bluuebunny/crossref_metadata_2025 huggingface dataset:
Amphicarpic plants: definition, ecology, geographic distribution, systematics, life history, evolution and use in agriculture
Authors: Zhang Keliang , Baskin Jerry M. , Baskin Carol C. , Cheplick Gregory P. , Yang Xuejun , Huang Zhenying
Published: May 2020

Although most plants produce all of their fruits (seeds) aboveground, amphicarpic species produce fruits (seeds) both above‐ and belowground. Our primary aims were to determine the number of reported amphicarpic species and their taxonomic, geographic, life form and phylogenetic distribution, to evaluate differences in the life history of plants derived from aerial and subterranean seeds, to discuss the ecological and evolutionary significance of amphicarpy, to explore the use of amphicarpic plants in agriculture, and to suggest future research directions for studies on amphicarpy. Amphicarpy occurs in at least 67 herbaceous species (31 in Fabaceae) in 39 genera and 13 families of angiosperms distributed in various geographical regions of the world and in various habitats. Seeds from aerial and subterranean fruits differ in size/mass, degree of dormancy, dispersal and ability to form a persistent seed bank, with aerial seeds generally being smaller, more dormant and more likely to be dispersed and to form a seed bank than subterranean seeds. In addition, plants produced by aerial and subterranean seeds may differ in survival and growth, competitive ability and biomass allocation to reproduction. Amphicarpic plants may exhibit a high degree of plasticity during reproduction. Subterranean fruits are usually formed earlier than aerial ones, and plants may produce only subterranean propagules under stressful environmental conditions. Differences in the life histories of plants from aerial and subterranean seeds may be an adaptive bet‐hedging strategy.
Recombinant Mycobacterium bovis BCG is a promising platform to develop vaccines against Trypansoma cruzi infection
Authors: Bontempi I , Leal K , Prochetto E , Díaz G , Cabrera G , Bortolotti A , Morbidoni H R , Borsuk S , Dellagostin O , Marcipar I
Published: May 2020

Chagas disease, caused by the hemoflagelate parasite Trypanosoma cruzi, is one of the most prevalent endemic parasitoses, affecting 7–8 million people. Due to the complexity of the infection, no vaccines are availabel at present. The extraordinary adjuvant capacity of bacille Calmette–Guérin (BCG) was explored in this work to develop a vaccine candidate to protect against T. cruzi infection using the recombinant BCG (rBCG) vaccine platform. Three antigens of the parasite corresponding to the N and C terminal fragments of the enzyme trans-sialidase (NT-TS and CT-TS, respectively) and a fragment of the cruzipain enzyme (CZf) were cloned into the vectors pUS997 and pUS2000 and transformed into the BCG Pasteur strain. In vaccinated mice, rBCG expressing NT-TS in pUS2000 plasmid provided the highest protection and the lowest parasitemia after challenging BALB/c mice with a 50% lethal dose of parasites. When mice vaccinated with pUS2000-NT-TS were challenged with a 100% lethal dose of parasite, high levels of protection were also obtained, together with a low degree of cardiac lesions 120 days after infection. In immunized mice with pUS2000-NT-TS/rBCG clone, the proliferation of CD4+ cells from splenocytes stimulated with the TS antigen was significant; this stimulation increased interferon (IFN)-γ and interleukin (IL)-17 within CD4⁺ T lymphocytes (LTCD4+) cells and IFN-γ and CD107 expression within LTCD8+ cells. Therefore, pUS2000-NT-TS/rBCG conferred high levels of protection, which correlated with an immune response orientated towards a T helper type 1 (Th1)/Th17 profile, together with an LTC-specific response, indicating that rBCG is a promising platform to develop vaccines against T. cruzi.
Two‐step traction‐assisted endoscopic submucosal dissection for colonic neoplasm of the ileocecal valve progressing to the terminal ileum
Authors: Esaki Mitsuru , Suzuki Sho , Ikehara Hisatomo
Published: May 2020

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Endoscopic ultrasound ablation in a patient with multiple metastatic pancreatic tumors from adrenocorticotropic hormone‐producing thymic neuroendocrine neoplasm
Authors: Chang Ling‐Kai , Chen Kuan‐Chih , Cheng Mei‐Fang , Lin Chia‐Chi , Wang Hsiu‐Po , Sung Chia‐Tung , Chen Jou‐Ho , Yen Ruoh‐Fang , Hsu Chia‐Lin , Shih Shyang‐Rong
Published: May 2020

Adrenocorticotropic hormone (ACTH)‐producing neuroendocrine neoplasm (NEN) of the thymus is rare. Lymph nodes and bones are the most common metastatic sites. Most cases present with florid Cushing's syndrome (CS). Here, we reported a 58‐year‐old woman, who presented with intermittent flush and weight loss. Imaging studies revealed tumors in the mediastinum, pancreas, and bones. Contrast‐enhanced harmonic endoscopic ultrasound (EUS) of the pancreatic tumors showed heterogeneous and hyperenhancing characteristics. EUS elastography revealed a heterogeneous stiff pattern. EUS‐fine needle biopsy to the pancreatic lesion confirmed the NEN nature. Serum ACTH and cortisol levels were abnormally high. Immunohistochemical staining of the thymic and pancreatic specimens was positive for ACTH. However, the patient did not have obvious CS appearance. The patient underwent surgery, radiation, EUS‐guided ethanol injection, and anti‐cancer medications, but the disease still progressed. The patient died from infection 16 months after NEN was diagnosed. In conclusion, the pancreas can be a metastatic site for ACTH‐producing thymic NEN. EUS‐associated procedures can help in the diagnosis and treatment of pancreatic metastatic NEN.
Optimizing a pheromone lure for the sugar beet root maggot fly, Tetanops myopaeformis
Authors: Wenninger Erik J. , Eigenbrode Sanford D.
Published: May 2020

We previously described a putative aggregation pheromone in adults of the sugar beet root maggot, Tetanops myopaeformis (von Röder) (Diptera: Ulidiidae), comprising nine compounds identified from males. Here, we conducted a series of experiments aimed at simplifying the blend of compounds necessary to achieve attraction as well as determining the dose that maximizes captures when formulated into an attractant lure. In all experiments, females showed stronger and more consistent evidence of attraction than males. White sticky traps baited with different blends of pheromone compounds that included the major component, (R)‐(−)‐2‐nonanol, showed significantly higher female captures relative to those baited with blends that excluded the major component. (R)‐(−)‐2‐nonanol alone was at least as effective as any blend that included this compound with other minor pheromone components. Lures using racemic 2‐nonanol were as effective as the (R) enantiomer for both females and males, with some evidence of weak attraction to the (S) enantiomer (which is not produced by males) observed as well. Maximum capture rates using racemic 2‐nonanol were estimated to occur with doses of ca. 795.5 and 621.6 mg for females and males, respectively. Addition of 2‐nonanol lures to standard orange sticky stake traps currently used to monitor flies increased captures of both sexes. The pheromone lure developed here could improve trapping efficiency of current monitoring programs for T. myopaeformis and may also be used to develop other management tools for this important pest of sugar beet.
Empirical orthogonal function regression: Linking population biology to spatial varying environmental conditions using climate projections
Authors: Thorson James T. , Cheng Wei , Hermann Albert J. , Ianelli James N. , Litzow Michael A. , O'Leary Cecilia A. , Thompson Grant G.
Published: May 2020

Ecologists and oceanographers inform population and ecosystem management by identifying the physical drivers of ecological dynamics. However, different research communities use different analytical tools where, for example, physical oceanographers often apply rank‐reduction techniques (a.k.a. empirical orthogonal functions [EOF]) to identify indicators that represent dominant modes of physical variability, whereas population ecologists use dynamical models that incorporate physical indicators as covariates. Simultaneously modeling physical and biological processes would have several benefits, including improved communication across sub‐fields; more efficient use of limited data; and the ability to compare importance of physical and biological drivers for population dynamics. Here, we develop a new statistical technique, EOF regression, which jointly models population‐scale dynamics and spatially distributed physical dynamics. EOF regression is fitted using maximum‐likelihood techniques and applies a generalized EOF analysis to environmental measurements, estimates one or more time series representing modes of environmental variability, and simultaneously estimates the association of this time series with biological measurements. By doing so, it identifies a spatial map of environmental conditions that are best correlated with annual variability in the biological process. We demonstrate this method using a linear (Ricker) model for early‐life survival (“recruitment”) of three groundfish species in the eastern Bering Sea from 1982 to 2016, combined with measurements and end‐of‐century projections for bottom and sea surface temperature. Results suggest that (a) we can forecast biological dynamics while applying delta‐correction and statistical downscaling to calibrate measurements and projected physical variables, (b) physical drivers are statistically significant for Pacific cod and walleye pollock recruitment, (c) separately analyzing physical and biological variables fails to identify the significant association for walleye pollock, and (d) cod and pollock will likely have reduced recruitment given forecasted temperatures over future decades.
Phase and microstructural evolution of BaZrO3‐CaZrO3 refractory and its interaction with titanium alloy melt
Authors: Lan Baobao , Chen Guangyao , Xiao Yubin , Feng Qisheng , Lu Xionggang , Li Chonghe
Published: May 2020

In this study, the effect of CaZrO3 additives on the phase and microstructure of BaZrO3 refractory were investigated as well as the interaction with titanium alloy melts. Results revealed that no second phase was observed in the BaZrO3 refractory with 10 and 20 mol% CaZrO3 additives, respectively, and the incorporation CaZrO3 additives promoted the densification and the growth of grains due to the generation of BaZrO3‐CaZrO3 solid solutions. Whereas, the appearance of CaZrO3 phase was in the BaZrO3 refractory with 30 mol% additive, indicating that the additive content excessed the solid solubility limit in the BaZrO3 refractory. Interaction analysis indicated that CaZrO3 additive could improve the performance of BaZrO3 refractory for resisting the penetration of Ti2Ni alloy melt. Meanwhile, an increasing extent of melt contamination by the BaZrO3 refractory was also detected with the increasing content of CaZrO3 additive. According to the thermodynamic calculation, an obvious increase in Gibbs free energy of formation for the BaZrO3 refractory was confirmed with the CaZrO3 additive, resulting in the increasing extent of the dissolution‐corrosion between the refractory and the titanium alloy melts.
The relationship between acne vulgaris and irritable bowel syndrome: A preliminary study
Authors: Demirbaş Abdullah , Elmas Ömer Faruk
Published: May 2020

Background

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease characterized by chronic abdominal pain and changes in bowel movements without underlying organic pathology. Many skin diseases have been reported to be more common in individuals with functional bowel diseases.

Aims

In this study, we aimed to investigate a possible relationship between acne vulgaris (AV) and IBS.

Patients/Methods

This prospective controlled study included patients with AV and healthy volunteers. All the subjects were evaluated in terms of the presence of IBS. The diagnosis of IBS was made based on the ROME IV diagnostic criteria. The clinical severity of AV was calculated using the global acne grading system (GAGS).

Results

A total of 300 patients with acne vulgaris and 300 age and gender‐matched healthy controls were included in the study. The majority of the patients were female (n = 175, 58.3%). The mean ages of the patients and controls were 20.22 ± 5.24 years and 20.49 ± 5.36 years, respectively. A total of 183 patients (61.0%) and 84 (28.0%) controls were diagnosed with IBS based on the Rome IV diagnostic criteria. The frequency of IBS was statistically significantly higher in the patient group than in the control group. (P = .001). There was also statistically significant relationship between the GAGS scores and IBS diagnosis (P = .001), abnormal stool form (P = .001), abdominal distention (P = .001), and feeling of incomplete evacuation (P = .001).

Conclusion

Our study showed that IBS is significantly more common in patients with AV than in healthy controls. Additionally, GAGS scores were higher in patients diagnosed with IBS. To the best of our knowledge, this is the first study focusing on the subject.
Bilateral, buccinator myomucosal advancement flaps to reconstruct central upper labial myomucosal defects after ablation of early‐stage cancer in minor salivary glands
Authors: Liao Juan‐Kun , Tang Qiong‐Lan , Chen Wei‐Liang , Zhou Bin , Wen Zuo‐Zheng , Huang Zi‐Xian
Published: May 2020

Background

Reconstruction of upper labial myomucosal defects is surgically challenging.

Aims

We evaluated whether central defects could be repaired using bilateral, buccinator myomucosal advancement flaps (b‐BMAFs).

Methods

We evaluated five patients with early‐stage, minor salivary gland mucoepidermoid carcinomas (low‐grade [n = 2], intermediate‐grade [n = 2], and high‐grade [n = 1]) who underwent central, upper labial myomucosal reconstruction using b‐BMAFs after cancer ablation. We treated two men and three women aged 25‐59 years. Tumors ranged in size from 1.8 × 1.8 to 2.5 × 2.2 cm. Clinical stages were I and II in two and three patients, respectively. Defect dimensions ranged from 2.8 × 2.8 to 3.5 × 3.2 cm.

Results

All patients underwent successful reconstruction of central, upper labial myomucosal defects using b‐BMAFs and were satisfied with the esthetic results. Adequate orbicularis oris and speech function were maintained. No reduction in mouth opening was observed. Patients were followed up for 24‐36 months; one pulmonary metastasis was observed at 36 months postoperatively.

Conclusion

Placement of b‐BMAFs is safe and feasible when reconstructing central, upper labial myomucosal defects after ablation of early‐stage, minor salivary gland cancer.
To rely or not to rely on common sense? Introducing critical Realism's insights to social network analysis
Authors: Singh Sourabh
Published: May 2020

In this article, I aim to critically evaluate the epistemological position of social network analysis. My main point is that while the two main schools of social network analysis – formalism and relationalism – claim to be different because of their respective comprehensions of the ontology of social networks, epistemologically they both rely on network actors' commonsensical comprehension of social ties to conduct social network analysis. Following critical realists' insights into the depth ontology of the social world, I argue that social network analysts must break from their and network actors' commonsensical comprehension of social ties in order to illustrate the objective principles of social networks. I suggest that one strategy for doing so is to treat the current networks of social actors under investigation as a product of historically shaped and state‐mediated contests among social actors to define hierarchical features of their social relations. I present my study of the history of social networks in Indian politics during the early postcolonial period (1947–64) in support of my points.
Two versions of perspectives on caring for older patients scale: Translation and psychometric testing among Chinese nursing students
Authors: Cheng Hui‐Lin , Liu Xian‐Liang , Bi Rui‐Xue , Liu Lan‐Fang , Lam Simon Ching
Published: May 2020

This study aimed to translate the Perspectives on Caring for Older Patients scale into Chinese, both the full and the shortened versions, and test its psychometric properties among Chinese nursing students. In this methodological research, the scale were translated and administered to 307 nursing students recruited from two universities in mainland China. The psychometric testing mainly included internal consistency reliability using Cronbachʼs alphas, 2‐week test–retest reliability using the intraclass correlation coefficient, convergent validity with Koganʼs Attitude toward Older People scale, and factorial validity using exploratory factor analysis. Cronbachʼs alphas for the full and the shortened version scales were 0.77 and 0.75, respectively. The intraclass correlation coefficient values of both versions exceeded 0.70 and their scores were moderately correlated with the Koganʼs Attitude toward Older People scaleʼs scores. While exploratory factor analyses revealed a six‐factor structure for the full version with factor loadings of five items below 0.3, the shortened version identified two factors with all factor loadings above 0.3. This study concluded that the psychometric properties of the full version scale were adequate and similar to those of the shortened version except for factorial validity.
Transfer cells: what regulates the development of their intricate wall labyrinths?
Authors: Offler Christina E. , Patrick John W.
Published: May 2020

Transfer cells (TCs) support high nutrient rates into, or at symplasmic discontinuities within, the plant body. Their transport capacity is conferred by an amplified plasma membrane surface area, enriched in nutrient transporters, supported on an intricately invaginated wall labyrinth (WL). Thus, development of the WL is at the heart of TC function. Enquiry has shifted from describing WL architecture and formation to discovering mechanisms regulating WL assembly. Experimental systems used to examine these phenomena are critiqued. Considerable progress has been made in identifying master regulators that commit stem cells to a TC fate (e.g. the maize Myeloblastosis (MYB)‐related R1‐type transcription factor) and signals that induce differentiated cells to undergo trans‐differentiation to a TC phenotype (e.g. sugar, auxin and ethylene). In addition, signals that provide positional information for assembly of the WL include apoplasmic hydrogen peroxide and cytosolic Ca2+ plumes. The former switches on, and specifies the intracellular site for WL construction, while the latter creates subdomains to direct assembly of WL invaginations. Less is known about macromolecule species and their spatial organization essential for WL assembly. Emerging evidence points to a dependency on methyl‐esterified homogalacturonan accumulation, unique patterns of cellulose and callose deposition and spatial positioning of arabinogalactan proteins.
Volar, Splitting, and Collapsed Type of Die‐Punch Fracture Treated by Volar Locking Plate (VLP): A Retrospective Study
Authors: Zhang Bing , Hu Pan , Cheng Xiao‐dong , Zhu Yan‐bin , Kong Ling‐de , Zhang Xu , Tian De‐hu , Zhang Ying‐ze
Published: May 2020

Objective

To compare the results of different types of die‐punch fractures treated by volar locking plate (VLP).

Methods

Between January 2013 and February 2018, a total of 71 patients with die‐punch fracture of distal radius were treated by VLP and their medical records were retrospectively reviewed. Of them, 18 were classified as volar type, 24 as splitting type, and 28 as collapsed type of fracture, based on the preoperative radiographs and CT scans. The minimum follow‐up period was 12 months. Radiological parameters, wrist function, range of motion (ROM), and complications were evaluated and compared. Pearson chi‐square test was used to assess the difference of gender distribution, injury side, dominance, mechanism, type and classification of fracture, and postoperative complications, when necessary (P < 0.05), followed by pairwise comparisons using partitions of chi‐square test. Two‐tailed P value <0.05 was considered as statistically significant. For pairwise comparisons, adjustment of statistical level as P < 0.017 (0.05/3) was used. SPSS 21.0 was used to perform all the analyses.

Results

The mean follow‐up time was 14.5 months, and at the mean of postoperative 8 weeks all patients obtained bony union, without delayed or non‐union. The grip strength was 26.6 ± 7.9 kg for patients in volar fracture group, 27.0 ± 9.4 kg in splitting group, and 26.2 ± 9.4 kg in collapsed group, without significant difference (P = 0.628).The disabilities of the arm, shoulder, and hand (DASH) (9.2 ± 10.0 for volar group, 8.8 ± 7.9 for splitting group, and 10.6 ± 8.7 for collapsed group) or Gartland–Werley score (5.1 ± 2.8 for volar group, 4.8 ± 3.2 for splitting group, and 6.4 ± 2.7 for collapsed group) either did not differ among the three groups (all P > 0.05). There was a poorer ROM in the group of collapsed fractures, but the difference was non‐significant for any parameter (P > 0.05). As for radiographic parameters, we did not find any significant difference for volar tilt, radial inclination, radial height, and ulnar variance (all P > 0.05), except for articular step‐off (P < 0.001). Pairwise comparisons showed a significantly greater step‐off (1.2 mm vs 0.4 mm, 0.5 mm) and higher rate of total complications in group of collapsed fracture (39.3%), compared to either volar (10.5%) or splitting type (12.5%).

Conclusions

The collapsed type of die‐punch fracture posed a greater articular step‐off and a higher rate of complications, especially secondary wrist osteoarthritis, which deserved more attention in clinical treatment.
Characterization of the novel HLA‐DRB3*02:02:25 allele by sequencing‐based typing
Authors: Cargou Marine , Andreani Marco , Troiano Maria , Ralazamahaleo Mamy , Visentin Jonathan
Published: May 2020

HLA‐DRB3*02:02:25 differs from HLA‐DRB3*02:02:01:02 by one nucleotide substitution in codon 116 in exon 3.
Characterization of the novel HLA‐DQA1*03:15 allele by sequencing‐based typing
Authors: Cargou Marine , Andreani Marco , Galluccio Tiziana , Guidicelli Gwendaline , Visentin Jonathan
Published: May 2020

HLA‐DQA1*03:15 differs from HLA‐DQA1*03:01:01:01 by one nucleotide substitution in codon 79 in exon 2.
Characterization of the novel HLA‐DPB1*1089:01 allele by sequencing‐based typing
Authors: Cargou Marine , Elsermans Vincent , Top Isabelle , Guidicelli Gwendaline , Visentin Jonathan
Published: May 2020

HLA‐DPB1*1089:01 differs from HLA‐DPB1*02:01:02:04 by two nucleotide substitutions in codon 43 in exon 2.
Reviewer Acknowledgements
Authors: Brown Bennett
Published: May 2020

International Journal of Law and Public Administration (IJLPA) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this Volume. Many authors, regardless of whether IJLPA publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this Volume.Reviewers for Volume 3, Number 1 Adrian Cristian Moise, Spiru Haret University of Bucharest, RomaniaBranko Dimeski, St. Kliment Ohridski University, MacedoniaChijioke Okorie, University of Cape Town, South AfricaElena Atienza-Macias, University of the Basque Country UPV/EHU, SpainEncarnación Abad Arenas, National University of Distance Education (UNED), SpainGeorge Ndi, University of Huddersfield, UKGustavo Costa de Souza, Federal University of Lavras, BrazilJosé Sebastián Kurlat Aimar, University of Buenos Aires, ArgentinaJuanita Goicovici, University Babeș-Bolyai of Cluj-Napoca, RomaniaMarcin Czubala Czubala Ostapiuk, Universidad Nacional de Eduación a Distancia, SpainOzgur Demirtas, Inonu University, TurkeyTatiana Bachvarova, Special Tribunal for Lebanon, BulgariaTaylisi de Souza Corrêa Leite, Anhanguera University, BrazilThomas Prehi Botchway, University of Education, Winneba, Ghana Best Regards, Bennett BrownEditorial AssistantInternational Journal of Law and Public Administration--------------------------------------------------------------------Redfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USATel: 1-503-828-0536 ext. 511Fax: 1-503-828-0537E-mail: ijlpa@redfame.comURL: http://ijlpa.redfame.com
Tendencias en los estudios brasileños sobre el cambio de normativa contable
Authors: Vazquez Carrazana Xiomara E. , Miranda Gilberto José
Published: May 2020

Este artículo tiene como objetivo describir las tendencias en la producción científica brasileña en relación con la nueva normativa contable en el escenario económico nacional. Se emplearon elementos del método bibliométrico, mediante un proceso de recolección de datos en la plataforma electrónica Scientific Periodicals Electronic Library –SPELL–. Fueron seleccionadas revistas clasificadas como A2, B1 y B2 en el sistema Qualis (plataforma para la evaluación de los programas de post-graduación brasileños según su producción científica), en el periodo 2008-2017. El análisis realizado muestra el eminente carácter mercadológico del pensamiento de la época, en estrecha relación con la teoría de los mercados eficientes. Los artículos publicados marcan tendencias hacia el conservadurismo contable, la divulgación voluntaria y el análisis del desempeño económico.
Controlled removal of hydrogen atoms from H-terminated silicon surfaces
Authors: Alemansour Hamed , Moheimani S. O. Reza , Owen James H. G. , Randall John N. , Fuchs Ehud
Published: May 2020

The controlled formation of dangling bond structures on a H-terminated silicon surface is the first step in an atomically precise method of fabrication of silicon quantum electronic devices. An ultrahigh vacuum scanning tunneling microscope (STM) tip is used to selectively desorb hydrogen atoms from a Si(100)-2×1:H surface by injecting electrons with the sample held at a positive bias voltage. The authors propose a lithography method that allows the STM to operate under negative bias imaging conditions and simultaneously desorb H atoms as required. A high frequency signal is added to the negative bias voltage to deliver the required energy for hydrogen removal. The resulting current at this frequency and its harmonics are filtered to minimize their effect on the operation of the STM’s feedback control loop. The authors show that the chance of tip-sample crash during the lithography process is reduced by employing this method. They also demonstrate that this approach offers a significant potential for controlled and precise removal of H atoms from a H-terminated silicon surface and thus may be used for the fabrication of practical silicon-based atomic-scale devices.
UV radiation blamed in ancient mass extinction
Authors: Voosen Paul
Published: May 2020

Malformed spores suggest powerful storms drove ozone loss as climate warmed.
Biotic interactions drive ecosystem responses to exotic plant invaders
Authors: Waller L. P. , Allen W. J. , Barratt B. I. P. , Condron L. M. , França F. M. , Hunt J. E. , Koele N. , Orwin K. H. , Steel G. S. , Tylianakis J. M. , Wakelin S. A. , Dickie I. A.
Published: May 2020

Exotic plants reduce carbon sequestration

Invasive exotic plants have become a major problem worldwide, with transformational effects on the composition and function of ecosystems. In a multifactorial experiment in New Zealand, Waller
et al.
show that exotic plants accelerate carbon loss from soils through their interactions with invertebrate herbivores and soil biota (see the Perspective by Urcelay and Austin). They built 160 mini-ecosystems in the field, manipulating interactions among plants, invertebrate herbivores, and soil biota. Key biological and abiotic responses were measured to quantify the relative contribution and interactions of the components of each community, revealing the potential of invasive plants to influence and suppress carbon sequestration through biotic interactions.

Science
, this issue p.
967
; see also p.
934
Total synthesis of bryostatin 3
Authors: Trost Barry M. , Wang Youliang , Buckl Andreas K. , Huang Zhongxing , Nguyen Minh H. , Kuzmina Olesya
Published: May 2020

Stitching alkynes into bryostatin 3

The bryostatin family of marine natural products has been explored for a wide variety of pharmaceutical applications but remains challenging to source. The general structure comprises a macrocycle that contains three smaller, six-membered rings. Bryostatin 3 is distinguished by the added complexity of a fourth, fused lactone ring. Trost
et al.
report a convergent synthesis of this complex molecule, taking advantage of alkyne coupling reactions to stitch together three main fragments and asymmetric dihydroxylation and propargylation reactions to set stereochemistry.

Science
, this issue p.
1007
Catching up to nature's ribosomes
Authors: Proulx Caroline
Published: May 2020

Flow chemistry enables total chemical synthesis of proteins without solution-phase ligation
Moving academic research forward during COVID-19
Authors: Wigginton N. S. , Cunningham R. M. , Katz R. H. , Lidstrom M. E. , Moler K. A. , Wirtz D. , Zuber M. T.
Published: May 2020

A gradual, stepwise approach to reopening, informed by public health expertise, will be essential
National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study
Authors: Parisi Rosa , Iskandar Ireny Y K , Kontopantelis Evangelos , Augustin Matthias , Griffiths Christopher E M , Ashcroft Darren M
Published: May 2020

Objective

To systematically review and provide information on the incidence of psoriasis and quantify global, regional, and country specific estimates of its prevalence.

Design

Systematic review and meta-analysis.

Data sources

Medline, Embase, Web of Science, SciELO, Korean Journal Databases, Russian Science Citation Index, WPRIM, SaudiMedLit, Informit, IndMed, and HERDIN were searched systematically from their inception dates to October 2019.

Methods

Studies were included if they reported on the incidence or prevalence of psoriasis in the general population. Incidence data were summarised descriptively, whereas bayesian hierarchical models were fitted to estimate the global, regional, and country specific prevalence of psoriasis.

Results

41 164 records were identified and 168 studies met the inclusion criteria. In adults, the incidence of psoriasis varied from 30.3 per 100 000 person years (95% confidence interval 26.6 to 34.1) in Taiwan to 321.0 per 100 000 person years in Italy. The prevalence of psoriasis varied from 0.14% (95% uncertainty interval 0.05% to 0.40%) in east Asia to 1.99% (0.64% to 6.60%) in Australasia. The prevalence of psoriasis was also high in western Europe (1.92%, 1.07% to 3.46%), central Europe (1.83%, 0.62% to 5.32%), North America (1.50%, 0.63% to 3.60%), and high income southern Latin America (1.10%, 0.36% to 2.96%).

Conclusions

Eighty one per cent of the countries of the world lack information on the epidemiology of psoriasis. The disease occurs more frequently in adults than in children. Psoriasis is unequally distributed across geographical regions; it is more frequent in high income countries and in regions with older populations. The estimates provided can help guide countries and the international community when making public health decisions on the appropriate management of psoriasis and assessing its natural history over time.

Systematic review registration

PROSPERO CRD42019160817.
Engaging men to transform inequitable gender attitudes and prevent intimate partner violence: a cluster randomised controlled trial in North and South Kivu, Democratic Republic of Congo
Authors: Vaillant Julia , Koussoubé Estelle , Roth Danielle , Pierotti Rachael , Hossain Mazeda , Falb Kathryn L
Published: May 2020

Introduction

The study objective was to understand the effectiveness of Engaging Men through Accountable Practice (EMAP), a group-based discussion series which sought to transform gender relations in communities, on intimate partner violence (IPV), gender inequitable attitudes and related outcomes.

Methods

A two-armed, matched-pair, cluster randomised controlled trial was conducted between 2016 and 2018 in eastern Democratic Republic of Congo. Adult men (n=1387) and their female partners (n=1220) participated in the study. The primary outcomes of the study were female report of past year physical and/or sexual IPV and men’s intention to commit violence. Secondary outcomes included men’s gender attitudes, women’s economic and emotional IPV, women’s perception of negative male behaviours and perceived quality of the relationship.

Results

Men in EMAP reported significant reductions in intention to commit violence (β=−0.76; SE=0.23; p<0.01), decreased agreement with any reason that justifies wife beating (OR=0.59; SE=0.08; p<0.01) and increased agreement with the ability of a woman to refuse sex for all reasons (OR=1.47; SE=0.24; p<0.05), compared with men in the control group. We found no statistically significant differences in women’s experiences of IPV between treatment and control group at follow-up (physical or sexual IPV: adjusted OR=0.95; SE=0.14; p=0.71). However, female partners of men in EMAP reported significant improvements to the quality of relationship (β=0.28; p<0.05) and significant reductions in negative male behaviour (β=−0.32; p<0.01).

Conclusion

Interventions engaging men have the potential to change gender attitudes and behaviours in conflict-affected areas. However, while EMAP led to changes in gender attitudes and behaviours related to perpetration of IPV, the study showed no overall reduction of women’s experience of IPV. Further research is needed to understand how working with men may lead to long-term and meaningful changes in IPV and related gender equitable attitudes and behaviours in conflict areas.

Trial registration number

NCT02765139.
Impact of community-based chronic obstructive pulmonary disease service, a multidisciplinary intervention in an area of high deprivation: a longitudinal matched controlled study
Authors: Saini Pooja , Rose Tanith , Downing Jennifer , Matata Bashir , Pilsworth Samantha , Pemberton Allan , Comerford Terence , Wilson Keith , Shaw Matthew , Harper Lesley M , Daras Konstantinos , Barr Benjamin
Published: May 2020

Objective

To examine the effects of a consultant-led, community-based chronic obstructive pulmonary disease (COPD) service, based in a highly deprived area on emergency hospital admissions.

Design

A longitudinal matched controlled study using difference-in-differences analysis to compare the change in outcomes in the intervention population to a matched comparison population, 5 years before and after implementation.

Setting

A deprived district in the North West of England between 2005 and 2016.

Intervention

A community-based, consultant-led COPD service providing diagnostics, treatment and rehabilitation from 2011 to 2016.

Main outcome measures

Emergency hospital admissions, length of stay per emergency admission and emergency readmissions for COPD.

Results

The intervention was associated with 24 fewer emergency COPD admissions per 100 000 population per year (95% CI −10.6 to 58.8, p=0.17) in the postintervention period, relative to the control group. There were significantly fewer emergency admissions in populations with medium levels of deprivation (64 per 100 000 per year; 95% CI 1.8 to 126.9) and among men (60 per 100 000 per year; 95% CI 12.3 to 107.3).

Conclusion

We found limited evidence that the service reduced emergency hospital admissions, after an initial decline the effect was not sustained. The service, however, may have been more effective in some subgroups.
Perception of modern radiotherapy learning: study protocol for a mixed-methods analysis of trainees and trainers at a UK cancer centre
Authors: Walls Gerard , McAleer James J , Hanna Gerard G
Published: May 2020

Introduction

Radiotherapy technology and postgraduate medical training have both evolved significantly over the last 20 years. Clinical Oncology is a recognised craft specialty where the apprenticeship model of clinical training is applicable. The challenges of learning radiotherapy in the modern radiotherapy department workplace have not been comprehensively described and no optimal method has been identified.

Methods and analysis

Five Clinical Oncology trainers and five Clinical Oncology trainees at a regional cancer centre will be invited to undertake a semistructured interview regarding their personal accounts of learning radiotherapy. Both trainees and consultants will be treated as equal co-investors in the process of radiotherapy learning, with the common shared aim of passing radiotherapy skills from trainers to trainees. Interviews will last up to 40 min. After transcription, an interpretative phenomenological analysis will be performed. All trainees and trainers at the same centre (n=34) will then be invited to complete the same purpose-built questionnaire. Four trainers and three trainees have piloted the questionnaire, and input was sought from the national leads of the biennial UK Clinical Oncology training survey. Significance testing will be performed on predefined questions and thematic analysis on white space questions.

Ethics and dissemination

Medical education research is evolving in Clinical Oncology and Radiation Oncology but there are few studies comprehensively assessing this from the viewpoint of trainees and trainers. Pending the success of the proposed study, the approach detailed represents a novel method that could be used to identify the strengths and weaknesses of radiotherapy training in other centres and settings. Ethical and governance approvals have been granted by the University Research Ethics Committee and the Integrated Research Application System, respectively. This study has been funded by Friends of the Cancer Centre.
Limiting surveillance imaging for patients with lymphoma in remission: a mixed methods study leading to a Choosing Wisely recommendation
Authors: Paltiel Ora , Raviv Sharabi Galor , Tzemach Reut , Rechavi Talya , Trachtenberg Estherina , Goldschmidt Neta , Dann Eldad J , Bar-Shalom Rachel
Published: May 2020

Background

Under the ‘Choosing Wisely’ (CW) framework, professional organisations internationally have advocated limiting imaging for asymptomatic patients following curative cancer therapy, based on limited value and high cost. F18-fluorodeoxyglucose (FDG) positron emission tomography-CT (PET/CT) was widely adopted locally for surveillance lymphoma imaging after 2004.

Objectives

Prior to ratification of a local CW recommendation to limit surveillance imaging in lymphoma, we aimed to assess: (A) performance characteristics of surveillance FDG-PET/CT; (B) rates, clinical consequences and costs of false positives (FP); and (C) patients and professionals’ attitudes towards overuse.

Methods

Mixed methods (quantitative and qualitative) study. We analysed surveillance FDG-PET/CT results of two patient cohorts (n1=215 Hodgkin lymphoma and non-Hodgkin lymphoma; n2=203 Hodgkin lymphoma only). FPs were defined by negative biopsy or clinical follow-up. We held focus group discussions and in-depth interviews eliciting attitudes of 26 patients and 11 clinicians, respectively.

Results

FPs were observed in 25.1% (95% CI 20.5 to 30.5) per scan—cohort 1, and 41.7% (95% CI 37.9 to 45.6) per patient—cohort 2, engendering frequent additional testing. Specific characteristics and location of findings altered the FP rate. The estimated cost per relapse detected was $50 000 (cohort 2). Patients sought reassurance via surveillance imaging, which they considered highly accurate, yet stressful. Aware of radiation risks, they were largely unconcerned about consequences of FPs. Confidence in the treating physicians was an important factor in patients’ acceptance of forgoing imaging. Clinicians, frequently under patient pressure to order imaging, generally believed that it did not affect prognosis (with important exceptions), welcomed professional guidelines, but rejected regulatory restrictions on its use.

Conclusion

Acceptance of CW recommendations to limit overuse may be enhanced by quantitative data on consequences and costs of surveillance imaging, supplemented by qualitative data on patient and physician attitudes.
Symptom burden and clinical profile of COVID-19 deaths: a rapid systematic review and evidence summary
Authors: Keeley Paul , Buchanan Deans , Carolan Clare , Pivodic Lara , Tavabie Simon , Noble Simon
Published: May 2020

The spread of pandemic COVID-19 has created unprecedented need for information. The pandemic is the cause of significant mortality and with this the need for rapidly disseminated information for palliative care professionals regarding the prevalence of symptoms, their intensity, their resistance or susceptibility to symptom control and the mode of death for patients.

Methods

We undertook a systematic review of published evidence for symptoms in patients with COVID-19 (with a specific emphasis on symptoms at end of life) and on modes of death. Inclusion: prospective or retrospective studies detailing symptom presence and/or cause or mode of death from COVID-19.

Results

12 papers met the inclusion criteria and gave details of symptom burden: four of these specifically in the dying and two detailed the cause or mode of death. Cough, breathlessness, fatigue and myalgia are significant symptoms in people hospitalised with COVID-19. Dyspnoea is the most significant symptom in the dying. The mode of death was described in two papers and is predominantly through respiratory or heart failure.

Conclusions

There remains a dearth of information regarding symptom burden and mode of death to inform decisions regarding end-of-life care in patients dying with COVID-19. Rapid data gathering on the mode of death and the profile of symptoms in the dying and their prevalence and severity in areas where COVID-19 is prevalent will provide important intelligence for clinicians. This should be done urgently, within ethical norms and the practicalities of a public health, clinical and logistical emergency.
High disease activity status suggests more severe disease and damage accrual in systemic lupus erythematosus
Authors: Koelmeyer Rachel , Nim Hieu Tri , Nikpour Mandana , Sun Ying B , Kao Amy , Guenther Oliver , Morand Eric , Hoi Alberta
Published: May 2020

Objective

Disease severity in SLE is an important concept related to disease activity, treatment burden and prognosis. We set out to evaluate if high disease activity status (HDAS), based on ever attainment of a Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) disease activity score of ≥10, is an indicator for disease severity in SLE.

Methods

Using prospectively collected data, we assessed the association of HDAS with sociodemographic and disease characteristics and adverse clinical outcomes using logistic regression or generalised estimating equations.

Results

Of 286 patients with SLE, who were observed for a median (range) of 5.1 years (1–10.8 years), 43.7% experienced HDAS at least once during the observational period. Autoantibody positivity, particularly anti-dsDNA and anti-Sm positivity, were associated with increased likelihood of HDAS. Age ≥45 years at diagnosis was associated with reduced likelihood of HDAS (p=0.002). Patients with HDAS had higher Physician Global Assessment score (>1: OR 8.1, p<0.001) and were more likely to meet criteria for flare (mild/moderate flare: OR 4.4, p<0.001; severe flare: OR 17.2, p<0.001) at the time of experiencing HDAS. They were also more likely to have overall higher disease activity, as defined by time-adjusted mean SLEDAI-2K score in the highest quartile (OR 11.7, 95% CI 5.1 to 26.6; p>0.001), higher corticosteroid exposure (corticosteroid dose in highest quartile: OR 7.7, 95% CI 3.9 to 15.3; p<0.001) and damage accrual (OR 2.3, 95% CI 1.3 to 3.9; p=0.003) when compared with non-HDAS patients.

Conclusions

HDAS is associated with more severe disease, as measured by higher disease activity across time, corticosteroid exposure and damage accrual. The occurrence of HDAS may be a useful prognostic marker in the management of SLE.
Cultivating the dispositions to connect: an exploration of therapeutic empathy
Authors: Hardman Doug , Hutchinson Phil
Published: May 2020

Empathy is a broad concept that involves the various ways in which we come to know and make connections with one another. As medical practice becomes progressively orientated towards a model of engaged partnership, empathy is increasingly important in healthcare. This is often conceived more specifically through the concept of therapeutic empathy, which has two aspects: interpersonal understanding and caring action. The question of how we make connections with one another was also central to the work of the novelist E.M. Forster. In this article we analyse Forster’s interpretation of connection—particularly in the novelHowards End—in order to explore and advance current debates on therapeutic empathy. We argue that Forster conceived of connection as a socially embedded act, reminding us that we need to consider how social structures, cultural norms and institutional constraints serve to affect interpersonal connections. From this, we develop a dispositional account of therapeutic empathy in which connection is conceived as neither an instinctive occurrence nor a process of representational inference, but a dynamic process of embodied, embedded and actively engaged enquiry. Our account also suggests that therapeutic empathy is not merely an untrainable reflex but something that can be cultivated. We thus promote two key ideas. First, that empathy should be considered as much a social as an individual phenomenon, and second that empathy training can and should be given to clinicians.
Suspicious minds: cinematic depiction of distrust during epidemic disease outbreaks
Authors: Han Qijun , Curtis Daniel R
Published: May 2020

One key factor that appears to be crucial in the rejection of quarantines, isolation and other social controls during epidemic outbreaks is trust—or rather distrust. Much like news reporting and social media, popular culture such as fictional novels, television shows and films can influence people’s trust, especially given that the information provided about an epidemic disease is sometimes seen as grounded in ‘scientific fact’ by societies. As well as providing information on the ‘correct science’ behind disease transmission, spread and illness in films and literature, popular culture can also inform societies about how to feel and how to react during epidemics—that is to say create some expectations about the kinds of societal responses that could potentially occur. In this article we closely analyse three films that centre around epidemic diseases—Contagion(Steven Soderbergh, 2011),Blindness(Fernando Meirelles, 2008) andThe Painted Veil(John Curran, 2006)—in order to highlight three categories of distrust that have recently been identified and conceptualised in broader discussions regarding trust and health: institutional, social and interpersonal. These films raise two key issues about trust and social responses during epidemics. First, while certain aspects of trust are badly diminished during epidemic disease outbreaks, epidemics can also interact with pre-existing structural inequalities within society—based on race, gender or wealth—to create mixed outcomes of discord, prejudice and fear that coexist with new forms of cohesion. Second, the breakdown in trust seen at certain levels during epidemics, such as at the institutional level between communities and authorities or elites, might be mediated or negotiated, perhaps even compensated for, by heightened solidity of trust at the social level, within or between communities.