bluuebunny/crossref_metadata_2025 huggingface dataset:
How Can Released State Test Items Support Interim Assessment Purposes in an Educational Crisis?
Authors: Klugman Emma M. , Ho Andrew D.
Published: September 2020

State testing programs regularly release previously administered test items to the public. We provide an open‐source recipe for state, district, and school assessment coordinators to combine these items flexibly to produce scores linked to established state score scales. These would enable estimation of student score distributions and achievement levels. We discuss how educators can use resulting scores to estimate achievement distributions at the classroom and school level. We emphasize that any use of such tests should be tertiary, with no stakes for students, educators, and schools, particularly in the context of a crisis like the COVID‐19 pandemic. These tests and their results should also be lower in priority than assessments of physical, mental, and social–emotional health, and lower in priority than classroom and district assessments that may already be in place. We encourage state testing programs to release all the ingredients for this recipe to support low‐stakes, aggregate‐level assessments. This is particularly urgent during a crisis where scores may be declining and gaps increasing at unknown rates.
Algorithms for complex interval‐valued q‐rung orthopair fuzzy sets in decision making based on aggregation operators, AHP, and TOPSIS
Authors: Garg Harish , Ali Zeeshan , Mahmood Tahir
Published: September 2020

The interval‐valued q‐rung orthopair fuzzy set (IVq‐ROFS) and complex fuzzy set (CFS) are two generalizations of the fuzzy set (FS) to cope with uncertain information in real decision making problems. The aim of the present work is to develop the concept of complex interval‐valued q‐rung orthopair fuzzy set (CIVq‐ROFS) as a generalization of interval‐valued complex fuzzy set (IVCFS) and q‐rung orthopair fuzzy set (q‐ROFS), which can better express the time‐periodic problems and two‐dimensional information in a single set. In this article not only basic properties of CIVq‐ROFSs are discussed but also averaging aggregation operator (AAO) and geometric aggregation operator (GAO) with some desirable properties and operations on CIVq‐ROFSs are discussed. The proposed operations are the extension of the operations of IVq‐ROFS, q‐ROFS, interval‐valued Pythagorean fuzzy, Pythagorean fuzzy (PF), interval‐valued intuitionistic fuzzy, intuitionistic fuzzy, complex q‐ROFS, complex PF, and complex intuitionistic fuzzy theories. Further, the Analytic hierarchy process (AHP) and technique for order preference by similarity to ideal solution (TOPSIS) method are also examine based on CIVq‐ROFS to explore the reliability and proficiency of the work. Moreover, we discussed the advantages of CIVq‐ROFS and showed that the concepts of IVCFS and q‐ROFS are the special cases of CIVq‐ROFS. Moreover, the flexibility of proposed averaging aggregation operator and geometric aggregation operator in a multi‐attribute decision making (MADM) problem are also discussed. Finally, a comparative study of CIVq‐ROFSs with pre‐existing work is discussed in detail.
It takes a village to build illegality: Minorities' noncompliance as manifestation of distrust
Authors: Gofen Anat , Cohen‐Blankshtain Galit , Ibraheem Maram
Published: September 2020

Often portrayed as social resistance fueled by authorities' discrimination and legal racism, minorities' noncompliance is considered to undermine the current order and commonly ascribed to distrust in government. To better understand noncompliance as a manifestation of distrust, this article focuses on the well‐documented violation of planning, building, and property laws among the Israeli‐Arab minority, who consistently exemplify distrust in government. Differing from current research, our analysis explores what facilitates noncompliance on‐the‐ground, draws on face‐to‐face interviews with 30 Arab‐Israeli offenders who built their houses illegally, and uses the noncompliant behavior as the unit of analysis. In contrast to the common idiosyncratic portrayal of noncompliance, illegal building emerged as depending on a threefoldcollectiveeffort: institutional, social, and practical. Uncovering collective support mechanisms for noncompliance suggests that distrust in government is compensated by trust in informal arrangements, thus raising new dilemmas around where personal responsibilities end and public ones begin.
3. FROM ENVIRONMENTAL CASE STUDY TO ENVIRONMENTAL KIN STUDY
Authors: KANNGIESER ANJA , TODD ZOE
Published: September 2020

This article explores the relationships among place, knowing, and being in environmental histories. Grounding ourselves in the work of Indigenous scholars from North America and the Pacific, we propose a method of listening and attuning that can attend to the dislocation and abstraction often found in work addressing ecocide and environmental violence. Against the ubiquity of the case‐study approach, we propose a method we call “kin study,” which invites more embedded, expansive, material, and respectful relations to people and lands. This article frames the issues and then proposes, though a dialogue, how kin studies may be constituted and applied in studying environmental histories of the Pacific and Western Canada.
HISTORY WRITING WITHOUT CLOSURE
Authors: Grever Maria
Published: September 2020

In The Work of History: Constructivism and a Politics of the Past, Kalle Pihlainen pays tribute to Hayden White's work on narrative constructivism through a comprehensive and critical evaluation of his work. The book's seven chapters are based on previously published and reworked essays, starting with Pihlainen's 2013 essay on narrative truth and ending with his 2006 essay on the confines of the form. The Work of History is timely in light of some world political leaders’ apparent immunity to facts, their use of history, and the role of power, as Pihlainen also discusses the ethics and politics of historical constructivism (xiii). At the same time, the book is “a meta‐critical enterprise,” as White states in his foreword (x): it scrutinizes and explains White's work and its reception, including the debates on the production of knowledge, the ontological status of historiography, the various representations of history, and the kinds of audiences historians envision. Although narrative constructivism seems a bit passé, Pihlainen wants to further elaborate this theoretical approach to disentangle and explain some fundamental misconceptions about it that still exist among historians. One misconception is that constructivism inherently neglects the ethical impulse and supposedly lacks the potential for political engagement. Pihlainen urges historians and theorists to find ways of becoming politically committed in their writings and to challenge their readers to do the same.
Short‐ and medium‐term prognosis of HIV‐infected patients receiving intensive care: a Brazilian multicentre prospective cohort study
Authors: Andrade HB , da Silva IRF , Ramos GV , Medeiros DM , Ho YL , de Carvalho FB , Bozza FA , Japiassú AM
Published: September 2020

Objectives

The characteristics of critically ill HIV‐positive patients and the causes of their admission to intensive care units (ICUs) are only known through retrospective and unicentric studies. This study aims to fill this knowledge gap.

Methods

This is a prospective, multicentre cohort study of short‐ and medium‐term prognostic factors. The setting consisted of ICUs of three tertiary referral hospitals from the three largest metropolitan areas in Brazil in the period January 2014 to November 2015. In all, 161 HIV patients over 18 years old were included.

Results

The clinical data of the outcomes (ICU mortality, hospital mortality and 90‐day survival) were extracted from medical records using the REDCap®️ web‐based form and analysed with the MedCalc®️ application. Median age was 41.7 [interquartile range (IQR): 34–50] years, the Simplified Acute Physiologic Score 3 (SAPS 3) was 64 (IQR: 56–74), and the Sequential Organ Failure Assessment Score (SOFA) was 6 (IQR: 4–9) points. The main causes of admission were sepsis (54.5%) and acute respiratory failure (13.7%). ICU and hospital mortality rates were 32.3% and 40.4%, respectively. In a multivariate analysis, time until ICU admission ≥ 3 days (P = 0.0013), performance status (Eastern Cooperative Oncology Group score, P = 0.0344), coma (Glasgow Coma Scale ≤ 8 points, P = 0.0213) and sepsis (P = 0.0003) were associated with increased hospital mortality. Coma (P = 0.0002) and sepsis (P = 0.0008) were independently associated with 90‐day survival.

Conclusions

Delayed ICU admission and the severity of critical illness determine the short‐ and medium‐term mortality rates of HIV‐infected patients admitted to the ICU, rather than factors associated with HIV infection. These results suggest that prognostic factors of HIV‐infected patients in the ICU are similar to those of non‐HIV‐infected populations.
Chemical and mechanical influence of root canal irrigation on biofilm removal from lateral morphological features of simulated root canals, dentine discs and dentinal tubules
Authors: Pereira T. C. , Dijkstra R. J. B. , Petridis X. , Sharma P.K. , van de Meer W. J. , van der Sluis L. W. M. , de Andrade F. B.
Published: September 2020

Aim

To investigate the anti‐biofilm efficacy of irrigation using a simulated root canal model, the chemical effect of irrigants against biofilms grown on dentine discs and their impact on biofilm viscoelasticity, the efficacy of the irrigants in decontaminating infected dentinal tubules and the capacity of bacteria to regrow.

Methodology

Biofilm removal, viscoelastic analysis of remaining biofilms and bacterial viability were evaluated using a simulated root canal model with lateral morphological features, dentine discs and a dentinal tubule model, respectively. Experiments were conducted using a two‐phase irrigation protocol. Phase 1: a modified salt solution (RISA) and sodium hypochlorite (NaOCl) were used at a low flow rate to evaluate the chemical action of the irrigants. Ultrasonic activation (US) of a chemically inert solution (buffer) was used to evaluate the mechanical efficacy of irrigation. Phase 2: a final irrigation with buffer at a high flow rate was performed for all groups. Optical coherence tomography (OCT), low load compression testing (LLCT) and confocal scanning laser microscopy analysis were used in the different models. One‐way analysis of variance (anova) was performed for the OCT and LLCT analysis, whilst Kruskal–Wallis and Wilcoxon ranked tests for the dentinal tubule model.

Results

US and high flow rate removed significantly more biofilm from the artificial lateral canal. For biofilm removal from the artificial isthmus, no significant differences were found between the groups. Within‐group analysis revealed significant differences between the steps of the experiment, with the exception of NaOCl. For the dentine discs, no significant differences regarding biofilm removal and viscoelasticity were detected. In the dentinal tubule model, NaOCl exhibited the greatest anti‐biofilm efficacy.

Conclusions

The mechanical effect of irrigation is important for biofilm removal. An extra high flow irrigation rate resulted in greater biofilm removal than US in the artificial isthmus. The mechanical effect of US seemed to be more effective when the surface contact biofilm–irrigant was small. After the irrigation procedures, the remaining biofilm could survive after a 5‐day period. RISA and NaOCl seemed to alter post‐treatment remaining biofilms.
Dental nerves: a neglected mediator of pulpitis
Authors: Zhan C. , Huang M. , Yang X. , Hou J.
Published: September 2020

As one of the most densely innervated tissues, the dental pulp contains abundant nerve fibres, including sensory, sympathetic and parasympathetic nerve fibres. Studies in animal models and human patients with pulpitis have revealed distinct alterations in protein expression and histological appearance in all types of dental nerve fibres. Various molecules secreted by neurons, such as classical neurotransmitters, neuropeptides and amino acids, not only contribute to the induction, sensitization and maintenance of tooth pain, but also regulate non‐neuronal cells, including fibroblasts, odontoblasts, immune cells and vascular endothelial cells. Dental nerves are particularly important for the microcirculatory and immune responses in pulpitis via their release of a variety of functional substances. Further, nerve fibres are found to be involved in dental soft and hard tissue repair. Thus, understanding how dental nerves participate in pulpitis could have important clinical ramifications for endodontic treatment. In this review, the roles of dental nerves in regulating pulpal inflammatory processes are highlighted and their implications for future research on this topic are discussed.
The role of hydrogen sulphide signalling in macrophage activation
Authors: Sun Fei , Luo Jia‐Hui , Yue Tian‐Tian , Wang Fa‐Xi , Yang Chun‐Liang , Zhang Shu , Wang Xin‐Qiang , Wang Cong‐Yi
Published: September 2020

Hydrogen sulphide (H2S) is the latest identified small gaseous mediator enabled by its lipophilic nature to freely permeate the biological membranes. Initially, H2S was recognized by its roles in neuronal activity and vascular relaxation, which makes it an important molecule involved in paracrine signalling pathways. Recently, the immune regulatory function of gasotransmitters, H2S in particular, is increasingly being appreciated. Endogenous H2S level has been linked to macrophage activation, polarization and inflammasome formation. Mechanistically, H2S‐induced protein S‐sulphydration suppresses several inflammatory pathways including NF‐κB and JNK signalling. Moreover, H2S serves as a potent cellular redox regulator to modulate epigenetic alterations and to promote mitochondrial biogenesis in macrophages. Here in this review, we intend to summarize the recent advancements of H2S studies in macrophages, and to discuss with focus on the therapeutic potential of H2S donors by targeting macrophages. The feasibility of H2S signalling component as a macrophage biomarker under disease conditions would be also discussed.
Candida albicans and candidalysin in inflammatory disorders and cancer
Authors: Ho Jemima , Camilli Giorgio , Griffiths James S. , Richardson Jonathan P. , Kichik Nessim , Naglik Julian R.
Published: September 2020

As our understanding of mycology progresses, the impact of fungal microbes on human health has become increasingly evident. Candida albicans is a common commensal fungus that gives rise to local and systemic infections, particularly in immunocompromised patients where it can result in mortality. However, C. albicans has also been quietly linked with a variety of inflammatory disorders, to which it has traditionally been considered incidental; recent studies may now provide new aspects of these relationships for further consideration. This review provides a novel perspective on the impact of C. albicans and its peptide toxin, candidalysin, on human health, exploring their contributions to pathology within a variety of diseases.
Saudi service users’ perceptions and experiences of the quality of their mental health care provision in the Kingdom of Saudi Arabia (KSA): A qualitative inquiry
Authors: Al Mousa Yaqoub , Callaghan Patrick , Michail Maria , Caswell Glenys
Published: September 2020

This paper presents, as part of a larger mixed‐methods design, a study generating a theoretical understanding of issues pertinent to the quality of mental health care in the KSA from the perspective of those using services. Semi‐structured interviews were undertaken with thirty service users admitted to inpatient psychiatric wards, using an interview guide developed by the researchers, based on relevant literature. Findings from the thematic analysis showed five themes: (1) The hospital as a prison: a custody versus care dilemma, (2) quality of interactions between staff and service users, (3) quality of services, (4) staff qualities and (5) suggestions for achieving quality of care. A theoretical model drawing upon Donabedian Health Care Model for Evaluating quality of care and the Andersen Behavioural Model of Health Service Use is evident from the data. Structural aspects of care include staff experience and qualifications and key enablers around social and financial support, service users’ health needs and status and the physical infrastructure and ward rules. These drive processes of care based upon robust rates of interaction between staff and service users and appear central to quality of mental health care in KSA. Quality of mental health care in KSA is manifested by a therapeutic ethos with a high degree of interaction between professional carers and service users, with the former being highly educated, competent, compassionate, with a high degree of self‐awareness, and specialized in mental health. We have uncovered elements of Fanon and Azoulay’s ‘Cultural Originality’ as well as contemporary examples of Goffman’s mortification of the self.
Overrepresentation of South Asian ethnic groups among cases of influenza A(H1N1)pdm09 during the first phase of the 2009 pandemic in England
Authors: Trienekens Suzan C. M. , Shepherd Wendi , Pebody Richard G. , Mangtani Punam , Cleary Paul
Published: September 2020

Background

During the first wave of the influenza A(H1N1)pdm09 pandemic in England in 2009, morbidity and mortality were higher in patients of South Asian (Indian, Pakistani or Bangladeshi) ethnic minority groups.

Objectives

This study aims to provide insights in the representation of this group among reported cases, indicating susceptibility and exposure.

Methods

All laboratory‐confirmed cases including basic demographic and limited clinical information that were reported to the FluZone surveillance system between April and October 2009 were retrieved. Missing ethnicity data were imputed using the previously developed and validated South Asian Names and Group Recognition Algorithm (SANGRA). Differences between ethnic groups were calculated using chi‐square, log‐rank and t tests and rate ratios. Geographic clustering was compared using Ripley's K functions.

Results

SANGRA identified 2447 (28%) of the total of 8748 reported cases as South Asian. South Asian cases were younger (P < .001), more often male (P = .002) and more often from deprived areas (P < .001) than cases of other ethnic groups. Time between onset of symptoms and laboratory sampling was longer in this group (P < .001), and they were less often advised antiviral treatment (P < .001), however, declined treatment less. The highest cumulative incidence was seen in the West Midlands region (32.7/10 000), London (7.0/10 000) and East of England region (5.7/10 000).

Conclusions

People of South Asian ethnic groups were disproportionally affected by the first wave of the influenza pandemic in England in 2009. The findings presented contribute to further understanding of demographic, socioeconomic and ethnic factors of the outbreak and inform future influenza preparedness to ensure appropriate prevention and care.
Solving the winner determination problem in combinatorial auctions for fractional ownership of autonomous vehicles
Authors: Takalloo Mahdi , Bogyrbayeva Aigerim , Charkhgard Hadi , Kwon Changhyun
Published: September 2020

The introduction of autonomous vehicles (AVs) to consumer markets will expedite the trend of car sharing and enable co‐owning or co‐leasing a car. In this paper, we consider a combinatorial auction market for fractional ownership of AVs, which is unique in two aspects. First, items are neither predefined nor discrete; rather, items are continuous time slots defined by bidders. Second, the spatial information of bidders should be incorporated within the winner determination problem (WDP) so that sharing a vehicle is indeed a viable plan. The consideration of spatial information increases the computational complexity significantly. We formulate the WDP, which plays a critical role in various auction designs and pricing schemes, for both discrete‐ and continuous‐time settings. In terms of social welfare maximization, we show that the continuous‐time model is superior to the discrete‐time model. We provide a conflict‐based reformulation of the continuous‐time model, for which we develop an effective solution approach based on a heuristic and maximal clique based reformulations. Using samples of the 2010–2012 California Household Travel Survey, we verify that the proposed solution methods provide effective computational tools for the combinatorial auction with bidder‐defined items.
Topical cannabis‐based medicines – A novel paradigm and treatment for non‐uremic calciphylaxis leg ulcers: An open label trial
Authors: Maida Vincent , Shi Runjie B. , Fazzari Francesco G. T. , Zomparelli Lydia
Published: September 2020

Non‐Uremic Calciphylaxis (NUC) is a rare condition that often manifests as intractable and painful integumentary wounds, afflicting patients with a high burden of co‐morbidity. The Endocannabinoid System (ECS) is a ubiquitous signalling system that is theorised to be dysregulated within wound beds and associated peri‐wound tissues. Preclinical research has shown that the dominant chemical classes derived from the cannabis plant, cannabinoids, terpenes, and flavonoids, interact with the integumentary ECS to promote wound closure and analgesia. This is a prospective open label cohort study involving two elderly Caucasian females with recalcitrant NUC leg ulcers of greater than 6 months duration. Topical Cannabis‐Based Medicines (TCBM) composed of cannabinoids, terpenes, and flavonoids were applied daily to both the wound bed and peri‐wound tissues until complete wound closure was achieved. Wounds were photographed regularly, and the digital images were subjected to planimetric analysis to objectively quantify the degree of granulation and epithelization. Analgesic utilisation, as a surrogate/proxy for pain scores, was also tracked. The cohort had a mean M3 multimorbidity index score of 3.31. Complete wound closure was achieved in a mean of 76.3 days. Additionally, no analgesics were required after a mean of 63 days. The treatments were well tolerated with no adverse reactions. The positive results demonstrated in very challenging wounds such as NUC, among highly complex patients, suggest that TCBM may have an even broader role within integumentary and wound management. This treatment paradigm warrants being trialled in other wound types and classes, and ultimately should be subjected to randomised controlled trials.
Whey research
Authors: Evans E. W.
Published: September 2020

The composition of whey is briefly discussed and less well‐known areas for research on whey are highlighted. On whole whey solids aspects of lactose intolerance and of whey taint require attention. Lactose derivatives, the flavour‐binding quality of lactose, and its precise behaviour in dough require sudy. A long‐shot application for binding fines in steelmaking forms the subject of an American specification. Whey proteins, with or without chemical or physical modification, in human foods require study of functional properties. The high nutrient density of whey proteins suit them for the so‐called prudent diet foods. The importance of lactoperoxidase as part of a bactericidal system in the gut of neonates is stressed. Further research is required on fractionation of proteins by membrane processes and ion‐exchange.
Comparable, but distinct: Perceptions of primary care provided by physicians and nurse practitioners in full and restricted practice authority states
Authors: Moldestad Megan , Greene Preston A. , Sayre George G. , Neely Emily L. , Sulc Christine A. , Sales Anne E. , Reddy Ashok , Wong Edwin S. , Liu Chuan‐Fen
Published: September 2020

Aims

To understand patients’ and providers’ perceptions of primary care delivered by nurse practitioners (NPs) in the Veterans Affairs Healthcare System.

Design

Qualitative exploratory study (in convergent mixed‐methods design).

Methods

Semi‐structured interviews in 2016 with primary care providers and patients from facilities in states with full and restricted practice authority for NPs. Patient sample based on reassignment to: (a) a NP; or (b) a different physician following an established physician relationship. Data were analysed using content analysis.

Results

We interviewed 28 patients, 17 physicians and 14 NPs. We found: (a) NPs provided more holistic care than physicians; (b) patients were satisfied with NPs; and (c) providers’ professional experience outweighed provider type.

Conclusions

Patients’ preferences for NPs (compared with prior physicians) contributed to perceptions of patient centredness. Similarities in providers’ perceptions suggest NPs and physicians are both viable providers for primary care.

Impact

Nurse Practitioners (NPs): practice authority

Veterans Affairs Health care: nurse practitioners will continue to be a viable resource for primary care delivery

United States Health care: challenges notions patients may not be satisfied with care provided by NPs and supports expanding their use to provide much‐needed access to primary care services; expanding Full Practice Authority would allow states to provide acceptable primary care without diminishing patient or provider experiences
The European Union's ‘Potential We’ between Acceptance and Contestation: Assessing the Positioning of Six Eastern Partnership Countries*
Authors: Vieira Alena
Published: September 2020

The present contribution analyses the European neighbourhood policy and the Eastern Partnership (EaP), which celebrated its tenth anniversary in 2019, from the perspective of social identity theory. It is argued that the evolution of both the European neighbourhood policy and the EaP corresponds to the emergence of a distinct EU identity: its ‘potential we’, which has been defying the Russian ‘significant we’ extended to the EaP states. Drawing on the framing analysis of strategic documents and statements, which identifies eight distinct themes, the contribution ascertains three different patterns of EaP states’ interaction with the EU: Georgia, Moldova and Ukraine accepting the ‘EU's potential we’, Armenia holding to the potential we, and Azerbaijan, as well as Belarus, contesting the potential we.
Dysregulation of genes and microRNAs in localized aggressive periodontitis
Authors: Gonçalves Fernandes Jussara , Morford Lorri Ann , Harrison Peter Lloyd , Kompotiati Theodora , Huang Hong , Aukhil Ikramuddin , Wallet Shannon Margaret , Macchion Shaddox Luciana
Published: September 2020

Aim

Previous data from our laboratory have demonstrated that localized aggressive periodontitis (LAP) patients produce elevated levels of pro‐inflammatory cytokines in response to TLR4 and TLR2 ligation compared to unrelated and periodontally healthy controls (HC). The aim of the present work is to evaluate the contribution of TLR‐related gene expression and miRNA regulation in LAP disease.

Material and methods

Peripheral blood mononuclear cells (PBMCs) from LAP and health control (HC) patients were isolated. Gene and miRNA expression involved in TLR signalling pathway and immunopathology were evaluated in unstimulated PBMCs by real‐time PCR (RT‐PCR).

Results

TICAM‐1 (TRIF), FOS, IRAK1, TLR2 and CCL2 genes and the miRNAs miR‐9‐5p, miR‐155‐5p and 203a‐3p, miR‐147a, miR‐182‐5p and miR‐183‐5p were significantly up‐regulated in LAP compared to HC.

Conclusions

Most of the genes and miRNAs overexpressed here are directly or indirectly related to immune response and inflammation. This profile supports our previous findings that suggests LAP patients have a “hyper‐responsive” phenotype upon activation of TLR pathway by periodontal pathogens.
Commentary: What conflicts of interest tell us about autism intervention research—a commentary on Bottema‐Beutel et al. (2020)
Authors: Dawson Michelle , Fletcher‐Watson Sue
Published: September 2020

Abstract

Bottema‐Beutel, Crowley, Sandbank, and Woynaroski (Journal of Child Psychology and Psychiatry, 2020) have performed a Herculean and invaluable task in their investigation of conflicts of interest (COIs) in nonpharmacological early autism intervention research. Drawing on a meta‐analysis of 150 articles reporting group designs, they found COIs in 105 (70%), only 6 (5.7%) of which had fully accurate COI statements. Most reports had no COI statements, but among the 48 (32%) which did, the majority of those declaring no COIs had detectable COIs (23 of 30; 77%). Thus, COI reporting in the literature examined is routinely missing, misleading, and/or incomplete; accurate reporting is the exception rather than the rule. That 120 of the 150 reports were published in 2010 or later, compared to 6 pre‐2000, tells us this is not about practices confined to decades past. Instead, it reflects and is a telling indictment of established standards in autism intervention research.
Applying systems and complexity science to real patient care
Authors: Ramshaw Bruce
Published: September 2020

Aims and objectives

To describe the application of systems and complexity science principles to real patient care.

Rationale

Our current global health care system is not sustainable. It is structured based on the principles of reductionist science, which was discovered and developed over the past 400 to 600 years. Because of increasing pace of change and increasing complexity in our world, we have increased fragmentation in our health care system leading to more harm and waste. Over 100 years ago, the principles of systems, or complexity, science were discovered, first in the discipline of physics. These principles accommodate the constant change and biologic variability in our world. While reductionist principles would be applicable in a static, mechanical world where parts of the system could be isolated, this does not exist in the real biologic world.

Methods

For the past decade, our abdominal wall hernia team has been applying the principles of systems science to real patient care. Some of the tools we have applied include continuous quality improvement for whole hernia patient processes and non‐linear analytical tools to gain insight to improve value‐based outcomes. Until we learn to apply and scale these principles across our whole global health care system, we will continue to suffer the consequences of our current unsustainable system.

Results

We have learned that the application of systems and complexity science to real patient care can lead to lower costs and better outcomes in the context of patients with complex hernia problems. However, these concepts have not yet been adopted in our global health care system.

Conclusion

Applying the principles of systems and complexity science to our global health care system has the potential to lower costs and improve patient outcomes for any patient care process to which it is applied.
Current flood risk management practices in Ghana: Gaps and opportunities for improving resilience
Authors: Almoradie Adrian , de Brito Mariana Madruga , Evers Mariele , Bossa Aymar , Lumor Mawuli , Norman Charlotte , Yacouba Yira , Hounkpe Jean
Published: September 2020

This article evaluates the current gaps and describes opportunities for improving flood risk management (FRM) in Ghana, West Africa. A mixed‐method participatory approach comprising questionnaires, workshops, interviews with key stakeholders, and a systematic literature review were employed. Existing problems, discourses, FRM practices, and opportunities to enhance flood resilience were identified. They provided the basis for outlining potential research directions into ways of tracking these challenges. The results show how different actors perceive FRM in Ghana. The stakeholders interviewed have different, and even contradictory perceptions of the effectiveness of FRM, which are embedded in their diverse storylines. The findings show that Ghana's FRM is still reactive rather than preventive and that research in the field of quantitative hazard and risk assessment is still rudimentary. FRM policies and flood early warning systems (FEWS) are in place, but efforts should be directed towards their implementation and monitoring, investigation of social and technical capacity aspects, and enhancement of institutions’ mandates, and coordination. Moreover, the findings illustrate that FRM is moving toward a more constructive engagement of citizens and stakeholders. However, policies and action plans need to consider more inclusive community participation in planning and management to effectively improve their resilience and develop sustainable solutions.
The Arabidopsis phosphatase PP2C49 negatively regulates salt tolerance through inhibition of AtHKT1;1
Authors: Chu Moli , Chen Pengwang , Meng Sufang , Xu Peng , Lan Wenzhi
Published: September 2020

Type 2C protein phosphatases (PP2Cs) are the largest protein phosphatase family. PP2Cs dephosphorylate substrates for signaling in Arabidopsis, but the functions of most PP2Cs remain unknown. Here, we characterized PP2C49 (AT3G62260, a Group G PP2C), which regulates Na+ distribution under salt stress and is localized to the cytoplasm and nucleus. PP2C49 was highly expressed in root vascular tissues and its disruption enhanced plant tolerance to salt stress. Compared with wild type, the pp2c49 mutant contained more Na+ in roots but less Na+ in shoots and xylem sap, suggesting that PP2C49 regulates shoot Na+ extrusion. Reciprocal grafting revealed a root‐based mechanism underlying the salt tolerance of pp2c49. Systemic Na+ distribution largely depends on AtHKT1;1 and loss of function of AtHKT1;1 in the pp2c49 background overrode the salt tolerance of pp2c49, resulting in salt sensitivity. Furthermore, compared with plants overexpressing PP2C49 in the wild‐type background, plants overexpressing PP2C49 in the athtk1;1 mutant background were sensitive to salt, like the athtk1;1 mutants. Moreover, protein–protein interaction and two‐voltage clamping assays demonstrated that PP2C49 physically interacts with AtHKT1;1 and inhibits the Na+ permeability of AtHKT1;1. This study reveals that PP2C49 negatively regulates AtHKT1;1 activity and thus determines systemic Na+ allocation during salt stress.
N4‐methylcytidine ribosomal RNA methylation in chloroplasts is crucial for chloroplast function, development, and abscisic acid response in Arabidopsis
Authors: Tieu Ngoc Le Nguyen , Jung Park Su , Thi Huong Trinh , Lee Kwang Ho , Kang Hunseung
Published: September 2020

Although the essential role of messenger RNA methylation in the nucleus is increasingly understood, the nature of ribosomal RNA (rRNA) methyltransferases and the role of rRNA methylation in chloroplasts remain largely unknown. A recent study revealed that CMAL (for Chloroplast
mr
aW‐
Like) is a chloroplast‐localized rRNA methyltransferase that is responsible for N4‐methylcytidine (m4C) in 16S chloroplast rRNA in Arabidopsis thaliana. In this study, we further examined the role of CMAL in chloroplast biogenesis and function, development, and hormone response. The cmal mutant showed reduced chlorophyll biosynthesis, photosynthetic activity, and growth‐defect phenotypes, including severely stunted stems, fewer siliques, and lower seed yield. The cmal mutant was hypersensitive to chloroplast translation inhibitors, such as lincomycin and erythromycin, indicating that the m4C‐methylation defect in the 16S rRNA leads to a reduced translational activity in chloroplasts. Importantly, the stunted stem of the cmal mutant was partially rescued by exogenous gibberellic acid or auxin. The cmal mutant grew poorer than wild type, whereas the CMAL‐overexpressing transgenic Arabidopsis plants grew better than wild type in the presence of abscisic acid. Altogether, these results indicate that CMAL is an indispensable rRNA methyltransferase in chloroplasts and is crucial for chloroplast biogenesis and function, photosynthesis, and hormone response during plant growth and development.
Dopamine‐induced interactions of female mouse hypothalamic proteins with progestin receptor‐A in the absence of hormone
Authors: Acharya Kalpana D. , Nettles Sabin A. , Lichti Cheryl F. , Warre‐Cornish Katherine , Dutan Polit Lucia , Srivastava Deepak P. , Denner Larry , Tetel Marc J.
Published: September 2020

Neural progestin receptors (PR) function in reproduction, neural development, neuroprotection, learning, memory and the anxiety response. In the absence of progestins, PR can be activated by dopamine (DA) in the rodent hypothalamus to elicit female sexual behaviour. The present study investigated mechanisms of DA activation of PR by testing the hypothesis that proteins from DA‐treated hypothalami interact with PR in the absence of progestins. Ovariectomised, oestradiol‐primed mice were infused with a D1‐receptor agonist, SKF38393 (SKF), into the third ventricle 30 minutes prior to death. Proteins from SKF‐treated hypothalami were pulled‐down with glutathione S‐transferase‐tagged mouse PR‐A or PR‐B and the interactomes were analysed by mass spectrometry. The largest functional group to interact with PR‐A in a DA‐dependent manner was synaptic proteins. To test the hypothesis that DA activation of PR regulates synaptic proteins, we developed oestradiol‐induced PR‐expressing hypothalamic‐like neurones derived from human‐induced pluripotent stem cells (hiPSCs). Similar to progesterone (P4), SKF treatment of hiPSCs increased synapsin1/2 expression. This SKF‐dependent effect was blocked by the PR antagonist RU486, suggesting that PR are necessary for this DA‐induced increase. The second largest DA‐dependent PR‐A protein interactome comprised metabolic regulators involved in glucose metabolism, lipid synthesis and mitochondrial energy production. Interestingly, hypothalamic proteins interacted with PR‐A, but not PR‐B, in an SKF‐dependent manner, suggesting that DA promotes the interaction of multiple hypothalamic proteins with PR‐A. These in vivo and in vitro results indicate novel mechanisms by which DA can differentially activate PR isoforms in the absence of P4 and provide a better understanding of ligand‐independent PR activation in reproductive, metabolic and mental health disorders in women.
Postnatal ossification sequences inAcrocephalus scirpaceusandChroicocephalus ridibundus(Aves: Neognathae): The precocial–altricial spectrum and evolution of compound bones in birds
Authors: Skawiński Tomasz , Borczyk Bartosz , Hałupka Lucyna
Published: September 2020

Although the development of the avian skeleton has attracted considerable attention, most of the studies have been concentrated on the embryonic period, while studies on the postnatal period are rare. We studied the postnatal development of the skeleton in two phylogenetically distant birds, an altricial passerineAcrocephalus scirpaceusand a semiprecocial charadriiformChroicocephalus ridibundus. The neonates of the former, despite being altricial, have well‐ossified skeleton—the degree of development approaches that of the semiprecocial gull. However, after hatching the limb bones (particularly those of the hind limb) ossify earlier in the gull which is probably related to faster acquisition of locomotor abilities. We have observed that, in contrast to previous reports from neognathous birds, in the ankle of the gull, the ascending process fuses with the astragalus rather than with the calcaneum. This type of development is present in palaeognaths and nonavian dinosaurs but has not yet been reported in neognaths. This indicates a greater diversity within Neognathae and suggests a more complex scenario for the evolution of the avian ankle. However, data from a greater number of species are needed to establish the developmental sequence ancestral for neognathous birds. Furthermore, the sequence of bone fusions in the wrist ofAcrocephalusis similar to the fossil‐documented evolutionary sequence observed in the phylogeny of early birds, with the semilunate carpal and major metacarpal fusing first, followed by the alular metacarpal fusing with the major metacarpal and then the major and minor metacarpal fusing proximally. These data underscore the importance of developmental studies for reconstructing the evolutionary history.
Discourse Dynamics and Cultural Context in the Antiwar Movement in the United States (2002–2004)
Authors: Sánchez Estellés Isis M. , Sánchez‐Pinilla Mario Domínguez
Published: September 2020

This paper addresses the impact of the antiwar movement (2002–2004) in the United States by analysis the three main coalitions at that time: ANSWER, UFPJ and Win Without War. New concepts and tools have been provided within discourse theory that can improve the analysis of framing and impact. Furthermore, the failure in discourse dynamics of the antiwar movement (2002–2004) is analyzed with a qualitative approach. Finally, we study the cultural context of 9/11, demonstrating that the best analysis for culture might not be ideational and static but, rather, contextual and dynamic.
Comparative Study of Dimensional Stability and Detail Reproduction of Reformulated and Nonreformulated Elastomeric Impression Materials
Authors: Aivatzidou Konstantina , Kamalakidis Savvas N. , Emmanouil Ioannis , Michalakis Konstantinos , Pissiotis Argirios L.
Published: September 2020

Purpose

To evaluate the dimensional stability and the detail reproduction of five current elastomeric impression materials in vitro.

Materials and Methods

The materials examined were: 3 different polyether impression materials, a vinyl polysiloxane impression material, and a vinyl polyether silicone impression material. All impression materials were of a medium viscosity. One stainless steel die was fabricated according to the ANSI/ADA specification no.19 criteria. Twenty impressions of this die were made for each material. Dimensional accuracy and surface detail were evaluated 24 hours after making the impressions using a measuring microscope. The data were analyzed using Welch's analysis of variance, Games‐Howell Post‐Hoc, and the Pearson's chi‐square tests (α = 0.05).

Results

Statistical differences were observed in the mean percent dimensional stability (F [4,47] = 39, p < 0.001) of the tested impression materials. The highest dimensional change was recorded for the vinyl polysiloxane impression material, with a mean percent value of –0.09 ± 0.02% (p < 0.001). The lowest dimensional change was recorded for the Monophase polyether material with a mean percent value of –0.03 ± 0.01% (p < 0.038). The best surface detail reproduction results were obtained using the Monophase polyether material (90% acceptable impressions), with no significant differences (χ² [4] = 3.86, p = 0.483) observed between the Monophase and the rest impression materials.

Conclusions

All materials exhibited acceptable dimensional stability, well below the ANSI/ADA specification no.19 standard of ≤0.5% dimensional change. All impression materials demonstrated acceptable surface detail reproduction with no significant differences between them.
Training Professionals to Facilitate Future Planning for Aging Caregivers: Exploratory Results From a Multistate Intervention
Authors: Owen Aleksa , Stober Kaitlin , Crabb Caitlin , Mahar Elizabeth , Heller Tamar
Published: September 2020

Planning for the future is important for individuals with intellectual and/or developmental disabilities (I/DD) and their families. When caregivers are no longer able to provide support, individuals with I/DD may experience loss of services or benefits, residential or employment‐related disruption, or other adverse consequences. Up until now, most future planning related interventions and approaches have been focused on directly supporting families and individuals with I/DD. We present findings from a training intervention designed for professionals who work with individuals with I/DD and their families, suggesting that future planning be included in service provision and community outreach. Training participants increased their confidence in helping families plan and their likelihood to take action after participating in a 1‐day training. We discuss the implications of developing disability professionals as allies and resources to families as they engage in future planning activities.
Macroevolutionary patterns in European vegetation
Authors: Lososová Zdeňka , Divíšek Jan , Chytrý Milan , Götzenberger Lars , Těšitel Jakub , Mucina Ladislav
Published: September 2020

Question

Habitat‐specific species pools are shaped by ecological and evolutionary processes such as speciation, extinction, and migration. However, their role is poorly known because of the lack of robust data on species pools across a large number of plant community types and large areas. Here, we analyse a unique dataset of species pools of diagnostic species for all European vegetation types, asking: (a) what are the patterns of phylogenetic structure and phylogenetic beta‐diversity across European vegetation types and biomes; (b) what are the drivers of these patterns; and (c) is there a signal of niche conservatism at the level of biomes and broad categories of vegetation types?

Location

Europe, Canary Islands, Madeira, Azores, Cyprus, Caucasus, Iceland and Greenland.

Methods

We built a dataset comprising 10,804 vascular plant species (almost 85% of the European flora) assigned to 106 vegetation types representing all European vegetated habitats, grouped into 11 biomes. This dataset represented habitat‐specific species pools. We analysed the phylogenetic structure of the species pools and related it to distribution range sizes of individual vegetation types, their successional status, levels of disturbance and environmental stress.

Results

In European vegetation, phylogenetic overdispersion is associated with late‐successional habitats: several forest types, aquatic vegetation, and rock‐cliff vegetation serve as depositories of relict lineages. In contrast, phylogenetic clustering is typical of early successional and disturbed vegetation in anthropogenic, coastal and saline habitats, and in open‐canopy Mediterranean vegetation. The phylogenetic similarity of vegetation types is higher within than between broad categories of vegetation types and biomes.

Conclusions

The variable phylogenetic structure of European vegetation types is a heritage of evolutionary processes in the Tertiary and Quaternary. Habitat‐specific species pools of different vegetation types and biomes have been formed by different evolutionary processes as indicated by the observation that certain clades are significantly associated with certain vegetation types or biomes, hence indicating the phylogenetic niche conservatism.
Mixed‐sex offspring produced via cryptic parthenogenesis in a lizard
Authors: Kratochvíl Lukáš , Vukić Jasna , Červenka Jan , Kubička Lukáš , Johnson Pokorná Martina , Kukačková Dominika , Rovatsos Michail , Piálek Lubomír
Published: September 2020

Facultative parthenogenesis in vertebrates is believed to be exceptional, and wherever documented, it always led to single‐sex progeny with genome‐wide homozygosity. We report the first challenge to this paradigm: frequent facultative parthenogenesis in the previously assumed sexually reproducing tropical night lizard Lepidophyma smithii results in offspring of both sexes and preserves heterozygosity in many loci polymorphic in their mothers. Moreover, we documented a mixture of sexually and parthenogenetically produced progeny in a single clutch, which documents how cryptic a facultative parthenogenesis can be. Next, we show that in the studied species, 1) parthenogenetically produced females can further reproduce parthenogenetically, 2) a sexually produced female can reproduce parthenogenetically, 3) a parthenogenetically produced female can reproduce sexually, and 4) a parthenogenetically produced male is fully fertile. We suggest that facultative parthenogenesis should be considered even in vertebrates with frequent males and genetically variable, heterozygous offspring.