bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome-wide Expression Profiling and Pathway Analysis in Cyclic Stretched Human Trabecular Meshwork Cells
Authors: Drewry Michelle D. , Cai Jingwen , Helwa Inas , Hu Eric , Liu Sabrina , Mu Hongmei , Hu Yanzhong , Johnson William M. , Gonzalez Pedro , Stamer W. Daniel , Liu Yutao
Published: August 2018

Purpose

Regulation of intraocular pressure is dependent upon homeostatic responses of trabecular meshwork (TM) cells to mechanical stretch. Despite the important roles of miRNAs in regulating TM function and aqueous outflow, it remains unclear how miRNA and their target genes interact in response to physiological cyclic mechanical stretch. We aimed to identify differentially expressed miRNAs and their potential targets in human TM cells in response to cyclic mechanical stress.

Methods

Monolayers of TM cells from non-glaucomatous donors (n=3-6) were cultured in the presence or absence of 15% mechanical stretch, 1 cycle/s, for 6 or 24-hours using computer-controlled Flexcell Unit. We profiled the expression of 800 miRNAs using NanoString Human miRNA assays and identified differentially expressed miRNAs using the Bioconductor Limma package. We identified differentially expressed genes using Operon Human Oligo Arrays with GeneSpring software. Pathway analysis with WebGestalt identified stretch-related pathways. We used Integrative miRNA Target Finder from Ingenuity Pathway Analysis to identify potential miRNA-mRNA regulations.

Results

We identified 540 unique genes and 74 miRNAs with differential expression in TM cells upon cyclic mechanical stretch. Pathway analysis indicated the significant enrichment of genes involved in Wnt-signaling, receptor protein serine/threonine kinase signaling, TGF-β pathway, and response to unfolded protein. We also identified several miRNA master regulators, including miR-19b-3p and miR-93-5p, which may act as switches to control several mechano-responsive genes.

Conclusions

This study suggests that cyclic mechanical stress of TM cells triggers alterations in the expression of both mRNAs and miRNAs implicated in glaucoma-associated pathways.
A conceptual model for e-textbook creation based on proposed characteristics
Authors: Pešut Darija
Published: August 2018

Purpose

This paper is part of an extensive research conducted as part of a doctoral thesis. The purpose of this paper is to collect and present the comprehensive list of e-textbook characteristics acquired from research in the English as a foreign language (EFL) subject area in Croatian higher education and present a useful checklist in the form of a conceptual model for e-textbook creation.

Design/methodology/approach

Literature was reviewed with the aim of collecting published e-textbook characteristics which were then combined with the characteristics obtained from research data. The data were collected through four distinct online questionnaires on the Survey Monkey platform.

Findings

Teaching EFL requires the use of different materials, authentic and specifically published for this purpose. The research results are used to discuss the possibility of blending all materials into one electronically published unit by considering the proposed e-textbook characteristics. The presented conceptual model for e-textbook creation can be used as a foundation for e-textbook design and evaluation in all subject fields.

Originality/value

The paper presents a list of e-textbook characteristics as an extensive list which can be applied in e-textbook design and evaluation in any subject field.
Real‐world use of apremilast for patients with psoriasis in Japan
Authors: Kishimoto Megumi , Komine Mayumi , Hioki Tomoyuki , Kamiya Koji , Sugai Junichi , Ohtsuki Mamitaro
Published: August 2018

Apremilast is a novel oral phosphodiesterase 4 inhibitor effective for psoriasis. It regulates the production of pro‐inflammatory mediators. Apremilast was approved in December 2016 in Japan; however, its efficacy and safety in a real‐world setting among Japanese patients have not been reported. We report on 44 patients treated with apremilast between March and October 2017. The median treatment duration was 25 weeks (range, 2–33). Thirty‐five patients (79.5%) continued the drug for at least 23 weeks, and five (11.4%) achieved a Psoriasis Area and Severity Index 100 response within 12 weeks. Nine patients discontinued the drug within 24 weeks mainly due to insufficient efficacy (n = 3) and adverse events (n = 4). Seven patients continued their previous systemic therapies such as cyclosporin (n = 1), methotrexate (n = 1), etretinate + methotrexate (n = 1) and biologics (n = 4) combined with apremilast. Of these patients, 55.9% had at least one adverse event although no severe adverse events. The most common adverse event was diarrhea (31.8%), followed by nausea (25.0%), headache (13.6%), abdominal discomfort (6.8%) and vomiting (6.8%). The proportion of diarrhea in our patients was higher than those of previous clinical trials. Among 10 patients with psoriatic arthritis, apremilast did not improve joint pain in nine (90%). To investigate the relationship between treatment efficacy and plaque size, we defined a small plaque as an individual rash diameter of 1 inch or less. The efficacy of apremilast was greater in patients with small plaques than in patients with large plaques.
The Quiet‐Loud‐Quiet Politics of Post‐Crisis Consumer Bankruptcy Law: The Case of Ireland and the Troika
Authors: Spooner Joseph
Published: August 2018

A decade after the Global Financial Crisis, many developed economies continue to strain under excessive household debt. This article presents evidence suggesting that the failure of policymakers to enact debt relief measures may lie in the superior influence of the coordinated and concentrated financial sector over legislative processes, as compared to the diffuse and disorganised interests of consumer debtors. Post‐crisis popular interest in technical issues of personal insolvency law created only a narrow space of political opportunity. Soon these questions returned to the domain of technocratic actors and corporate influence. The article examines this situation through an inter‐disciplinary case study of consumer bankruptcy reform in Ireland under ‘Troika’ supervision. Proposals initially billed as assisting over‐indebted households developed into increasingly creditor‐friendly legislation in ‘quieter’ stages of technocratic decision‐making. The stark implications of these findings highlight obstacles to resolving household debt problems and consequent risks of economic and political instability.
The effect of unilateral tubal block diagnosed by hysterosalpingogram on clinical pregnancy rate in intrauterine insemination cycles: systematic review and meta‐analysis
Authors: Tan J , Tannus S , Taskin O , Kan A , Albert AY , Bedaiwy MA
Published: August 2018

Background

Fallopian tube occlusion is a common cause of infertility, but the effect of unilateral tubal block (UTB) on pregnancy rates (PR) after controlled ovarian hyperstimulation and intrauterine insemination (COH‐IUI) remains controversial.

Objective

To evaluate PR after COH‐IUI among infertile women with proximal and distal UTB diagnosed by hysterosalpingogram (HSG), compared against women with bilateral patent tubes experiencing unexplained infertility.

Search strategy

We searched EMBASE, MEDLINE, Google Scholar, Cochrane Library, and PUBMED from inception to 14 January 2018.

Selection criteria

Studies that report PR/cycle or cumulative PR among women with UTB and controls were included.

Data collection and analysis

Two authors independently selected and extracted study characteristics and data. Methodological quality was assessed using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines.

Main results

Among 2965 patients and 5749 IUI cycles across ten studies, no significant difference in PR/cycle (odds ratio, OR = 0.88; 95% confidence interval, 95% CI = 0.69–1.12) and cumulative PR (OR = 0.80, 95% CI = 0.62–1.04) was observed. Patients with proximal UTB demonstrated similar PR/cycle (OR = 1.06, 95% CI = 0.68–1.66) and cumulative PR (OR = 1.10, 95% CI = 0.75–1.62), compared with controls, whereas patients with distal UTB had significantly lower cumulative PR (OR = 0.49, 95% CI = 0.25–0.97, P = 0.04). Patients with proximal block also demonstrated significantly improved cumulative PR, compared with patients with distal block (OR=2.41, 95% CI = 1.37–4.25, P = 0.002).

Conclusion

Infertile patients with proximal UTB diagnosed by HSG can expect similar pregnancy rates after COH‐IUI, compared with those with bilateral tubal patency and unexplained infertility, whereas patients with distal UTB have lower odds of pregnancy. These differences may reflect inherent diagnostic limitations of HSG or differences in underlying pathologies.

Tweetable abstract

Meta‐analysis evaluates pregnancy outcomes after COH‐IUI in women with unilateral tubal block diagnosed by HSG.
Discrimination Between Infant and Adult Bloodstains Using Micro‐Raman Spectroscopy: A Preliminary Study
Authors: Fujihara Junko , Nishimoto Naoki , Yasuda Toshihiro , Takeshita Haruo
Published: August 2018

In the present study, we used micro‐Raman spectroscopy with high‐resolution analysis to discriminate between bloodstains from infants and bloodstains from adults. Raman peaks were detected at 674, 754, 976, 1002, 1105, 1127, 1176, 1248, 1340, 1368, 1390, 1560, and 1611 cm−1; these peaks were derived from hemoglobin, albumin, and glucose. However, a peak was obtained at 1105 cm−1, which was assigned to histidine; this peak was observed only for bloodstains from adults. Human adult hemoglobin (HbA) is composed of an α2β2 tetramer structure, whereas human fetal hemoglobin (HbF) is composed of an α2γ2. Therefore, the lack of a Raman peak at 1105 cm−1 in bloodstains from infants indicates the possibility of two histidine substitutions (His116Ile and His143Ser) in the γ chain of HbF. This study discriminates between bloodstains from infants and bloodstains from adults using micro‐Raman spectroscopy, with beneficial implications in forensic science.
Review article: Best practice management of neck pain in the emergency department (part 6 of the musculoskeletal injuries rapid review series)
Authors: Strudwick Kirsten , McPhee Megan , Bell Anthony , Martin‐Khan Melinda , Russell Trevor
Published: August 2018

Neck pain and whiplash injuries are a common presentation to the ED, and a frequent cause of disability globally. This rapid review investigated best practice for the assessment and management of musculoskeletal neck pain in the ED. PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites, were searched in 2017. Primary studies, systematic reviews and guidelines were considered for inclusion. English‐language articles published in the past 12 years addressing acute neck pain assessment, management or prognosis in the ED were included. Data extraction was conducted, followed by quality appraisal to rate levels of evidence where possible. The search revealed 2080 articles, of which 51 were included (n = 22 primary articles, n = 13 systematic reviews and n = 16 guidelines). Consistent evidence was found to support the use of ‘red flags’ to screen for serious pathologies, judicious use of imaging through clinical decision rule application and promotion of functional exercise coupled with advice and reassurance. Clinicians may also consider applying risk‐stratification methods, such as using a clinical prediction rule, to guide patient discharge and referral plans; however, the evidence is still emerging in this population. This rapid review provides clinicians managing neck pain in the ED a summary of the best available evidence to enhance quality of care and optimise patient outcomes.
Review article: Do inferior vena cava filters prevent pulmonary embolism in critically ill trauma patients and does the benefit outweigh the risk of insertion? A narrative review article
Authors: Moynihan Gerard V , Koelzow Heike
Published: August 2018

Venous thromboembolic disease (VTE) increases the risk of mortality in trauma patients. To decrease the occurrence of VTE, low dose anticoagulants are commonly prescribed. This may be unacceptable in trauma patients who have a high risk of bleeding. Inferior vena cava (IVC) filters can be employed as an alternative strategy to decrease the risk of pulmonary embolism (PE). Insertion of an IVC filter is an invasive procedure that has a range of complications. The benefits of IVC filter insertion must be compared to its risk of complications in each individual patient. A search of the literature since 2005 was conducted on MEDLINE, Evidence‐Based Medicine Reviews, Cochrane Central Register of Controlled Trials and Embase. The clinical question posed was does prophylactic IVC filter insertion decrease the risk of PE in trauma patients? The available evidence was low level and unable to definitively answer this question. The majority of articles infer that IVC filter insertion is safe and may decrease the risk of PE. However, there is a need for well‐designed randomised controlled trials to be conducted in this area.
Carotid ultrasound findings in rheumatoid arthritis and control subjects: A case‐control study
Authors: Wah‐Suarez Martin I. , Galarza‐Delgado Dionicio A. , Azpiri‐Lopez Jose R. , Colunga‐Pedraza Iris J. , Abundis‐Marquez Estefania E. , Davila‐Jimenez Jose A. , Guillen‐Gutierrez Cinthia Y. , Elizondo‐Riojas Guillermo
Published: August 2018

Abstract Rheumatoid arthritis (RA) is a chronic, inflammatory disease closely linked with atherosclerosis. Recommended cardiovascular disease (CVD) integral evaluation includes screening for asymptomatic atherosclerosis plaques with carotid ultrasound (US). The aim of this study is to evaluate the carotid US characteristics, including carotid intima media thickness (cIMT) and carotid plaque (CP), and compare RA‐patients and controls in a Mexican‐mestizo population.

Method

Prospective cross‐sectional, observational study comparing RA‐patients and matched controls without RA. Medical history and physical exam was performed in all subjects by a rheumatologist and two clinical blinded radiologists did the carotid US. Increased cIMT was defined as ≥0.9 mm. CP was defined as a focal narrowing ≥0.5 mm of the surrounding lumen or a cIMT ≥1.2 mm. Multivariable analysis was done comparing RA‐patients and control subjects characteristics with carotid US.

Result

In the final analysis 209 patients were included, 103 patients with RA and 106 controls. Bilateral CP was found more than twice in RA than controls (15.5% vs 6.6%). Unilateral CP was more common in either side evaluated, being heterogeneous plaques the most common in RA‐patients. The prevalence of increased cIMT was found higher in RA‐patients either in both sides (right 37.9% vs 15.1%, P = 0.00; left 43.7% vs 19.8%, P = 0.00) were statistically significant.

Conclusion

It was confirmed that RA‐patients have greater subclinical atherosclerosis represented in the carotid US measuring cIMT and CP as surrogates. RA‐patients with subclinical atherosclerotic disease have more heterogeneous plaques characteristics.
Influence of methotrexate on gastrointestinal symptoms in patients with rheumatoid arthritis
Authors: Asai Shuji , Nagai Kaoru , Takahashi Nobunori , Watanabe Tatsuo , Matsumoto Takuya , Asai Nobuyuki , Sobue Yasumori , Ishiguro Naoki , Kojima Toshihisa
Published: August 2018

Aim

This study aimed to determine the influence of methotrexate (MTX) on gastrointestinal (GI) symptoms in patients with rheumatoid arthritis (RA).

Methods

This cross‐sectional study examined 529 consecutive patients with RA receiving oral MTX in our department between April 1 and September 30, 2017. GI symptoms were evaluated by the Gastrointestinal Symptom Rating Scale (GSRS); a score of ≥2 was considered “symptomatic.” Prevalence of GI symptoms was compared between patients receiving ≤8 mg/wk (low‐dose) vs >8 mg/wk (high‐dose) of MTX.

Results

Of our study population, 313 (59%) received low‐dose MTX at a median (interquartile range) dose of 6 (6‐8) mg/wk, whereas 216 (41%) received high‐dose MTX at a median dose of 12 (10‐12) mg/wk. Relative to the low‐dose MTX group, the high‐dose MTX group exhibited a higher prevalence of reflux (32% vs 24%, P = 0.043) and abdominal pain (28% vs 18%, P = 0.007). There was no significant group‐dependent difference in the prevalence of indigestion, diarrhea or constipation. Multivariate logistic regression analysis revealed that high‐dose MTX (>8 mg/wk) was independently associated with reflux (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.07‐2.43) and abdominal pain (OR: 1.60, 95% CI: 1.04‐2.43), and that the ORs for reflux and abdominal pain among those receiving high‐dose MTX (>8 mg/wk) were similar to those using nonsteroidal anti‐inflammatory drugs.

Conclusion

High‐dose MTX is independently associated with the prevalence of upper GI symptoms in Japanese patients with RA.
Invasive thymoma with multiple ring calcifications and osseous metaplasia: A case report
Authors: Jung Jae Jun , Kim Sung Hwan , Kang Dong Hoon , Kim Ki Nyun , Moon Seong Ho , Yang Jun Ho , Byun Joung Hun , Kim Jong Woo , Jeon Kyung Nyeo , Bae Kyungsoo , Kim Ho Cheol , Kim Ju Young , Park Hyun Oh , Choi Jun Young
Published: August 2018

An 8.0 × 7.0 × 3.0 cm calcified anterior mediastinal mass was found in a 57‐year‐old man during a regular health checkup. The tumor had invaded the pericardium and phrenic nerve. The Masaoka–Koga classification was stage III. Multiple ring calcifications were present in the gross feature, and osseous metaplasia was observed in the histologic examination. World Health Organization histologic classification of the tumor was type B2. The patient is currently undergoing chemotherapy and radiation therapy to prevent tumor recurrence. To our knowledge, this is the first case of multiple ring calcifications and osseous metaplasia in invasive thymoma.
EYESI surgical simulator: validity evidence of the vitreoretinal modules
Authors: Cissé Cécile , Angioi Karine , Luc Amandine , Berrod Jean‐Paul , Conart Jean‐Baptiste
Published: August 2018

Purpose

To investigate the validity of six vitreoretinal modules on the Eyesi Surgical Simulator.

Methods

Fifteen residents with no vitreoretinal experience and six trained vitreoretinal surgeons (>100 procedures per year) were included in the study. Four modules were selected in agreement with an experienced surgeon: the navigation (Nav), forceps (For), vitrector (Vit) and epiretinal membrane (ERM) peeling modules. The first level of the basic training modules (Nav1 and For1) and the first two levels of the more procedural modules (Vit1, Vit2, ERM1 and ERM2) were completed twice by both groups in the above order. The performance parameters for each task were calculated by the simulator software. The results from both iterations were recorded for analysis.

Results

Experienced vitreoretinal surgeons outperformed residents with regard to the overall score on the Nav1 (p = 0.01), For1 (p < 0.01), ERM1 (p = 0.02) and ERM2 (p = 0.04) modules. No differences in overall score were found between the two groups on the Vit1 (p = 0.17) and Vit2 modules (p = 0.26).

Conclusion

Validity for the simulator metrics was found on four vitreoretinal modules not previously investigated, with regard to construct validity, content and the response process. These exercises could be included in a future competency‐based training programme that could potentially be applied in the standard ophthalmological curriculum.
Physicochemical predictors of Multi‐Walled Carbon Nanotube–induced pulmonary histopathology and toxicity one year after pulmonary deposition of 11 different Multi‐Walled Carbon Nanotubes in mice
Authors: Knudsen Kristina B. , Berthing Trine , Jackson Petra , Poulsen Sarah S. , Mortensen Alicja , Jacobsen Nicklas R. , Skaug Vidar , Szarek Józef , Hougaard Karin S. , Wolff Henrik , Wallin Håkan , Vogel Ulla
Published: August 2018

Multi‐walled carbon nanotubes (MWCNT) are widely used nanomaterials that cause pulmonary toxicity upon inhalation. The physicochemical properties of MWCNT vary greatly, which makes general safety evaluation challenging to conduct. Identification of the toxicity‐inducing physicochemical properties of MWCNT is therefore of great importance. We have evaluated histological changes in lung tissue 1 year after a single intratracheal instillation of 11 well‐characterized MWCNT in female C57BL/6N BomTac mice. Genotoxicity in liver and spleen was evaluated by the comet assay. The dose of 54 μg MWCNT corresponds to three times the estimated dose accumulated during a work life at a NIOSH recommended exposure limit (0.001 mg/m3). Short and thin MWCNT were observed as agglomerates in lung tissue 1 year after exposure, whereas thicker and longer MWCNT were detected as single fibres, suggesting biopersistence of both types of MWCNT. The thin and entangled MWCNT induced varying degree of pulmonary inflammation, in terms of lymphocytic aggregates, granulomas and macrophage infiltration, whereas two thick and straight MWCNT did not. By multiple regression analysis, larger diameter and higher content of iron predicted less histopathological changes, whereas higher cobalt content significantly predicted more histopathological changes. No MWCNT‐related fibrosis or tumours in the lungs or pleura was found. One thin and entangled MWCNT induced increased levels of DNA strand breaks in liver; however, no physicochemical properties could be related to genotoxicity. This study reveals physicochemical‐dependent difference in MWCNT‐induced long‐term, pulmonary histopathological changes. Identification of diameter size and cobalt content as important for MWCNT toxicity provides clues for designing MWCNT, which cause reduced human health effects following pulmonary exposure.
Financing uterus transplants: The United States context
Authors: Blake Valarie K.
Published: August 2018

The first baby has successfully been born by uterus transplantation (UTx) in the United States and the procedure is swiftly becoming a viable clinical option for patients with uterine factor infertility (UFI). This raises a practical ethical question: should health insurers finance UTx and what issues should they consider in coming to this decision? The article lays forth some of the factors that shape the decision over whether to finance UTx in the United States, including what procedures must be covered, whether UTx is more like organ transplantation or infertility treatment (which are treated differently in the United States), and the benefits and alternatives of the procedure. Then, the article explores arguments around why UTx should be financed, or at least considered along with other important medical needs. The paper argues that UTx ought to be considered along with other competing claims for healthcare services. In countries that generously cover other infertility services, it may logically follow that medical services that enable gestation should be insured when the healthcare system covers services to conceive. In the United States, however, many groups have long suffered inadequate access to medical care, in the context of infertility and more broadly. U.S. healthcare may need to be made more widely equitable, before covering UTx is seen as financially or politically possible.
ROLE‐REVERSAL CONSISTENCY: AN EXPERIMENTAL STUDY OF THE GOLDEN RULE
Authors: Costa‐Gomes Miguel A. , Ju Yuan , Li Jiawen
Published: August 2018

We report an experiment that asks whether people in a strategic situation behave according to the Golden Rule, that is, do not treat others in ways that they find disagreeable to themselves, a property that we call role‐reversal consistency. Overall, we find that over three quarters of the subjects are role‐reversal consistent. Regression analysis suggests that this finding is not driven by players maximizing their subjective expected monetary earnings given their stated beliefs about their opponents' behavior. We find that subjects' stated beliefs and actions reveal mild projection bias. (JEL C78, C91)
The improvement of crack propagation modelling in triangular 2D structures using the extended finite element method
Authors: Chen Jun‐Wei , Zhou Xiao‐Ping , Berto Filippo
Published: August 2018

In this paper, a novel geometric method combined with the piecewise linear function method is introduced into the extended finite element method (XFEM) to determine the crack tip element and crack surface element. Then, by combining with the advanced mesh technique, a novel method is proposed to improve the modelling of crack propagation in triangular 2D structure with the XFEM. The numerical tests show that the accuracy, the convergence, and the stability of the XFEM can be improved using the proposed method. Moreover, the applicability of the conventional multiple enrichment scheme is discussed. Compared with the proposed method, the conventional multiple enrichment scheme has deficiency in mixed mode I and II crack. Finally, a comparative study shows that the performance of the XFEM by using the proposed method to model the crack propagation can be greatly improved.
TIME‐VARYING VOLATILITY, DEFAULT, AND THE SOVEREIGN RISK PREMIUM
Authors: Seoane Hernán D.
Published: August 2018

This article studies how volatility changes affect sovereign spreads in strategic default models. Volatility changes affect savings and sovereign spreads. However, the impact of volatility shocks is state dependent; when the economy has a low debt, an increase in volatility is prone to generate precautionary savings. Instead, with high debt, an increase in volatility is likely to induce an even further increase in debt and spreads, both in endowment and production economies. I document a positive correlation between sovereign spreads and aggregate income volatility for a set of European economies during the debt crisis, consistent with the model's implications.
Living with Compromised Legal Status: Irregular Temporary Foreign Workers in Alberta and the Importance of Imagining, Strategizing, and Inter‐Provincial Legal Consciousness
Authors: Tungohan Ethel
Published: August 2018

This article highlights the manifold ways that migrants strategically use their social networks in order to survive in Alberta with compromised legal status. The conditionality of their status is affected by individual encounters and by new policy developments, showing that their ability to control their life trajectories is constrained by factors beyond their control. Nevertheless, although they experienced high amounts of stress because of their situations, the role played by cognitive processes, which include imagining, strategizing, and what I call “inter‐provincial legal consciousness”, allowed them to exercise agency. These processes allowed them to build communities and networks of support and to imagine potential life paths in other provinces through other provinces’ provincial nominee programmes.
The influence of air annealing on the microstructure and scintillation properties of Ce,Mg:LuAG ceramics
Authors: Chen Xiaopu , Hu Zewang , Dai Jiawei , Chen Haohong , Shi Yun , Kou Huamin , Wang Tiantian , Vedda Anna , Beitlerova Alena , Kucerkova Romana , Nikl Martin , Li Jiang
Published: August 2018

The microstructures and optical properties of Ce,Mg:Lu3Al5O12 scintillator ceramics are investigated with particular focus on the effect of postannealing in air from 1000 to 1450°C. The formation of Al2O3 clusters after annealing above 1300°C is evidenced by scanning electron microscopy. The presence of this secondary phase is tentatively explained by the occurrence of Ce and Mg evaporation, proved by inductive coupled plasma optical emission spectrometry measurements, followed by defect diffusion and clustering during high temperature annealing. Meanwhile, optical investigations including absorption, X‐ray induced luminescence, light yield, scintillation decay, and thermoluminescence prove the positive role of post‐annealing that leads to a brighter and faster scintillation emission. This behavior is associated to the removal of oxygen vacancies occurring during such treatments. In parallel, the partial conversion of Ce3+ ions into Ce4+ is also observed as a consequence of annealings and the role of Ce4+ ions in the scintillation process is discussed.
Liberal Intergovernmentalism and the Crises of the European Union
Authors: Schimmelfennig Frank
Published: August 2018

The Euro, Schengen and Brexit crises pose important explanatory challenges to liberal intergovernmentalism (LI). In contrast with the historical context in which LI originated, they have threatened existing integration regimes with disintegration in a highly politicized domestic environment. How relevant does LI remain under these circumstances in comparison with its neofunctionalist and postfunctionalist competitors? A comparative analysis of the three crises shows that LI offers only a partial explanation of national preference formation in the crises. As a static theory, it fails to take into account endogenous preferences that may result from path‐dependence (in the euro crisis) or politicization (in the Brexit crisis). By contrast, LI provides a convincing and indispensable analysis of intergovernmental bargaining.
Of Principal(s') Interest? A Disaggregated, Multiple Principals' Approach to Commission Discretion
Authors: Gastinger Markus , Adriaensen Johan
Published: August 2018

How much discretion does the Commission enjoy in the European Union? To address this question, we draw on principal–agent theory and propose ‘interest in a decision’ by principals as a proxy for agent discretion. This has three advantages over existing approaches. First, it overcomes the high‐conflict bias of case studies. Second, it accounts for the phenomenon of rational anticipation. Third, it allows for a more fine‐grained measurement than analyses of the act of delegation. Empirically, we disaggregate the Transatlantic Trade and Investment Partnership (TTIP) into 27 chapters and account for multiple principals. We use surveys and interviews with Commission negotiators, which we triangulate with publicly available data sources. Our findings paint a picture of a Commission that is constrained rather tightly. While the Council follows all chapters and acts as a ‘safety net’, citizens and the European Parliament act as fire alarms and focus on selected, often overlapping, chapters.
Investigation of the predisposing factor of pemphigus and its clinical subtype through a genome‐wide association and next generation sequence analysis
Authors: Sun Y. , Liu H. , Yang B. , Wang C. , Foo J.N. , Bao F. , Irwanto A. , Yu G. , Fu X. , Wang Z. , You J. , Liu J. , Zhou G. , Liu J. , Zhang F.
Published: August 2018

Background

Pemphigus is an autoimmune blistering disease with pemphigus vulgaris (PV) and foliaceus (PF) as the two major histological subtypes. Associations with HLA molecules have been suggested, but specific HLA risk variants as well as non‐HLA risk variants remain to be discovered.

Methods

We performed a two‐stage genome‐wide association study in the Chinese Han population through a genome‐wide discovery analysis and follow‐up validation analysis in a total number of 210 PV, 159 PF and 2493 healthy controls. HLA imputation as well as high coverage next generation sequencing based HLA genotyping was employed to investigate the association of classical HLA alleles and amino acid change.

Results

We have discovered independent novel associations with PF at rs2178077 on 12q24.33, located next to RAN (PPF = 1.57 × 10−9) and rs3888722 within the MHC region (P = 6.73 × 10−9). For the HLA variants, we confirmed independent genome‐wide level risk associations in HLA‐DQB1 and HLA‐DRB1, with DQB1*05:03 to be the strongest association with PV (P = 8.59 × 10−68, OR = 31.16) and PF (P = 4.84 × 10−17, OR = 5.64). In addition, DRB1*14 was demonstrated to be a second independent variants (P = 4.2 × 10−63, OR = 35.47) for PV, while DRB1*04:06 was demonstrated to be the second independent signal (P = 7.44 × 10−13, OR = 5.58) for PF.

Conclusions

These findings advance our understanding of the genetic basis of pemphigus susceptibility and may offer opportunities for risk prediction and preventive treatment for pemphigus, in particular for PV.
Evaluation of a non‐ablative, fractional 1565 nm laser for the improvement of striae distensae albae
Authors: Guertler A. , Reinholz M. , Steckmeier S. , Gauglitz G.G.
Published: August 2018

Background and objective

Striae distensae (SD) represent therapeutically challenging forms of dermal atrophic scarring. In addition to topical ointments, medical needling and various energy‐based devices, non‐ablative fractional lasers have been suggested for their improvement. However, objective evaluations of their efficacy are widely missing. In this study, we aimed to assess the clinical improvement of SD albae after three treatments with a non‐ablative fractional 1565 nm Er: glass laser by employing three‐dimensional analysis and several questionnaires.

Methods

A total of 16 Caucasians suffering from SD albae were included in this prospective study. Every patient received three treatments – one every 4 weeks – using a non‐ablative, fractional 1565 nm laser (two passes: 300 μbeams/cm2, 40 mJ inside the SD; 150 μbeams/cm2, 50 mJ inside the SD and within the surrounding area). Questionnaires (DLQI, POSAS), digital photography and three‐dimensional analysis employing PRIMOS® software and VECTRA® camera system were taken at baseline, 1 and 6 months after the last treatment.

Results

Evaluation of objective measurements at 6‐month follow‐up (FU) showed a significant reduction in depth of atrophic lesions by 31.7% and less skin irregularities with Smax at baseline of 621.2 μm decreasing to 411.6 μm (P < 0.01, respectively).

Improvement in objective measurements was supported by significant changes in patients’ rating of skin appearance. POSAS patient total score declined from 33.5 points to 17.5 points throughout the study (P < 0.001). From baseline to 6‐month FU, patients’ life quality improved by 68.0% (DLQI score). Procedures showed no lasting negative side‐effects and little to no down time.

Conclusion

The use of a fractional non‐ablative 1565 nm laser represents a safe approach for the treatment of SD albae. Clinically observed improvements were supported by significant data from objective measurements. The results achieved at 1‐month FU represented at 6‐month FU, showing stable clinical improvements.
High level of genetic connectivity in a deep‐water reef fish, Caulolatilus microps
Authors: McDowell Jan R. , Brightman Heid L.
Published: August 2018

The life‐history characteristics of blueline tilefish make them particularly vulnerable to overfishing. Although North Carolina, U.S.A. was previously considered to be the northern extent of the range of C. microps, concentrations have recently been discovered in Virginia and Maryland, with reports as far north as Montauk, New York. Attempts to manage the fishery have been hampered by a lack of information about whether the U.S. East Coast includes multiple stocks. To assess the appropriateness of alternate management options, we used 25 variable microsatellite loci and sequencing of the mitochondrial (mt)DNA control region (CR) to evaluate the genetic structure of 490 C. microps sampled from across the U.S. East Coast range. Pairwise comparisons of genetic differentiation among collection locations based on both nuclear microsatellite and mtCR sequence data were all low and non significant. No significant autocorrelation was observed across multiple distance classes, consistent with widespread dispersal., Although the assumed sedentary nature of adult C. microps suggests population structuring, the genetic data were consistent with the presence of sufficient gene flow to prevent the accumulation of significant genetic differences and supports management of C. microps as a single stock along the U.S. East Coast.
Continuous invasive hemodynamic monitoring using steerable guide catheter to optimize mitraclip transcatheter mitral valve repair: A multicenter, proof‐of‐concept study
Authors: Tang Gilbert H. L. , Ong Lawrence Y. , Kaple Ryan , Ramlawi Basel , Dutta Tanya , Zaid Syed , Ahmad Hasan , Kalimi Robert , Undemir Cenap , Khan Asaad , Yudi Matias B. , Nadir M. Adnan , Majeed Farhan , Ali Omar , Skiles Jeffrey , Bhim Chandra , Cohen Martin , Lansman Steven L. , Sharma Samin K. , Kini Annapoorna
Published: August 2018

Objectives

We report our multicenter experience on continuous hemodynamic monitoring using exclusively the steerable guide catheter (SGC) during MitraClip repair.

Background

Left atrial pressure (LAP) and V‐wave are useful to evaluate MitraClip repair but no simple method of continuous monitoring exists.

Methods

From 11/2016 to 8/2017, 74 patients from four centers with symptomatic moderate‐severe to severe mitral regurgitation (MR), underwent MitraClip NT repair with continuous hemodynamic monitoring via the SGC. Real‐time LAP/V‐wave changes were compared with transesophageal echocardiography (TEE). When mitral stenosis was suspected, transmitral gradients were verified by invasive hemodynamics. Clinical and echocardiographic outcomes were determined.

Results

Mean age was 78 ± 10 years and STS score 9.1 ± 11.0%. Pathology included leaflet prolapse/flail (45%), restriction (35%), and mixed (20%). Number of clips averaged 1.7 ± 0.7 per case. There was a significant reduction in LAP (21 ± 10 to 15 ± 7 mmHg, P < 0.0001) and V‐wave(37 ± 19 to 24 ± 10 mmHg, P < 0.0001) post MitraClip, but the decrease was less in patients with atrial fibrillation (P < 0.05). Transmitral gradient significantly increased from 2.0 ± 1.2 to 4.0 ± 1.7 mmHg (P < 0.0001). Paradoxical increases in LAP and V‐wave despite MR reduction were observed in three cases requiring MitraClip repositioning or retrieval to avoid stenosis. Follow‐up averaged 5.0 ± 2.9 months and was 100% complete. KCCQ improvement was significant and MR reduction to <1+ was 67% and <2+ was 93% at 30 days.

Conclusions

Continuous hemodynamic monitoring using the SGC complements TEE to assess and optimize MitraClip repair in real‐time. Further validation is necessary but this feature may be part of future MitraClip and other transcatheter mitral repair systems.
Association between type of health insurance and children's oral health, NHANES 2011–2014
Authors: Duffy Erin L. , Kranz Ashley M. , Dick Andrew W. , Sorbero Mark , Stein Bradley D.
Published: August 2018

Objectives

To examine the association between type of health insurance (public, uninsured, private, or other) and oral health outcomes for children in the United States using nationally representative surveillance data.

Methods

Using the National Health and Nutrition Examination Survey (2011/12–2013/14), logistic regression models were used to estimate the odds of any dental caries and any untreated caries by type of health insurance (public, uninsured, private, and other) for children aged 2–19 years, with adjustment for relevant individual and socioeconomic characteristics.

Results

Among 6,057 children, the odds of having any dental caries or untreated caries was not significantly different for publicly insured and uninsured children compared to privately insured children, when adjusting for family income and education. Children in families with income to poverty ratios <200 percent had greater odds of caries and untreated caries relative to children in families with income to poverty ratios ≥400 percent. Children with less educated parents also experienced greater odds of caries and untreated caries.

Conclusions

Oral health outcomes, after adjusting for covariates, were similar for children with public and private health insurance. However, children in low‐income families and with less educated parents had greater odds of untreated caries and dental caries, suggesting that initiatives focused on publicly insured populations may miss other vulnerable children of low socioeconomic status.
Towards a new “folkloric turn” in the literature of early modernIreland
Authors: Covington Sarah
Published: August 2018

This essay offers new suggestions in the study of sixteenth‐ and seventeenth‐century English and Irish literature through a specifically folkloric lens. While scholars of medieval and modern texts in Ireland have made much progress in uncovering and debating the presence of popular oral traditions (and orality in general) in their respective sources, those who focus on the sixteenth and seventeenth centuries have yet to fully explore the same attributes in their own rich body of literature. This essay will therefore survey the sources, methods, and directions which a “folkloric turn” can take, especially as it incorporates a range of models that can be used to analyze orality, residues of popular traditions, and the utilization of particular motifs to open a new prism onto the period. While there are certainly challenges in utilizing this approach, folklore has the potential to contextualize and deepen our understanding of sources that include antiquarian records, travel accounts, ballads, legal depositions, English and Irish poetry, and even the modern folkloric tales to which they relate.
Monetary policy, inequality and political instability
Authors: Duarte Pablo , Schnabl Gunther
Published: August 2018

Voters in the industrialised countries are increasingly expressing dissatisfaction by dissenting from the established political parties and candidates. Based on the concepts of justice by Hayek, Rawls and Buchanan, we argue that the growing dissatisfaction is rooted in the asymmetric pattern of monetary policies since the mid‐1980s for two reasons. First, the structurally declining interest rates and the unconventional monetary policy measures have granted privileges to specific groups. Second, the increasingly expansionary monetary policies have negative growth effects, which have reduced the scope for compensation of the ones excluded from the privileges. As a result, the acceptance of the prevailing economic and political order is undermined and political instability increases.
Evaluating veterinary student skill acquisition on a laparoscopic suturing exercise after simulation training
Authors: Kilkenny Jessica J. , White Kadi , Singh Ameet
Published: August 2018

Objective

To determine whether veterinary students could train to a predefined proficiency level on a simulated intracorporeal laparoscopic suturing task.

Study design

Single group preinterventional and postinterventional study.

Sample population

Ten veterinary students.

Methods

Ten veterinary students completed a questionnaire about prior experiences and watched a 7‐minute demonstration video prior to performing a laparoscopic intracorporeal suture task on a simulator. Participants were tested at pretraining and for a period of 8 weeks. Overall group improvement in scores and time to completion (seconds) from pretraining to final testing was analyzed by using a Wilcoxon matched‐pairs signed‐rank test. The same variables were compared among individuals with different background experiences (eg, video game experience) by using a Mann‐Whitney U test. The average number of repetitions to reach proficiency was recorded.

Results

All participants reached the predefined proficiency level on the Fundamentals of Laparoscopic Surgery intracorporeal suture task. The average number of repetitions required to reach proficiency was 18 ± 7, and there was significant improvement in both time to completion (seconds) and scores from pretraining to final testing (P = .005). The number of repetitions required to reach proficiency, pretraining times, final times, pretraining scores, and final scores did not differ among veterinary students with different background experiences.

Conclusion

Veterinary students naïve to laparoscopic surgery can learn the technical skills required to perform a simulated intracorporeal suture through repetitive, self‐directed practice on a laparoscopic box trainer regardless of prior experiences (eg, videogame experience, craft experience, chopstick use, etc).

Clinical significance

Simulation offers an adequate platform for the standardized training of laparoscopic skills in veterinary students and likely novice laparoscopic surgeons.
Prognostication in urgent intensive care unit referrals: a cohort study
Authors: Ramos Joao Gabriel Rosa , Dias Roger Daglius , Passos Rogerio da Hora , Batista Paulo Benigno Pena , Forte Daniel Neves
Published: August 2018

Objectives

Prognostication is an essential ability to clinicians. Nevertheless, it has been shown to be quite variable in acutely ill patients, potentially leading to inappropriate care. We aimed to assess the accuracy of physician’s prediction of hospital mortality in acutely deteriorating patients referred for urgent intensive care unit (ICU) admission.

Methods

Prospective cohort of acutely ill patients referred for urgent ICU admission in an academic, tertiary hospital. Physicians’ prognosis assessments were recorded at ICU referral. Prognosis was assessed as survival without severe disabilities, survival with severe disabilities or no survival. Prognosis was further dichotomised in good prognosis (survival without severe disabilities) or poor prognosis (survival with severe disabilities or no survival) for prediction of hospital mortality.

Results

There were 2374 analysed referrals, with 2103 (88.6%) patients with complete data on mortality and physicians’ prognosis. There were 593 (34.4%), 215 (66.4%) and 51 (94.4%) deaths in the groups ascribed a prognosis of survival without disabilities, survival with severe disabilities or no survival, respectively (p<0.001). Sensitivity was 31%, specificity was 91% and the area under the receiver operating characteristic curve was 0.61 for prediction of mortality. After multivariable analysis, severity of illness, performance status and ICU admission were associated with an increased likelihood of incorrect classification, while worse predicted prognosis was associated with a lower chance of incorrect classification.

Conclusions

Physician’s prediction was associated with hospital mortality, but overall accuracy was poor, mainly due to low sensitivity to detect risk of poor prognosis.
Further improvement in the control of bovine tuberculosis recurrence in Ireland
Authors: Houtsma Erik , Clegg Tracy Ann , Good Margaret , More Simon J
Published: August 2018

Ongoing objective assessment of national bovine tuberculosis (bTB) policy in Ireland is important to monitor efforts towards improved bTB control. The study objective was to investigate temporal trends in the risk of herd recurrence. The study included all herds derestricted following a bTB episode ending in 1998, 2008 or 2012. The respective ‘study periods’ were up to the end of 2001 for 1998‐derestricted herds, to the end of 2011 for 2008‐derestricted herds, and to the end of 2015 for 2012‐derestricted herds. A multivariable Cox proportional‐hazard model was developed to examine time to next restriction. The results from the model showed a continuing significant decreasing trend in herd recurrence of bTB in Ireland from 1998 until 2015: herds derestricted in 2008 were 0.75 (95 per cent CI 0.68 to 0.82) times as likely to develop a further restriction compared with 1998 herds, and herds derestricted in 2012 were 0.85 (95per cent CI 0.76 to 0.95) times as likely as 2008 herds. However, despite significant improvements, recurrence of bTB remains a concern, with 30.2 per cent (95 per cent CI 28.0 to 32.4 per cent) of herds derestricted in 2012 being re‐restricted over the subsequent three years. Further work is needed to address the two key drivers of herd recurrence, namely residual infection and local reinfection.