bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Mineral Density Response With Denosumab in Combination With Standard or High-Dose Teriparatide: The DATA-HD RCT
Authors: Ramchand Sabashini K , David Natalie L , Leder Benjamin Z , Tsai Joy N
Published: November 2019

Context

In the Denosumab and High-Dose Teriparatide Administration (DATA-HD) study, we reported that 15 months of combined high-dose (HD) teriparatide and denosumab increased mean areal bone mineral density (aBMD) at the hip and spine more than combined denosumab and standard-dose (SD) teriparatide.

Objective

In the current analysis, we compare the individual rates of aBMD response between the treatment groups.

Design

Single-site, open-label, randomized controlled trial in which postmenopausal women received either teriparatide 20-μg daily (SD) or 40-μg daily (HD) given months 0 through 9, overlapped with denosumab 60 mg, given months 3 through 15 (15 months’ total duration). The proportion of participants in the SD and HD groups experiencing total hip, femoral neck, and lumbar spine aBMD gains of >3%, >6%, and >9% were compared.

Participants

Postmenopausal women with osteoporosis completing all study visits (n = 60).

Main outcome measure(s)

aBMD (dual x-ray absorptiometry).

Results

At the end of the 15-month treatment period, a higher proportion of women in the HD group had aBMD increases >3% (83% vs. 58%, P = .037) and >6% (45% vs. 19%, P = .034) at the total hip, and >3% at the femoral neck (86% vs. 63%, P = .044). At the lumbar spine, >3% response rates were similar, whereas the >6% and >9% response rates were greater in the HD group (100% vs. 79%, P = .012 and 93% vs. 59%, P = .003, respectively).

Conclusion

Compared with the SD regimen, more women treated with the HD regimen achieved clinically meaningful and rapid gains in hip and spine aBMD. These results suggest that this approach may provide unique benefits in the treatment of postmenopausal osteoporosis.
Role of Mineralocorticoid Receptor in Adipogenesis and Obesity in Male Mice
Authors: Ferguson Daniel , Hutson Irina , Tycksen Eric , Pietka Terri A , Bauerle Kevin , Harris Charles A
Published: November 2019

Increased visceral adiposity and hyperglycemia, 2 characteristics of metabolic syndrome, are also present in conditions of excess glucocorticoids (GCs). GCs are hormones thought to act primarily via the glucocorticoid receptor (GR). GCs are commonly prescribed for inflammatory disorders, yet their use is limited due to many adverse metabolic side effects. In addition to GR, GCs also bind the mineralocorticoid receptor (MR), but there are many conflicting studies about the exact role of MR in metabolic disease. Using MR knockout mice (MRKO), we find that both white and brown adipose depots form normally when compared with wild-type mice at P5. We created mice with adipocyte-specific deletion of MR (FMRKO) to better understand the role of MR in metabolic dysfunction. Treatment of mice with excess GCs for 4 weeks, via corticosterone in drinking water, induced increased fat mass and glucose intolerance to similar levels in FMRKO and floxed control mice. Separately, when fed a high-fat diet for 16 weeks, FMRKO mice had reduced body weight, fat mass, and hepatic steatosis, relative to floxed control mice. Decreased adiposity likely resulted from increased energy expenditure since food intake was not different. RNA sequencing analysis revealed decreased enrichment of genes associated with adipogenesis in inguinal white adipose of FMRKO mice. Differentiation of mouse embryonic fibroblasts (MEFs) showed modestly impaired adipogenesis in MRKO MEFs compared with wild type, but this was rescued upon the addition of peroxisome proliferator-activated receptor gamma (PPARγ) agonist or PPARγ overexpression. Collectively, these studies provide further evidence supporting the potential value of MR as a therapeutic target for conditions associated with metabolic syndrome.
Filling the Organ Donor Pool by Giving Priority
Authors: Meng Matthew D. , Clarke Roberta N.
Published: November 2019

Context: Many of the alternatives for procuring donor organs are considered either ineffective, unethical, or illegal. One possibility that may not face such challenges is a priority system whereby individuals who register as an organ donor are given priority to receive an organ over those who have not registered. However, providing extrinsic rewards can sometimes paradoxically reduce the target behavior, especially for those who are more altruistically motivated.

Methods: Two behavioral experiments were employed and data were analyzed using regressions as well as examining open-ended responses.

Findings: The results suggest that giving priority to receive an organ to those who register to donate postmortem could increase overall registration rates. Further, the effect of providing priority appears to work by inducing anticipated regret, which can be used to overcome common obstacles to registration. Finally, it was found that a priority system is most effective in increasing donor rates for those individuals who are less altruistically motivated and does not reduce registration rates for those who are more altruistically motivated.

Conclusions: Given the unabated shortage of transplant organs, the finding that a priority system could increase the willingness to register as a donor without crowding out altruistically motivated individuals is highly encouraging.
When State Policy Makes National Politics: The Case of “Obamacare” Marketplace Implementation
Authors: Trachtman Samuel
Published: November 2019

Context: State governments have been powerful sites of Republican resistance to the implementation of the Affordable Care Act (ACA), the Democratic Party's signature 2010 law. By influencing how citizens experience the ACA, state-level implementation can affect the national-level political implications of the law.

Methods: I examine three largely unstudied areas of marketplace implementation: navigator laws, transitional plan termination, and rating area configurations. For each policy area, I use linear probability models to investigate the determinants of state lawmakers bolstering or eroding marketplaces.

Findings: In each case, Democrat-controlled states were more likely to bolster marketplaces than Republican-controlled states were, with decisions more polarized in those policy areas—navigator laws and transitional plan termination—and with greater potential for national-level feedback. For navigator laws, where Republican state lawmakers were most cross-pressured by national party interests and local interests, marketplace eroding policy was highly associated with strength of conservative networks.

Conclusion: Crafters of federal legislation cannot expect state lawmakers to universally implement federal law to maximize the direct benefits to their constituents. Rather, we should expect state lawmakers to, in many instances, implement federal law in ways that benefit their parties.
Employed for Higher Pay? How Medicare Payment Rules Affect Hospital Employment of Physicians
Authors: Dranove David , Ody Christopher
Published: November 2019

Hospitals employ an increasing number of physicians and bill for a growing share of outpatient procedures. We exploit a plausibly exogenous increase in Medicare prices for hospital-employed physicians relative to Medicare prices for other physicians to show that payer reimbursement rules explain part of this trend. The shock we study explains 20 percent of the increase in physician employment and 75 percent of the increase in hospital-billed outpatient procedures between 2009 and 2013.(JEL G22, I22, I13, J23, J31, J44)
New Evidence on Information Disclosure through Restaurant Hygiene Grading
Authors: Ho Daniel E. , Ashwood Zoe C. , Handan-Nader Cassandra
Published: November 2019

The case of restaurant hygiene grading occupies a central role in information disclosure scholarship. Comparing Los Angeles, which enacted grading in 1998, with California from 1995–1999, Jin and Leslie (2003) found that grading reduced foodborne illness hospitalizations by 20 percent. Expanding hospitalization data and collecting new data on mandatorily reported illnesses, we show that this finding does not hold up under improvements to the original data and methodology. The largest salmonella outbreak in state history hit Southern California before Los Angeles implemented grading. Placebo tests detect the same treatment effects for Southern California counties, none of which changed restaurant grading. (JEL D83, H75, I12, I18, L83, L88)
Reducing Inequality through Dynamic Complementarity: Evidence from Head Start and Public School Spending
Authors: Johnson Rucker C. , Jackson C. Kirabo
Published: November 2019

We compare the adult outcomes of cohorts who were differentially exposed to policy-induced changes in Head Start and K–12 spending, depending on place and year of birth. IV and sibling-difference estimates indicate that, for poor children, these policies both increased educational attainment and earnings, and reduced poverty and incarceration. The benefits of Head Start were larger when followed by access to better-funded schools, and increases in K–12 spending were more efficacious when preceded by Head Start exposure. The findings suggest dynamic complementarities, implying that early educational investments that are sustained may break the cycle of poverty. (JEL H52, H75, I21, I26, I28, I32, I38)
An automated approach for the optimised estimation of breast density with Dixon methods
Authors: Goodburn Rosie , Kousi Evanthia , Macdonald Alison , Morgan Veronica , Scurr Erica , Reddy Mamatha , Wilkinson Louise , O'Flynn Elizabeth , Pope Romney , Allen Steven , Schmidt Maria Angélica
Published: November 2019

Objective:

To present and evaluate an automated method to correct scaling between Dixon water/fat images used in breast density (BD) assessments.

Methods:

Dixon images were acquired in 14 subjects with different T  1 weightings (flip angles, FA, 4°/16°). Our method corrects intensity differences between water (W) and fat (F) images via the application of a uniform scaling factor (SF), determined subject-by-subject. Based on the postulation that optimal SFs yield relatively featureless summed fat/scaled-water (F+WSF) images, each SF was chosen as that which generated the lowest 95th-percentile in the absolute spatial-gradient image-volume of F+WSF . Water-fraction maps were calculated for data acquired with low/high FAs, and BD (%) was the total percentage water within each breast volume.

Results:

Corrected/uncorrected BD ranged from, respectively, 10.9–71.8%/8.9–66.7% for low-FA data to 8.1–74.3%/5.6–54.3% for high-FA data. Corrected metrics had an average absolute increase in BD of 6.4% for low-FA data and 18.4% for high-FA data. BD values estimated from low- and high-FA data were closer following SF-correction.

Conclusion:

Our results demonstrate need for scaling in such BD assessments, where our method brought high-FA and low-FA data into closer agreement.

Advances in knowledge:

We demonstrated a feasible method to address a main source of inaccuracy in Dixon-based BD measurements.
Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial
Authors: McMeekin Nicola , Geue Claudia , Briggs Andrew , Rombach Ines , Li Ho Kwong , Bejon Philip , McNally Martin , Atkins Bridget L. , Ferguson Jamie , Scarborough Matthew ,   OVIVA collaborators
Published: November 2019

Background: Bone and joint infections are becoming increasingly common and are usually treated with surgery and a course of intravenous antibiotics. However, there is no evidence to support the superiority of intravenous therapy and there is a growing body of literature showing that oral therapy is effective in treating these infections.Given this lack of evidence the clinical trial ‘Oral Versus Intravenous Antibiotics’ (OVIVA) was designed to assess the clinical and cost-effectiveness of intravenous versus oral antibiotics for the treatment of bone and joint infections, using a non-inferiority design. Clinical results from the trial indicate that oral antibiotics are non-inferior to intravenous antibiotics. The aim of this paper is to evaluate the cost-effectiveness of intravenous compared to oral antibiotics for treating bone and joint infections, using data from OVIVA.

Methods: A cost-utility analysis was carried out, the main economic outcome measure was the quality adjusted life-year, measured using the EQ-5D-3L questionnaire, combined with costs to estimate cost-effectiveness over 12-months follow-up.

Results: Results show that costs were significantly lower in the oral arm compared to the intravenous arm, a difference of £2,740 (95% confidence interval £1,488 to £3,992). Results of four sensitivity analyses were consistent with the base-case results. QALYs were marginally higher in the oral arm, however this difference was not statistically significant; -0.007 (95% confidence interval -0.045 to 0.031).

Conclusions: Treating patients with bone and joint infections for the first six weeks of therapy with oral antibiotics is both less costly and does not result in detectable differences in quality of life compared to treatment with intravenous antibiotics. Adopting a practice of treating bone and joint infections with oral antibiotics early in the course of therapy could potentially save the UK National Health Service over £17 million annually.
Optimizing the Multistage University Admission Decision Process
Authors: Kim Donghyun , Kim Namyong , Cho Junoh , Shin Hayong
Published: November 2019

The authors discuss their use of a multistage process to determine admissions to Korea Advanced Institute of Science and Technology. They use logistic regression with past data to estimate the enrollment probability of each applicant and then model the admission decision problem as a Markov decision process.
An Experiment in Hiring Discrimination via Online Social Networks
Authors: Acquisti Alessandro , Fong Christina
Published: November 2019

We investigate whether personal information posted by job candidates on social media sites is sought and used by prospective U.S. employers. We create profiles for job candidates on popular social networks, manipulating information protected under U.S. laws, and submit job applications on their behalf to more than 4,000 employers. We estimate employer search activity and bias in interview callbacks. We find evidence of employers searching online for the candidates. At the national level, we find no significant difference in the callback rates for a Muslim versus a Christian candidate, or for a gay versus a straight candidate. However, employers in Republican areas exhibit significant bias against the Muslim candidate relative to the Christian candidate. This bias is significantly larger than the bias in Democratic areas. The results on callback bias are robust to using state- and county-level data, to controlling for firm, job, and geographical characteristics, to including additional interaction effects in the empirical specification, and to several estimation strategies. The results suggest that the online disclosure of certain personal traits can influence the hiring decisions of some U.S. employers, but the likelihood of hiring discrimination via online searches varies across employers.

This paper was accepted by Chris Forman, information systems.
Integrated care systems and nurse leadership
Authors: Duncan Monica
Published: November 2019

There will be significant changes to the way in which primary and community health services are provided in the wake of the NHS Long Term Plan published in January 2019. Community nurses are already preparing themselves for these changes by exploring models of care that are patient-centred and link to neighbourhood, place and system levels. This article discusses two examples of such models of care, the Buurtzorg and Embrace model, both from the Netherlands. Styles of leadership and associated development, both within nursing and on a multi-professional basis will be crucial to ensure success. This article outlines Alban-Metcalfe's engaging transformational leadership model as a potential platform to move to flatter, more diverse teams and collective leadership.
The development of the general practice nursing induction template
Authors: Aldridge-Bent Sharon
Published: November 2019

Sharon Aldridge-Bent explains how she developed and wrote the Queen's Nursing Institute's general practice nursing induction template
Practice nurses need better diabetes education to meet service and individual needs
Authors: Phillips Anne
Published: November 2019

Anne Phillips, from the iDEAL advisory group, highlights the need for constant evidence-based educational opportunities to be available and accessible, via a variety of means, to ensure practice nurses can keep up to date and deliver evidence-based diabetes care
Cost-effectiveness of negative-pressure wound therapy in adults with severe open fractures of the lower limb: evidence from the WOLLF randomized controlled trial
Authors: Petrou S. , Parker B. , Masters J. , Achten J. , Bruce J. , Lamb S. E. , Parsons N. , Costa M. L. ,   WOLLF Trial Collaborators
Published: November 2019

Aims

The aim of this study was to estimate the cost-effectiveness of negative-pressure wound therapy (NPWT) in comparison with standard wound management after initial surgical wound debridement in adults with severe open fractures of the lower limb.

Patients and Methods

An economic evaluation was conducted from the perspective of the United Kingdom NHS and Personal Social Services, based on evidence from the 460 participants in the Wound Management of Open Lower Limb Fractures (WOLLF) trial. Economic outcomes were collected prospectively over the 12-month follow-up period using trial case report forms and participant-completed questionnaires. Bivariate regression of costs (given in £, 2014 to 2015 prices) and quality-adjusted life-years (QALYs), with multiple imputation of missing data, was conducted to estimate the incremental cost per QALY gained associated with NPWT dressings. Sensitivity and subgroup analyses were undertaken to assess the impacts of uncertainty and heterogeneity, respectively, surrounding aspects of the economic evaluation.

Results

The base case analysis produced an incremental cost-effectiveness ratio of £267 910 per QALY gained, reflecting higher costs on average (£678; 95% confidence interval (CI) -£1082 to £2438) and only marginally higher QALYS (0.002; 95% CI -0.054 to 0.059) in the NPWT group. The probability that NPWT is cost-effective in this patient population did not exceed 27% regardless of the value of the cost-effectiveness threshold. This result remained robust to several sensitivity and subgroup analyses.

Conclusion

This trial-based economic evaluation suggests that NPWT is unlikely to be a cost-effective strategy for improving outcomes in adult patients with severe open fractures of the lower limb. Cite this article: Bone Joint J 2019;101-B:1392–1401.
Prescribing and adherence to bone protection medications following hip fracture in the United Kingdom
Authors: Cehic Matthew , Lerner Robin G. , Achten Juul , Griffin Xavier L. , Prieto-Alhambra Daniel , Costa Matthew L.
Published: November 2019

Aims

Bone health assessment and the prescription of medication for secondary fracture prevention have become an integral part of the acute management of patients with hip fracture. However, there is little evidence regarding compliance with prescription guidelines and subsequent adherence to medication in this patient group.

Patients and Methods

The World Hip Trauma Evaluation (WHiTE) is a multicentre, prospective cohort of hip fracture patients in NHS hospitals in England and Wales. Patients aged 60 years and older who received operative treatment for a hip fracture were eligible for inclusion in WHiTE. The prescription of bone protection medications was recorded from participants’ discharge summaries, and participant-reported use of bone protection medications was recorded at 120 days following surgery.

Results

Of 5456 recruited patients with baseline data, 2853 patients (52%) were prescribed bone protection medication at discharge, of which oral bisphosphonates were the most common, 4109 patients (75%) were prescribed vitamin D or calcium, and 606 patients (11%) were not prescribed anything. Of those prescribed a bone protection medication, only 932 patients (33%) reported still taking their medication 120 days later.

Conclusion

These data provide a reference for current prescription and adherence rates. Adherence with oral medication remains poor in patients with hip fracture. Cite this article: Bone Joint J 2019;101-B:1402–1407.
Does the professional know their supracondylar from their gluteus maximus?
Authors: Myatt A , Cheadle C , Hannant G , Samir A , Howard A
Published: November 2019

An international multiple centre investigation into nature versus nurture.
Análise da variação da qualidade microbiológica do leite cru refrigerado: uma revisão sistemática de literatura
Authors: Strassburger Alexandre Henrique , Caye Valmir Augustinho Hartamann , Costella Marcelo Fabiano , Dalcanton Francieli
Published: November 2019

A qualidade do leite é um dos temas mais discutidos atualmente no cenário nacional da atividade leiteira. O estudo dos principais pontos que interferem na melhoria da matéria prima e seu impacto na cadeia de lácteos torna-se cada vez mais necessário para que se possa padronizar a atividade e com isso conquistar novos mercados consumidores, uma vez que este mercado está mais exigente e a demanda cada vez maior. Objetivou-se com este trabalho avaliar a qualidade do leite cru ao longo da sua cadeia de produção até a chegada à indústria processadora, em função do tipo de ordenha, armazenamento e condições de transporte, por meio de uma revisão sistemática da literatura de trabalhos acadêmicos nos últimos 10 anos. Foram definidas palavras-chave para a realização da busca, selecionando-se os trabalhos por resumo, e depois filtrando por artigo completo. Ao final da pesquisa foram selecionados 19 artigos para avaliação nas áreas de produção primária, armazenamento e transporte da matéria prima. Foram identificados que 100% dos estudos apresentaram resultados insatisfatórias com relação ao limite definido pela legislação para a Contagem Bacteriana Total, evidenciando falhas nos procedimentos adotados para a produção da matéria prima, armazenamento e transporte. A adequação dos procedimentos adotados para a produção de leite deve ser implementada em todos os elos da cadeia, de forma a garantir a produção dentro dos padrões legais, tendo como objetivo a melhoria de renda do produtor, melhor desempenho das indústrias e segurança ao consumidor final.
ESPELHO: AUTOETNOGRAFIA DE TRAJETÓRIA NA VIDA, NO TRABALHO E NA MILITÂNCIA
Authors: Medeiros Marielda Barcellos
Published: November 2019

Esta escrita tem como objetivo, a realização de uma autoetnografia, onde tomo como base minhas experiências de vida, docência e militância. Minha opção por esta metodologia se ancora na possibilidade de poder relacionar as trajetórias que, de certo modo, me impulsionaram e ainda impulsionam a relação que estabeleço com o mundo. Escolher a autoetnografia foi estabelecer a partir da delimitação do foco aqui estabelecido, a compreensão dos contextos de vivência, de sentimentos e aprendizagem do sujeito que se investiga.Palavras-chave: Trajetória; Militância; Autoetnografia; Negritude
Accessibility and Conservation in Contemporary Cities: A(n) (Im)possible Coupling
Authors: Pretto Albertina , Everett Glyn
Published: November 2019

Cities are built by and for able-bodied people and are often composed of a range of elements that make them partially (or not) accessible to disabled people. Architectural barriers within and around buildings can limit disabled people’s access to structures and services, precluding their full participation in a social life. It is not possible to talk about making further social progress until disabled people are no longer victims of marginalisation caused by our urban architecture. In order to identify some specific problems and possible solutions, a qualitative research study was carried out in a city in northern Italy, involving people with sensory and physical impairments. Findings indicate that cities in general, and the oldest ones in particular, can present an important problem: some historic centres and buildings are not (or cannot be) restored to become more accessible.

This lack of accessibility will increase the exclusion of disabled people by imposing limitations and restrictions, from mobilising around urban centres, to use of pavements, entry into shops or workplaces, through to accessing treatment and health services. Moreover, this research demonstrates that, in many cases, relatively inexpensive and simple measures and arrangements might be enough to help tackle and solve many of these problems. This paper argues that a first, fundamental step in looking to improve access should be to involve disabled people in participatory planning. These users will be the best experts of their own needs and some of the best informed about the attributes and particularities of any alterations or adaptations needed to help them negotiate, manage and plan the areas in which they live.
Nonsuicidal self-injury in mentally ill patients: a clinical case
Authors: Balabanova V. V. , Tyuvina N. A. , Voronina E. O. , Goncharova E. M. , Dmitrieva A. A.
Published: November 2019

Nonsuicidal self-injuries (autotomy, self-inflicted destruction, self-mutilation) is a variant of autoaggression in a patient without the intent to take his/her own life. Patients with the consequences of self-injuries receive help from physicians of various specialties, who often cannot determine their motivation for autoaggressive actions, since it is associated with mental disorders. The paper presents data on phenomenology, some classifications and motivation of nonsuicidal self-injuries. Various mental disorders are noted to be the most common cause of autoaggressive behavior. The paper describes a clinical case of a female patient who has mutilated her face for a long time, hiding the cause of her autoaggressive action. A detailed clinical and psychopathological analysis of her medical history and mental status allowed for classifying hypochondriacal delirium within schizophrenia as a cause of self-mutilating actions. The motivation for this behavior was to fight against a pseudotumor, for which the patient suffered pain and prolonged suppurative processes on the skin of the face, without visiting physicians.
Timor-Leste 1974–1975: Decolonisation, a nation-in-waiting and an adult literacy campaign
Authors: Cabral Estêvão
Published: November 2019

This article contributes to the strand of research within the New Literacy Studies that has investigated the ways in which adult literacy campaigns are bound up with social and political movements. The focus is on the adult literacy campaign initiated in Timor-Leste in 1974, as the process of decolonisation from Portugal got underway. This campaign was based on a Freirean approach to adult literacy and was initiated by Timorese students returning from Lisbon. The article draws on archival research and oral history interviews with people who volunteered to serve as adult literacy tutors at the time. The analysis presented in the main body of the article provides insights into the nature of the training, and into the tutors’ own understandings of the purpose of the campaign and of adult literacy pedagogy. It also draws attention to the difficult conditions in which this short-lived campaign was conducted in 1974 and 1975. The final section of the article details the worsening nature of the conditions encountered after the Indonesian invasion of December 1975 and concludes that, despite the constraints imposed by these conditions, this campaign has had an enduring symbolic legacy in the field of adult literacy education in Timor-Leste.
Adult literacy in Timor-Leste: Insights from ethnographic research with teachers, learners and coordinators of contemporary literacy programs
Authors: Boon Danielle
Published: November 2019

This article is based on ethnographically-informed research carried out as part of a wider study of adult literacy education in Timor-Leste (Boon 2014). The research was designed as a multi-site and multi-scalar case study that was conducted in 2011. It included class observations and interviews with adult learners, teachers and coordinators who were involved in different types of literacy programs. In the article, I present some of the insights that I gleaned into the ways in which the research participants understood what it means to be literate, into their representations of the significance of involvement in literacy programs, into their understandings of the challenges and opportunities associated with such programs and into their discourses about literacy. The research findings are presented in three central sections of the article as follows: (1) literacy in the lives of adult learners; (2) teachers and coordinators navigating the challenges and opportunities of local literacy programs; and (3) teachers’ and coordinators’ discourses about adult literacy. The research presented here complements other research on adult literacy in Timor-Leste by building knowledge about what is happening “on the ground” in post-independence literacy programs.
Knowledge Sharing Limitations among Academia: Analytic Network Process Approach
Authors: Oyenuga Olamilekan Gbenga , Adebiyi Sulaimon Olanrewaju , Dakare Olamitunji , Omoera Charles I.
Published: November 2019

The importance of the continuous regeneration of value-resource that is knowledge cannot be overemphasized, especially owing to its strategic importance in promoting competitive edge within institutions. Therefore, universities being knowledge-based institutions need to understand that the bane to knowledge sharing amid its staffs is of great relevance. Thus, this study examined the multiple conflicting criteria influencing the will of an average academia to share knowledge within its environment through the utilization of an operations research model named analytical network process.
Private Labor Market Intermediaries in the Europeanized Live-in Care Market between Germany and Poland: A Typology
Authors: Leiber Simone , Matuszczyk Kamil , Rossow Verena
Published: November 2019

This article looks at the role of private companies involved in organizing so-called live-in care arrangements between two EU member states, Germany and Poland. Due to gaps in the public long-term care system, employing livein migrant care workers in private households has become a widespread individualized solution to rising long-term care needs in Germany. Since eastern EU enlargement, private brokerage agencies placing Polish live-in migrant care workers in German households have grown considerably. Building on approaches conceptualizing the role of intermediaries in formalizing domestic work, we aim to provide a more fine-grained typology of private brokerage agencies, taking into account not only the legal environment and structural features of these private enterprises, but also theirstrategic positioningunder conditions of high legal uncertainty in the EU multi-level governance system. By analyzing corporate as well as political strategies of these intermediaries, we distinguish three different agency types we call pioneers, minimum effort players and followers.
Functional AssessmentIn Vivoof the Mouse Homolog of the Human Ala-9-Ser NHE6 Variant
Authors: Ouyang Qing , Joesch-Cohen Lena , Mishra Sasmita , Riaz Hasib A. , Schmidt Michael , Morrow Eric M.
Published: November 2019

Christianson syndrome (CS) is an X-linked neurogenetic disorder resulting from loss-of-function (LoF) mutations inSLC9A6, which encodes the endosomal Na+/H+exchanger 6 (NHE6). NHE6 regulates proton efflux from endosomes and, thus, participates in regulating cargo processing and trafficking. LoF mutations in NHE6 cause aberrant acidification of endosomes. While CS arises in males generally due to clear LoF mutations, other potentially hypomorphic variants have emerged, yet most of these variants have not been evaluated for functional effects, particularlyin vivo. Here we characterize anSLC9A6variant that has been previously reported in patients, yet now also appears in exome datasets of largely control individuals—c.25G>T, p.A9S. By heterologous expression in cell lines, we show that human NHE6A9S is expressed and localizes in a manner comparable to control NHE6. By genome editing, we generated the equivalent NHE6 mutation in mouse—p.A11S—and determined that male NHE6A11S mice have normal brain size at 6 months of age and do not show cerebellar degeneration or defective neuronal arborization. Neurons from male NHE6A11S mice also did not demonstrate an abnormality in intraendosomal pH compared with controls. These findings are in contrast to findings in NHE6-null mice previously reported and indicate that the NHE6A11S variant functions at a level equivalent to control NHE6 for many of the assays performed. These data stand in support of the population genetic data, which are also evaluated here, indicating that the A9S variant is unlikely to confer disease susceptibility with high penetrance.
Disrupted Blood-Retina Lysophosphatidylcholine Transport Impairs Photoreceptor Health But Not Visual Signal Transduction
Authors: Lobanova Ekaterina S. , Schuhmann Kai , Finkelstein Stella , Lewis Tylor R. , Cady Martha A. , Hao Ying , Keuthan Casey , Ash John D. , Burns Marie E. , Shevchenko Andrej , Arshavsky Vadim Y.
Published: November 2019

Retinal photoreceptor cells contain the highest concentration of docosahexaenoic acid (DHA) in our bodies, and it has been long assumed that this is critical for supporting normal vision. Indeed, early studies using DHA dietary restriction documented reduced light sensitivity by DHA-deprived retinas. Recently, it has been demonstrated that a major route of DHA entry in the retina is the delivery across the blood–retina barrier by the sodium-dependent lipid transporter, Mfsd2a. This discovery opened a unique opportunity to analyze photoreceptor health and function in DHA-deprived retinas using theMfsd2aknock-out mouse as animal model. Our lipidome analyses ofMfsd2a−/−retinas and outer segment membranes corroborated the previously reported decrease in the fraction of DHA-containing phospholipids and a compensatory increase in phospholipids containing arachidonic acid. We also revealed an increase in the retinal content of monounsaturated fatty acids and a reduction in very long chain fatty acids. These changes could be explained by a combination of reduced DHA supply to the retina and a concomitant upregulation of several fatty acid desaturases controlled by sterol regulatory element-binding transcription factors, which are upregulated inMfsd2a−/−retinas.Mfsd2a−/−retinas undergo slow progressive degeneration, with ∼30% of photoreceptor cells lost by the age of 6 months. Despite this pathology, the ultrastructureMfsd2a−/−photoreceptors and their ability to produce light responses were essentially normal. These data demonstrate that, whereas maintaining the lysophosphatidylcholine route of DHA supply to the retina is essential for long-term photoreceptor survival, it is not important for supporting normal phototransduction.

SIGNIFICANCE STATEMENTPhospholipids containing docosahexaenoic acid (DHA) are greatly enriched in the nervous system, with the highest concentration found in the light-sensitive membranes of photoreceptor cells. In this study, we analyzed the consequences of impaired DHA transport across the blood–retina barrier. We have found that, in addition to a predictable reduction in the DHA level, the affected retinas undergo a complex, transcriptionally-driven rebuilding of their membrane lipidome in a pattern preserving the overall saturation/desaturation balance of retinal phospholipids. Remarkably, these changes do not affect the ability of photoreceptors to produce responses to light but are detrimental for the long-term survival of these cells.
Iron Metabolism in the Peripheral Nervous System: The Role of DMT1, Ferritin, and Transferrin Receptor in Schwann Cell Maturation and Myelination
Authors: Santiago González Diara A. , Cheli Veronica T. , Wan Rensheng , Paez Pablo M.
Published: November 2019

Iron is an essential cofactor for many cellular enzymes involved in myelin synthesis, and iron homeostasis unbalance is a central component of peripheral neuropathies. However, iron absorption and management in the PNS are poorly understood. To study iron metabolism in Schwann cells (SCs), we have created 3 inducible conditional KO mice in which three essential proteins implicated in iron uptake and storage, the divalent metal transporter 1 (DMT1), the ferritin heavy chain (Fth), and the transferrin receptor 1 (Tfr1), were postnatally ablated specifically in SCs. Deleting DMT1, Fth, or Tfr1in vitrosignificantly reduce SC proliferation, maturation, and the myelination of DRG axons. This was accompanied by an important reduction in iron incorporation and storage. When these proteins were KOin vivoduring the first postnatal week, the sciatic nerve of all 3 conditional KO animals displayed a significant reduction in the synthesis of myelin proteins and in the percentage of myelinated axons. Knocking out Fth produced the most severe phenotype, followed by DMT1 and, last, Tfr1. Importantly, DMT1 as well as Fth KO mice showed substantial motor coordination deficits. In contrast, deleting these proteins in mature myelinating SCs results in milder phenotypes characterized by small reductions in the percentage of myelinated axons and minor changes in theg-ratio of myelinated axons. These results indicate that DMT1, Fth, and Tfr1 are critical proteins for early postnatal iron uptake and storage in SCs and, as a consequence, for the normal myelination of the PNS.

SIGNIFICANCE STATEMENTTo determine the function of the divalent metal transporter 1, the transferrin receptor 1, and the ferritin heavy chain in Schwann cell (SC) maturation and myelination, we created 3 conditional KO mice in which these proteins were postnatally deleted in Sox10-positive SCs. We have established that these proteins are necessary for normal SC iron incorporation and storage, and, as a consequence, for an effective myelination of the PNS. Since iron is indispensable for SC maturation, understanding iron metabolism in SCs is an essential prerequisite for developing therapies for demyelinating diseases in the PNS.
Application of bacteria symbiotic with Butia archeri (Arecaceae) to the biocontrol of the phytopathogenic fungi that deteriorate seeds of Glycine max
Authors: Vitorino Luciana Cristina , Palharini Kelly Maria Zanuzzi , Rocha Ana Flávia de Souza , Prates Letícia Souza , Goulart Lucy Gomes , Silva André Luiz , Bessa Layara Alexandre
Published: November 2019

Rhizospheric and endophytic microorganisms compete with phytopathogens for ecological niches, which led us to hypothesise that bacteria symbiotic with the palm Butia archeri may influence the germination of the seeds of Glycine max and provide effective biocontrol against phytopathogens. We evaluated seed biopriming with rhizospheric strains of the bacteria Enterobacter asburiae and Bacillus cereus, and endophytic strains of Enterobacter cloacae, Enterobacter sp., Bacillus sp. and Pantoea agglomerans. Seeds treated with E. cloacae and Enterobacter sp. presented higher germination potential, germination velocity index and accumulation of fresh biomass in the radicle than seeds that were untreated or treated with other bacteria. Seeds that were not treated were also most affected by fungi, in particular Fusarium and Penicillium, during storage. When treated with B. cereus and E. asburiae, fungal infestation of the stored seeds was reduced to levels similar to those found in seeds treated with chemical fungicide. Our combined analysis of the influence of these strains on radicular growth and the control of phytopathogens, indicates that the rhizospheric strains of B. cereus and E. asburiae may have the best potential for biocontrol. The present study also demonstrated that the microbiota associated with plants native to the Brazilian Cerrado may be a promising source of species or biomolecules with potential for the biocontrol of plant pathogens.
Caregiver Medication Management and Understanding After Pediatric Hospital Discharge
Authors: Philips Kaitlyn , Zhou Roy , Lee Diana S. , Marrese Christine , Nazif Joanne , Browne Constance , Sinnett Mark , Tuckman Steven , Griffith Kimberly , Kiely Victoria , Lutz Marcia , Modi Anjali , Rinke Michael L.
Published: November 2019

OBJECTIVES:

Caregivers frequently make mistakes when following instructions on discharge medications, and these instructions often contain discrepancies. Minimal literature reflects inpatient discharges. Our objective was to describe failures in caregiver management and understanding of inpatient discharge medications and to test the association of documentation discrepancies and sociodemographic factors with medication-related failures after an inpatient hospitalization.

METHODS:

This study took place in an urban tertiary care children’s hospital that serves a low-income, minority population. English-speaking caregivers of children discharged on an oral prescription medication were surveyed about discharge medication knowledge 48 to 96 hours after discharge. The primary outcome was the proportion of caregivers who failed questions on a 10-item questionnaire (analyzed as individual question responses and as a composite outcome of any discharge medication–related failure). Bivariate tests were used to compare documentation errors, complex dosing, and sociodemographic factors to having any discharge medication-related failure.

RESULTS:

Of 157 caregivers surveyed, 70% had a discharge medication–related failure, most commonly because of lack of knowledge about side effects (52%), wrong duration (17%), and wrong start time (16%). Additionally, 80% of discharge instructions provided to caregivers lacked integral medication information, such as duration or when the next dose after discharge was due. Twenty five percent of prescriptions contained numerically complex doses. In bivariate testing, only race and/or ethnicity was significantly associated with having any failure (P = .03).

CONCLUSIONS:

The majority of caregivers had a medication-related failure after discharge, and most discharge instructions lacked key medication information. Future work to optimize the discharge process to support caregiver management and understanding of medications is needed.
Update on Erythropoiesis-Stimulating Agents Administered to Neonates for Neuroprotection
Authors: Maxwell Jessie R. , Ohls Robin K.
Published: November 2019

Erythropoiesis-stimulating agents (ESAs) such as erythropoietin and darbepoetin have been studied as red blood cell growth factors in preterm and term infants for more than 30 years. Recently, studies have focused on the potential neuroprotective effects of ESAs. In this review, we summarize preclinical animal models and recent clinical trials that provide evidence for ESAs as potential treatments to improve neurodevelopmental outcomes in preterm and term infants.
Querying Dialogues: A Performative Editorial on Queering Music Therapy
Authors: Bain Candice , Gumble Maevon
Published: November 2019

Queer theory is a post-structuralist critical theory that destabilizes sexuality and gender categories and challenges the concept of normal, fixed, and binary identities. This approach to understanding identities has evolved into a verb, “queering,” to encapsulate an action or method of challenging a range of systems of oppression. Literature on the application of queer theory to the field of music therapy is developing, particularly the expansion of queer theory to identities beyond sexuality and gender in the clinical space. For example, how does queer theory apply to music therapy with clients of multiple, intersecting marginalized identities, such as those who are disabled, ethnic minorities, etc. How do we move beyond fixed categories, attend to intersectionality, and resist the pathologization of those we work with? Ultimately, queer theory offers opportunities to push us in new directions for how we understand therapists, therapy participants, the therapeutic relationship, and radically inclusive practice.
Metastatic Thymoma Harboring a Deleterious BRCA2 Mutation Derives Durable Clinical Benefit from Olaparib
Authors: Principe Daniel R. , Kamath Suneel D. , Munshi Hidayatullah G. , Mohindra Nisha A.
Published: November 2019

Thymomas comprise a group of rare epithelial neoplasms of the anterior mediastinum. Whereas localized disease carries a favorable prognosis, the majority of patients with metastatic thymomas experience progression or recurrence over a 10-year period. Although targeted therapies have become standard of care in many malignancies, no clinically actionable mutations have consistently been identified in metastatic thymomas. Here, we describe a patient with an aggressive thymoma complicated by extensive pleural metastases. Over a 16-year period, she progressed on multiple treatment regimens. To identify additional treatment options, tissue from a pleural metastasis was sent for next-generation sequencing, revealing mutations in BRCA2, tyrosine kinase 2, and SET domain containing 2. Based on supporting evidence for poly (ADP-ribose) polymerase (PARP) inhibition in other BRCA-mutated tumors, the patient was started on the PARP inhibitor olaparib. She derived significant clinical benefit from treatment, with imaging showing overall stabilization of her disease. Here, we review the genotyping results of her tumor and discuss the functional and clinical significance of the mutations in her cancer as well as implications for managing patients with advanced BRCA-mutant thymomas.

Key Points

Targeted therapy has yet to enter the standard clinical management of metastatic thymomas. Patients with BRCA2-mutant thymomas may benefit from poly (ADP-ribose) polymerase inhibition.
Influence of phase composition and local crystal structure on the transport properties of ZrO2−Y2O3 and ZrO2−Gd2O3 solid solutions
Authors: Agarkova E. A. , Borik M. A. , Bublik V. T. , Volkova T. V. , Kulebyakin A. V. , Kuritsyna I. E. , Larina N. A. , Lomonova E. E. , Milovich F. O. , Myzina V. A. , Ryabochkina P. A. , Tabachkova N. Yu.
Published: November 2019

Abstract. The results of investigation of crystal structure, ion conductivity and local structure of solid solutions (ZrO2)1−x(Gd2O3)x and (ZrO2)1−x(Y2O3)x (x = 0.04, 0.08, 0.10, 0.12, 0.14). The crystals were grown by directional crystallization of the melt in a cold container. The phase composition of the crystals was studied by X−ray diffractometry and transmission electron microscopy. Transport characteristics were studied by impedance spectroscopy in the temperature range 400—900 °C. The local crystal structure was studied by optical spectroscopy. Eu3+ ions were used as a spectroscopic probe. The results of the study of the local structure of solid solutions of ZrO2—Y2O3 and ZrO2—Gd2O3 systems revealed the peculiarities of the formation of optical centers, which reflect the nature of the localization of oxygen vacancies in the crystal lattice depending on the stabilizing oxide concentration. It is established that the local crystal environment of Eu3+ Ions in solid solutions (ZrO2)1−x(Y2O3)x and (ZrO2)1−x(Gd2O3)x is determined by the stabilizing oxide concentration and practically does not depend on the type of stabilizing oxide (Y2O3 or Gd2O3). The maximum conductivity at 900 °C was observed in crystals containing 10 mol.% Gd2O3 and 8 mol.% Y2O3. These compositions correspond to the t′′−phase and are close to the boundary between the regions of the cubic and tetragonal phases. It was found that in the system ZrO2—Y2O3 stabilization of the highly symmetric phase occurs at a lower stabilizing oxide concentration than in the system ZrO2—Gd2O3. Analysis of the data obtained allows us to conclude that in this range of compositions the main influence on the concentration dependence of the ion conductivity has a phase composition, rather than the nature of the localization of oxygen vacancies in the crystal lattice.