bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative changes in the secretion of exosomes from keratinocytes homeostatically regulate skin pigmentation in a paracrine manner
Authors: Takano Kei , Hachiya Akira , Murase Daiki , Tanabe Hiroki , Kasamatsu Shinya , Takahashi Yoshito , Moriwaki Shigeru , Hase Tadashi
Published: January 2020

The content and distribution of melanin in the epidermis determines the wide variety of skin colors associated with ethnic/racial diversity. Although it was previously reported that qualitative changes in keratinocyte‐derived exosomes regulate melanocyte pigmentation in vitro, their practical involvement, especially in skin color development in vivo, has remained unclear. To address this unexplained scientific concern, the correlation of epidermal exosomes isolated from human skin tissues with melanosomal protein expression levels was demonstrated in this study for the first time. After confirming the quantitative effect of human keratinocyte‐derived exosomes on human melanocyte activation, even in the absence of ultraviolet B (UV‐B) exposure, the impact of exosomes secreted from UV‐B‐irradiated keratinocytes on melanogenesis was consistently detected, which suggests their constitutive role in regulating cutaneous pigmentation. Additionally, both a specific exosome secretion inducer and a suppressor were consistently found to significantly control melanin synthesis in a co‐culture system composed of keratinocytes and melanocytes as well as in an ex vivo skin culture system. These results suggest that quantitative changes, in addition to already known qualitative changes, in exosomes secreted from human epidermal keratinocytes homeostatically regulate melanogenic activity in a paracrine manner, which leads to skin color determination.
The association of hospital teaching intensity with 30‐day postdischarge heart failure readmission and mortality rates
Authors: Shahian David M. , Liu Xiu , Mort Elizabeth A. , Normand Sharon‐Lise T.
Published: January 2020

Objective

To investigate risk‐adjusted, 30‐day postdischarge heart failure mortality and readmission rates stratified by hospital teaching intensity.

Data Sources and Study Setting

A total of 709 221 Medicare fee‐for‐service beneficiaries discharged from 3135 US hospitals between 1/1/2013 and 11/30/2014 with a principal diagnosis of heart failure.

Study Design

Hospitals were classified as Council of Teaching Hospitals and Health Systems (COTH) major teaching hospitals, non‐COTH teaching hospitals, and nonteaching hospitals. Hospital teaching status was linked with MedPAR patient data and FY2016 Hospital Readmission Reduction Program penalties. Index hospitalization survival probabilities were estimated with hierarchical logistic regression and used to stratify index hospitalization survivors into severity deciles. Decile‐specific models were estimated for 30‐day postdischarge readmission and mortality. Thirty‐day postdischarge outcomes were estimated by teaching intensity and penalty categories.

Principal Findings

Averaged across deciles, adjusted 30‐day COTH hospital readmission rates were, on a relative scale ([COTH minus nonteaching] ÷ nonteaching), 1.63 percent higher (95% CI: 0.89 percent, 2.25 percent) than at nonteaching hospitals, but their average adjusted 30‐day postdischarge mortality rates were 11.55 percent lower (95% CI: −13.78 percent, −9.37 percent). Penalized COTH hospitals had the highest readmission rates of all categories (23.99 percent [95% CI: 23.50 percent, 24.49 percent]) but the lowest 30‐day postdischarge mortality (8.30 percent [95% CI: 7.99 percent, 8.57 percent] vs 9.84 percent [95% CI: 9.69 percent, 9.99 percent] for nonpenalized, nonteaching hospitals).

Conclusions

Heart failure readmission penalties disproportionately impact major teaching hospitals and inadequately credit their better postdischarge survival.
Actigraphic patterns, impulsivity and mood instability in bipolar disorder, borderline personality disorder and healthy controls
Authors: McGowan N.M. , Goodwin G.M. , Bilderbeck A.C. , Saunders K.E.A.
Published: January 2020

Objectives

To differentiate the relation between the structure and timing of rest‐activity patterns and symptoms of impulsivity and mood instability in bipolar disorder (BD), borderline personality disorder (BPD) and healthy controls (HC).

Methods

Eighty‐seven participants (31 BD, 21 BPD and 35 HC) underwent actigraph monitoring for 28 days as part of the Automated Monitoring of Symptom Severity (AMoSS) study. Impulsivity was assessed at study entry using the BIS‐11. Mood instability was subsequently longitudinally monitored using the digital Mood Zoom questionnaire.

Results

BPD participants show several robust and significant correlations between non‐parametric circadian rest‐activity variables and worsened symptoms. Impulsivity was associated with low interdaily stability (r = −0.663) and weak amplitude (r = −0.616). Mood instability was associated with low interdaily stability (r = −0.773), greater rhythm fragmentation (r = 0.662), weak amplitude (r = −0.694) and later onset of daily activity (r = 0.553). These associations were not present for BD or HCs. Classification analysis using actigraphic measures determined that later L5 onset reliably distinguished BPD from BD and HC but did not sufficiently discriminate between BD and HC.

Conclusions

Rest‐activity pattern disturbance indicative of perturbed sleep and circadian function is an important predictor of symptom severity in BPD. This appears to validate the greater subjective complaints of BPD individuals that are sometimes regarded as exaggerated by clinicians. We suggest that treatment strategies directed towards improving sleep and circadian entrainment may in the future be investigated in BPD.
Reference values and secular trends for cardiorespiratory fitness in children and adolescents with obesity
Authors: Johansson Linnea , Brissman Markus , Morinder Gunilla , Westerståhl Maria , Marcus Claude
Published: January 2020

Aim

To present specific reference values for cardiorespiratory fitness (CRF) in children with obesity and to analyse secular trends of CRF in the studied population.

Methods

Cardiorespiratory fitness, the maximal oxygen uptake (VO2 max), was estimated with the Åstrand‐Rhyming submaximal bicycle test, in 705 Swedish children (356 girls, 8‐20 years) with obesity according to the International Obesity Task Force (IOTF). Data were collected from 1999 to 2013. Secular trends, analysed with multiple linear regression, were adjusted for age, height and body mass index standard deviation score (BMI SDS).

Results

All children had low CRF compared with normal weight standards but there was a marked variability of CRF in children with obesity, which was possible to quantify with the developed obesity specific CRF reference values. The mean value of absolute VO2 max (L/min) increased with age and relative VO2 max (mL/kg/min) decreased with age in both boys and girls. There was a negative secular trend in both sexes (P < .001).

Conclusion

These are the first obesity specific reference values of CRF in children enabling clinical evaluation in childhood obesity treatment. Cardiorespiratory fitness in children with obesity has declined the last decades, indicating that also within this vulnerable group physical activity has gone down.
The mechanics of myeloid cells
Authors: Bashant Kathleen R , Toepfner Nicole , Day Christopher J , Mehta Nehal N , Kaplan Mariana J , Summers Charlotte , Guck Jochen , Chilvers Edwin R
Published: January 2020

The effects of cell size, shape and deformability on cellular function have long been a topic of interest. Recently, mechanical phenotyping technologies capable of analysing large numbers of cells in real time have become available. This has important implications for biology and medicine, especially haemato‐oncology and immunology, as immune cell mechanical phenotyping, immunologic function, and malignant cell transformation are closely linked and potentially exploitable to develop new diagnostics and therapeutics. In this review, we introduce the technologies used to analyse cellular mechanical properties and review emerging findings following the advent of high throughput deformability cytometry. We largely focus on cells from the myeloid lineage, which are derived from the bone marrow and include macrophages, granulocytes and erythrocytes. We highlight advances in mechanical phenotyping of cells in suspension that are revealing novel signatures of human blood diseases and providing new insights into pathogenesis of these diseases. The contributions of mechanical phenotyping of cells in suspension to our understanding of drug mechanisms, identification of novel therapeutics and monitoring of treatment efficacy particularly in instances of haematologic diseases are reviewed, and we suggest emerging topics of study to explore as high throughput deformability cytometers become prevalent in laboratories across the globe.
Extensive subpial cortical demyelination is specific to multiple sclerosis
Authors: Junker Andreas , Wozniak Jadwiga , Voigt David , Scheidt Uta , Antel Jack , Wegner Christiane , Brück Wolfgang , Stadelmann Christine
Published: January 2020

Cortical demyelinated lesions are frequent and widespread in chronic multiple sclerosis (MS) patients, and may contribute to disease progression. Inflammation and related oxidative stress have been proposed as central mediators of cortical damage, yet meningeal and cortical inflammation is not specific to MS, but also occurs in other diseases. The first aim of this study was to test whether cortical demyelination was specific for demyelinating CNS diseases compared to other CNS disorders with prominent meningeal and cortical inflammation. The second aim was to assess whether oxidative tissue damage was associated with the extent of neuroaxonal damage. We studied a large cohort of patients diagnosed with demyelinating CNS diseases and non‐demyelinating diseases of autoimmune, infectious, neoplastic or metabolic origin affecting the meninges and the cortex. Included were patients with MS, acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO), viral and bacterial meningoencephalitis, progressive multifocal leukoencephalopathy (PML), subacute sclerosing panencephalitis (SSPE), carcinomatous and lymphomatous meningitis and metabolic disorders such as extrapontine myelinolysis, thus encompassing a wide range of adaptive and innate cytokine signatures. Using myelin protein immunohistochemistry, we found cortical demyelination in MS, ADEM, PML and extrapontine myelinolysis, whereby each condition showed a disease‐specific histopathological pattern. Remarkably, extensive ribbon‐like subpial demyelination was only observed in MS, thus providing an important pathogenetic and diagnostic cue. Cortical oxidative injury was detected in both demyelinating and non‐demyelinating CNS disorders. Our data demonstrate that meningeal and cortical inflammation alone accompanied by oxidative stress are not sufficient to generate the extensive subpial cortical demyelination found in MS, but require other MS‐specific factors.
Four kinds of design thinking: From ideating to making, engaging, and criticizing
Authors: Dell'Era Claudio , Magistretti Stefano , Cautela Cabirio , Verganti Roberto , Zurlo Francesco
Published: January 2020

Design thinking is spreading extremely rapidly among organizations in terms of interest and practices. Far from being linked to the “form” of products, design thinking is accepted as a formal creative problem‐solving method with the intent to foster innovation. However, the spread of design thinking in practice has not been coupled with a similarly rapid and robust diffusion of its theoretical underpinnings. This paper aims to clarify the theoretical contribution of design thinking by identifying the practices that connote different interpretations of the paradigm. Moreover, we investigate the innovation challenges that the adoption of the design thinking paradigm aims to address. From an empirical perspective, through 47 case studies of consulting organizations that provide advisory services based on the design thinking paradigm in Italy, we identify four different interpretations of the paradigm characterized by different practices: creative problem solving, sprint execution, creative confidence, and innovation of meaning.
EVOLUTION OF COMMUNITY DETERRENCE: EVIDENCE FROM THE NATIONAL HOCKEY LEAGUE
Authors: Depken Craig A. , Groothuis Peter A. , Strazicich Mark C.
Published: January 2020

Community and specialized enforcement are recognized as important components of deterring antisocial behavior. To provide insights on the interplay between deterrence methods, we examine the empirical evolution of fighting and scoring in the National Hockey League using time series data. We identify structural changes that correlate with changes in player behavior and rules. In particular, we find that player behavior related to fighting changed 4 or 5 years prior to most rule changes aimed at reducing fighting. We conclude that the decline in fighting in hockey was more closely associated with a change in community rather than specialized deterrence methods. (JEL Z22, D71, L83)
Bioengineered microenvironment to culture early embryos
Authors: Gu Zhen , Guo Jia , Wang Hongmei , Wen Yongqiang , Gu Qi
Published: January 2020

The abnormalities of early post‐implantation embryos can lead to early pregnancy loss and many other syndromes. However, it is hard to study embryos after implantation due to the limited accessibility. The success of embryo culture in vitro can avoid the challenges of embryonic development in vivo and provide a powerful research platform for research in developmental biology. The biophysical and chemical cues of the microenvironments impart significant spatiotemporal effects on embryonic development. Here, we summarize the main strategies which enable researchers to grow embryos outside of the body while overcoming the implantation barrier, highlight the roles of engineered microenvironments in regulating early embryonic development, and finally discuss the future challenges and new insights of early embryo culture.
The diagnosis value of endobronchial ultrasound transbronchial lung biopsy combined with rapid on‐site evaluation in peripheral lung cancer
Authors: Xu Chun Hua , Wang Ji Wang , Wang Wei , Yuan Qi , Wang Yu Chao , Chi Chuan Zhen , Zhang Qian , Zhang Xiu Wei
Published: January 2020

Introduction

Rapid on‐site evaluation (ROSE) has the potential to increase endobronchial ultrasound transbronchial lung biopsy with guide sheath (EBUS‐GS‐TBLB) accuracy in the diagnosis of peripheral lung cancer. However, studies have reported controversial results.

Objectives

The aim of the study was to evaluate the diagnosis value of EBUS‐GS‐TBLB combination with ROSE in peripheral lung cancer.

Methods

A total of 138 patients undergoing EBUS‐GS‐TBLB and ultimately diagnosed with lung cancer were allocated into the ROSE group and non‐ROSE group. The result of the diagnostic yields, number of biopsy sites, the complication, cytopathological diagnostic cost and procedure times of EBUS‐GS‐TBLB with ROSE and without ROSE were compared.

Results

The diagnostic yields of TBLB were 87.8% and 78.1% in ROSE group and non‐ROSE group, respectively (P < .05). The number of biopsy, procedure times and the percentage of the complication in ROSE group was significantly lower than in non‐ROSE group (P < .05, respectively). The cytopathological diagnostic cost of ROSE group was lower compared with non‐ROSE group (P < .05).

Conclusions

EBUS‐GS‐TBLB combined with ROSE could be helpful to diagnose peripheral lung cancer, and could reduce the number of biopsy, procedure times, cytopathological diagnostic cost and complication.
Role of Elevated SFLT‐1 on the Regulation of Placental Transporters in Women With Pre‐Eclampsia
Authors: Kojovic Dea , V. Workewych Natalie , Piquette‐Miller Micheline
Published: January 2020

Pre‐eclampsia (PE) is an obstetric complication associated with elevated levels of fms‐like tyrosine kinase 1 (sFlt‐1) and dysregulated trophoblast differentiation. However, limited information exists on the expression and regulation of placental drug transporters in PE. Transporter mRNA and protein expression were analyzed in human placentas diagnosed with PE (n = 34) and gestational age‐matched controls (n = 24), whereas placental BeWo cells were treated with angiogenic factors in vitro. Significant downregulation of breast cancer resistance protein (BCRP) and several other transporters were seen in placentas complicated by PE compared with controls, whereas mRNA levels of sFlt‐1 were induced by 2.5‐fold in PE placentas (P < 0.01). Treatment of BeWo cells with sFlt‐1 resulted in an 85–90% downregulation of BCRP, which was attenuated by vascular endothelial growth factor. Our findings suggest that placental function is compromised during PE due to altered expression of clinically important transporters. Furthermore, our in vitro results show that sFlt‐1 is involved in the regulation of BCRP.
Probability and correlates of transition from cannabis use to DSM‐5 cannabis use disorder: Results from a large‐scale nationally representative study
Authors: Feingold Daniel , Livne Ofir , Rehm Jürgen , Lev‐Ran Shaul
Published: January 2020

Introduction and Aims

It has been previously reported that more than 34% of individuals who use cannabis may qualify for a diagnosis of DSM‐IV cannabis abuse or dependence throughout their lifetime. The introduction of the DSM‐5 cannabis use disorder (CUD) diagnostic criteria reflects several intrinsic changes in the perception of substance use disorders. However, little is known about the probability of transition from cannabis use to CUD over time nor about the sociodemographic and clinical correlates associated with this transition.

Design and Methods

Participants were individuals ≥18 years interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions‐III in 2012–2013. Measurements included univariable and multivariable discrete‐time survival analyses performed to examine the association between previously reported cannabis dependence predictors and the hazards of transitioning from cannabis use to CUD. Survival plots assessed the probability of transition from cannabis use to CUD over time since age of first use and differences in probability between predictor levels.

Results

Among lifetime cannabis users (N = 11 272), lifetime probability of transition to CUD was approximately 27%. A higher probability of transition from cannabis use to CUD was observed in the following: men, participants belonging to an ethnic minority group, early‐onset cannabis users and individuals who reported experiencing three or more childhood adverse events.

Discussion and Conclusions

This is the first study to explore transition from cannabis use to the DSM‐5 CUD diagnosis. The current study identified specific predictors of this transition, which may assist in targeting at‐risk populations.
Stroke transcranial Doppler in children with human immunodeficiency virus
Authors: Dlamini Nomazulu , Pohl Keith , Eley Brian , Van Toorn Ronald , Kilborn Tracy , Padayachee Soundrie , Pontigon Ann‐Marie , Kirkham Fenella J , Wilmshurst Jo
Published: January 2020

Aims

To describe stroke syndromes and transcranial Doppler (TCD) findings in children with human immunodeficiency virus (HIV) and examine the associations between TCD and clinical and laboratory data.

Method

We enrolled 42 children (24 males, 18 females) with HIV (median age=7y 6mo; 2y 7mo–15y 6mo), with and without stroke who underwent a TCD examination of the anterior and posterior circulations to derive time‐averaged maximum mean velocity (TAMMV) measurements for comparison with previous studies. Clinical and laboratory variables were extracted from the medical records.

Results

Of the 42 children with HIV, five had right‐sided hemiparesis, three had chronic lung disease, two occurred post‐varicella infection, one after herpetic oral ulceration, and one had a poorly functioning left ventricle. Neuroimaging showed middle cerebral artery (MCA) TAMMV greater than 200cm/s, moyamoya‐like arteriopathy, left basal ganglia infarction with ipsilateral stenosis, hygroma consistent with venous thrombosis, and a hyperdense left MCA. Eight neurologically asymptomatic children had atypical TCD. The CD4 cell count was non‐significantly lower in 6 out of 30 children with atypical TCD (median=21.5; interquartile range=16.1–26.5) compared with the remainder (median=29; interquartile range=21.3–35.0; p=0.09).

Interpretation

A variety of stroke syndromes occur in children with HIV. TCD suggests atypical intracranial vessels and/or haemodynamics in some children with HIV infection, consistent with vasculopathy, possibly related directly to immunodeficiency and/or infection.

What this paper adds

A range of stroke syndromes are found in children with human immunodeficiency virus (HIV).

Transcranial Doppler (TCD) velocities in HIV are commonly outside the range for typically developing children.

TCD and neuroimaging data in children with HIV suggest intracranial vasculopathy as one mechanism for stroke.

CD4 cell count is non‐significantly lower in children with HIV and atypical TCD.
Motivation: key to a healthy lifestyle in people with diabetes? Current and emerging knowledge and applications
Authors: Lakerveld J. , Palmeira A. L. , van Duinkerken E. , Whitelock V. , Peyrot M. , Nouwen A.
Published: January 2020

Aim

Motivation to take up and maintain a healthy lifestyle is key to diabetes prevention and management. Motivations are driven by factors on the psychological, biological and environmental levels, which have each been studied extensively in various lines of research over the past 25 years. Here, we analyse and reflect on current and emerging knowledge on motivation in relation to lifestyle behaviours, with a focus on people with diabetes or obesity. Structured according to psychological, (neuro‐)biological and broader environmental levels, we provide a scoping review of the literature and highlight frameworks used to structure motivational concepts. Results are then put in perspective of applicability in (clinical) practice.

Results

Over the past 25 years, research focusing on motivation has grown exponentially. Social–cognitive and self‐determination theories have driven research on the key motivational concepts ‘self‐efficacy’ and ‘self‐determination’. Neuro‐cognitive research has provided insights in the processes that are involved across various layers of a complex cortical network of motivation, reward and cognitive control. On an environmental – more upstream – level, motivations are influenced by characteristics in the built, social, economic and policy environments at various scales, which have provided entry points for environmental approaches influencing behaviour.

Conclusions

Current evidence shows that motivation is strongly related to a person's self‐efficacy and capability to initiate and maintain healthy choices, and to a health climate that supports autonomous choices. Some approaches targeting motivations have been shown to be promising, but more research is warranted to sustainably reduce the burden of diabetes in individuals and populations.
Interplay of adenosine monophosphate‐activated protein kinase/sirtuin‐1 activation and sodium influx inhibition mediates the renal benefits of sodium‐glucose co‐transporter‐2 inhibitors in type 2 diabetes: A novel conceptual framework
Authors: Packer Milton
Published: January 2020

Long‐term treatment with sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors slows the deterioration of renal function in patients with diabetes. This benefit cannot be ascribed to an action on blood glucose, ketone utilization, uric acid or systolic blood pressure. SGLT2 inhibitors produce a striking amelioration of glomerular hyperfiltration. Although initially ascribed to an action of these drugs to inhibit proximal tubular glucose reabsorption, SGLT2 inhibitors exert renoprotective effects, even in patients with meaningfully impaired levels of glomerular function that are sufficient to abolish their glycosuric actions. Instead, the reduction in intraglomerular pressures may be related to an action of SGLT2 inhibitors to interfere with the activity of sodium‐hydrogen exchanger isoform 3, thereby inhibiting proximal tubular sodium reabsorption and promoting tubuloglomerular feedback. Yet, experimentally, such an effect may not be sufficient to prevent renal injury. It is therefore noteworthy that the diabetic kidney exhibits an important defect in adenosine monophosphate‐activated protein kinase (AMPK) and sirtuin‐1 (SIRT1) signalling, which may contribute to the development of nephropathy. These transcription factors exert direct effects to mute oxidative stress and inflammation, and they also stimulate autophagy, a lysosomally mediated degradative pathway that maintains cellular homeostasis in the kidney. SGLT2 inhibitors induce both AMPK and SIRT1, and they have been shown to stimulate autophagy, thereby ameliorating cellular stress and glomerular and tubular injury. Enhanced AMPK/SIRT1 signalling may also contribute to the action of SGLT2 inhibitors to interfere with sodium transport mechanisms. The dual effects of SGLT2 inhibitors on AMPK/SIRT1 activation and renal tubular sodium transport may explain the protective effects of these drugs on the kidney in type 2 diabetes.
A comparison of pedigree, genetic and genomic estimates of relatedness for informing pairing decisions in two critically endangered birds: Implications for conservation breeding programmes worldwide
Authors: Galla Stephanie J. , Moraga Roger , Brown Liz , Cleland Simone , Hoeppner Marc P. , Maloney Richard F. , Richardson Anne , Slater Lyndon , Santure Anna W. , Steeves Tammy E.
Published: January 2020

Conservation management strategies for many highly threatened species include conservation breeding to prevent extinction and enhance recovery. Pairing decisions for these conservation breeding programmes can be informed by pedigree data to minimize relatedness between individuals in an effort to avoid inbreeding, maximize diversity and maintain evolutionary potential. However, conservation breeding programmes struggle to use this approach when pedigrees are shallow or incomplete. While genetic data (i.e., microsatellites) can be used to estimate relatedness to inform pairing decisions, emerging evidence indicates this approach may lack precision in genetically depauperate species, and more effective estimates will likely be obtained from genomic data (i.e., thousands of genome‐wide single nucleotide polymorphisms, or SNPs). Here, we compare relatedness estimates and subsequent pairing decisions using pedigrees, microsatellites and SNPs from whole‐genome resequencing approaches in two critically endangered birds endemic to New Zealand: kakī/black stilt (Himantopus novaezelandiae) and kākāriki karaka/orange‐fronted parakeet (Cyanoramphus malherbi). Our findings indicate that SNPs provide more precise estimates of relatedness than microsatellites when assessing empirical parent–offspring and full sibling relationships. Further, our results show that relatedness estimates and subsequent pairing recommendations using PMx are most similar between pedigree‐ and SNP‐based approaches. These combined results indicate that in lieu of robust pedigrees, SNPs are an effective tool for informing pairing decisions, which has important implications for many poorly pedigreed conservation breeding programmes worldwide.
Engaging Parents About the Importance of Play: The Impact of a Brief, Arts‐Informed Community Presentation
Authors: Rathunde Kevin , Isabella Russell
Published: January 2020

Objective

This study evaluated the effectiveness of an arts‐informed approach to parent education using a 50‐minute, arts‐informed parent education presentation that integrated the creative arts (e.g., film, photography, music, dance, and design). The focus of the arts‐informed program was to communicate more effectively about the importance of play for child and adult development.

Background

Arts‐informed or arts‐based educational approaches have been found useful for science outreach because of their potential to enhance affective engagement with information. This raises the question of whether arts‐informed methods could be used to engage and inform parents on research topics relevant for the family.

Method

The study used analysis of covariance and a pretest–posttest control group design (N = 97).

Results

One month after attending the arts‐informed presentation, parents of children in early childhood reported greater knowledge about play, support for play, and time spent playing with their child and that their children engaged in more free play. Parents also reported an increase in their amount of flow experience (i.e., states of enjoyable absorption), although they did not report changes in time spent engaging in leisure play.

Conclusion

These findings are discussed in terms of the utility of arts‐informed approaches for family researchers interested in science outreach and community engagement as well as using the arts to enhance parents' affective engagement with information about play.
Causes and consequences of eastern Australia's 2019–20 season of mega‐fires
Authors: Nolan Rachael H. , Boer Matthias M. , Collins Luke , Resco de Dios Víctor , Clarke Hamish , Jenkins Meaghan , Kenny Belinda , Bradstock Ross A.
Published: January 2020

See Letter to the Editor on this article by Adam et al., 26, 3756–3758. See also Response to the Letter by Bradstock et al., 26, e8–e9.
Association of physical and/or cognitive activity with cognitive impairment in older adults
Authors: Kurita Satoshi , Tsutsumimoto Kota , Doi Takehiko , Nakakubo Sho , Kim Minji , Ishii Hideaki , Shimada Hiroyuki
Published: January 2020

Aim

We aimed to examine the association between physical activity (PA) and/or cognitive activity (CA) and cognitive impairment in a sample of older adults from a community‐based cohort in Nagoya, Japan.

Methods

A total of 2726 participants (mean age 75.5 ± 3.9 years; 51.8% women) met the study criteria. The time of moderate‐to‐vigorous intensity PA was measured using an accelerometer. CA was subjectively assessed by the frequency of engagement in six activities (reading, writing for pleasure, doing crossword puzzles, playing board games/cards, participating in organized group discussions and playing musical instruments). Participants were categorized into four groups by high or low PA combined with high or low CA. Cognitive impairment was defined by at least one of four neuropsychological tests with a result of at least 1.5 standard deviations below the reference threshold.

Results

The prevalence of cognitive impairments differed significantly between the groups (P < 0.001), with 29.5% in the low PA and low CA group, to 14.8% in the high PA and high CA group. Compared with the low PA and low CA group, other groups had significantly lower odds ratio (OR) of cognitive impairment (low PA and high CA: OR 0.54, 95% CI 0.37–0.79; high PA and low CA: OR 0.64, 95% CI 0.45–0.92; high PA and high CA: OR 0.42, 95% CI 0.30–0.58).

Conclusions

Both PA and CA showed a protective association with cognitive impairment, even when one or the other is lowly engaged. Therefore, older adults with difficulty engaging in sufficient PA might benefit from CA to prevent cognitive impairment. Geriatr Gerontol Int 2020; 20: 31–35.
Development and validity of the Computer‐Based Cognitive Assessment Tool for intervention in community‐dwelling older individuals
Authors: Takahashi Junta , Kawai Hisashi , Suzuki Hiroyuki , Fujiwara Yoshinori , Watanabe Yutaka , Hirano Hirohiko , Kim Hunkyung , Ihara Kazushige , Miki Akiko , Obuchi Shuichi
Published: January 2020

Aim

The Mini‐Mental State Examination is a widely used cognitive assessment tool. However, it has several limitations, including the learning effect and interrater reliability. Therefore, we developed a Computer‐Based Cognitive Assessment Tool (CompBased‐CAT), which runs on a tablet or personal computer. In this study, we examined the validity and discrimination ability of the CompBased‐CAT.

Methods

Participants were recruited from the Otasha‐Kenshin study carried out in 2016. We included 773 community‐dwelling older individuals in Japan (332 men, 441 women, aged 65–97 years). CompBased‐CAT scores were converted to z‐scores, and the correlation with Mini‐Mental State Examination scores was examined using Pearson's correlation coefficient. Furthermore, the ability to discern cognitive impairment was examined using the receiver operating characteristic curve.

Results

The Pearson's correlation coefficient for the Mini‐Mental State Examination scores and each task component of the CompBased‐CAT ranged from 0.24 to 0.41 (P < 0.001), and the correlation coefficient of the total z‐scores was 0.51 (P < 0.001). The sensitivity, specificity and area under the receiver operating characteristic curve of the discriminating ability of the CompBased‐CATool for cognitive impairment were 0.81, 0.77 and 0.85, respectively.

Conclusions

The CompBased‐CAT certainly possesses validity, discriminating ability and utility as a new cognitive assessment tool in community‐dwelling older individuals. Geriatr Gerontol Int 2020; ••: ••–••.
Long‐Term Evaluation of Mulch Biowall Performance to Treat Chlorinated Solvents
Authors: Walker Kenneth L. , McGuire Travis M. , Adamson David T. , Anderson R. Hunter
Published: January 2020

Permeable reactive barriers (PRBs), such as mulch biowalls, have been installed at numerous groundwater cleanup sites, and laboratory and field studies have demonstrated biotic and abiotic processes that degrade chlorinated volatile organic compounds (CVOCs) in groundwater passing through these engineered remedies. However, the longevity of mulch biowalls remains a fundamental research question. Soil and groundwater sampling at seven mulch biowalls at Altus Air Force Base (AFB) approximately 10 years after installation demonstrated the ongoing degradation of CVOCs. Trichloroethene was not detected in five of seven groundwater samples collected from the biowall despite upgradient detections above federal drinking water standards. Microbial sampling established the presence of key dechlorinating bacteria and the abundance of genes encoding specific enzymes for degradation, high methane concentrations, low sulfate concentrations, and negative oxidation‐reduction potential, all indicative of highly reducing conditions within the biowalls and favorable conditions for CVOC destruction via microbial reductive dechlorination. High cellulose content (>79%) of the mulch, elevated total organic carbon (TOC) content in groundwater, and elevated potentially bioavailable organic carbon (PBOC) measurements in soil samples further supports an ongoing, long‐lived source of carbon. These results demonstrate the ongoing and long‐term efficacy of the mulch biowalls at Altus AFB. In addition, concentrations of bacteria, TOC, PBOC, and other geochemical parameters suggest a modest impact of the biowalls downgradient. The continued presence of CVOCs downgradient may be attributable to back diffusion from low‐permeability shale. However, the biowalls continue to provide benefits by removing CVOCs in groundwater, thus reducing further CVOC loading to the downgradient, low‐permeability strata.
Ultrafine porous boron nitride nanofiber‐toughened WC composites
Authors: Li Xiaoqiang , Cao Ting , Zhang Minai , Qiu Hao , Huang Yang , Qu Shengguan , Liang Liang , Song Tao
Published: January 2020

Porous fibers are widely used in catalysis chemistry and hydrogen storage but are rarely used in structural ceramics. In this study, spark plasma sintering was used to prepare an ultrafine porous boron nitride nanofiber‐toughened WC composite for the first time. The obtained WC‐0.05 wt% ultrafine porous boron nitride nanofiber composites exhibited better properties (ie, a 2.3% increase in hardness and a 19.6% increase in fracture toughness) compared to those of the pure WC specimen. The fiber porosity improved the second phase‐WC matrix microstructural combination. The described approach is a novel preparation method for the WC composites. Furthermore, a new toughening mechanism, which is based on “pinning and stretching”, was determined. These findings suggest that porous boron nitride fibers can be considered to be second phases for toughening the WC composites.
Plasmacytoid dendritic cells from parent strains of the NZB/W F1 lupus mouse contribute different characteristics to autoimmune propensity
Authors: Zhan Yifan , Kong Isabella , Chopin Michael , Macri Christophe , Zhang Jian‐Guo , Xie Jiaying , Nutt Stephen L , O'Keeffe Meredith , Hawkins Edwin D , Morand Eric F , Lew Andrew M
Published: January 2020

The NZB/W F1 (F1) mice develop severe disease that is similar to human systemic lupus erythematosus. By contrast, each parent strain, NZB or NZW, has limited autoimmunity, suggesting traits of both strains contribute to pathogenesis. Although many of the contributing genes have been identified, the contributing cellular abnormality associated with each parent strain remains unresolved. Given that plasmacytoid dendritic cells (pDCs) are key to the pathogenesis of lupus, we investigated the properties of pDCs from NZB and NZW mice. We found that NZB mouse had higher numbers of pDCs, with much of the increase being contributed by a more abundant CD8+ pDC subset. This was associated with prolonged survival and stronger proliferation of CD4+ T cells. By contrast, NZW pDCs had heightened capacity to produce interferon‐α (IFNα) and IFNλ, and promoted stronger B‐cell proliferation upon CpG stimulation. Thus, our data reveal the different functional and numerical characteristics of pDCs from NZW and NZB mouse.
Mitigating distress and promoting positive aspects of caring in caregivers of children and adolescents with schizophrenia: Mediation effects of resilience, hope, and social support
Authors: Wang Anni , Bai Xiaoling , Lou Ting , Pang Jin , Tang Siyuan
Published: January 2020

Assistance for distressed caregivers can indirectly facilitate recovery of the people being cared for, yet how resilience, hope, and social support mediate between caregiving burden and adjustment outcomes is unclear. A structural equation model was constructed based on data from a cross‐sectional survey of 324 caregivers of children and adolescents with schizophrenia using multidimensional caregiver burden inventory, Connor‐Davidson resilience scale, Herth hope index, perceived social support scale, distress management screening measure, and positive aspects of caregiving instruments. On distress, caregiving burden had a relatively large direct effect, and an indirect effect, mainly mediated by resilience. Resilience had a greater effect than social support or hope on distress. On positive aspects of caregiving (PAC), caregiving burden had only an indirect effect, primarily via the processes from social support and resilience to hope. Hope had a significant direct effect, while resilience and support had moderate indirect effects on PAC via hope. Resilience is an important mediator between caregiving burden and distress, with a greatest effect. Resilience, hope, and social support all mediated between caregiving burden and PAC, with hope having a greatest effect. Reducing the care burden may greatly help to relieve caregiver distress. Providing needed social support, encouraging caregivers to proactively utilize the support, and enhancing resilient coping skills will be helpful in developing resilience and mitigating distress. Health professionals should assess and ameliorate burden, be particularly aware of caregiver hopes, provide formal support, and encourage informal support to promote PAC.
Embryonic development of the false limpet Siphonaria lateralis from Atlantic Patagonia
Authors: Zabala Soledad , Averbuj Andrés , Bigatti Gregorio , Penchaszadeh Pablo E.
Published: January 2020

Siphonariids are pulmonate gastropods inhabiting rocky intertidal habitats, and many studies have focused on these false limpets around the world. In the southern South Atlantic, studies on reproduction and development in species of Siphonaria are scarce. We studied the embryonic development and egg masses of Siphonaria lateralis at its northernmost distribution in Atlantic Patagonia. In S. lateralis, as in most species of Siphonaria, individuals spawn benthic egg masses that strongly attach to intertidal rocky substrata. A single spherical egg that measures ~120 µm develops inside the egg capsule of S. lateralis. Considering the relatively small egg size, and reports from previous studies, the developmental modality of S. lateralis might be expected to include a planktotrophic larval phase. However, we found that hatchlings emerged as 1‐mm crawling juveniles, probably owing to the presence of intracapsular fluid, which may provide the energetic requirements for direct development. The embryonic size changed little from the egg to veliger stages, and then increased rapidly until the hatchling stage. We compared development in S. lateralis with development in the sympatric Siphonaria lessonii, in which egg size was reported to be ~80 µm and hatching occurs as planktotrophic veliger larvae. In these two species, spawn and early intracapsular developmental modes are remarkably different; these differences represent contrasting ways to survive in the harsh and physically stressful intertidal Patagonian coasts.
It's OK to pay well, if you write well: The effects of remuneration disclosure readability
Authors: Hemmings Danial , Hodgkinson Lynn , Williams Gwion
Published: January 2020

We examine whether, and how, shareholders’ votes in the Say‐on‐Pay (SOP) are affected by the readability of the Compensation Discussion and Analysis (CD&A). Despite the SEC's Plain English requirement, qualitative disclosures on executive remuneration are generally long and complex. Extant evidence on whether low readability results in higher or lower shareholder dissent in the SOP, however, is ambiguous. We resolve this debate by demonstrating that the effects of readability on SOP voting are heterogeneous; while obfuscation may reduce dissent when CEO compensation is close to “normal” levels, diminished readability results in increased scepticism when pay levels are clearly excessive. The moderating role of readability is most pronounced for firms with less sophisticated shareholders, consistent with readability acting as a heuristic cue. Our results are robust to propensity score matching, and are less pronounced (1) when shareholders have less time to review the CD&A, and (2) when shareholders are distracted by competing AGMs, suggesting they are driven by readability, directly. Overall, our results highlight that greater use of Plain English in remuneration disclosures can have a substantial persuasive impact on shareholders.
Costs and complications associated with transvenous lead reoperation in cardiac implantable electronic devices
Authors: Griffiths Robert I. , Amorosi Stacey L. , Jacobsen Caroline M. , McBee Patrick J. , Menzin Joseph , Reynolds Matthew R.
Published: January 2020

Background

Cardiac implantable electronic device transvenous (TV) lead reoperations are projected to increase, and robust economic data are needed to assess the resulting financial impact and the cost‐effectiveness of prevention and treatment strategies. This study estimates Medicare costs, and describes patterns of complications, in patients who underwent TV lead reoperation.

Methods and Results

Medicare data (2010‐2014) were used to identify patients who underwent TV lead reoperation. Cumulative costs to Medicare, and rates of infection and mechanical complications were calculated from 180 days before, to 180 days after, lead reoperation. Multivariate analysis was used to estimate adjusted costs, and to examine the impact of complications on medical resource use and costs. There were 1691 patients, 63.2% of whom underwent inpatient lead reoperation. Overall, the mean age was 78.2 years, 39.6% were female, and 92.3% were white. The mean cumulative cost was $36 199 (95% confidence interval [CI], $31 864‐$40 535) for TV lead repositioning, $27 701 (95% CI, $19 869‐$35 534) for repair, and $54 442 (95% CI, $51 651‐$57 233) for removal. Underlying infection was associated with increased odds of inpatient reoperation and of lead removal, as well as longer length of stay and higher costs.

Conclusions

The economic consequences of TV lead reoperation are substantial. Strategies aimed at reducing reoperation, particularly lead removal, are likely to result in considerable cost offsets.
Long‐term cardiac arrhythmia and chronotropic evaluation in patients with severe anorexia nervosa (LACE‐AN): A pilot study
Authors: Farasat Morteza , Watters Ashlie , Bendelow Tiffany , Schuller Joseph , Mehler Philip S. , Krantz Mori J.
Published: January 2020

Background

Anorexia nervosa (AN) is associated with autonomic dysfunction and carries a high risk of sudden death, putatively attributed to ventricular tachyarrhythmias. To date, long‐term cardiac monitoring has not been performed to confirm this speculation.

Methods and Results

We assessed the safety and acceptability of an insertable cardiac monitor (ICM) in patients with severe AN with markedly reduced body mass index (BMI), and investigated heart rate (HR) and rhythm before and after weight restoration. Autonomic function was assessed as HR response to a standardized activity protocol at baseline and four additional visits over 360 days. The Florida Patient Acceptance Survey (FPAS) was used to measure ICM acceptability.

During a mean follow‐up of 10 months, no ICM‐related complications occurred and ICM was well‐accepted by the 11 study participants (nine women, aged 19‐59 years, baseline BMI = 12.7 ± 1.6 kg/m2). Both resting and peak HR increased with weight restoration and were directly associated with BMI (both P < .001). No ventricular tachyarrhythmias occurred during the study period, but two participants (18%) experienced eight sinus pauses (3.0‐7.0 seconds) and three runs of supraventricular tachycardia.

Conclusions

Long‐term cardiac rhythm monitoring with an ICM is feasible, safe, and acceptable in patients with severe AN. Autonomic dysfunction in AN results in not only profound resting bradycardia, but also some degree of chronotropic incompetence, both of which improve with weight restoration. Clinically significant bradyarrhythmias are more common than ventricular tachyarrhythmias in AN, and may represent a competing underlying mechanism for the high risk of sudden death in this population.
Merchants of doubt: Corporate political action when NGO credibility is uncertain
Authors: Chiroleu‐Assouline Mireille , Lyon Thomas P.
Published: January 2020

The literature on special interest groups emphasizes two main influence channels: campaign contributions and informational lobbying. We introduce a third channel: providing information about the credibility of political rivals. In particular, nongovernmental organizations (NGOs) often aim to communicate scientific knowledge to policymakers, but industry‐backed groups often attempt to undermine their credibility. We extend a standard signaling model of interest‐group lobbying to include fixed costs of policymaker action and show that these costs make possible two mechanisms for creating doubt about the value of policy action. The first uses Bayesian persuasion to suggest the NGO may be a noncredible radical. The second involves creating an opposition think tank (TT) that acts as a possible radical, not a credible moderate. We show that the TT cannot always implement the Bayesian persuasion benchmark, and we characterize how optimal TT design varies with exogenous parameters.