bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytology and direct human papillomavirus testing on fine needle aspirates from cervical lymph node metastases of patients with oropharyngeal squamous cell carcinoma or occult primary
Authors: Rollo F. , Dona’ M. G. , Pellini R. , Pichi B. , Marandino F. , Covello R. , Benevolo M.
Published: June 2018

Objective

Cervical lymph node fine needle aspirates (FNAs) may represent the only specimens available for an initial characterisation of patients with lymphadenopathy. Morphology and human papillomavirus (HPV) DNA presence were evaluated in FNAs collected from patients with oropharyngeal squamous cell carcinoma (OPSCC) or cancer of unknown primary (CUP). FNA HPV results were compared with those of the respective formalin‐fixed paraffin‐embedded (FFPE) primary cancer.

Methods

Liquid‐based cytology was performed on FNAs collected in PreservCyt. HPV‐DNA was analysed by the INNO‐LiPA HPV genotyping Extra II on both cytological and FFPE samples. The CINtec® Histology Kit was used to assess p16 expression in cancer tissues.

Results

Forty‐seven FNAs were collected from OPSCC and 16 from CUP patients. Cancer cells were found in 35/47 cases (74.5%), while 11 (23.4%) showed only necrosis and one (2.1%) was negative for malignancy. HPV‐DNA was detected in 30/47 FNAs (63.8%), mostly harbouring HPV16 (90.0%). An excellent agreement was observed between the FNA and corresponding FFPE HPV status (raw agreement: 97.5%; Cohen κ: 0.94). The HPV test result on the necrotic FNAs completely matched that of the respective primary cancer. FNA HPV testing correctly identified 26/27 HPV‐driven OPSCCs (96.3%). HPV was detected in nine of 16 FNAs (56.2%) from CUP patients.

Conclusions

HPV status of metastatic cervical lymph node FNAs reflects that of the corresponding primary OPSCCs even when cell integrity in the FNA is not preserved and only necrotic debris are present. In patients with initial CUP, HPV‐positivity on the FNA may guide the diagnostic workup and therapeutic management, since it suggests an oropharyngeal origin.
Aquaporin‐1 expression in fluoro‐edenite‐induced mesothelioma effusions: An approach by cell‐block procedure
Authors: Angelico G. , Ieni A. , Caltabiano R. , Zeppa P. , Tuccari G.
Published: June 2018

Objective

Aquaporin 1 (AQP‐1) is a water channel protein found in cell membranes, whose expression has been considered an independent favourable prognostic factor in pleural malignant mesothelioma (MM). The aim of this study was to evaluate the expression of AQP‐1 and its prognostic value in a series of pleural MM effusions, from a geographical area with high concentrations of fluoro‐edenite (FE).

Methods

We selected 25 MM cases from Biancavilla (Italy), an area with high environmental concentrations of FE. Cytological samples, cell‐blocks (CB), clinical and follow‐up data were available for all cases. Immunohistochemistry for calretinin, CK5/6, WT1, CK7 and TTF1 was used on CB sections to confirm the cytological diagnosis of MM. Immunohistochemistry for AQP‐1 was performed and high expression was defined when ≥50% of tumour cells showed linear and circumferential membranous staining.

Results

The cohort included 16 men and nine women (median age: 67.5 years; range: 49‐88 years). The median survival was 14 months (range 1.5‐60 months), with a significant value (P = 0.006). All cases have been histologically confirmed and classified as epithelioid (16 cases), biphasic (seven cases) and sarcomatoid (two cases). AQP‐1 high expression has been observed in 16 cases. Comparing AQP‐1 high expression to the survival of corresponding patients, a significant association with a slight increased overall survival of 12 months has been demonstrated. Nine patients with a AQP‐1 score less than 50% showed a shorter median overall survival (7 months).

Conclusions

AQP‐1 high expression is detectable on cytological samples of FE‐induced MM with a prognostic value.
Foamy macrophages on cytosmear—The approach to diagnosis
Authors: Gochhait Debasis , Rangarajan Vidhyalakshmi , Subramanian Hema , Jacob Sajini Elizabeth , Siddaraju Neelaiah , Chandrasekhar Laxmisha
Published: June 2018

The authors form a quiz around an uncommon nodal infection which can easily be diagnosed by the alert mind because of the negative images in the background and inside the foamy macrophages.
Perceived support for medical cannabis use among approved medical cannabis users in Canada
Authors: Leos‐Toro Cesar , Shiplo Samantha , Hammond David
Published: June 2018

Introduction and Aims

Very little is known about the social experience of medical cannabis use, including the experience of stigma among approved users. The current study examined perceptions of support from physicians, family and friends as well as the prevalence of ‘hiding’ medicinal cannabis use.

Design and Methods

An online cross‐sectional survey (N = 276) was conducted from 29 April to 8 June 2015. No public sampling frame was available from which to sample approved medical cannabis users (MCU). Eligible respondents were approved MCUs, aged 18 years or older, and reported cannabis use in the past 30 days for health reasons. Logistic regression analyses were used to assess aspects of stigma, including perceived support from their immediate social environment as well as behaviours reflecting a perceived social disapproval.

Results

Approximately one‐third of respondents (32.6%) reported that their physician had refused to provide a medical document, and the vast majority of respondents (79.3%) reported hiding their medical cannabis use, most commonly to avoid judgement. Fewer than half of approved users perceived that their doctor was ‘supportive’ (38%), whereas two‐thirds perceived support from family (66.3%) and friends (66.3%). Perceptions of support were similar across most socio‐demographic sub‐groups.

Discussion and Conclusions

Substantial proportions of approved MCUs in Canada report a lack of support and most have made some effort to conceal their medical cannabis use. Overall, the findings suggest that social norms around medical cannabis use remain unfavourable for many users, despite that fact that medical cannabis has been legal in Canada for more than a decade.
The National Alcohol Strategy 2018–2026 has to become a set of commitments
Authors: Kypri Kypros , Thorn Michael , Crozier John
Published: June 2018

Alcohol consumption is behind only smoking and obesity among leading contributors to the burden of disease in Australia. For the first time in over a decade, Australian governments are developing a National Alcohol Strategy, and plan to finalise it in 2018. The draft contains evidence‐based recommendations but lacks a framework for accountability, and the Commonwealth Minister of Health recently suggested that the alcohol industry help devise the final version. We recommend that the Government rely on advice from health experts for health policy, pre‐specify outcome indicators, commit to modest activities initially, to develop momentum; and commission independent evaluation after 3 years.
S3 Guideline for the treatment of psoriasis vulgaris, update – Short version part 2 – Special patient populations and treatment situations
Authors: Nast Alexander , Amelunxen Lasse , Augustin Matthias , Boehncke Wolf‐Henning , Dressler Corinna , Gaskins Matthew , Härle Peter , Hoffstadt Bernd , Klaus Joachim , Koza Joachim , Mrowietz Ulrich , Ockenfels Hans‐Michael , Philipp Sandra , Reich Kristian , Rosenbach Thomas , Rzany Berthold , Schlaeger Martin , Schmid‐Ott Gerhard , Sebastian Michael , von Kiedrowski Ralph , Weberschock Tobias
Published: June 2018

The German guideline for the treatment of psoriasis vulgaris was updated using GRADE methodology. The guideline is based on a systematic literature review completed on December 1, 2016, and on a formal consensus and approval process. The second part of this short version of the guideline covers the following special patient populations and treatment situations: tuberculosis screening before and during psoriasis treatment, choice of psoriasis treatment for individuals wishing to have children, as well as during pregnancy and breast‐feeding, and patients with joint involvement and vaccinations. In addition, recommendations on the choice of treatment are presented for patients with the following comorbidities: hepatitis and other hepatic impairment, HIV, malignancies, neurological and psychiatric disorders, ischemic heart disease and congestive heart failure, diabetes mellitus, renal impairment and inflammatory bowel disease.
S3‐Leitlinie zur Therapie der Psoriasis vulgaris Update – Kurzfassung Teil 2 – Besondere Patientengruppen und spezielle Behandlungssituationen
Authors: Nast Alexander , Amelunxen Lasse , Augustin Matthias , Boehncke Wolf‐Henning , Dressler Corinna , Gaskins Matthew , Härle Peter , Hoffstadt Bernd , Klaus Joachim , Koza Joachim , Mrowietz Ulrich , Ockenfels Hans‐Michael , Philipp Sandra , Reich Kristian , Rosenbach Thomas , Rzany Berthold , Schlaeger Martin , Schmid‐Ott Gerhard , Sebastian Michael , von Kiedrowski Ralph , Weberschock Tobias
Published: June 2018

Die deutsche Psoriasis‐Leitlinie zur Behandlung der Psoriasis vulgaris wurde unter Verwendung der GRADE‐Methodik aktualisiert. Die Leitlinie wurde aufbauend auf einer systematischen Literaturrecherche (letzte Update‐Recherche am 01.12.2016) entwickelt und in einem formalen Konsensus‐ und Freigabeverfahren verabschiedet. Der zweite Teil dieser Kurzfassung stellt die Empfehlungen zum Tuberkulose‐Screening vor und unter Therapie, zur Therapieauswahl bei Kinderwunsch, Schwangerschaft und Stillzeit, vorliegender Gelenkbeteiligung sowie zum Umgang mit Impfungen dar. Zudem werden die Empfehlungen zur Therapieauswahl bei Komorbidität mit Hepatitis und Leberfunktionseinschränkungen, HIV, Tumorerkrankungen, Erkrankungen aus dem neurologischen und psychiatrischen Formenkreis, koronarer Herzkrankheit und Herzinsuffizienz, Diabetes mellitus, Niereninsuffizienz sowie chronisch entzündlicher Darmerkrankung dargestellt.
Protective effects of the SGLT2 inhibitor luseogliflozin on pancreatic β‐cells in db/db mice: The earlier and longer, the better
Authors: Kimura Tomohiko , Obata Atsushi , Shimoda Masashi , Okauchi Seizo , Kanda‐Kimura Yukiko , Nogami Yuka , Moriuchi Saeko , Hirukawa Hidenori , Kohara Kenji , Nakanishi Shuhei , Mune Tomoatsu , Kaku Kohei , Kaneto Hideaki
Published: June 2018

Aims

We compared the protective effects of sodium glucose co‐transporter (SGLT) 2 inhibitor luseogliflozin on pancreatic β‐cells between early and advanced stages of diabetes and between short‐ and long‐term use.

Materials and methods

Diabetic db/db mice were treated with luseogliflozin for 2 weeks in an early stage of diabetes (7‐9 weeks of age) and an advanced stage of diabetes (16‐18 weeks) for a longer period of time (7‐18 weeks). We performed various morphological analyses of pancreatic islets and examined gene expression profiles in islets after such treatment.

Results

In diabetic db/db mice, insulin biosynthesis and secretion were markedly increased by luseogliflozin in an early stage of diabetes but not in an advanced stage. In addition, β‐cell mass was preserved by luseogliflozin only in an early stage. Furthermore, when db/db mice were treated with luseogliflozin for a longer period of time, starting from an early stage, β‐cell function and mass were markedly preserved even after a longer period of time compared to untreated db/db mice.

Conclusion

Luseogliflozin exerts more protective effects in an early stage of diabetes compared to an advanced stage, and longer‐term use of luseogliflozin exerts more beneficial effects on pancreatic β‐cells compared to short‐term use.
User‐based evaluation of applicability and usability of a wearable accelerometer device for detecting bilateral tonic–clonic seizures: A field study
Authors: Meritam Pirgit , Ryvlin Philippe , Beniczky Sándor
Published: June 2018

Clinical validation studies of seizure detection devices conducted in epilepsy monitoring units (EMUs) can be biased by the artificial environment. We report a field (phase 4) study of a wearable accelerometer device (Epi‐Care) that has previously been validated in EMUs for detecting bilateral tonic–clonic seizures (BTCS). Seventy‐one patients using the device (or their caregivers) completed the modified Post‐Study System Usability Questionnaire. Median time patients had been using the device was 15 months (range = 24 days‐6 years). In 10% of cases, patients stopped using the device due to reasons related to the device. The median sensitivity (90%) and false alarm rate (0.1/d) were similar to what had been determined in EMUs. Patients and caregivers were overall satisfied with the device (median = 5.5 on the 7‐point Likert scale), considered the technical aspects satisfactory, and considered the device comfortable and efficient. Adverse effects occurred in 11%, but were only mild: skin irritation at the wrist and interference with home electronic appliances. In 55% the device influenced the number of seizures logged into the seizure diary, and in 40% it contributed to fewer seizure‐related injuries. This field study demonstrates the applicability and usability of the wearable accelerometer device for detecting BTCS.
Dead man walking? Current European interest in the ordoliberal tradition
Authors: Hien Josef , Joerges Christian
Published: June 2018

During the years of the financial crisis, ordoliberalism became the target of a European‐wide critical campaign. This school of thought is widely perceived as the ideational source of Germany's crisis politics, which has even led to an “ordoliberalisation of Europe”. This essay questions the validity of such assessments. It focuses on two aspects that are widely neglected in current debates. One is the importance of law in the ordoliberal vision of the ordering of economy and society. The second is its cultural and religious background, in particular in German Protestantism. The influence of the ordoliberal school on European law, so the essay argues, is overrated in all stages of the integration project. Anglo‐American neoliberalism rather than German ordoliberalism has been in the ideational driver's seat since the 1980s. In the responses to the financial crisis, the ordoliberal commitment to the rule of law gave way to discretionary emergency measures. While the foundational synthesis of economic and legal concepts became indefensible, the cultural underpinnings of the ordoliberal tradition survived and developed a life of their own, in particular in German political discourses.
Increased expression of IL‐33 in rosacea skin and UVB‐irradiated and LL‐37‐treated HaCaT cells
Authors: Suhng Eunah , Kim Bo Hee , Choi You Won , Choi Hae Young , Cho Hyunjin , Byun Ji Yeon
Published: June 2018

Rosacea is one of the most common dermatoses of adults. Although the detailed pathophysiology remains unknown, it is thought that rosacea is caused by a consistently aberrant, innate immune response, and that LL‐37 plays an important role. However, involvement of the inflammatory cytokine IL‐33 has not yet been studied. We explored the role played by IL‐33 in the pathophysiology of rosacea. First, we immunohistochemically evaluated the expression of IL‐33 and its receptor (ST2) in rosacea skin. Second, we exposed HaCaT cells to ultraviolet B (UVB) irradiation in the presence or absence of LL‐37 and measured the expression of proinflammatory cytokines including IL‐33. We also analysed VEGF (vascular endothelial growth factor) mRNA expression and protein release after costimulation of HaCaT cells by LL‐37 and IL‐33. Immunohistochemically, IL‐33 expression was enhanced in the skin of rosacea patients, especially with erythematotelangiectatic subtype. In vitro, UVB and LL‐37 synergistically increased mRNAs expression of proinflammatory cytokines, especially IL‐33 and IL‐1β. IL‐33 protein release was also synergistically increased by LL‐37 and UVB treatment. LL‐37 and IL‐33 stimulated VEGF mRNA expression and VEGF release from HaCaT cells. Our findings suggest that rosacea skin with abundant LL‐37 may robustly produce and release IL‐33 when exposed to UV radiation. IL‐33 may participate in the angiogenesis and vasodilation of rosacea skin by enhancing VEGF release.
The diagnostic accuracy of bleeding assessment tools for the identification of patients with mild bleeding disorders: A systematic review
Authors: Moenen F. C. J. I. , Nelemans P. J. , Schols S. E. M. , Schouten H. C. , Henskens Y. M. C. , Beckers E. A. M.
Published: June 2018

Introduction

The bleeding assessment tool (BAT) has been developed to standardize and interpret bleeding history for mild bleeding disorders. However, a critical appraisal addressing the quality and results of validation studies is lacking.

Aim

We performed a systematic review of diagnostic studies assessing the performance of the BAT in patients referred for evaluation of bleeding symptoms.

Methods

The electronic database PubMed was searched from inception through July 27, 2017. Eligible publications were original studies that assessed and validated the diagnostic accuracy of bleeding questionnaires for identification of adults with mild bleeding disorders. For each study, sensitivity, specificity and diagnostic odds ratio (DOR) were calculated. Quality was assessed using the Quality Assessment of Diagnostic studies‐2 tool. To assess the influence of specific study characteristics on DOR, univariate meta‐regression analyses were performed.

Results

Nine studies were included. Five studies investigating the ISTH‐BAT or other bleeding questionnaires had a moderate to low DOR. Four studies investigating Vicenza‐based BATs had a high DOR, with high specificity (>90%) and sensitivity of 59%‐85%. Study characteristics such as case‐control design, retrospective data collection and differences in reference standard were associated with optimistic estimates of diagnostic performance. Three of four studies with a high DOR had these study characteristics. Studies with good methodological quality mainly had a low DOR.

Conclusion

The main advantage of the BAT is that it offers a complete and structured interview. However, the BAT is of limited diagnostic value to the workup of patients referred for bleeding evaluation in clinical practice.
Head trauma in the haemophilic child and management in a paediatric emergency department: Descriptive study
Authors: García Sánchez P. , Molina Gutiérrez M. Á. , Martín Sánchez J. , Inisterra Viu L. , García García S. , Rivas Pollmar M. I. , Martín Salces M. , Álvarez Román M. T. , Jiménez Yuste V.
Published: June 2018

Introduction

Haemophilia is one of the most common inherited bleeding disorders in the Emergency Department (ED). The most dangerous site of bleeding is the central nervous system.

Aims

To describe the characteristics of haemophiliacs arrived to our ED following a head trauma and to analyse the incidence of intracranial haemorrhage (ICH).

Materials and Methods

Retrospective, analytical, observational study, conducted in a Paediatric ED. We included haemophilic patients aged from birth to 16 years who consulted after a head trauma over a 6‐year period. Data collected included age, type of haemophilia and head trauma, symptoms, prophylaxis status, CT imaging, treatment and number of visits to the ED.

Results

About 46 males and 85 episodes were analysed. The median age was 2.38 years. Severe haemophilia A was the most frequent type of disease (50%). All head injuries were mild, and the most frequent mechanism was a collision with an object (38.8%). In 62 episodes (72.9%) the patients were asymptomatic. The rest 23 events had symptomatology, being the most common headache (26%), emesis (21.7%) and drowsiness (17.4%). Head CT was obtained in 31 episodes, founding altered results in 10 (6 of them corresponding to ICH). All the patients with ICH had symptomatology. About 37 episodes required admission.

Conclusion

Intracranial haemorrhage is one of the most dangerous events in haemophiliacs and it may occur after a head trauma. Our study suggests that, in case of head trauma, CT must be obtained in symptomatic patients and in those with additional risk factors. Asymptomatic patients must have prolonged observation.
Retrospective study on outcome of salvage Helicobacter pylori eradication therapies based on molecular genetic susceptibility testing
Authors: Blümel Benjamin , Goelz Hanna , Kist Manfred , Glocker Erik‐Oliver
Published: June 2018

Background

Antimicrobial susceptibility of Helicobacter (H.) pylori is usually determined by phenotypic methods. When H. pylori cannot be grown owing to contaminations or delay in transport of gastric tissue samples to the microbiological laboratory, molecular genetic testing is a reasonable alternative. The aim of this retrospective study was to assess the outcome of salvage eradication treatments based on molecular genetic susceptibility testing.

Methods

Data on 144 H. pylori PCR‐positive gastric tissue samples of patients primarily with prior unsuccessful eradication treatments were retrospectively analyzed. Eradication treatments were recommended based on genotypic clarithromycin and/or levofloxacin susceptibility as tested by real‐time PCR or reverse hybridization. Treatment success was assessed by attending physicians using urea breath test; stool‐antigen ELISA; and microbiology/histopathology.

Results

Overall success rate of molecular genetic testing‐guided salvage treatments was low (68%); none of the regimens chosen was significantly better than another. Multivariable logistic regression analysis did not reveal any factors that may predict treatment failure.

Conclusions

Eradication success was poor despite susceptibility testing. Gastroenterologists are advised to prescribe recommended salvage treatments, considering recommended dosages and prolonged treatment duration.
Information literacy skills and training of licensed practical nurses in Alberta, Canada: results of a survey
Authors: Wadson Kelley , Phillips Leah Adeline
Published: June 2018

Background

Although information literacy skills are recognized as important to the curriculum and professional outcomes of two‐year nursing programs, there is a lack of research on the information literacy skills and support needed by graduates.

Objective

To identify the information literacy skills and consequent training and support required of Licensed Practical Nurses (LPNs) in Alberta, Canada.

Method

An online survey using a random sample of new graduates (graduated within 5 years) from the registration database of the College of Practical Nurses of Alberta (CLPNA).

Results

There was a 43% response rate. Approximately 25–38% of LPNs felt they were only moderately or to a small extent prepared to use evidence effectively in their professional practice. LPNs use the internet and websites most frequently, in contrast to library resources that are used least frequently. Developing lifelong learning skills, using information collaboratively, and locating and retrieving information are areas where LPNs desire more effective or increased training.

Conclusion

The results suggest there are significant gaps in the preparedness and ability of LPNs to access and apply research evidence effectively in the workplace. There are several areas in which the training provided by Librarians appears either misaligned or ineffective.
A MODEL OF PATENT TROLLS
Authors: Choi Jay Pil , Gerlach Heiko
Published: June 2018

This article develops a model of patent trolls to understand various litigation strategies employed by nonpracticing entities (NPEs). When an NPE faces multiple potential infringers who use related technologies, it can gain a credible threat to litigate even when it has no such credibility vis‐à‐vis any single potential infringer in isolation. This is due to an information externality generated by an early litigation outcome for subsequent litigation. Successful litigation creates an option value against future potential infringers through Bayesian updating. We discuss policy implications including legal fee shifting and the use of injunctive relief.
INFORMATION ASYMMETRY, MANUFACTURER–RETAILER CONTRACTS, AND TWO‐SIDED ENTRY
Authors: Chan Tat , Murphy Alvin , Wang Li
Published: June 2018

We investigate the economic determinants of contract structure and entry with transfer contracts, which specify that manufacturers directly sell their products in retail stores while retailers collect sales revenue and return a transfer to the manufacturers. Using a unique data set describing entry decisions of clothing manufacturers into a retail department store, we estimate a two‐sided, asymmetric‐information entry model. We compare profit estimates under transfer contracts to counterfactual profit estimates under common alternative contract formats. Results show that, when adverse selection is present, transfer contracts dominate other contract formats from the retailer's perspective; otherwise, the common alternative contract formats dominate.
Incidence of pemphigus vulgaris and pemphigus foliaceus in North‐East Poland (Podlaskie Province) – a 15‐year (2001–2015) bicentric retrospective study
Authors: Serwin Agnieszka B. , Koper Marta , Flisiak Iwona
Published: June 2018

Background

The average incidence of pemphigus reported from European countries ranged between 0.5 and eight cases per one million inhabitants. Studies on epidemiology of pemphigus group in entire Province of Poland over a period of more than a decade are lacking.

Aim

To analyze the incidence of pemphigus vulgaris (PV) and pemphigus foliaceus (PF) in Podlaskie Province (North‐East Poland) in years 2001–2015 with regard to patients’ age, gender, and residency.

Results

Sixty‐six cases of pemphigus were diagnosed in the period analyzed: 44 cases of PV (66.67%) and 22 of PF (33.33%). Female to male ratio was 2.88. The average incidence of PV and PF together was 3.67 ± 2.19 per one million inhabitants. In females the incidence was 5.34 ± 3.20 and in males, 1.90 ± 1.91 (P < 0.05). The incidence in inhabitants of rural areas was 4.96 ± 4.07 and those of urban areas, 2.70 ± 2.01 (P < 0.05). The age of the pemphigus onset was 54.69 ± 12.58 for PV and 64.24 ± 13.33 for PF (P < 0.05). The majority of PV and PF patients were residents of urban areas and rural areas, respectively.

Conclusions

The incidence of pemphigus group in Podlaskie Province was within the range of the average incidence rates reported from other European countries. Surprisingly, the female to male ratio was the highest in Europe. Moreover, for the first time we have demonstrated that the incidence was higher in the population living in rural than in urban areas. Similar studies in other regions of Poland are needed.
How many of 1829 antidepressant users report withdrawal effects or addiction?
Authors: Read John , Cartwright Claire , Gibson Kerry
Published: June 2018

More than 10% of adults are prescribed antidepressants annually in some countries. Recent increases in prescribing can be explained more by repeat prescriptions than new patients. This raises the question of whether antidepressants are addictive. A total of 1829 New Zealanders who had been prescribed antidepressants completed an online survey; 44% had been taking antidepressants for more than 3 years and were still taking them. Withdrawal effects when stopping medication were reported by 55%, and addiction by 27%. Paroxetine had particularly high rates of withdrawal symptoms. Only 1% of participants recalled being told about withdrawal effects when prescribed the drugs. Such high rates of withdrawal symptoms suggest that all concerned, including mental health nurses, need to help people considering antidepressants to understand that it can be difficult to withdraw from them. It will also be beneficial to closely monitor people already taking antidepressants and who are at risk of long‐term usage.
Morphology and function of the skin epithelium covering the giant keyhole limpet Megathura crenulata
Authors: Martin Gary G. , Bailey Abby K. , Cohen Seth , Loera Yeraldi , Crooke Anne M. , Stamnes Stephanie , Field Naomi , Natha Zain , Ramesh Nisha , Rose Kasey
Published: June 2018

Mucus‐secreting epithelia protect marine gastropods from abrasive particles and microbes in seawater. We studied the morphology and function of the epithelium in the giant keyhole limpet Megathura crenulata. All exposed surfaces of the limpets were covered by a mucus‐secreting, simple columnar epithelium, in which most cells on the sole of the foot bore cilia, while the majority of cells on the side of the foot and three mantle regions bore microvilli. None of the coatings had antibacterial properties. The epithelium of the foot was distinct from that of other regions, in that the mucus secreted was used for locomotion and was left behind as the limpet moved. The glycocalyx bound to the microvilli of the mantle cells appeared to be clean in visual and SEM examinations, and attempts to enhance the binding of inert particles and bacteria were unsuccessful. Because studies have shown that standard tissue processing may cause artifactual shrinkage of mucous layers, cryostat sections and additives to standard fixatives were tested, but we found no change in the thickness of the mucous layers of the limpets compared to routinely processed tissues. Sloughing of the glycocalyx in vertebrate systems removes bound microbes, and alterations of the glycocalyx layers are associated with disease conditions. Sloughing of the glycocalyx on limpets was rarely observed. In one case, the outer mantle of the limpet was covered with silt and the glycocalyx appeared to be detaching. This process could be experimentally induced by dousing the outer mantle with talc particles. The types of secretory cells producing the mucus in each region of the skin were characterized using standard histological stains and lectin staining. Because analysis was hampered by their small size, classification of the types of secretory cells was based on TEM descriptions of granule morphology, which allowed for comparison to the secretory cells described from skin of the abalone. The possible roles of the numerous secretions, and the mechanisms of mucus production and loss, are compared to what is known in vertebrate systems and to our relative lack of knowledge regarding invertebrate systems.
Diurnal foraging of a wild coral‐reef fish Parapercis australis in relation to late‐summer temperatures
Authors: Chase Tory John , Nowicki Jessica P. , Coker Darren J.
Published: June 2018

In situ observations of diurnal foraging behaviour of a common site‐attached shallow reef mesopredator Parapercis australis during late summer, revealed that although diet composition was unaffected by seawater temperature (range 28.3–32.4°C), feeding strikes and distance moved increased with temperature up to 30.5°C, beyond which they sharply declined, indicative of currently living beyond their thermal optimum. Diel feeding strikes and distance moved were however, tightly linked to ambient temperature as it related to the population's apparent thermal optimum, peaking at times when it was approached (1230 and 1700 h) and declining up to four fold at times deviating from this. These findings suggest that although this population may be currently living beyond its thermal optimum, it copes by down regulating energetically costly foraging movement and consumption and under future oceanic temperatures, these behavioural modifications are probably insufficient to avoid deleterious effects on population viability without the aid of long‐term acclimation or adaptation.
AGENCY CONFLICTS IN RESIDENTIAL MORTGAGE SECURITIZATION: WHAT DOES THE EMPIRICAL LITERATURE TELL US?
Authors: Frame W. Scott
Published: June 2018

Agency conflicts inherent in securitization are viewed as having been a key contributor to the recent financial crisis. A review of empirical research for the U.S. home mortgage market suggests that the problem may not have been securitization itself, but rather the origination and distribution of observably riskier loans. Low‐documentation mortgages, for which asymmetric information problems are acute, performed especially poorly during the crisis. Low‐documentation mortgages performed better when included in deals where issuers were affiliated with lenders or had reputational capital at stake. Investors priced low‐documentation loan risk via higher required equity tranches and security yields.
Parental experiences of family‐centred care from admission to discharge in the neonatal intensive care unit
Authors: Serlachius Anna , Hames Jessica , Juth Vanessa , Garton Dale , Rowley Simon , Petrie Keith J
Published: June 2018

Aim

It has been increasingly recognised that family‐centred care (FCC) is associated with enhanced well‐being for both parents and infants in paediatric settings, including the neonatal intensive care unit (NICU). Over the past 4 years, our NICU has increasingly adopted a collaborative philosophy of care. The purpose of the study was to examine parental experiences of FCC during both the admission and discharge time points in order to examine differences in parents’ experiences and identify areas for improvement.

Methods

We conducted interviews at two time points (admission and discharge) with 83 parents (mothers and fathers) of premature and medically fragile infants and analysed the data using thematic analysis.

Results

Three key themes (and sub‐themes) were identified: disempowerment, hierarchy between parents and staff and the father's peripheral role. The themes were equally prevalent across admission and discharge.

Conclusions

The challenges relating to FCC reported by parents at both admission and discharge represent some of the key barriers that parents still face in terms of being truly involved in the care of their infant in the NICU. Similar themes at both time points suggest that parents need equal amounts of support during their stay in NICU, irrespective of the level of care the infant is receiving and whether they are approaching discharge. Implications for improving FCC more generally are discussed.
Emergency department presentations of febrile children to an Australian public hospital
Authors: Bereznicki Bonnie J , Tucker Madeline GA , Beggs Sean A , Zosky Graeme R , Bereznicki Luke RE
Published: June 2018

Aim

We investigated the presentations of children with unspecified fever to an Australian emergency department (ED): (i) to determine the proportion of these presentations that could be classified as potentially avoidable and (ii) to identify factors associated with an increased risk of hospital admission.

Methods

This study retrospectively identified and described children aged <6 years who presented to the Royal Hobart Hospital (Tasmania, Australia) ED with unspecified fever (ICD‐10‐AM code R50.9) between January 2013 and December 2015, using data from the ED information system and digital medical records. The Australian Institute of Health and Welfare method was used to estimate the number of potentially avoidable general practitioner‐type presentations. Predictors of hospital admission were determined using multivariate logistic regression.

Results

A total of 459 patients aged <6 years presented to the ED with a primary diagnosis description of unspecified fever. Of these, 30.7% were classed as potentially avoidable general practitioner‐type presentations. Overall, 26.1% of presentations resulted in admission to hospital. Administration of intravenous fluids in the ED and a longer treat time were identified as significant predictors of a child with non‐specific fever being admitted to hospital. Older age, administration of antipyretics in the ED and presentations triaged as semi‐urgent and non‐urgent significantly reduced the probability of admission.

Conclusions

To our knowledge, this is the first Australian study that has assessed the impact of unspecified childhood fever on an Australian ED. Further investigation of presentations classified as potentially avoidable is warranted to investigate whether these could be managed in the primary care setting.
Contributions toward understanding the biodiversity of Passiflora in North America: Updates and a new combination from the Baja California Peninsula, Mexico and vicinity
Authors: Svoboda Harlan T. , Harris AJ
Published: June 2018

The Baja California Peninsula and surrounding landmasses harbor an abundant flora in an otherwise harsh and arid environment. Of the many plant groups native to this peninsular and insular region, passionflowers (Passiflora, Passifloraceae) are represented by several conspicuous taxa that all belong to a single lineage, section Dysosmia. Basic questions remain regarding this group, particularly the taxonomic status among the Passiflora arida complex. Therefore, we investigated the claims of endemism, habitat characteristics, and taxon boundaries with in section Dysosmia in the Baja California region using extensive sampling of herbarium specimens and iNaturalist observations. We confirmed that only one of the native Passiflora taxa (P. fruticosa) was endemic to the Baja California Peninsula, with an additional taxon (P. palmeri) considered near‐endemic. Environmental data revealed significant distinctions between the habitats of many of the native taxa as well as within the P. arida complex, especially with respect to precipitation and temperature tolerances. Geometric morphometric analyses of leaf shape were largely not successful at separating taxa, indicating leaf shape may not be a good indicator of taxon identity in this particular group. Based on ecological differences and discrete macro‐ and micromorphological features, a varietal name is here synonymized and a new combination is proposed: Passiflora pentaschista.
Exploring the impact of experimental sleep restriction and sleep deprivation on subjectively perceived sleep parameters
Authors: Maric Angelina , Bürgi Manuel , Werth Esther , Baumann Christian R. , Poryazova Rositsa
Published: June 2018

We aimed to investigate the effect of increased sleep pressure and shortened sleep duration on subjective sleep perception in relation to electroencephalographic sleep measures. We analyzed the data from a study in which 14 healthy male volunteers had completed a baseline assessment with 8 hr time in bed, a sleep deprivation (40 hr of wakefulness) and a sleep restriction protocol with 5 hr time in bed during 7 nights. In this work, we assessed perception index, derived through dividing the subjectively perceived total sleep time, wake after sleep onset and sleep latency duration by the objectively measured one at each condition. We found that total sleep time was subjectively underestimated at baseline and shifted towards overestimation during sleep restriction and after deprivation. This change in accuracy of subjective estimates was not associated with any changes in sleep architecture or sleep depth. Wake after sleep onset was significantly underestimated only during sleep restriction. Sleep latency was always overestimated subjectively without any significant change in this misperception across conditions. When comparing accuracy of subjective and actimetry estimates, subjective estimates regarding total sleep time and wake after sleep onset deviated less from electroencephalography derived measures during sleep restriction and after deprivation. We conclude that self‐assessments and actimetry data of patients with chronic sleep restriction should be interpreted cautiously. The subjectively decreased perception of wake after sleep onset could lead to overestimated sleep efficiency in such individuals, whereas the underestimation of sleep time and overestimation of wake after sleep onset by actimetry could lead to further underestimated sleep duration.
Teaching about endangered languages in the undergraduate curriculum
Authors: Hildebrandt Kristine A.
Published: June 2018

This paper is a case study of the development and teaching of a course on language endangerment and death, including related topics like language preservation, language revitalization and revival, and the historical, socio‐cultural, economic, and political factors behind the recent exacerbation of the depletion of global linguistic diversity. This case study also demonstrates how students can learn to apply methods of evaluating primary and secondary sources towards constructing a web‐based, digital exhibit that explores the story behind endangerment of a specific language. Underlying this case study is the argument that such a course is equally as critical to undergraduate linguistics and general education. It builds on critical discipline‐specific skills and also offers opportunities for broader cross‐disciplinary inquiry and acquisition of professional skills for undergraduate students as young global citizens.
Enterococcus adhesin PrgB facilitates type IV secretion by condensation of extracellular DNA
Authors: Kohler Verena , Keller Walter , Grohmann Elisabeth
Published: June 2018

Conjugative type IV secretion systems (T4SSs) are multi‐protein complexes in Gram‐negative and Gram‐positive (G+) bacteria, responsible for spreading antibiotic resistances and virulence factors among different species. Compared to Gram‐negative bacteria, which establish close contacts for conjugative transfer via sex pili, G+ T4SSs are suggested to employ surface adhesins instead. One example is pCF10, an enterococcal conjugative sex‐pheromone responsive plasmid with a narrow host range, thus disseminating genetic information only among closely related species. This MicroCommentary is dedicated to the crystal structure of the pCF10‐encoded adhesion domain of PrgB presented by Schmitt et al. The authors show in their work that this adhesion domain is responsible for biofilm formation, tight binding and condensation of extracellular DNA (eDNA) and conjugative transfer of pCF10. A sophisticated two‐step mechanism for highly efficient conjugative transfer is postulated, including the formation of PrgB‐mediated long‐range intercellular contacts by binding and establishment of shorter‐range contacts via condensation of eDNA. PrgB binding to lipoteichoic acid on the recipient cell surface stabilizes junctions between the mating partners. The major findings by Schmitt et al. will be brought into a broader context and potential medical applications targeting eDNA as essential component in biofilm formation and conjugation will be discussed.
Does life have meaning, or is it self‐deception at best and terrifyingly absurd at worst?
Authors: Ruse Michael
Published: June 2018

A discussion of the meaning of life takes many twists and turns in an exploration of what great minds from several centuries have had to say regarding this question.
Whole‐genome sequencing in a pair of monozygotic twins with discordant cleft lip and palate subtypes
Authors: Takahashi Masahiro , Hosomichi Kazuyoshi , Yamaguchi Tetsutaro , Nagahama Ryo , Yoshida Hiroshi , Maki Koutaro , Marazita Mary L. , Weinberg Seth M. , Tajima Atsushi
Published: June 2018

Objective

Orofacial clefts (OFCs) are common and etiologically complex birth defects. This study explored potential genetic differences in a pair of Japanese monozygotic (MZ) twins with different forms of OFC using whole‐genome sequencing.

Subjects and Methods

One co‐twin (MZ‐1) presented with nonsyndromic bilateral cleft lip and palate; the other co‐twin (MZ‐2) had nonsyndromic bilateral cleft lip and unilateral left‐sided cleft alveolus. Neither parent had an OFC. Craniofacial morphologic features and potential genetic differences were compared using standard cephalometry and whole‐genome sequencing, respectively.

Results

Morphologically, MZ‐1 had a smaller vertical mandibular height, compared to MZ‐2. However, no discordant genetic differences were detected. Moreover, both twins and their parents harbored rare candidate gene variants (GRHL3; TPM1) considered to be associated with OFCs.

Conclusion

The observed differences between MZ‐1 and MZ‐2 in craniofacial morphology assessed by cephalograms might be directly attributable to the effects of the OFC on growth and/or differences in surgical history, given the lack of any differences in genetic background. However, comparisons of discordant MZ twins should continue to identify novel candidates that might control OFC or that might partly explain the missing heritability for this common birth defect, in addition to understanding craniofacial growth and development.
Infinite idealizations in physics
Authors: Shech Elay
Published: June 2018

In this essay, I provide an overview of the debate on infinite and essential idealizations in physics. I will first present two ostensible examples: phase transitions and the Aharonov–Bohm effect. Then, I will describe the literature on the topic as a debate between two positions: Essentialists claim that idealizations are essential or indispensable for scientific accounts of certain physical phenomena, while dispensabilists maintain that idealizations are dispensable from mature scientific theory. I will also identify some attempts at finding a middle ground between the essentialists and dispensabilists camps. Finally, I will raise questions for future research on essential and infinite idealizations via the notion of exploration.
A Defence of the Indispensability of Metaphor
Authors: González de Prado Salas Javier
Published: June 2018

I argue for the possibility of the thesis that metaphors are indispensable for grasping and expressing certain propositions. I defend this possibility against the objection that, if metaphors express propositions, once these propositions are identified they should be specifiable by non‐metaphorical means. I argue that this objection loses its strength if one adopts a Wittgensteinian, particularist view of thought, according to which grasping a propositional thought requires the ongoing exercise of a suitable skill often not characterizable by algorithmic rules. Within this particularist framework, thus, it becomes possible that metaphorical skills have an indispensable role in cognition and communication.
Is population genetic structure of vascular plants shaped more by ecological or geographic factors? A study case on the Mediterranean endemic Centaurea filiformis (Asteraceae)
Authors: Farris E. , Filigheddu R. , Mameli G. , Falanga V. , Vanetti I. , Rosati L. , Binelli G.
Published: June 2018

All known populations of the Sardinian endemic Centaurea filiformis Viv. (Asteraceae) were studied in order to understand the impact of both geographic and ecological factors on the genetic structuring of this species.

Fourteen populations and 234 individuals were sampled. The demographic structure of the populations and the reproductive ecology were estimated in 28 plots. Population genetic analyses were based on SSR markers. Genetic structure was investigated by spatial Bayesian methods.

Average densities of 0.51 individuals m−2 were detected, with a prevalence of adults. Ten species of pollinators were identified; C. filiformis ability to self‐pollinate and myrmecochory were demonstrated experimentally. The populations displayed an average heterozygosity value of He = 0.576 and high genetic differentiation (overall FST = 0.218). Bayesian analysis suggests that five is the most probable number of gene pools of origin. A strong correlation between geographic distances and genetic distances among populations was highlighted.

The demographic population structure of C. filiformis is dominated by adults, suggesting that it is a stable‐regressive or senile species, investing more in local persistence than colonisation ability. Despite the scattered distribution, the populations studied do not present evidence of genetic erosion. The analysis of genetic differentiation reveals very high differentiation levels among populations, thus indicating that effective barriers exist against gene flow. A general conclusion is that population distribution results in a clear genetic structure for the populations studied, and that geography and not ecology is shaping the present distribution of this species.