bluuebunny/crossref_metadata_2025 huggingface dataset:
CFIUS issues final regulations on national security review of foreign investments in the United States under FIRRMA: broader reach, mandatory filings, and limited exceptions
Authors: Dohale Sonali , Bombach Kara M. , Brennan Cyril T. , Latour Renée A. , Urie Axel S.
Published: November 2020

Purpose

The article examines the sweeping changes to the review process undertaken by Committee on Foreign Investment in the United States (CFIUS) as a result of the Foreign Investment Risk Review Modernization Act of 2018 (FIRRMA). The Article specifically reviews the long-awaited final sets of regulations, effective as of February 13, 2020, and analyzes their impact on the CFIUS process, as well as considers the implications of FIRRMA for parties to foreign acquisition, control, and investment transactions.

Design/methodology/approach

The Article begins with an overview of the CFIUS framework and a general explanation of FIRRMA. It then moves to an analysis of FIRRMA and the resulting changes to the prior CFIUS regime. The Article concludes with general considerations and provides recommendations for parties who may find themselves analyzing the potential applicability of CFIUS to foreign acquisition and investment transactions.

Findings

FIRRMA resulted in significant changes to the existing CFIUS regulatory framework.

Practical implications

Parties should learn the CFIUS changes as a result of FIRRMA, including the new mandatory filing requirements as well as implications for non-controlling investment transactions. Parties should include CFIUS analysis and planning in the earliest stages of deal planning and due diligence.

Originality/value

The article provides an in-depth review of the changes to CFIUS resulting from FIRRMA. The changes to the existing CFIUS landscape have resulted in new mandatory filing requirements and expanded jurisdiction over non-controlling investment and real estate transactions, which are discussed in the article.
Mobile banking usage and gamification: the moderating effect of generational cohorts
Authors: Çera Gentjan , Pagria Ina , Khan Khurram Ajaz , Muaremi Lindita
Published: November 2020

Purpose

The extended unified theory of acceptance and use of technology (UTAUT2) model has been adapted and applied by scholars to gain insight into mobile banking (m-banking) usage. By combining three perspectives, UTAUT2, gamification (GM) and generational cohort theory, this study aims to investigate the factors which impact m-banking usage and examine the moderating effect of generations Y and Z on the relationship between GM and intention to use m-banking.

Design/methodology/approach

The adopted model was tested in a quantitative study by using partial least square structural equation modelling. A total of 380 valid questionnaires from a transition country, Albania, have been examined.

Findings

In the study, scientific evidence concerning the UTAUT2 model and GM elements are provided. Thus, facilitation conditions, habit and hedonic motivation were found to be significant determinants of GM. Moreover, the results revealed that age moderates the relationship between GM and behavioural intention (BI). Compared to generation Z, individuals born prior to 1996 (generation Y), exhibited a much stronger relationship.

Research limitations/implications

Although Albania bears similarities with other transition countries in terms of regional, economic and political environments, the generalisation of these results to another context is rather limited.

Practical implications

This paper offers a model integrating UTAUT2, GM and generational cohorts in the context of a transition country. The findings can be applied in the form of guidelines for a number of financial institutions.

Originality/value

Besides identifying the determinants of m-banking adoption and GM, this study notably reveals the importance of generational cohorts because it governs the effect of GM on m-banking BI.
Influence of student-perceived service quality on sustainability practices of university and student satisfaction
Authors: Chaudhary Sartaj , Dey Ajoy Kumar
Published: November 2020

Purpose

The past decade has seen a proliferation of research on service quality in education. However, little attempt has been made to understand the impact of student perceived service quality on sustainability practices of the university or the effect of such practices on student satisfaction. To bridge this gap, this paper aims to propose a conceptual framework to examine the relationships between service quality, sustainable practices and student satisfaction from the perspective of students.

Design/methodology/approach

A quantitative methodology was employed, and data were collected through an online structured questionnaire. Responses were gathered from undergraduate students (n = 419) studying in four colleges affiliated to a university in Delhi, India. Exploratory and confirmatory factor analyses were used to validate the instruments. Structural equation modelling was used to examine the associations between the constructs.

Findings

The research revealed that student perceived service quality in education has a significant effect on their perception of sustainable practices of the university and student satisfaction. Further, sustainable practices predict student satisfaction.

Research limitations/implications

The findings may guide the key decision-makers in the education industry to incorporate service quality and sustainable practices in their strategy and thereby enhance student satisfaction.

Originality/value

This research is the first of its kind to examine the impact of service quality as perceived by students on the perception of sustainability practices of the university. Further, it empirically tests the effect of perceived sustainability practices on student satisfaction.
Least‐cost path analysis for urban greenways planning: A test with moths and birds across two habitats and two cities
Authors: Balbi Manon , Croci Solène , Petit Eric J. , Butet Alain , Georges Romain , Madec Luc , Caudal Jean‐Pierre , Ernoult Aude
Published: November 2020

One of the major planning tools to respond to urban landscape fragmentation is the development of ecological corridors, that is, interconnected networks of urban green and blue spaces. Least‐cost paths (LCP) appear to be an easy and appropriate resistance‐based modelling method to respond to urban planners’ needs. However, the ecological validation of urban corridors using LCP is rarely performed and needs to be generalized to different species, habitats and cities.

We developed an experimental design to test the efficiency of LCP predictions to detect highly connecting landscape contexts that facilitate individual movements compared to movements in less connecting landscape contexts. We deliberately assigned LCP analysis parameters based on the scientific literature and expert knowledge to test a method potentially easy to use for urban stakeholders. To extend the validation, we applied our LCP model to two biological taxa with different habitat requirements: grassland‐dwelling moths and forest‐dwelling passerines, and to two medium‐sized cities.

We used mark–release–recapture (MRR) methods for moths and playback recall protocols for passerines to compare the patterns of individual movement between two contrasted connectivity contexts determined by the presence and absence of modelled LCPs. MRR protocol estimated movement rates between herbaceous patches and the two contrasted connectivity contexts. Playback recall protocol consisted in attracting individuals from wooded patches to the two contrasted connectivity contexts. A movement was considered facilitated, when displacement was rapidly engaged and individuals moved a long distance from their wooded patch.

Moth and passerine movement patterns differed between the two connectivity contexts: moth recapture rates were higher in highly connecting contexts than in less connecting contexts. For passerine birds, responses to playback recalls were faster and movement distance longer in highly connecting contexts. All results support the hypothesis that both taxa were more prone to move in corridors modelled by LCP.

Synthesis and applications. The convergence of the results for different biological models and across cities strengthens the relevance of LCP analysis for planning urban greenways and provides guidelines for landscape planners in the development of these corridors to favour the movement and survival of multiple urban species.
From community of practice to epistemic community – law, discipline and security in the battle for the legalisation of medical cannabis in Poland
Authors: Wagner Aleksandra , Polak Paulina , Świątkiewicz‐Mośny Maria
Published: November 2020

Although public debates on cannabis are ongoing in many countries, there are currently no EU‐wide rules for either medical or recreational use of cannabis. Numerous studies have illustrated that creating such rules is a complex challenge. The battle over the legalisation of medical use of cannabis in Poland is a good example for analysing the mutual impact of the social practices that various actors perform through and by the discourses in the field of health care: how they discursively create their own roles and take positions and how they shape the coalitions and opposition in trying to achieve their strategic goals. This article aims to reconstruct and explain how different types of knowledge are discursively used to sustain or question power relations in the healthcare field. The dispersed knowledge‐power influences social actors, who try to define or redefine social practices and aspire to guide them in the healthcare field. The presented approach allows authors to go beyond the social actors’ perception vs institutional regulations and to analyse discursive actions as elements of the complex networks of meanings activating various type of resources. Those dynamic networks, involving the different (and sometimes the same) actors in the different actions, open the new fields of rationality. Starting by identifying the crucial actors and their discursive actions visible in the mainstream press discourse, we will reconstruct three types of groups related to medical cannabis. We will then investigate three types of dispositives – law, discipline and security – to investigate the relations between discursive and non‐discursive elements. The proposed analysis belongs to the Critical Discourse Analysis (CDA) paradigm and includes investigation of the media discourses and in‐depth interviews with the identified actors.
Having a say or getting your way? Political choice and satisfaction with democracy
Authors: HOBOLT SARA B. , HOERNER JULIAN M. , RODON TONI
Published: November 2020

Citizen satisfaction with democracy is greater when parties offer choices that are congruent with voter preferences. But are citizens content with simply having a party that represents their views or does their satisfaction depend on whether that party can also be instrumental in implementing policies? We argue that instrumentality moderates the effect of ideological congruence on democratic satisfaction. Combining an analysis of cross‐national survey data with an experimental conjoint design, we find that citizens able to vote for a congruent party with a chance of entering government are more satisfied with democracy, whereas congruence without instrumentality has no such effect.
Efficacy and safety of a novel submucosal injection solution for endoscopic resection in porcine models
Authors: Chen Chen , Liu Xiao Yu , Cheng Cui E , Xiong Yu Jia , Sun Yi Bin , Tan Chen Huan , Liu Yi Ting , Feng Ji , Ma Yi Fan , Shi Dong Tao , Li Rui
Published: November 2020

Objective

A submucosal injection is usually required to improve the efficacy and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR). This study aimed to evaluate the performance of 3.3% sodium carboxymethyl starch (Na‐CMS) solution, a novel submucosal injection solution, for ESD and EMR.

Methods

Na‐CMS, normal saline (NS) and two commercially available agents (sigMAVisc and Eleview) were injected into the esophageal submucosa of randomly grouped pigs. The level of submucosal elevation was examined. Subsequently, ESD or EMR procedures using 3.3% Na‐CMS or NS as submucosal injections were performed in the gastrointestinal tract of the pigs.

Results

Submucosal elevation was significantly higher and more sustained in the 3.3% Na‐CMS group than in the controls (P < 0.05). The volume required for ESD or EMR was significantly lower in the 3.3% Na‐CMS group than in the NS group (ESD: 12.21 ± 4.09 mL vs 28.25 ± 8.02 mL, P < 0.001; EMR: 3.99 ± 1.98 mL vs 7.15 ± 3.67 mL, P = 0.001). The ESD resection time was significantly shorter in the 3.3% Na‐CMS group than in the NS group (16.58 ± 7.30 min vs 25.29 ± 11.89 min, P = 0.004). Hemorrhage after ESD in the 3.3% Na‐CMS group was less severe than that in the NS group (P = 0.006).

Conclusion

3.3% Na‐CMS is an effective, safe and low‐cost submucosal injection solution and holds promise as preferable agent for submucosal injection in ESD and EMR procedures.
Clinical implication of minimal presence of solid or micropapillary subtype in early‐stage lung adenocarcinoma
Authors: Choi Sun Ha , Jeong Ji Yun , Lee Shin Yup , Shin Kyung Min , Jeong Shin Young , Park Tae‐In , Do Young Woo , Lee Eung Bae , Seok Yangki , Lee Won Kee , Park Ji Eun , Park Sunji , Lee Yong Hoon , Seo Hyewon , Yoo Seung Soo , Lee Jaehee , Cha Seung‐Ick , Kim Chang Ho , Park Jae Yong
Published: November 2020

Background

We investigated the clinical features and surgical outcomes of lung adenocarcinoma with minimal solid or micropapillary (S/MP) components, with a focus on stage IA.

Methods

We enrolled 506 patients with lung adenocarcinoma who underwent curative resection in this study. Clinical features and surgical outcomes were compared between the groups with and without the S/MP subtype (S/MP+ and S/MP−, respectively), and between the group with an S/MP proportion of ≤5% (S/MP5) and the S/MP−.

Results

The S/MP subtype was present in 247 patients (48.8%); 129 (25.5%) were grouped as the S/MP5 group. The S/MP+ and S/MP5 groups had larger tumors, higher frequency of lymph node metastasis, and more advanced stages of disease than the S/MP− group (P < 0.001, all comparisons). Pleural, lymphatic, and vascular invasions occurred more frequently in the S/MP+ and S/MP5 groups (P < 0.001, all comparisons for S/MP+ vs. S/MP−; P ≤ 0.01, all comparisons for S/MP5 vs. S/MP−). The S/MP+ and S/MP5 groups showed a shorter time to recurrence and cancer‐related death than the S/MP− group(P < 0.001, both comparisons). For stage I, the presence or absence of the S/MP subtype defined prognostic subgroups better than the stage IA/IB classification. Notably, in the multivariate analysis, the minimal S/MP component was a significant predictor of recurrence, even in stage IA.

Conclusions

The presence of the minimal S/MP component was a significant predictor of poor prognosis after surgery, even in stage IA patients. Clinical trials to evaluate the advantages of adjuvant chemotherapy for this subset of patients and further investigations to understand underlying biological mechanisms of poor prognosis are needed.

Key points

Significant findings of the study: We demonstrated that only minimal presence of solid or micropapillary component was profoundly associated with aggressive clinicopathological features and poor prognosis after complete resection even in stage IA lung adenocarcinoma. What this study adds: Our results suggest that minimal presence of these subtypes is a strong prognostic factor which should be taken into account in the risk assessment for adjuvant chemotherapy in lung adenocarcinoma.
An assessment of the treatment information contained within the websites of direct‐to‐consumer orthodontic aligner providers
Authors: Meade MJ , Dreyer CW
Published: November 2020

Background

The use of direct‐to‐consumer (DTC) orthodontic aligners is growing. The purpose of this study was to evaluate the quality of information contained within the websites of DTC orthodontic aligner providers.

Methods

Websites that satisfied inclusion criteria were assessed for the presence of specific treatment‐related features. Four validated quality of information instruments and readability tools were used to evaluate the content of the websites. Descriptive statistical analyses and intra‐examiner reliability tests were performed.

Results

Twenty‐one websites were evaluated. Few websites referred to the need for pre‐treatment dental health (38.1%) and indefinite post‐treatment retention (23.8%). Most websites (95.2%) were categorized as either ‘poor’ or ‘very poor’ according to their DISCERN scores. DISCERN items regarding information bias and treatment risks scored particularly poorly. Cohen’s kappa intra‐examiner reliability testing for DISCERN scores was 0.81–0.89. Three websites honoured two out of the four Journal of the American Medical Association benchmarks and 18 honoured one benchmark only. The readability scores indicated ‘difficult to read’ content.

Conclusions

The quality of information contained within the websites of DTC orthodontic aligner providers is poor. Patient consent for DTC aligner treatment based solely on the information contained within the websites is likely to be invalid.
Neutrophil injury and function alterations induced by high mechanical shear stress with short exposure time
Authors: Sun Wenji , Wang Shigang , Zhang Jiafeng , Arias Katherin , Griffith Bartley P. , Wu Zhongjun J.
Published: November 2020

High mechanical shear stresses (HMSS) can cause damage to blood, which manifests as morphologic changes, shortened life span, biochemical alterations, and complete rupture of blood cells and proteins, leading to the alterations of normal blood function. The aim of this study is to determine the state of neutrophil activation and function alterations caused by HMSS with short exposure time relevant to ventricular assist devices. Blood from healthy donors was exposed to three levels of HMSS (75Pa, 125Pa, and 175Pa) for a short exposure time (0.5 s) using our Couette‐type blood‐shearing device. Neutrophil activation (Mac‐1, platelet‐neutrophil aggregates) and surface expression levels of two key functional receptors (CD62L and CD162) on neutrophils were evaluated by flow cytometry. Neutrophil phagocytosis and transmigration were also examined with functional assays. Results showed that the expression of Mac‐1 on neutrophils and platelet‐neutrophil aggregates increased significantly while the level of CD62L expression on neutrophils decreased significantly after the exposure to HMSS. The Mac‐1 expression progressively increased while the CD62L expression progressively decreased with the increased level of HMSS. The level of CD162 expression on neutrophils slightly increased after the exposure to HMSS, but the increase was not significant. The phagocytosis assay data revealed that the ability of neutrophils to phagocytose latex beads coated with fluorescently labeled rabbit IgG increased significantly with the increased level of HMSS. The transmigration ability of neutrophils slightly increased after the exposure to HMSS, but did not reach a significant level. In summary, HMSS with a short exposure time of 0.5 seconds could induce neutrophil activation, platelet‐neutrophil aggregation, shedding of CD62L receptor, and increased phagocytic ability. However, the exposure to the three levels of HMSS did not cause a significant change in neutrophil transmigration capacity and shedding of CD162 receptor on neutrophils.
RNA‐binding motif protein 39 (RBM39): An emerging cancer target
Authors: Xu Yuewei , Nijhuis Anke , Keun Hector C.
Published: November 2020

RNA‐binding motif protein 39 (RBM39) is an RNA‐binding protein involved in transcriptional co‐regulation and alternative RNA splicing. Recent studies have revealed that RBM39 is the unexpected target of aryl sulphonamides, which act as molecular glues between RBM39 and the DCAF15‐associated E3 ubiquitin ligase complex leading to selective degradation of the target. Loss of RBM39 leads to aberrant splicing events and differential gene expression, thereby inhibiting cell cycle progression and causing tumour regression in a number of preclinical models. Many clinical studies have shown that aryl sulphonamides were well tolerated, but their clinical performance was limited due to an insufficient understanding of the target, RBM39 biology and a lack of predictive biomarkers. This review summarises the current knowledge of RBM39 function and discusses the therapeutic potential of this spliceosome target in cancer therapy.

LINKED ARTICLES

This article is part of a themed issue on New avenues in cancer prevention and treatment (BJP 75th Anniversary). To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.12/issuetoc
A rapid review of the impact of quarantine and restricted environments on children's play and the role of play in children's health
Authors: Graber Kelsey M. , Byrne Elizabeth M. , Goodacre Emily J. , Kirby Natalie , Kulkarni Krishna , O'Farrelly Christine , Ramchandani Paul G.
Published: November 2020

Amidst the coronavirus disease 2019 (COVID‐19) pandemic, there is uncertainty regarding potential lasting impacts on children's health and educational outcomes. Play, a fundamental part of childhood, may be integral to children's health during crises. We undertook a rapid review of the impact of quarantine, isolation and other restrictive environments on play and whether play mitigates adverse effects of such restrictions. Fifteen peer‐reviewed studies were identified, spanning hospitals, juvenile and immigration detention and refugee camps. We found evidence of changes in children's access to play in crises and quarantine. These studies indicated how play might support children enduring isolation but lacked robust investigations of play as an intervention in mitigating impacts of restriction. Studies pertaining to children in isolation due to infectious disease outbreaks were notably absent. It is important that the potential effects of changes to such a crucial aspect of childhood are better understood to support children in this and future crises.
Primal/Dual Descent Methods for Dynamics
Authors: Macklin M. , Erleben K. , Müller M. , Chentanez N. , Jeschke S. , Kim T.Y.
Published: November 2020

We examine the relationship between primal, or force‐based, and dual, or constraint‐based formulations of dynamics. Variational frameworks such as Projective Dynamics have proved popular for deformable simulation, however they have not been adopted for contact‐rich scenarios such as rigid body simulation. We propose a new preconditioned frictional contact solver that is compatible with existing primal optimization methods, and competitive with complementarity‐based approaches. Our relaxed primal model generates improved contact force distributions when compared to dual methods, and has the advantage of being differentiable, making it well‐suited for trajectory optimization. We derive both primal and dual methods from a common variational point of view, and present a comprehensive numerical analysis of both methods with respect to conditioning. We demonstrate our method on scenarios including rigid body contact, deformable simulation, and robotic manipulation.
Distant Collision Response in Rigid Body Simulations
Authors: Coevoet E. , Andrews S. , Relles D. , Kry P.G.
Published: November 2020

We use a finite element model to predict the vibration response of objects in a rigid body simulation, such that rigid objects are augmented to provide a plausible elastic collision response between distant objects due to vibration. We start with a generalized eigenvalue decomposition of the elastic model to precompute a response to an impact at any point on an elastic object with fixed boundary conditions. Then, given a collision between objects, we generate an approximate response impulse to distribute to other objects already in contact with the colliding bodies. This can lead to distant impacts causing an object to slip, or a delicate stack of objects to fall. We also use a geodesic distance based spatial attenuation approximation for travelling waves in objects to respond to an impact at one contact with an impulse at other locations. This response ultimately allows a long distance relationship between contacts, both across a single object being struck, but also traversing the contact graph of a larger collection of objects. We qualitatively validate our approach with a ground truth simulation, and demonstrate a number of scenarios where a long distance relationship between contacts is valuable.
Cloth and Skin Deformation with a Triangle Mesh Based Convolutional Neural Network
Authors: Chentanez Nuttapong , Macklin Miles , Müller Matthias , Jeschke Stefan , Kim Tae‐Yong
Published: November 2020

We introduce a triangle mesh based convolutional neural network. The proposed network structure can be used for problems where input and/or output are defined on a manifold triangle mesh with or without boundary. We demonstrate its applications in cloth upsampling, adding back details to Principal Component Analysis (PCA) compressed cloth, regressing clothing deformation from character poses, and regressing hand skin deformation from bones' joint angles. The data used for training in this work are generated from high resolution extended position based dynamics (XPBD) physics simulations with small time steps and high iteration counts and from an offline FEM simulator, but it can come from other sources. The inference time of our prototype implementation, depending on the mesh resolution and the network size, can provide between 4 to 134 times faster than a GPU based simulator. The inference also only needs to be done for meshes currently visible by the camera.
Statistics‐based Motion Synthesis for Social Conversations
Authors: Yang Yanzhe , Yang Jimei , Hodgins Jessica
Published: November 2020

Plausible conversations among characters are required to generate the ambiance of social settings such as a restaurant, hotel lobby, or cocktail party. In this paper, we propose a motion synthesis technique that can rapidly generate animated motion for characters engaged in two‐party conversations. Our system synthesizes gestures and other body motions for dyadic conversations that synchronize with novel input audio clips. Human conversations feature many different forms of coordination and synchronization. For example, speakers use hand gestures to emphasize important points, and listeners often nod in agreement or acknowledgment. To achieve the desired degree of realism, our method first constructs a motion graph that preserves the statistics of a database of recorded conversations performed by a pair of actors. This graph is then used to search for a motion sequence that respects three forms of audio‐motion coordination in human conversations: coordination to phonemic clause, listener response, and partner's hesitation pause. We assess the quality of the generated animations through a user study that compares them to the originally recorded motion and evaluate the effects of each type of audio‐motion coordination via ablation studies.
Interpretability in healthcare: A comparative study of local machine learning interpretability techniques
Authors: ElShawi Radwa , Sherif Youssef , Al‐Mallah Mouaz , Sakr Sherif
Published: November 2020

Although complex machine learning models (eg, random forest, neural networks) are commonly outperforming the traditional and simple interpretable models (eg, linear regression, decision tree), in the healthcare domain, clinicians find it hard to understand and trust these complex models due to the lack of intuition and explanation of their predictions. With the new general data protection regulation (GDPR), the importance for plausibility and verifiability of the predictions made by machine learning models has become essential. Hence, interpretability techniques for machine learning models are an area focus of research. In general, the main aim of these interpretability techniques is to shed light and provide insights into the prediction process of the machine learning models and to be able to explain how the results from the prediction was generated. A major problem in this context is that both the quality of the interpretability techniques and trust of the machine learning model predictions are challenging to measure. In this article, we propose four fundamental quantitative measures for assessing the quality of interpretability techniques—similarity, bias detection, execution time, and trust. We present a comprehensive experimental evaluation of six recent and popular local model agnostic interpretability techniques, namely, LIME, SHAP, Anchors, LORE, ILIME“ and MAPLE on different types of real‐world healthcare data. Building on previous work, our experimental evaluation covers different aspects for its comparison including identity, stability, separability, similarity, execution time, bias detection, and trust. The results of our experiments show that MAPLE achieves the highest performance for the identity across all data sets included in this study, while LIME achieves the lowest performance for the identity metric. LIME achieves the highest performance for the separability metric across all data sets. On average, SHAP has the smallest average time to output explanation across all data sets included in this study. For detecting the bias, SHAP and MAPLE enable the participants to better detect the bias. For the trust metric, Anchors achieves the highest performance on all data sets included in this work.
PCSK9 and atherosclerosis: Looking beyond LDL regulation
Authors: Ragusa Rosetta , Basta Giuseppina , Neglia Danilo , De Caterina Raffaele , Del Turco Serena , Caselli Chiara
Published: November 2020

Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) is involved in cholesterol homeostasis. After binding to the complex low‐density lipoprotein (LDL)‐receptor, PCSK9 induces its intracellular degradation, thus reducing serum LDL clearance. In addition to the well‐known activity on the hepatic LDL receptor‐mediated pathway, PCSK9 has been, however, associated with vascular inflammation in atherogenesis. Indeed, PCSK9 is expressed by various cell types that are involved in atherosclerosis (e.g. endothelial cells, smooth muscle cells and macrophages) and is detected inside human atherosclerotic plaques. We here analyse the biology of PCSK9 and its possible involvement in molecular processes involved in atherosclerosis, beyond the regulation of circulating LDL cholesterol levels.
Concept Proliferation as an Educational Good: Epistemic Injustice, Conceptual Revolutions, and Human Flourishing
Authors: Nikolaidis A. C.
Published: November 2020

Abstract

This article presents a pedagogical approach for disrupting epistemic injustice. In it, A. C. Nikolaidis first demonstrates that different forms of epistemic injustice — testimonial, hermeneutical, and contributory — are the result of limited or distorted conceptual resources and then argues that concept proliferation can be a promising educational means for overcoming such limitations and distortions. Concept proliferation involves a combination of increasing exposure to diverse, especially marginalized, concepts and providing students with necessary critical tools for questioning harmful and erroneous concepts. Concept proliferation is beneficial for both individual students and society at large. It liberates students from the confines of harmful concepts that limit their self‐understanding, but also provides them with skills necessary to challenge hegemonic concepts that distort collective (social) understanding and contribute to epistemic and systemic injustice.
Evaluating Item Fit Statistic Thresholds in PISA: Analysis of Cross‐Country Comparability of Cognitive Items
Authors: Joo Seang‐Hwane , Khorramdel Lale , Yamamoto Kentaro , Shin Hyo Jeong , Robin Frederic
Published: November 2020

In Programme for International Student Assessment (PISA), item response theory (IRT) scaling is used to examine the psychometric properties of items and scales and to provide comparable test scores across participating countries and over time. To balance the comparability of IRT item parameter estimations across countries with the best possible model fit, a partial invariance approach is used in PISA. In this approach, international or common item parameters are estimated for the majority of items, while unique or country‐specific item parameters are allowed for item‐country combinations where a misfit to the common parameters can be identified. The goal of the current study is to establish item fit statistic thresholds for identifying such misfits. We investigated the impact of various thresholds on scale and score estimation. To evaluate the impact of various item fit thresholds, we systematically examined the number of unique item parameters and country performance distributions and compared the overall model fit statistics using data from PISA 2015 and 2018. Results showed that RMSD = .10 provides the best fitting model while still establishing stable parameter estimations and sufficient comparability across groups. The applications and implications of the results are discussed.
Connectome biomarkers of drug‐resistant epilepsy
Authors: Larivière Sara , Bernasconi Andrea , Bernasconi Neda , Bernhardt Boris C.
Published: November 2020

Drug‐resistant epilepsy (DRE) considerably affects patient health, cognition, and well‐being, and disproportionally contributes to the overall burden of epilepsy. The most common DRE syndromes are temporal lobe epilepsy related to mesiotemporal sclerosis and extratemporal epilepsy related to cortical malformations. Both syndromes have been traditionally considered as "focal," and most patients benefit from brain surgery for long‐term seizure control. However, increasing evidence indicates that many DRE patients also present with widespread structural and functional network disruptions. These anomalies have been suggested to relate to cognitive impairment and prognosis, highlighting their importance for patient management. The advent of multimodal neuroimaging and formal methods to quantify complex systems has offered unprecedented ability to profile structural and functional brain networks in DRE patients. Here, we performed a systematic review on existing DRE network biomarker candidates and their contribution to three key application areas: (1) modeling of cognitive impairments, (2) localization of the surgical target, and (3) prediction of clinical and cognitive outcomes after surgery. Although network biomarkers hold promise for a range of clinical applications, translation of neuroimaging biomarkers to the patient's bedside has been challenged by a lack of clinical and prospective studies. We therefore close by highlighting conceptual and methodological strategies to improve the evaluation and accessibility of network biomarkers, and ultimately guide clinically actionable decisions.
The development and testing of the C/WoundComp instrument for assessing chronic wound‐care competence in student nurses and podiatrists
Authors: Kielo‐Viljamaa Emilia , Suhonen Riitta , Ahtiala Maarit , Kolari Terhi , Katajisto Jouko , Salminen Leena , Stolt Minna
Published: November 2020

The purpose of this study was to describe the level of chronic wound‐care competence among graduating student nurses and student podiatrists in comparison with that of professionals and to develop and test a new instrument (the C/WoundComp) that assesses both theoretical and practical competence in chronic wound care as well as attitudes towards wound care. The data (N = 135) were collected in 2019 from four groups (1): graduating student nurses (n = 44) (2); graduating student podiatrists (n = 28) (3); registered nurses (n = 54); and (4) podiatrists (n = 9). The data were analysed using statistical analysis. According to the results, the students' total mean competence score was 62%. Their mean score for theoretical competence was 67%, and for practical competence, it was 52%. The students' competence level was statistically significantly lower than that of the professionals (P < .0001), but the students showed a positive attitude towards chronic wound care. The instrument demonstrated preliminary validity and reliability, but this warrants further testing. This study provides new knowledge about student nurses' and student podiatrists' competence in chronic wound care, suggesting that their theoretical and practical competence is limited. In addition, it provides information on different methods of assessing competence and how they can be combined.
The impact of incisional negative pressure wound therapy on the wound healing process after midline sternotomy
Authors: Rashed Aref , Csiszar Marton , Beledi Agnes , Gombocz Karoly
Published: November 2020

Previous studies have reported that the use of incisional negative pressure wound therapy (INPWT) might reduce the incidence of wound infections, although its mechanism remains unknown. We designed a prospective study to explore the effects of INPWT on different stages of the wound healing process. After meeting the inclusion criteria, 108 patients were enrolled. Based on exclusion criteria four patients were excluded and 104 patients were randomised into two groups. INPWT was applied after primary closure of the midline sternotomy in the study group (n = 52), while conventional wound dressing was applied in the control group (n = 52). We documented the incidence of deep sternal wound infections and analysed the pre‐ and postoperative inflammatory biomarkers and scar size in both groups. No wound infections were observed in the study group compared with six cases (11.1%) in the control group, (P = .026). No significant differences were observed in the inflammatory biomarkers between the groups. Scar size was significantly smaller in the study group. We concluded that INPWT has less effect on the inflammatory phase and appears to have more effect on the proliferation phase through pronounced scar formation.
Incisional negative pressure wound therapy to reduce perineal wound infection after abdominoperineal resection
Authors: Kaneko Tomoaki , Funahashi Kimihiko , Ushigome Mitstunori , Kagami Satoru , Goto Mayu , Koda Takamaru , Kurihara Akiharu
Published: November 2020

We explored the effects of incisional negative pressure wound therapy in perineal wound infections after abdominoperineal resection. We retrospectively evaluated 146 patients who underwent abdominal perineal resection from December 2004 to December 2019 and compared conventional gauze dressing (controls) with incisional negative pressure wound therapy. We compared patients' characteristics, surgical factors, and perineal infection rates between groups, and patients' characteristics, surgical factors, and negative pressure therapy use between perineal infection vs non‐infection groups, as well as the risk factors for perineal infections. In the negative pressure therapy group, compared with controls, the number of men, smoking prevalence, blood transfusion, drainage via the perineal wound, and intraoperative blood loss were significantly lower (p < 0.05, p < 0.05, p < 0.05, p < 0.001, p < 0.01, respectively), and operation time was significantly longer (p < 0.05). Infections were significantly less common in the negative pressure group (p < 0.05). In the univariate analysis, the infection‐positive group had significantly higher laparoscopic surgery (p < 0.01) and negative pressure wound therapy‐free rates (p < 0.01), and significantly more intraoperative blood loss (p < 0.05). Multivariate analysis using these three factors and preoperative radiotherapy showed that incisional negative pressure wound therapy‐free status was a risk factor for infection. Incisional negative pressure wound therapy was beneficial in managing perineal wound infections after abdominoperineal resection.
Outcomes and prognosis of diabetic foot ulcers treated by an interdisciplinary team in Canada
Authors: Patry Jérôme , Tourigny André , Mercier Marie‐Philippe , Dionne Clermont E.
Published: November 2020

The aim of this study was to determine the wound healing outcomes of patients with a plantar diabetic foot ulcer (DFU) treated with an interdisciplinary team approach, and to identify associated variables. A retrospective observational cohort study of 140 adult patients, with a plantar DFU, treated between 2012 and 2018 at a wound care clinic of a University affiliated hospital was conducted. Predictive and explicative analyses were conducted with logistic multivariate methods and with a Receiver Operating Characteristics curve. The best predictor of wound healing at 3 months was a 41.8% wound size reduction at 4 weeks (AUC: 0.86; sensitivity: 83.1%; specificity: 67.2%, positive predictive value: 72.8%; negative predictive value: 78.9%; positive and negative likelihood ratios: 2.53 and 0.25, respectively). Main baseline variables independently associated with this predictor were: a monophasic Doppler waveform (OR 7.52, 95% CI [2.64–21.39]), cigarette smoking (OR 4.7, 95% CI [1.44–15.29]), and male gender (OR 3.58, 95% CI [1.30–9.87]). The health care provider should be cautious and intensify its management of DFUs particularly with patients of male gender; smoking, having a monophasic waveform with a hand‐held Doppler, and not achieving a minimal 41.8% wound area reduction at 4 weeks of treatment.
The sorptivity and durability of gelling fibre dressings tested in a simulated sacral pressure ulcer system
Authors: Lustig Adi , Alves Paulo , Call Evan , Santamaria Nick , Gefen Amit
Published: November 2020

Wound‐dressing performances are affected by exudate viscosity, resistance to flow because of gravity, and bodyweight loads, the level of which is related to the body position. Here, we focussed on two dressing properties: (a) Sorptivity—the ability of dressings to transfer exudate away from the wound bed by capillary action—and (b) Durability—the capacity of dressings to maintain their integrity over time and during their removal. Both properties are critically important for avoiding further tissue damage but require the development of new laboratory tests for their measurement. A computer‐controlled phantom of an exuding sacral pressure ulcer has therefore been developed and used to compare the performances of Exufiber (Mölnlycke Health Care) vs an alternative market‐leading dressing. Sorptivity was determined using weight tests, and durability was measured through tensile tests of the used dressings. For a supine configuration, the Exufiber dressing demonstrated ~three times higher sorptivity and better durability, withstanding ~five times greater strain energy than the other product before failure occurred. This work paves the way for quantitative, standardised testing of dressings in all aspects of exudate management. The reported tests are further suitable for testing dressing combinations or how dressings interact with negative pressure wound therapy.
CENTRAL HEMODYNAMICS IN SEVERE POISONING BY HYPNOTIC DRUGS
Authors: Bevegård Sture , Thorstrand Curt
Published: November 2020

Hemodynamic data have been recorded in nine patients during initial and late phases of severe poisoning by hypnotic drugs. Cardiac output (C.O.) was determined by the dye dilution method and right heart catheterization using “floating” catheter technique. Oxygen uptake was calculated from C.O. and arterio‐venous oxygen difference. During deep coma, characterized by hypothermia, the C.O., stroke volume and oxygen uptake were significantly decreased and the peripheral vascular resistance markedly increased. The arterio‐venous oxygen difference was generally normal, which implies that C.O. varied with oxygen uptake. Central venous pressures were normal or somewhat low, as also were the pressures in the pulmonary artery. During recovery the heart rate, stroke volume and C.O. increased in proportion to the increase in tissue metabolism as evaluated from the calculated oxygen uptake. The reduced tissue metabolism, reflected in reduced body temperature and low oxygen uptake, seems to be the main explanation of the hypo‐kinetic circulation in patients with deep coma because of poisoning by hypnotic drugs. The rather frequent roentgenological signs of pulmonary congestion or edema during the course of intoxication with hypnotic drugs do not seem to be explained by increased left ventricular filling pressures as reflected in elevated pulmonary artery diastolic pressures. A toxic effect on the vascular bed with increased permeability may be the most important underlying explanation.
INTRAVENOUS NUTRITION WITH AMINO ACID SOLUTIONS IN PATIENTS WITH CHRONIC URAEMIA
Authors: Bergström J. , Bucht H. , Fürst P. , Hultman E. , Josephson B. , Norée L.‐O. , Vinnars E.
Published: November 2020

Studies are reported dealing with nutrition of patients in terminal uraemia by i.v. infusions of solution of the essential amino acids supplementing a diet with a low, standardized nitrogen content. The basic amino acids were neutralized with acetic acid. Most of the patients had a creatinine clearance below 5 ml/min. The nitrogen balance improved in all patients except in a few cases with intercurrent complications. In most cases the plasma urea concentration decreased concomitantly. The beneficial effect of the essential amino acids on the nitrogen balance and the plasma urea was enhanced by the addition of histidine and also of both histidine and arginine to the amino acid solution.
PLASMA CORTICOSTEROIDS IN PRIMARY AND SECONDARY ADRENOCORTICAL INSUFFICIENCY
Authors: Asfeldt V. H.
Published: November 2020

Plasma corticosteroids have been studied in primary (p.a.i.) and secondary adrenocortical insufficiency (s.a.i.). In eight cases of p.a.i. and in four cases of s.a.i. the circadian rhythm was absent; all except one had low values of plasma corticosteroids at 7 a.m. The 4‐hour intravenous ACTH test was carried out in nine cases of p.a.i. and in eight cases of s.a.i. In p.a.i. no adrenal response was found; in s.a.i. no response was found in one case, subnormal responses in six cases and a normal response in one case. Baseline values of radioimmunologically determined serum corticotropin were elevated in three cases of p.a.i.; in two cases of p.a.i. a circadian rhythm of serum corticotropin was demonstrated. Insulin tolerance test (ITT) was carried out in eight cases of s.a.i.; no pituitary‐adrenal response was found. The diagnostic values of ITT and the metyrapone test in s.a.i. are discussed. It is concluded that early morning baseline values of plasma corticosteroids are often abnormally low in p.a.i. and in s.a.i. During a 4‐hour ACTH test no adrenal response is to be found in p.a.i.; in s.a.i. a variable response will be found. A partial response is diagnostic for s.a.i. Subnormal responses during metyrapone test but normal during ITT have been reported in a few cases of s.a.i. However, subnormal responses during ITT indicate that the responses during the metyrapone test are also subnormal.