such as inflammatory M1 macrophages, Th1 and Th17 lymphocytes or activated microglia, must rapidly provide energy to fuel inflammation, which is essentially accomplished by glycolysis and high lactate production. On the other hand, regulatory T cells or M2 macrophages, which are involved in immune regulation and resolution of inflammation, preferentially use fatty acid oxidation through the TCA cycle as a main source for energy production. Here, we discuss the impact of glycolytic metabolism at the different steps of the inflammatory response. Finally, we review a wide variety of molecular mechanisms which could explain the relationship between glycolytic metabolites and the pro‐inflammatory phenotype, including signalling events, epigenetic remodelling, post‐transcriptional regulation and post‐translational modifications. Inflammatory processes are a common feature of many age‐associated diseases, such as cardiovascular and neurodegenerative disorders. The finding that immunometabolism could be a master regulator of inflammation broadens the avenue for treating inflammation‐related pathologies through the manipulation of the vascular and immune cell metabolism.
A broader perspective on the causes and consequences of eastern Australia's 2019–20 season of mega‐fires: A response to Adams et al.
Authors: Bradstock Ross A. , Nolan Rachael H. , Collins Luke , Resco de Dios Víctor , Clarke Hamish , Jenkins Meaghan , Kenny Belinda , Boer Matthias M.
Published: April 2020

This article is a Response to Adams et al. 26, 3756–3758. See also the Letter by Nolan et al. 26, 1039–1041.
Management and treatment options when facing malignant ureteral obstruction
Authors: Tabib Christian , Nethala Daniel , Kozel Zachary , Okeke Zeph
Published: April 2020

Malignant ureteral obstruction is an unfortunate finding that can be caused by a wide‐ranging number of malignancies with a prognosis of limited survival. Given its presentation and progression, it can be refractory to treatment by traditional single polymeric ureteral stents. With a higher failure rate than causes of benign ureteral obstruction, a number of other options are available for initial management, as well as in cases of first‐line therapy failure, including tandem stents, metallic stents, percutaneous nephrostomies and extra‐anatomic stents. We reviewed the literature and carried out a PubMed search including the following keywords and phrases: “malignant ureteral obstruction,” “tandem ureteral stents,” “metallic ureteral stents,” “resonance stent,” “metal mesh ureteral stents” and “extra‐anatomic stents.” The vast majority of studies were small and retrospective, with a large number of studies related to metallic stents. Given the heterogenous patient population and diversity of practice, it is difficult to truly assess the efficacy of each method. As there are no guidelines or major head‐to‐head prospective trials involving these techniques, it makes practicing up to the specific provider. However, this article attempts to provide a framework with which the urologist who is presented with malignant ureteral obstruction can plan in order to provide the individualized care on a case‐by‐case basis. What is clear is that prospective, randomized clinical trials are necessary to help bring evidence‐based medicine and guidelines for patients with malignant ureteral obstruction.
Does Alzheimer's Disease and Related Dementias Modify Delirium Severity and Hospital Outcomes?
Authors: Hshieh Tammy T. , Fong Tamara G. , Schmitt Eva M. , Marcantonio Edward R. , Xu Guoquan , Gou Yun R. , Travison Thomas G. , Metzger Eran D. , Jones Richard N. , Inouye Sharon K. ,   for the BASIL Study Group
Published: April 2020

OBJECTIVES

We examined the association between delirium severity and outcomes of delirium among persons with and without Alzheimer's disease and related dementias (ADRD).

DESIGN

Prospective cohort study.

SETTING

Academic tertiary medical center.

PARTICIPANTS

A total of 352 medical and surgical patients.

MEASUREMENTS

Delirium incidence and severity were rated daily using the Confusion Assessment Method (CAM) and CAM‐Severity (CAM‐S) score during hospitalization. Severe delirium was defined as a CAM‐S Short Form score in the highest tertile (3‐7 points out of 7). ADRD status was determined by a clinical consensus process. Clinical outcomes included prolonged length of stay (>6 d), discharge to post‐acute nursing facility, any decline in activities of daily living (ADLs) at 1 month from prehospital baseline, ongoing nursing facility stay, and mortality.

RESULTS

Patients with ADRD (n = 85 [24%]) had a significantly higher relative risk (RR) for incident delirium (RR = 2.31; 95% confidence interval [CI] = 1.64‐3.28) and higher peak CAM‐S scores (mean difference = 1.24 points; CI = .83‐1.65; P < .001). Among patients with ADRD, severe delirium significantly increased the RR for nursing facility stay (RR = 2.22; CI = 1.05‐4.69; P = .04) and increased the RR for mortality (RR = 2.10; CI = .89‐4.98; P = .09). Among patients without ADRD, severe delirium was associated with a significantly increased risk for all poor outcomes except mortality including prolonged length of stay in the hospital (RR = 1.47; CI = 1.18‐1.82) and discharge to a post‐acute nursing facility (RR = 2.17; CI = 1.58‐2.98) plus decline in ADLs (RR = 1.30; CI = 1.05‐1.60) and nursing facility stay at 1 month (RR = 1.93; CI = 1.31‐2.83).

CONCLUSION

Severe delirium is associated with increased risk for poor clinical outcomes in patients with and without ADRD. In both groups, severe delirium increased risk of nursing home placement. In patients with ADRD, delirium was more severe and associated with a trend toward increased mortality at 1 month. Although the increased risk remains substantial by RR, the study had limited power to examine the rarer outcome of death. J Am Geriatr Soc 68:1722‐1730, 2020.
Human capital investment, credentialing, and wage differentials
Authors: Tanaka Masashi
Published: April 2020

This study considers how individuals determine at what ratio they will invest in two different types of education. The first type contributes to the development of labor skills, while the other does not. We refer to the former as human capital investment and the latter as unproductive investment, which improves test scores but has no beneficial effect on students' human capital. We formulate an overlapping‐generations economy in which the rich and poor households invest in both types of education. We find that the ratio of human capital investment to unproductive investment is lower in the economy with medium size of the wage differentials. In a dynamic analysis, we identify two patterns of stable steady states for the dynamics of the wage differentials, namely, no‐inequality and high‐inequality steady states. Further, we show that a rapid increase in the level of skill‐biased technology may cause a switch from a steady state with no‐inequality to one with high inequality. This causes at least a temporary increase in the ratio of unproductive investment during the transition to the new steady state.
Sleep enhances strategic thinking at the expense of basic procedural skills consolidation
Authors: Conte Francesca , Cerasuolo Mariangela , Giganti Fiorenza , Ficca Gianluca
Published: April 2020

Recent studies show that sleep facilitates the learning of complex cognitive skills. Here, we assess the effect of sleep on performance in an ecological, multi‐componential task, which requires subjects to trace on a screen as many words as possible with 16 letters, some of which (“bonuses”) multiply the value of letters or words containing them. In a within‐subjects design, 23 healthy adults underwent training and retest, with a retention period (approximately 8 hr) spent awake (WK, with training in the morning and retest in the afternoon) or asleep (SL, with training in the evening and retest in the morning). The main performance measure (GLOB) results from the total value of the letters used, the number of words, their length and the strategic use of bonus letters. An additional measure (WORDS, i.e., the proportion of words correctly detected over all detectable words) was also used, mainly reflecting procedural rather than strategic skills. In WK, although GLOB increased at retest, a significant improvement emerged only for WORDS, whereas in SL only GLOB was enhanced. In WK, the GLOB improvement appears to depend on the increase in the number of words detected (GLOB and WORDS improvement measures were positively associated), whereas in SL this association was not observed, indicating a shift to more complex but more rewarding strategies. Our data contribute to the understanding of everyday life learning processes by suggesting that sleep benefits memories of future relevance and promotes preferential consolidation of strategic skills when this is useful to achieve one's goal.
Extracellular vesicular microRNAs as potential biomarker for early detection of doxorubicin‐induced cardiotoxicity
Authors: Beaumier Amelie , Robinson Sally R. , Robinson Nicholas , Lopez Katherine E. , Meola Dawn M. , Barber Lisa G. , Bulmer Barret J. , Calvalido Jerome , Rush John E. , Yeri Ashish , Das Saumya , Yang Vicky K.
Published: April 2020

Background

Long‐term use of doxorubicin (DOX) is limited by cumulative dose‐dependent cardiotoxicity.

Objectives

Identify plasma extracellular vesicle (EV)‐associated microRNAs (miRNAs) as a biomarker for cardiotoxicity in dogs by correlating changes with cardiac troponin I (cTnI) concentrations and, echocardiographic and histologic findings.

Animals

Prospective study of 9 client‐owned dogs diagnosed with sarcoma and receiving DOX single‐agent chemotherapy (total of 5 DOX treatments). Dogs with clinically relevant metastatic disease, preexisting heart disease, or breeds predisposed to cardiomyopathy were excluded.

Methods

Serum concentration of cTnI was monitored before each treatment and 1 month after the treatment completion. Echocardiography was performed before treatments 1, 3, 5, and 1 month after completion. The EV‐miRNA was isolated and sequenced before treatments 1 and 3, and 1 month after completion.

Results

Linear mixed model analysis for repeated measurements was used to evaluate the effect of DOX. The miR‐107 (P = .03) and miR‐146a (P = .02) were significantly downregulated whereas miR‐502 (P = .02) was upregulated. Changes in miR‐502 were significant before administration of the third chemotherapeutic dose. When stratifying miRNA expression for change in left ventricular ejection fraction, upregulation of miR‐181d was noted (P = .01). Serum concentration of cTnI changed significantly but only 1 month after treatment completion, and concentrations correlated with left ventricular ejection fraction and left ventricular internal dimension in diastole.

Conclusion and Clinical Significance

Downregulation of miR‐502 was detected before significant changes in cTnI concentrations or echocardiographic parameters. Further validation using a larger sample size will be required.
HSD17B13 as a promising therapeutic target against chronic liver disease
Authors: Stender Stefan , Romeo Stefano
Published: April 2020

See Article on Page 889
Movement ecology of large herbivores in African savannas: current knowledge and gaps
Authors: Owen‐Smith Norman , Hopcraft Grant , Morrison Thomas , Chamaillé‐Jammes Simon , Hetem Robyn , Bennitt Emily , Van Langevelde Frank
Published: April 2020

Nearly 90% of the world's large herbivore diversity occurs in Africa, yet there is a striking dearth of information on the movement ecology of these organisms compared to herbivores living in higher latitude ecosystems.

The environmental context for movements of large herbivores in African savanna ecosystems has several distinguishing features. African large herbivores move in landscapes with high spatiotemporal variability, low predictability, seasonal restrictions in surface water as well as food resources, and exposure to a diverse assemblage of competitors, predators, and pathogens. These features influence mobility, diel activity routines, home‐range fidelity, and exposure to predation.

We review the knowledge that has been gained about the movements of African herbivores from Global Positioning System (GPS) telemetry and identify important gaps in knowledge that exist. Topics addressed include seasonal movement patterns, daily activity schedules, space utilisation, water dependency, responses to risks of predation, pathogen transmission, social affiliations, and local population density determination.

While the growing number of GPS telemetry studies has addressed a wide range of topics in Africa, they remain fragmentary in terms of places and species represented. Most research has been focussed on three species, and practices for data sharing and analysis should be improved. African landscapes are changing perhaps faster than any other region on Earth, with rapidly expanding human populations, massive infrastructure development projects, and changes in climatic regimes. There is a crucial need to establish relationships between herbivore movements and their changing environments, especially in Africa where most of the world's large herbivore diversity resides.
Supporting the balance between well‐being and performance in medical education
Authors: Scheepers Renée A.
Published: April 2020

The author reflects on how clinician teachers can support the balance between well‐being and performance for trainees as stress‐related threats to performance can hamper patient care quality.
Leaf trait variation is similar among genotypes ofEucalyptus camaldulensisfrom differing climates and arises in plastic responses to the seasons rather than water availability
Authors: Asao Shinichi , Hayes Lucy , Aspinwall Michael J. , Rymer Paul D. , Blackman Chris , Bryant Callum J. , Cullerne Darren , Egerton John J. G. , Fan Yuzhen , Innes Peter , Millar A. Harvey , Tucker Josephine , Shah Shahen , Wright Ian J. , Yvon‐Durocher Gabriel , Tissue David , Atkin Owen K.
Published: April 2020

We used a widely distributed treeEucalyptus camaldulensissubsp.camaldulensisto partition intraspecific variation in leaf functional traits to genotypic variation and phenotypic plasticity. We examined if genotypic variation is related to the climate of genotype provenance and whether phenotypic plasticity maintains performance in a changing environment.

Ten genotypes from different climates were grown in a common garden under watering treatments reproducing the wettest and driest edges of the subspecies’ distribution. We measured functional traits reflecting leaf metabolism and associated with growth (respiration rate, nitrogen and phosphorus concentrations, and leaf mass per area) and performance proxies (aboveground biomass and growth rate) each season over a year.

Genotypic variation contributed substantially to the variation in aboveground biomass but much less in growth rate and leaf traits. Phenotypic plasticity was a large source of the variation in leaf traits and performance proxies and was greater among sampling dates than between watering treatments. The variation in leaf traits was weakly correlated to performance proxies, and both were unrelated to the climate of genotype provenance.

Intraspecific variation in leaf traits arises similarly among genotypes in response to seasonal environmental variation, instead of long‐term water availability or climate of genotype provenance.
Disrupted actin: a novel player in pathogen attack sensing?
Authors: Leontovyčová Hana , Kalachova Tetiana , Janda Martin
Published: April 2020

The actin cytoskeleton is widely involved in plant immune responses. The majority of studies show that chemical disruption of the actin cytoskeleton increases plant susceptibility to pathogen infection. Similarly, several pathogens have adopted this as a virulence strategy and produce effectors that affect cytoskeleton integrity. Such effectors either exhibit actin‐depolymerizing activity themselves or prevent actin polymerization. Is it thus possible for plants to recognize the actin's status and launch a counterattack? Recently we showed that chemical depolymerization of actin filaments can trigger resistance to further infection via the specific activation of salicylic acid (SA) signalling. This is accompanied by several defence‐related, but SA‐independent, effects (e.g. callose deposition, gene expression), relying on vesicular trafficking and phospholipid metabolism. These data suggest that the role of actin in plant–pathogen interactions is more complex than previously believed. It raises the question of whether plants have evolved a mechanism of sensing pathological actin disruption that eventually triggers defence responses. If so, what is the molecular basis of it? Otherwise, why does actin depolymerization specifically influence SA content but not any other phytohormone? Here we propose an updated model of actin's role in plant–microbe interactions and suggest some future directions of research to be conducted in this area.
Evaluation of PD‐L1, PD‐L2, PD‐1 and cytotoxic immune response in oral lichen planus
Authors: Costa Nádia Lago , Gonçalves Julie Ane Maria , de Lima Sara Lia Gonçalves , de Arruda José Alcides Almeida , Miranda Ana Carolina Campos , Mesquita Ricardo Alves , da Silveira Éricka Janine Dantas , Batista Aline Carvalho
Published: April 2020

Objective

To investigate the expression of programmed death‐ligands 1 and 2 (PD‐L1, PD‐L2), programmed death‐1 (PD‐1), CD8 and granzyme B (GrB), as well as its correlation with the severity of oral lichen planus (OLP).

Materials and Methods

In a collaborative study, 33 cases of OLP were evaluated according to the latest criteria proposed by the American Academy of Oral and Maxillofacial Pathology (AAOMP/2016) and were submitted to immunohistochemistry. Positivity was measured semiquantitatively (PD‐L1, PD‐L2) and quantitatively (PD‐1, CD8, GrB). The severity of OLP was assessed according to clinical subtype, symptomatology and response to corticosteroid therapy.

Results

Most OLPs were considered to be negative for PD‐L1 (66.6%), but high expression of PD‐L2 (96.9%) by keratinocytes and immunoinflammatory cells was observed. PD‐1+ cell density/mm2 was reduced compared to CD8+ cells. A low cytotoxic immune response (CD8:GrB ratio) was also demonstrated. Interestingly, there were fewer GrB+ cells in the intraepithelial region in reticular OLP compared to erosive/bullous OLP.

Conclusions

PD‐L1/PD‐1 pathways appear to be compromised in OLP due to low PD‐L1 expression in most samples. In contrast, PD‐L2 overexpression associated with a possible regulation of the cytotoxic immune response suggests an immune tolerance that may contribute to the chronic profile of OLP.
Silica entry and accumulation in standing trees in a hot‐spring environment: cellular pathways, rapid pace and fossilization potential
Authors: Liesegang Moritz , Gee Carole T.
Published: April 2020

Silicification is the most important process of fossilization resulting in the preservation of internal tissues in plants, thereby providing essential information on the anatomy, life history, and evolution of land plants. However, fundamental knowledge of silica uptake, precipitation, and contribution to in situ plant fossilization is limited. To identify the cellular pathway of aqueous silica and subsequent fluid–wood interaction processes, we investigated upright standing young trees of lodgepole pine (Pinus contorta) in the hot‐spring environment of Cistern Spring, Yellowstone National Park, USA. Our multi‐method analytical approach using x‐ray diffraction, Raman spectroscopy, scanning electron microscopy, and electron probe microanalyses shows that the surficial and internally co‐precipitated silica–halite–gypsum assemblage traces the flow of silica‐rich fluid and documents fluid retention after short‐term hot‐spring water immersion and evaporation. Element distribution maps reveal systematic 2D and 3D differences between silica quantities deposited in earlywood and latewood. The distribution of inorganic impurities in cell walls traces the anatomical structure of the wood and indicates rapid migration of homogeneous fluid into the waterlogged organic substrate. Our results show that the preferential pathway of silica‐rich fluid into the above‐ground wood was through the decorticated periphery which took place during a short‐term flooding, ranging from days to weeks, of hot‐spring fluid. In conclusion, the fluid retention capability in cellular pore space controls the in situ silicification process. The silicification of trees in growth position is a rapid process in which the in vivo transport of silica‐rich fluid upward through the secondary xylem plays an insignificant role.
Tofacitinib cream plus narrowband ultraviolet B phototherapy for segmental vitiligo in a child
Authors: Olamiju Brianna , Craiglow Brittany G.
Published: April 2020

Segmental vitiligo often presents in childhood and tends to be more recalcitrant to therapy than generalized vitiligo. Recently, Janus kinase inhibitors have emerged as a promising treatment option, with some reports suggesting that concomitant ultraviolet light exposure may enhance therapeutic response. Here, we present a child with segmental vitiligo who responded rapidly and completely to treatment with tofacitinib cream plus phototherapy.
Squamous cell carcinoma development in Fanconi anemia patients who underwent hematopoietic stem cell transplantation
Authors: Anak Sema , Yalman Nevin , Bilgen Hülya , Sepet Elif , Deviren Ayhan , Gürtekin Başak , Tunca Fatih , Başaran Bora
Published: April 2020

We examined SCC development of 24 FA patients, who received HSCT from HLA‐matched relatives. In our BMT center, we applied low‐dose CY + LFI + ATG (n:13) as conditioning regimen for FA patients between 1992 and 1999, and CY + BU + ATG (n:11) between 1999 and 2002. The aim of this study was to investigate SCC development after HSCT and examine features of the follow‐up patients. The 10‐year overall survival (OS) of the group with LFI + regimen was 43%, whereas the group without LFI regimen was 60%. There was a statistically significant relationship between infections (viral/bacterial) and overall survival (Fisher's Exact test P < .001). Five out of 13 long‐term (>1 year) surviving patients developed SCC in the HNSCC (n:4) and esophagus (n:2) region (a patient with oral SCC developed a second primary esophageal SCC). The SCC rate in our FA patients was 38%, four of the SCC patients were transplanted with irradiation used conditioning regimens, three of them had acuteGvHD (Grade II‐III), only one developed chronic GvHD. The interval between HSCT and SCC diagnosis was median 13 (range 6‐18) years, the age for the development of cancer was median 21 (range 15‐32) years. Survival after SCC was low, median 6 months (range 6‐12), due to delayed SCC diagnosis, tumor progression under therapy and treatment‐related toxicities of the usually reduced RT and/or CT.
The importance of sampling intensity when assessing ecosystem restoration: ants as bioindicators in northern Australia
Authors: Oberprieler Stefanie K. , Andersen Alan N.
Published: April 2020

Insects are commonly used as bioindicators for assessing ecosystem restoration, but such assessments are potentially influenced by sampling intensity. Uncommon species are often late colonizers of sites undergoing restoration, so that sampling that is effective for only common species can under‐represent differences between rehabilitation and reference sites. We found that differences in observed ant species richness and composition between rehabilitation and reference sites at a northern Australian uranium mine increased markedly with increasing sampling intensity (through repeat sampling), reflecting differences in the numbers of uncommon species. Ensuring appropriately high sampling intensity is important in assessments of restoration success using insect bioindicators.
Legal Ruralism and California Parole Hearings: Space, Place, and the Carceral Landscape*
Authors: Young Kathryne M.
Published: April 2020

This article discusses the important relationship between rurality and criminal justice processes, drawing on field observations and in‐depth interviews with parole commissioners to argue that California's physical carceral landscape profoundly shapes lifer parole hearings. First, commissioners report that prisons' location in rural areas affects the rehabilitative resources available, which are seen as an important aspect of their readiness for release. Location and perceived rurality of prisons shape commissioners' perception of the inmates at various institutions, creating implicitly different standards for inmates housed at different prisons. Second, spatiality and rurality influence parole commissioners' work lives, exacting a toll that includes onerous travel, early burnout, and challenges to assembling a diverse board. Together, these findings underscore the importance of legal ruralism to the relationship between spatial and carceral landscapes.
Motives for physical activity in older men and women: A twin study using accelerometer‐measured physical activity
Authors: Aaltonen Sari , Waller Katja , Vähä‐Ypyä Henri , Rinne Juha , Sievänen Harri , Silventoinen Karri , Kaprio Jaakko , Kujala Urho M.
Published: April 2020

Motives for physical activity may vary considerably by age, sex, and the level of physical activity. We aimed to examine motives for physical activity in older men and women with different physical activity levels as well as whether genetic and/or environmental factors explain those motives. Finnish twins (mean age 72.9 years, 262 full twin pairs) self‐reported their motives for physical activity. Time spent on moderate‐to‐vigorous physical activity was monitored using a hip‐worn accelerometer. Comparisons between the different physical activity groups of older twins (n = 764‐791/motive dimension) were analyzed using the Wald test, and effect sizes were calculated as Cohen's d. Quantitative genetic modeling was used to estimate genetic and environmental contributions. For both sexes, the most frequently reported motives for physical activity were physical fitness, health maintenance, and psychological well‐being. Conforming to others’ expectations was more important for men than for women (P < .001, Cohen's d = 0.38), while appearance (P = .001 Cohen's d = −0.24) and psychological well‐being (P = .02, Cohen's d = −0.17) were highlighted by women. Most of the motive dimensions differed significantly between the physically active and inactive individuals. It was estimated that 5%‐42% of the variation in motives was contributed by genetic factors and 58%‐95% by environmental factors. The result that environmental factors contribute in a great deal to motives indicates that interventions to motivate physically inactive older individuals to be physically active can be successful. However, personalized interventions are needed because sex and the level of physical activity were found to be associated with older individuals’ motives for physical activity.
Estimating individual action dispositions using binary and frequency egocentric sexual network data
Authors: Hansson Disa , Strömdahl Susanne
Published: April 2020

The degree distribution of nodes in a sexual network has been under thorough investigation, as has its implications for the spread of sexually transmitted infections. However, not only the structure of the network is of importance in regulating the propagation of an infection. Two nodes connected by an edge may take actions that reduce the transmission probability through that edge. Condom use is one such action. In this article, we derive models for individual action dispositions, and how they together generate an outcome on the edge connecting two nodes. We derive two main models: One where two connected nodes generate one outcome together (suitable for casual sex partners), and one where they generate several outcomes together (suitable for steady sex partners). We model different disposition distributions and different rules on how the dispositions generate outcomes, using an egocentric network dataset on condom use behavior.
Educating physician‐assistant students as agents of lifestyle medicine
Authors: Keyes Sarah‐Ann , Gardner Aimee
Published: April 2020

Background

The burden of chronic disease in the USA necessitates a shift in medicine and medical education from disease treatment to health and wellness promotion. At the forefront of this shift is the field of lifestyle medicine – the evidence‐based use of lifestyle modification to prevent, treat and reverse disease. Health care providers, including physician assistants (PAs), can be the vehicle of behaviour change for patients, families and communities, and must receive adequate training to practice lifestyle medicine.

Methods

We describe a pilot lifestyle medicine curriculum implemented through a PA training programme run in the USA in the academic year 2016/2017. The curriculum included four taught modules on lifestyle medicine, two assessment activities and a survey of self‐perceived competency, measured before and after the programme.

Results

Forty students participated in the curriculum. Results showed a significant increase in self‐perceived competencies in seven of nine lifestyle medicine areas (p < 0.001). After the curriculum, all students were successfully able to provide a written lifestyle medicine prescription for a mock patient, with the most common prescription topics including nutrition‐related prescriptions (41%), followed by physical activity (26%), addressing substance use (10%), mental health or stresses (10%) and sleep (7%). Furthermore, on average students were able to correctly identify 70% of the desired recommendations for a mock patient.

Conclusion

Lifestyle medicine curricula can be successfully integrated into existing PA curricula, with demonstrated increases in self‐assessments of competency and practical skills.
Stress and the ecology of urban experience: Migrant mental lives in central Shanghai
Authors: Amin Ash , Richaud Lisa
Published: April 2020

Responding to claims in urban studies and epidemiology that modern urban living negatively affects the mental health of the poor and newcomers to the city, this paper offers a different account based on an ethnography of a neighbourhood in central Shanghai, where precarious rural migrant lives unfold. Drawing on the concept of “ecologies of experience” to recognise the making of everyday sensibilities and affective tensions in urban dwelling, it focuses on subjectivity formed in habits of negotiating the urban environment, in coping with troubled thoughts and feelings posed by precariousness. The paper considers ecologies of experience arising in distinct prosaic locations – a public library, a large bookstore, and a café – found to be important in the everyday spatial practices of migrants, grounding to different degrees of success hopes for their present and future in the city. In such dwelling, the stresses to mental health – consistently described by migrants as “pressure” (yali) – seem to be moderated through varied forms of respite, slowing‐down, and “moments of being,” though always in ambivalent ways. In recognising the everyday materiality of urban living, the paper looks beyond the tendency in studies of China's internal migration to read off migrant mental health outcomes from structural disadvantages related to work, welfare, and living conditions. Conceptually, it opens new ground in thinking by acknowledging the role of the felt qualities of lived experience in managing mental states, building on work in geography, sociology, and anthropology attentive to the affective resonances of place and to practices of urban negotiation.
The geo‐constitution and responses to austerity: Institutional entrepreneurship, switching, and re‐scaling in the United Kingdom
Authors: Wills Jane
Published: April 2020

A nation's geo‐constitution – its spatially uneven political institutions – plays a critical role in mediating change. This paper explores this in relation to local government responses to austerity. The paper presents original research collected in Cornwall, United Kingdom, to highlight the scale and impact of asset transfers to town and parish councils. This degree of institutional switching was possible because of a willingness to use legacy constitutional institutions to mediate the trajectory and impact of reform in response to austerity. Town and parish councils have taken on important assets (public toilets, parks, and libraries) and raised local taxation to pay for them. This has reconfigured relationships between local government institutions while also incentivising innovation in service organisation. The research highlights the role of political institutions and their personnel in mediating responses to austerity, as well as raising broader questions about the rescaling of the social contract, and the scope for further constitutional reform.
Influence of closure technique on leakage pressures in an ex vivo canine typhlectomy model
Authors: Duffy Daniel J. , Chang Yi‐Jen , Moore George E.
Published: April 2020

Objective

To determine the influence of three closure techniques on leakage pressures of canine typhlectomies.

Study design

Experimental, ex vivo.

Sample population

Grossly normal cecal segments from 24 adult canine cadavers.

Methods

Typhlectomies were assigned to one of three closure techniques: simple continuous closure with a Parker‐Kerr pattern with 4‐0 polydioxanone (group 1), closure with a 60‐mm gastrointestinal stapler loaded with a 3.8‐mm staple cartridge (group 2), and placement of a Cushing suture to augment the stapled closure (group 3). The median (range) of initial leakage pressure (ILP) and maximum leakage pressure (MLP) was compared between groups along with leakage location.

Results

Typhlectomies in group 3 leaked at higher ILP (310 mm Hg; 188‐310) than those in groups 1 (43 mm Hg; 31‐80) and 2 (109.5 mm Hg; 68‐173;P < .0001). Maximum leakage pressure were greater in group 3 than in other groups (P < .0001). Leakage was detected in 20 of 24 (83%) typhlectomies, located at the incisional line in 13 of 24 (54%) specimens and from suture holes in seven of 24 (29%) specimens.

Conclusion

Placement of a Cushing suture pattern to augment stapled incisions improved the ability of typhlectomies to sustain pressure compared with sutured or stapled cadaveric specimens alone.

Clinical significance

These results provide evidence to support placement of a Cushing suture pattern to augment the staple line for typhlectomies in dogs, although in vivo studies are required to determine the clinical significance of these findings.
An Overview of Thermal and Mechanical Design, Control, and Testing of the World's Most Powerful and Fastest Supercomputer
Authors: Yuksel Anil , Mahaney Vic , Marroquin Chris , Tian Shurong , Hoffmeyer Mark , Schultz Mark , Takken Todd
Published: April 2020

A new era of computing has begun with the development of high-performance computing (HPC), artificial intelligence (AI), machine learning (ML), and cognitive systems. Dramatic increases in the power density of the electronic components have led to the design and architecture of efficient thermal management technologies on these systems. IBM designed and delivered in 2018 the most powerful and fastest supercomputers of the world known as Summit and Sierra having 200 petaflops peak computing performance through LINPACK benchmarks. These systems which are called as IBM POWER AC922 are both air and liquid cooled, where water is employed in liquid-cooled systems to cool the high-power electronic components including IBM POWER9 processors and NVIDIA graphics processing units (GPUs). In this paper, we highlight the overview of the thermal and mechanical design strategies applied to these systems. Testing and experimental analysis with comparison to computational modeling is provided. Thermal control strategies are investigated for the optimization of overall system efficiency. In air cooled systems, we discuss the fan and heat sink designs, as well as the preheating effect on the PCIe section. In liquid-cooled systems, which have a unique cold plate design cooling the processors and the GPUs with water, we examine the water flow path design for the central processing units (CPUs), the GPUs, and the thermal performance of the cold plate. An overview of the cooling assemblies such as TIMs and air baffles in these systems is discussed. Unit and rack manifolds and rear door heat exchanger (RDHx) are investigated. Water flow and pressure distribution at the node and rack-level are provided.