bluuebunny/crossref_metadata_2025 huggingface dataset:
Will converting naloxone to over‐the‐counter status increase pharmacy sales?
Authors: Murphy Sean M. , Morgan Jake R. , Jeng Philip J. , Schackman Bruce R.
Published: February 2019

Objective

To estimate the own‐price elasticity of demand for naloxone, a prescription medication that can counter the effects of an opioid overdose, and predict the change in pharmacy sales following a conversion to over‐the‐counter status.

Data Sources/Study Setting

The primary data source was a nationwide prescription claims dataset for 2010‐2017. The data cover 80 percent of US retail pharmacies and account for roughly 90 percent of prescriptions filled. Additional covariates were obtained from various secondary data sources.

Study Design

We estimated a longitudinal, simultaneous equation model of naloxone supply and demand. Our primary variables of interest were the quantity of naloxone sold, measured as total milligrams sold at pharmacies, and the out‐of‐pocket price paid per milligram, both measured per ZIP Code and quarter‐year.

Data Collection/Extraction Methods

Primary data came directly from payers and processors of prescription drug claims.

Principal Findings

We found that, on average, a 1 percent increase in the out‐of‐pocket price paid for naloxone would result in a 0.27 percent decrease in pharmacy sales. We predict that the total quantity of naloxone sold in pharmacies would increase 15 percent to 179 percent following conversion to over‐the‐counter status.

Conclusions

Naloxone is own‐price inelastic, and conversion to over‐the‐counter status is likely to lead to a substantial increase in total pharmacy sales.
Postmortem Analysis of Electrogram Records from an Implantable Cardioverter‐Defibrillator (ICD) in the Reconstruction of a Road Traffic Accident
Authors: Kaliszan Michał , Daniłowicz‐Szymanowicz Ludmiła , Kempa Maciej , Tomczak Ewa , Krzyżanowska Marta , Jankowski Zbigniew , Raczak Grzegorz
Published: February 2019

The case of a 69‐year‐old man, equipped with an ICD and suffering from several chronic cardiac diseases, who died in a car accident, was presented. We analyzed electrogram records from the ICD explanted from the body during the autopsy, which showed that the driver had suffered from malignant ventricular arrhythmia—ventricular fibrillation (VF). A thorough analysis of the details of the accident, as well as the timing of VF and the rhythm observed after the discharge of the ICD showed that the direct cause of the accident was the episode of arrhythmia resulting in a loss of consciousness. Therefore, the presented case illustrates the usefulness of postmortem analysis of electrogram records from ICDs in the reconstruction of road traffic accidents. In such cases, if the victims are implanted with ICDs, it should be a routine procedure performed by forensic pathologists.
A surgical case of ciliated muconodular papillary tumor
Authors: Yao Xiaojun , Gong Yanrong , Zhou Jian , Lyu Mengyuan , Zhang Hongewei , Zhou Haining , Luo Qichi , Liu Lunxu
Published: February 2019

Ciliated muconodular papillary tumor (CMPT) is a rare type of pulmonary tumor with mucoid features. Only a few cases confirmed by surgery have been reported worldwide. We report a case of CMPT following sublobectomy, with no recurrence detected in 10 months of follow‐up. The accumulation of similar cases is essential for pathologists and surgeons to improve their understanding of such tumors.
Tyrosine kinase inhibitor acquired resistance mechanism alternates between EGFR and ALK in a lung adenocarcinoma patient
Authors: Hu Yijuan , Xiao Lili , Yang Nong , Zhang Yongchang
Published: February 2019

Drive gene mutation positive non‐small cell lung cancer achieves reliable clinical responses to subsequent target therapy. However, most patients will inevitably develop disease progression with multiple treatment failure. Next generation sequencing can identify clear resistance mechanisms. We report a case of a late stage, non‐smoking, male non‐small cell lung cancer patient that developed dual mutations and our attempts to determine the novel resistance mechanism. After systematic chemotherapy, he was administered multiple target therapy according to different genotypes. Larger panel gene detection was adapted after the failure of different treatments to investigate the resistance mechanism. Re‐biopsy and large panel NGS revealed an EGFR mutant lung adenocarcinoma with alternating changes in acquired resistance between EGFR and ALK. The total survival time was 73 months. The genotypes and treatments in this patient provide new insight of target therapy resistance mechanisms. Re‐biopsy and large panel gene detection should be performed for each driver gene mutation to provide precision treatment strategies.
Activation of AMPK‐dependent autophagy in the nucleus accumbens opposes cocaine‐induced behaviors of mice
Authors: Lu Hai‐Feng , Xiao Wen , Deng Si‐Long , Cheng Xiao‐Ling , Zheng Hui‐Ling , Chen Jian‐Guo , Wang Fang
Published: February 2019

Cocaine is a strong central nervous system stimulant, which can induce drug addiction. Previous studies have reported that cocaine‐induced autophagy is involved in neuroinflammation and cell death. However, the role of autophagy in psychomotor sensitivity to cocaine has not been explored. Here, we reported that D1 receptor ‐CaMKII‐AMPK‐FoxO3a signaling pathway was involved in acute cocaine application‐induced autophagy in the nucleus accumbens (NAc) both in vitro and in vivo. Furthermore, we found that knockdown of the ATG5 gene in the NAc augmented behavioral response to cocaine, and induction of autophagy in the NAc with rapamycin attenuated cocaine‐induced behavioral response, which was coincident with the alterations of dendritic spine density in neurons of NAc. These results suggest that cocaine exposure leads to the induction of autophagy, which is a protective mechanism against behavioral response to cocaine of male mice.
A significant solidus: Punctuating sexual exploitation with discretionary practices
Authors: Phillips Catherine
Published: February 2019

In this article, I report on a study that examined how young people are framed within formalized child welfare reviews. The study examined reports of serious case reviews (SCRs) in England over a 6‐year period, 2008–2016. I report on a data set on sexual exploitation. I focus on both the professionals and the reviewers, who are considered experts in child protection. The study focused on two aspects: one, how did professionals produce a “young person,” and two, how is the cultural identity of a young person represented within, and (re)produced by, these documents. A thematic analysis was used to analyse the data. I report on both the semantic and latent levels, discussing the words and phrases used, and the meaning they carry as situated across multiple SCRs. The analysis revealed that young people are literally seen through a visual lens, figuratively through a series of labels and produced as an autonomous, free subject. I conclude by arguing that age is applied in a visual and highly problematic way.
Systematic review of quality of life in persons with hereditary thoracic aortic aneurysm and dissection diagnoses
Authors: Velvin Gry , Wilhelmsen Jan E. , Johansen Heidi , Bathen Trine , Geirdal Amy Ø.
Published: February 2019

The purpose of this study was to explore the literature on quality of life (QoL) in patients with hereditary thoracic aortic aneurysm and dissection (HTAAD); including Marfan syndrome (MFS), Loeys‐Dietz syndrome (LDS), vascular Ehlers‐Danlos syndrome (vEDS) and other HTAAD diagnoses, critically appraising and synthesizing the relevant literature. A systematic review was performed by searching the published literature using available medical, physical, psychological, social databases and other sources. Studies addressing QoL in persons with an HTAAD diagnosis, published in peer‐reviewed journals were assessed. Of 227 search results, 20 articles satisfied the eligibility criteria. No studies of QoL in LDS, vEDS, or other HTAAD were found, only on MFS. Most studies had been published in the last 3 years. All were cross‐sectional quantitative studies besides one pilot intervention study. Most studies were of small sample size, had low response rate or participants without verified diagnosis. Despite these limitations, most studies indicate that having an HTAAD diagnosis as MFS may negatively impact QoL, but few studies found any associations between the biomedical symptoms and decreased QoL. More research is needed on QoL in samples with verified HTAAD diagnosis to develop evidence‐based knowledge and appropriate guidelines for these diagnoses.
Urban Redevelopment, Cultural Philanthropy and the Commodification of Artistic Authenticity in Toronto
Authors: Bain Alison L. , March Loren
Published: February 2019

This article offers a multiscalar, sociohistoric account of the spatial struggles of Toronto artists from 1970 until the present to secure affordable living and work space downtown that foregrounds the contemporary role of the cultural philanthropist–developer. It argues that the cultural capital of artists to identify and embody authenticity facilitated temporary spatial claims that supported the development of a local art scene on Queen Street West, but one that became dependent upon, yet vulnerable to, the sociospatial unevenness of cultural philanthropy. Benevolence in arts and culture is not distributed evenly across time and space. Instead, as the case study of the 401 Richmond arts hub reveals, benevolence in its alliances with the real estate market and property development is concentrated in individualized commitments to particular neighborhoods, buildings, and local relationships, which temporally and operationally constrains its policy–transforming potential.
A moderate Buddhist animal research ethics
Authors: Fenton Andrew
Published: February 2019

Though there is a burgeoning interest in applied Buddhist ethics, Buddhist animal research ethics remains an underdeveloped area. In this paper I will explore how some central Buddhist ethical considerations can usefully engage our use of other animals (henceforth, animals) in science. As the scientific use of animals is broad, I will narrow my focus to laboratory science. I will show that, though a Buddhist abolitionism would not be unmotivated, it is possible to reject it. While doing so, it will be important to resist emphasizing elements of Buddhist thought that merely provide reasons to adopt the dominant ethical framework governing laboratory animal research ethics, known as the 3Rs. Though I will suggest how a Buddhist animal research ethics can sometimes permit the use of animals in harmful research, it will also require ethical constraints that resonate with some of the more progressive elements in ‘Western’ bioethics.
Decision aids for people with Type 2 diabetes mellitus: an effectiveness rapid review and meta‐analysis
Authors: Karagiannis T. , Andreadis P. , Manolopoulos A. , Malandris K. , Avgerinos I. , Karagianni A. , Tsapas A.
Published: February 2019

Aims

To perform a rapid review and meta‐analysis of randomized controlled trials (RCTs) evaluating patient decision aids (PtDAs) for people with Type 2 diabetes mellitus.

Methods

We searched Medline and the Cochrane Library for RCTs assessing PtDAs in people with Type 2 diabetes. PtDAs were defined as tools designed to help people engage in decision‐making about healthcare options, such as making treatment choices or setting therapeutic goals. The study selection process was facilitated by an automated screening tool to identify RCTs. We classified outcomes into seven domains and conducted meta‐analyses using random effects models.

Results

We included a total of 15 studies, nine of which were cluster RCTs, that evaluated 10 PtDAs. Thirteen trials compared a PtDA with usual care or usual care plus educational material, whereas two RCTs compared individually tailored vs. non‐tailored PtDAs. Meta‐analyses showed a favourable effect of PtDAs compared with usual care in reducing decisional conflict [weighted mean difference (WMD) −4.66, 95% confidence interval (CI) −7.93 to −1.39] and in improving knowledge (WMD 20.46, 95% CI 9.13 to 3.77). Use of PtDAs resulted in more active involvement in decision‐making during the consultation, although no effect was evident in terms of glycaemic control or self‐reported medication adherence.

Conclusions

PtDAs for people with Type 2 diabetes can improve the quality of decision‐making and increase knowledge transfer. Interpretation of our findings is attenuated due to limitations related to the rapid review approach, including searching only two databases and performing data extraction and risk of bias assessment by a single reviewer.
Who are the People in my Neighborhood?: The “Contextual Fallacy” of Measuring Individual Context with Census Geographies
Authors: Fowler Christopher S. , Frey Nathan , Folch David C. , Nagle Nicholas , Spielman Seth
Published: February 2019

Scholars frequently use counts of populations aggregated into geographic units like census tracts to represent measures of neighborhood context. Decades of research confirm that variation in how individuals are aggregated into geographic units can dramatically alter analyses conducted with these units. While most researchers are aware of the problem, they have lacked the tools to determine its magnitude or its capacity to affect analytical results obtained using these contextual measures. Using confidential access to the complete 2010 U.S. Decennial Census, we can construct—for all persons in the U.S.—individual‐specific contexts, which we group according to Census‐assigned block, block group, and tract. We compare these individual‐specific measures to the published statistics at each scale, and we then determine the degree to which published measures could be affected by how boundaries are drawn using a simple statistic, the standard deviation of individual context (SDIC). For three key measures (percent Black, percent Hispanic, and Entropy—a measure of ethno‐racial diversity), we find that block‐level Census statistics frequently contain a high degree of uncertainty meaning that they may not capture the actual context of individuals within them. More problematic, we uncover systematic spatial patterns in the uncertainty associated with contextual variables at all three scales.
Freighting English law: interpreting maritime spaces, law and the Armenian strategies in the Indian Ocean
Authors: SENGUPTA SANTANU
Published: February 2019

In this article, I examine the formation of the English East India Company's legal regime in the Indian Ocean between the mid‐eighteenth and early nineteenth centuries. I look at how this process affected maritime trade and space from the vantage point of Armenian merchants' interactions with the colonial regime in the courts of law. The productive tensions arising from the colonial regime's new protocols and the merchants' leveraging tactics make for a complex story of Anglo‐Armenian dialogue. I argue that indigenous agency in the colonial courts complicated the binary colonial/indigenous structure. The idea of legal pluralism that emerges from the article suggests that the identity of an imperial subject or the definition of law was neither a given nor simply imposed through colonial coercion but was a complex product of a long‐term dialogue and rationalization.
Natural variation in the promoter of OsHMA3 contributes to differential grain cadmium accumulation between Indica and Japonica rice
Authors: Liu Chao‐Lei , Gao Zhen‐Yu , Shang Lian‐Guang , Yang Chang‐Hong , Ruan Ban‐Pu , Zeng Da‐Li , Guo Long‐Biao , Zhao Fang‐Jie , Huang Chao‐Feng , Qian Qian
Published: February 2019

Rice is a major source of cadmium (Cd) intake for Asian people. Indica rice usually accumulates more Cd in shoots and grains than Japonica rice. However, underlying genetic bases for differential Cd accumulation between Indica and Japonica rice are still unknown. In this study, we cloned a quantitative trait locus (QTL) grain Cd concentration on chromosome 7 (GCC7) responsible for differential grain Cd accumulation between two rice varieties by performing QTL analysis and map‐based cloning. We found that the two GCC7 alleles, GCC7PA64s and GCC793‐11, had different promoter activity of OsHMA3, leading to different OsHMA3 expression and different shoot and grain Cd concentrations. By analyzing the distribution of different haplotypes of GCC7 among diverse rice accessions, we discovered that the high and low Cd accumulation alleles, namely GCC793‐11 and GCC7PA64s, were preferentially distributed in Indica and Japonica rice, respectively. We further showed that the GCC7PA64s allele can be used to replace the GCC793‐11 allele in the super cultivar 93‐11 to reduce grain Cd concentration without adverse effect on agronomic traits. Our results thus reveal that the QTL GCC7 with sequence variation in the OsHMA3 promoter is an important determinant controlling differential grain Cd accumulation between Indica and Japonica rice.
Physical therapy in Down syndrome: systematic review and meta‐analysis
Authors: Ruiz‐González L. , Lucena‐Antón D. , Salazar A. , Martín‐Valero R. , Moral‐Munoz J. A.
Published: February 2019

Background

Down syndrome is the most common chromosomal abnormality, with a worldwide incidence of around 0.1% in live births. It is related to several conditions in which the physical therapy could take action‐preventing co‐morbidities. This study aims to evaluate the effectiveness of physical therapy in Down syndrome, to know and compare the effectiveness of different physical therapy interventions in this population.

Methods

A systematic review and a meta‐analysis of randomised controlled trials were conducted. The search was performed during June 2018 in the following databases: PubMed, Web of Science, Physiotherapy Evidence Database and Scopus. The studies were selected using predefined inclusion and exclusion criteria. The Physiotherapy Evidence Database scale evaluated the quality of the methods used in the studies. Subsequently, the data were extracted, and statistical analysis was performed when possible.

Results

A total of 27 articles were included, of which nine contributed information to the meta‐analysis. Statistical analysis showed favourable results for the strength of upper and lower limbs [standardised mean difference (SMD) = 1.46; 95% confidence interval (CI): (0.77–2.15); and SMD = 2.04; 95% CI: (1.07–3.01)] and mediolateral oscillations of balance [SMD = −3.30; 95% CI: (−5.34 to −1.26)].

Conclusions

The results show the potential benefit of certain types of physical therapy interventions, specifically in strength and balance, in people with Down syndrome. There are still many aspects to clarify and new lines of research.
Implementation of the Champions for Skin Integrity model to improve leg and foot ulcer care in the primary healthcare setting
Authors: Parker Chrisina N. , Shuter Patricia , Maresco‐Pennisi Diane , Sargent Jodie , Collins Lou , Edwards Helen E. , Finlayson Kathleen J.
Published: February 2019

Aims

To facilitate evidence‐based leg and foot ulcer management through implementation of the Champions for Skin Integrity model to education in primary health care in Australia.

Background

Leg and foot ulcers are frequently seen wounds in general practice and wound care the most frequently performed activity by practice nurses. The literature reports the lack of evidence‐based leg and foot ulcer assessment, management and prevention strategies in this setting, and previous research in regard to confidence and knowledge has indicated that general practice health professionals have the greatest need for education in wound care.

Design

Pre–post, nonequivalent group research design.

Methods

The Champions for Skin Integrity model of evidence‐based wound management utilised strategies including workshops, development of Champions and use of resources. Pre‐ and post‐implementation health professional surveys and patient clinical audits were completed. Descriptive statistics were calculated for all variables. Paired t tests identified statistically significant differences between the pre/post staff survey data. STROBE guidelines for reporting were followed (See Appendix S1).

Results

One hundred nine general practice healthcare professional staff attended the workshops. Significant outcomes were noted in increased levels of confidence in ability to assess, manage and prevent all types of leg and foot ulcers, as well as to apply evidence‐based practice and change management following workshops. Pre‐ and post‐skin audits also indicated an increase in evidence‐based practices.

Conclusion

Implementation of Champions for Skin Integrity strategies in this sample of primary healthcare professionals in general practice fostered a positive change in evidence‐based wound management, assessment and prevention.

Relevance to clinical practice

The Champions for Skin Integrity model has supported increases in evidence‐based practices in treatment and management of wounds in primary healthcare professionals, similar to the positive outcomes gained in the aged care setting. This is likely to lead to positive outcomes for those with wounds in this setting.
An observational study of temperature and thermal images of surgical wounds for detecting delayed wound healing within four days after surgery
Authors: Siah Chiew‐Jiat Rosalind , Childs Charmaine , Chia Chung King , Cheng Kin Fong Karis
Published: February 2019

Aim

To elucidate the infrared thermal patterns and temperature readings of the surfaces of surgical wounds for detecting delayed wound healing within four days after surgery.

Background

The nursing assessment of surgical wounds within the first four days after surgery is commonly based on visual and physical examination. Surgical wounds with delayed healing may be not detected if they do not exhibit signs such as redness or exudate within four days after surgery.

Design

This study was conducted using prospective observational design with reference to the STROBE Statement (see Supporting Information Appendix ) to examine the temperatures of surgical wounds in their natural settings.

Methods

Based on convenience sampling, 60 participants admitted to the colorectal surgical ward for enterostoma closure from January–November 2013 were recruited.

Results

Although both infected and noninfected surgical wounds exhibited a significant increase in wound temperature from Days 1–4, the infected wounds revealed a statistically significantly lower temperature than the noninfected ones. Within the infrared thermal images, the infected wounds presented with partial warming of the skin surrounding and along the incision, suggesting that delayed healing could be identified.

Conclusion

This study demonstrates that delayed wound healing can be detected within the first four days after surgery for early intervention of prevention and treatment before discharge.

Relevance to Clinical Practice

This paper provides evidence‐based information for healthcare professionals in assessing surgical wounds for delayed healing within the first four days after surgery. The findings herein enable the early detection of delayed wound healing, based on which early intervention of prevention and treatment may be instituted for affected patients before their discharge.
Successful management of abnormal uterine bleeding from uterine arteriovenous malformations with progesterone in postabortal patients
Authors: Taneja Ashima , Chopra Isha , Kaur Harmeet , Naik Sushree S. , Aggarwal Reetika , Sachdeva Eshani , Kaur Poonampreet
Published: February 2019

Aim

To study the feasibility of conservative management with progesterone as a treatment option for postabortal patients with uterine arterio‐venous malformations (AVMs).

Methods

This prospective observational study was conducted in the tertiary care teaching hospital over a period of 2 years. Postabortal patients with abnormal uterine bleeding were enrolled. Diagnosis was made by history, clinical and radiological examinations. Oral norethisterone was used (10 mg twice daily for 3 weeks, maximum of three cycles). Descriptive statistics was used to present the data.

Results

A total of 30 patients were included. Majority (n = 17) had complete resolution of symptoms after a single 3‐week course of progesterone therapy. Rest (n = 13) remained symptomatic and required second course. Of the later, only three remained symptomatic after 2 months, and underwent CT angiography followed by embolization. There was no report of any serious adverse events.

Conclusion

Oral norethisterone is a safe, effective and novel oral drug as an alternative to embolization or surgical therapy for patients with postabortal AVM bleed. Larger studies are required to confirm the findings of the present study.
Crafting social resources on days when you are emotionally exhausted: The role of job insecurity
Authors: Breevaart Kimberley , Tims Maria
Published: February 2019

Workdays are demanding and draw upon one's emotional and physical resource pools. Consequently, employees become exhausted and need to recover by replenishing their resources during and/or after their workday. Building on conservation of resources theory, we argue that employees, especially those with low job insecurity, cope with exhaustion at work by crafting social resources on the days that they are exhausted. Specifically, we expect that employees who are exhausted will use their limited resources to gain social support from their co‐workers and supervisor, but only when employees feel they can profit from this newly gained resource in the long run (i.e., when the risk of losing one's job is low). We tested this idea in a sample of 271 elementary school teachers who filled out an online daily diary at the end of each workday for a period of 10 workdays (271 × 7.31 days = 1,539 data points). Results of multilevel modelling analyses showed that there was a significant cross‐level interaction effect for perceived risk of losing one's job (i.e., job insecurity). That is, on the days that employees were exhausted, they crafted more social resources, especially when they perceived low (vs. high) job insecurity. Our study shows that exhaustion is not necessarily detrimental to employees and organizations, but may also activate employees to reduce resource loss by proactively searching for support in their work environment.

Practitioner points

On a daily basis, employees who are exhausted search for social resources such as social support from colleagues.

Employees especially try to deal with their exhaustion by crafting social resources when they generally feel that their job is not at risk (i.e., low job insecurity).
Carbon forms, nutrients and water velocity filter hydrophyte and riverbank species differently: A trait‐based study
Authors: Lukács Balázs A. , E‐Vojtkó Anna , Erős Tibor , Molnár V. Attila , Szabó Sándor , Götzenberger Lars
Published: February 2019

Questions

The majority of theories of trait‐based plant community assembly have been developed and tested predominantly in terrestrial ecosystems. Studies investigating the functional trait composition of aquatic plant communities and their relation to environmental determinants remain scarce. Macrophytes are essential components of aquatic ecosystems, and a more detailed knowledge of their trait‐based assembly is crucial for their management. We identified how plant functional traits respond to environmental gradients in streams and rivers.

Location

Danube River Catchment, Hungary.

Methods

We studied the processes governing community assembly along major environmental gradients related to carbon‐ and nutrient‐limiting factors as well as physical strain. We used six continuous traits (leaf area, specific leaf area, leaf dry matter content, seed weight, seed shape, woodiness) and calculated community‐weighted mean and standardised effect size of functional diversity for each community. We then used stepwise regression analyses for each trait along the environmental gradients to test which environmental factors explain the changes in community‐weighted mean and functional diversity. All analyses were conducted for aquatic (hydato‐helophyte) and riverbank species separately.

Results

We found that the effect of environmental filtering significantly increased toward higher pH, indicating the response of functional traits to carbon limitation. Our results showed trait convergence among riverbank species in rivers with higher productivity. Larger functional diversity (i.e., trait divergence) among hydato‐helophyte species suggests an increase in the diversity of resource acquisition strategies under higher productivity.

Conclusions

Here, we have shown that the functional trait distribution of aquatic and riverbank plant communities responds to major environmental drivers related to nutrient and carbon availability. The understanding of how community assembly mechanisms varied along environmental gradients might be useful when proposing future management and restoration plans and actions towards the conservation of the aquatic vegetation in streams and rivers.
The rise of Clostridioides difficile infections and fall of associated mortality in hospitalized advanced cirrhotics
Authors: Rosenblatt Russell , Mehta Amit , Cohen‐Mekelburg Shirley , Shen Nicole , Snell David , Lucero Catherine , Jesudian Arun , Fortune Brett , Crawford Carl V. , Kumar Sonal
Published: February 2019

Background & Aims

Cirrhotics are at increased risk of Clostridioides difficile infection (CDI) and its associated high morbidity and mortality. However, the impact of CDI in cirrhotics over time remains unclear. This study analyses prevalence and mortality in CDI in hospitalized patients with advanced cirrhosis over 15 years and identifies trends.

Methods

Using the Nationwide Inpatient Sample (NIS) from 1998 to 2014, 3 049 696 weighted patients with advanced cirrhosis (defined as evidence of decompensation or oesophageal varices) were identified using a validated algorithm of ICD‐9‐CM codes and included in the study. Trends were analysed using Cochran Armitage test and joinpoint regression and compared to the general population. Multivariable logistic regression was performed controlling for risk factors that affect mortality in cirrhotics.

Results

CDI prevalence in advanced cirrhotics increased from 0.8% to 2.6%, annual percent change (APC) 8.8% (compared to 7.6% for the general population), while CDI‐related mortality decreased from 20.7% to 11.3%, APC −3.4% (compared to −2.0% for the general population), from 1998 to 2014. CDI independently increased mortality in advanced cirrhotics (OR 1.47, P < 0.001) and was associated with acute kidney injury (AKI) (OR 2.09, P < 0.001), which itself significantly increased mortality (OR 4.54, P < 0.001). Hepatic encephalopathy and Hispanic ethnicity were interestingly associated with a lower prevalence of CDI.

Conclusions

CDI is increasingly common in advanced cirrhotics, but on the contrary, its associated mortality is decreasing. Despite improvements in outcomes in patients with advanced cirrhosis, CDI is associated with an increased mortality, driven by AKI, and therefore, requires aggressive identification and therapy.
Dissimilar responses of fungal and bacterial communities to soil transplantation simulating abrupt climate changes
Authors: Zhao Mengxin , Sun Bo , Wu Linwei , Wang Feng , Wen Chongqing , Wang Mengmeng , Liang Yuting , Hale Lauren , Zhou Jizhong , Yang Yunfeng
Published: February 2019

Both fungi and bacteria play essential roles in regulating soil carbon cycling. To predict future carbon stability, it is imperative to understand their responses to environmental changes, which is subject to large uncertainty. As current global warming is causing range shifts toward higher latitudes, we conducted three reciprocal soil transplantation experiments over large transects in 2005 to simulate abrupt climate changes. Six years after soil transplantation, fungal biomass of transplanted soils showed a general pattern of changes from donor sites to destination, which were more obvious in bare fallow soils than in maize cropped soils. Strikingly, fungal community compositions were clustered by sites, demonstrating that fungi of transplanted soils acclimatized to the destination environment. Several fungal taxa displayed sharp changes in relative abundance, including Podospora, Chaetomium, Mortierella and Phialemonium. In contrast, bacterial communities remained largely unchanged. Consistent with the important role of fungi in affecting soil carbon cycling, 8.1%–10.0% of fungal genes encoding carbon‐decomposing enzymes were significantly (p < 0.01) increased as compared with those from bacteria (5.7%–8.4%). To explain these observations, we found that fungal occupancy across samples was mainly determined by annual average air temperature and rainfall, whereas bacterial occupancy was more closely related to soil conditions, which remained stable 6 years after soil transplantation. Together, these results demonstrate dissimilar response patterns and resource partitioning between fungi and bacteria, which may have considerable consequences for ecosystem‐scale carbon cycling.
The evolutionary history of grey wolf Y chromosomes
Authors: Smeds Linnéa , Kojola Ilpo , Ellegren Hans
Published: February 2019

Analyses of Y chromosome haplotypes uniquely provide a paternal picture of evolutionary histories and offer a very useful contrast to studies based on maternally inherited mitochondrial DNA (mtDNA). Here we used a bioinformatic approach based on comparison of male and female sequence coverage to identify 4.7 Mb from the grey wolf (Canis lupis) Y chromosome, probably representing most of the male‐specific, nonampliconic sequence from the euchromatic part of the chromosome. We characterized this sequence and then identified ≈1,500 Y‐linked single nucleotide polymorphisms in a sample of 145 resequenced male wolves, including 75 Finnish wolf genomes newly sequenced in this study, and in 24 dogs and eight other canids. We found 53 Y chromosome haplotypes, of which 26 were seen in grey wolves, that clustered in four major haplogroups. All four haplogroups were represented in samples of Finnish wolves, showing that haplogroup lineages were not partitioned on a continental scale. However, regional population structure was indicated because individual haplotypes were never shared between geographically distant areas, and genetically similar haplotypes were only found within the same geographical region. The deepest split between grey wolf haplogroups was estimated to have occurred 125,000 years ago, which is considerably older than recent estimates of the time of divergence of wolf populations. The distribution of dogs in a phylogenetic tree of Y chromosome haplotypes supports multiple domestication events, or wolf paternal introgression, starting 29,000 years ago. We also addressed the disputed origin of a recently founded population of Scandinavian wolves and observed that founding as well as most recent immigrant haplotypes were present in the neighbouring Finnish population, but not in sequenced wolves from elsewhere in the world, or in dogs.
Effects of miRNA‐342‐3p in modulating Hedgehog signaling pathway of human umbilical cord mesenchymal stem cells by down‐regulating Sufu
Authors: Qing Ying , Huang Mengqi , Cao Yingguang , Du Tianfeng , Song Ke
Published: February 2019

Objective

Previously, we have shown that miRNA‐342‐3p was increased during osteogenic differentiation of human umbilical mesenchymal stem cells (hUCMSCs) via regulating the sonic hedgehog (Shh) pathway. In this study, our objective is to further investigate the role of miRNA‐342‐3p in activation of Shh pathway by targeting suppressor of fused protein (Sufu), a suppressor of transcriptional factor Gli, as well as the potential interaction with transforming growth factor beta (TGF‐β) signaling pathway during osteogenic induction of hUCMSCs.

Materials and methods

HUCMSCs that stable overexpression or knockdown of miRNA‐342‐3p were established by infection with lentiviral vectors. mRNA and protein levels of Hedgehog signaling pathway and osteogenic genes were measured by RT‐qPCR and western blot assays. Luciferase reporter assay was performed to test the direct binding site of Sufu 5′UTR targeted by miRNA‐342‐3p.

Results

Overexpression of miRNA‐342‐3p in hUCMSCs enhanced the expression of osteogenic genes by targeting Sufu. And the potential of osteogenic differentiation of hUCMSCs was inhibited while knocking down miRNA‐342‐3p. Meanwhile, induced the TGF‐β expression level was also observed upon overexpressing miRNA‐342‐3p, suggesting activation of TGF‐β signaling pathway was a potential mechanism of miRNA‐342‐3p‐mediated osteogenesis in hUCMSCs.

Conclusions

Our findings provide new mechanistic evidence that miRNA‐342‐3p might be a valuable therapeutic target in bone regeneration.
Acute Pain Service: A 10‐Year Experience
Authors: Deni Francesco , Greco Massimiliano , Turi Stefano , Meani Renato , Comotti Laura , Perotti Valeria , Mello Alessandra , Colnaghi Eleonora , Pasculli Nicola , Nardelli Pasquale , Landoni Giovanni , Beretta Luigi
Published: February 2019

Background

Pain management after surgery is crucial to decrease perioperative morbidity and mortality. Acute pain services (APS) are multidisciplinary teams that represent a modern strategy to address pain inside hospitals. The APS defines and applies pain treatment protocols specific for each surgery. To evaluate the performance of the APS at our institute, we performed a large retrospective cohort study focusing on complications of epidural analgesia and IV opiates.

Methods

Data from the 10 years of activity of the APS were collected. Pain was assessed using the VAS at rest (VASr) and during movement (VASm) at each daily visit; the presence of side effects and complications was also assessed.

Results

A total of 17,913 adult patients were followed by APS during the study period. Epidural analgesia was used in 7,776 cases (43%), while 9,239 (52%) patients used IV patient‐controlled analgesia (PCA). A combination of the 2 was used in 87 patients (0.5%). A total of 456 perineural catheters (2.6%) were placed, while 442 patients(2.5%) used other analgesic techniques. We recorded 163 dural punctures during catheter placement, with no epidural hematoma, epidural abscess, or meningitis, and no permanent modification in sensitive or motor functions.

Conclusions

In our large case series, APS was confirmed safe and effective in treating postoperative pain, using both epidural analgesia and IV PCA with morphine.
Eosinophilic pustular folliculitis of infancy suppressed with cetirizine
Authors: Odyakmaz Demirsoy Evren , Demirsoy Uğur , Ozod Umay , Kiran Rebiay
Published: February 2019

Eosinophilic pustular folliculitis of infancy is a rare inflammatory disease characterized by recurrent, itchy sterile pustules mainly located on the scalp. Topical agents are mostly effective to suppress the symptoms in the majority of cases. However, systemic agents that are safe for long‐term use are required for patients with widespread or resistant lesions. We present a case with eosinophilic pustular folliculitis of infancy whose disease was suppressed with cetirizine but recurred after ceasing the drug.
A retrospective cohort study to evaluate the development of comorbidities, including psychiatric comorbidities, among a pediatric psoriasis population
Authors: Paller Amy S. , Schenfeld Jennifer , Accortt Neil A. , Kricorian Gregory
Published: February 2019

Background/Objective

Compared with the adult psoriasis population, knowledge about the incidence of comorbidities in the pediatric psoriasis population is limited. The objective of this study was to assess the prevalence and incidence of comorbidities, including psychiatric comorbidities, in patients with pediatric psoriasis.

Methods

In this claims‐based, retrospective cohort study, patients with pediatric psoriasis were matched 1:3 with a nonpsoriasis cohort based on age, sex, and index date (the earliest of inpatient claims or the latter of two outpatient claims).

Results

Obesity, serious infection, and juvenile idiopathic arthropathy had higher prevalence and incidence rates in the psoriasis cohort than the nonpsoriasis cohort. Psychiatric comorbidities were also more common in the psoriasis cohort than the nonpsoriasis cohort, as were ulcerative colitis and Crohn disease. Stratifying the psoriasis cohort by disease severity—mild and moderate‐to‐severe—found no differences in incidence rates of comorbidities between the two subsets.

Conclusion

The incidence rates of many comorbid conditions were higher for patients with pediatric psoriasis compared with patients without pediatric psoriasis, and similar between patients with moderate‐to‐severe and mild pediatric psoriasis.
Research on the effect and mechanism of antimicrobial peptides HPRP‐A1/A2 work against Toxoplasma gondii infection
Authors: Liu Ran , Ni Yangyue , Song Jingwei , Xu Zhipeng , Qiu Jingfan , Wang Lijuan , Zhu Yuxiao , Huang Yibing , Ji Minjun , Chen Yuxin
Published: February 2019

With increasing antibiotic resistance and drug safety concerns, novel therapeutics are urgently needed. Antimicrobial peptides are promising candidates that could address the spread of multidrug‐resistant pathogens. HPRP‐A1/A2 are known to display antimicrobial activity against gram‐negative bacteria, gram‐positive bacteria and some pathogenic fungi, but whether HPRP‐A1/A2 work on Toxoplasma gondii (T gondii) is unknown. In this study, we found that the viability of tachyzoites that received HPRP‐A1/A2 treatment was significantly decreased, and there was a reduction in the adhesion to and invasion of macrophages by tachyzoites after HPRP‐A1/A2 treatment. HPRP‐A1/A2 damaged the integrity of tachyzoite membranes, as characterized by membrane disorganization in and cytoplasm outflow from tachyzoites. In addition, in vivo injection with HPRP‐A1/A2 resulted in a significantly decreased number of tachyzoites and an accelerated Th1/Tc1 response, and elicited pro‐inflammatory cytokines in T gondii‐infected mice. Furthermore, HPRP‐A1/A2‐treated splenocytes exhibited a significantly increased Tc1/Th1 response, and HPRP‐A1/A2‐stimulated macrophages inhibited the growth of carboxyfluorescein succinimidyl amino ester (CFSE)‐labelled tachyzoites, which had higher TNF‐α/IL‐12 mRNA levels. Altogether, these results imply that HPRP‐A1/A2 are effective against T gondii through damaging the structure of tachyzoites and inducing a protective immune response, which could offer an alternative approach against T gondii infection.
How Service Provider Dependence Perceptions Moderate the Power–Opportunism Relationship with Professional Services
Authors: Handley Sean M. , deJong Jurriaan , Benton W. C.
Published: February 2019

In this study, we develop a novel theoretical model of how the relationship between the buyer's use of power and the service provider's opportunism is moderated by the provider's perceptions of dependence advantage. Analyzing a dyadic dataset of 109 professional service relationships, we find that the extent to which the buyer's use of mediated and non‐mediated power aligns with the service provider's perceptions of relative dependence is germane to the power–opportunism relationship. The notion that firm A's opportunism, in response to firm B's use of power, is in part influenced by firm A's perceptions of the relative dependence in the relationship, constitutes a significant theoretical contribution to the power‐dependence literature. Our findings underline the importance of (i) understanding the relative dependence in an inter‐organizational relationship, (ii) managing the other firm's perception of this dependence, and (iii) ensuring that the use of power is aligned with the other firm's perception of the relative dependence in the relationship.
The self‐perceptions of aging were an important factor associated with the quality of life in Chinese elderly with hypertension
Authors: Gu Rong , Zhang Dandan , Jin Xiaohong , Wu Wenya , Hou Yunying , Wu Qing , Wang Xiaohua
Published: February 2019

Background

In China, quality of life (QOL) of the elderly with hypertension was lower than that of normal elderly and lower self‐perceptions of aging (SPA) in the elderly with chronic diseases have been shown. Previous studies showed that SPA played a key role in QOL of the elderly. We hypothesised that SPA were associated with QOL in Chinese elderly with hypertension, with more negative SPA predicting lower QOL.

Methods

A cross‐sectional survey was conducted in one comprehensive hospital, 15 urban community clinics and 22 rural village clinics in Suzhou. In total, 1029 Chinese elderly with hypertension completed the self‐administered questionnaires, including socio‐demographic and clinical characteristics, aging perceptions questionnaire which contained seven dimensions and Medical Outcomes Study 36‐item Short Form Health Survey evaluating QOL which included physical component summary (PCS) and mental component summary (MCS).

Results

Correlation analysis between SPA and QOL showed that most dimensions of SPA were correlated with PCS and MCS, except for Emotional Representations not correlated with MCS. The results of multivariate logistic regression analysis showed: the dimensions Timeline Chronic (B = −2.651, P < 0.001), Consequences Negative (B = −2.155, P < 0.001) and Emotional Representations (B = −2.672, P < 0.001) had a negative association with PCS, while Timeline Cyclical (B = 1.401, P = 0.023), Consequences Positive (B = 1.200, P = 0.011) and Control Positive (B = 1.425, P = 0.004) had a positive association with PCS; the dimensions Timeline Cyclical (B = −1.734, P < 0.001) and Consequences Negative (B = −1.646, P < 0.001) had a negative association with MCS, while Timeline Chronic (B = 1.313, P < 0.001), Consequences Positive (B = 0.962, P = 0.012), Control Positive (B = 2.453, P < 0.001) and Control Negative (B = 1.860, P < 0.001) had a positive association with MCS.

Conclusions

Our results suggest that negative SPA tended to be associated with lower QOL in Chinese elderly with hypertension. Some measures to improve unhealthy negative SPA should be delivered to improve QOL in Chinese elderly with hypertension.
How Do Intrinsic Motivations, Work‐Related Opportunities, and Well‐Being Shape Bureaucratic Corruptibility?
Authors: Zhang Yahong , Kuo Ming‐feng , Guo Jinyun , Wang Chun‐yuan
Published: February 2019

A large body of research focuses on the institutional factors that shape country‐level corruption and the effectiveness of macro‐level anticorruption measures; however, corruption at the individual level remains understudied and thus poorly understood. This article examines the underlying causes of and mechanisms through which individual government bureaucrats engage in corruption. The researchers develop a framework that incorporates intrinsic motivations, work‐related opportunities, and work‐related well‐being to test the ways in which these micro‐level factors shape bureaucrats' propensity to engage in corrupt behaviors (or corruptibility). Using survey data from more than 1,300 Chinese public employees, the authors identify direct and indirect effects on corruptibility and discuss theoretical and practical implications.