bluuebunny/crossref_metadata_2025 huggingface dataset:
Misdiagnosis of ARVC leading to inappropriate ICD implant and subsequent ICD removal – lessons learned
Authors: Sharma Apurva , Assis Fabrizio , James Cynthia A. , Murray Brittney , Tichnell Crystal , Tandri Harikrishna , Calkins Hugh
Published: July 2019

Introduction

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited progressive cardiomyopathy characterized by frequent life‐threatening arrhythmias. The diagnosis of ARVC is challenging and is on the basis of a set of major and minor criteria as described by the modified Task Force Criteria (TFC). We report our clinical experience in a series of patients who were misdiagnosed with ARVC and subsequently underwent removal of their implantable cardioverter defibrillator (ICD) after a re‐evaluation at our center.

Methods and results

We studied 12 patients who were misdiagnosed with ARVC and had ICD implantation before our assessment. All patients had a repeat evaluation and were scored according to TFC before ICD removal. Cardiac magnetic resonance imaging (CMR) studies performed at outside institutions during the initial evaluation were reported abnormal and classified as meeting major TFC in ninety percent of patients. The most common abnormality reported was fatty infiltration of the right ventricular (RV) free wall and/or presence of focal intra‐myocardial fat in six patients (50%). On re‐evaluation, none of these findings fulfilled the TFC for the diagnosis.

Conclusion

This study demonstrated that high dependence on misinterpretation of CMR along with a misunderstanding of the TFC evaluation are the main reasons for the misdiagnosis of ARVC. Despite the updated criteria for almost a decade, this study reminds that the diagnosis of ARVC is complex and hence careful TFC evaluation and consideration of multiple cardiac test results should be the focused approach for clinicians when confronted with suspected ARVC patients.
Maintenance of long‐term blood pressure control and vascular health by low‐dose amiloride‐based therapy in hyperaldosteronism
Authors: Izzo Joseph L. , Hong Michael , Hussain Tanveer , Osmond Peter J.
Published: July 2019

Whether aldosterone itself contributes directly to macro‐ or microcirculatory disease in man or to adverse cardiovascular outcomes is not fully known. We report our long‐term single‐practice experience in an unusual group of five patients with chronic hyperaldosteronism (HA, including three with glucocorticoid‐remediable aldosteronism, GRA) treated with low‐dose amiloride (a specific epithelial sodium channel [ENaC] blocker) 5‐10 (mean 7) mg daily for 14‐28 (mean 20) years. Except for one GRA diagnosed in infancy, all had severe resistant hypertension. In each case, BP was normalized within 1‐4 weeks after starting amiloride and office BP’s remained well controlled throughout the next two decades. 24‐hour ambulatory BP monitoring with pulse wave analysis (cardiac output, vascular resistance, augmentation index, reflection magnitude), regional pulse wave velocities, pulse stiffening ratio, ankle‐brachial index, serum creatinine, estimated glomerular filtration rate, and spot urinary albumin:creatinine ratio were measured after a mean of 18 years; all of these indicators were essentially normal. Over two additional years of observation (100 patient‐years total), no cardiovascular or renal event occurred. We conclude that long‐term ENaC blockade with amiloride can normalize BP and protect macro‐ and microvascular function in patients with HA. This suggests that either (a) putative vasculopathic effects of aldosterone are mediated via ENaC or (b) aldosterone may not play a direct role in age‐dependent vasculopathic changes in humans independent of blood pressure. These findings, coupled with our literature review in both animal and human results, underscore the need for additional studies.
A Deeper Look at Bar Success: The Relationship Between Law Student Success, Academic Performance, and Student Characteristics
Authors: Farley Amy N. , Swoboda Christopher M. , Chanvisanuruk Joel , McKinley Keanen M. , Boards Alicia , Gilday Courtney
Published: July 2019

In recent years, law schools have experienced a decline in enrollment and bar passage, and legal education has been challenged to understand this new phenomenon and conduct research that can inform practices and policies regarding law student success. This article presents findings from research conducted at the University of Cincinnati College of Law, a large, midwestern public university, which aimed to investigate which factors and student characteristics contribute to bar passage within the home jurisdiction (Ohio). Results suggest bar passage can be predicted by a wide battery of variables, most notably student performance during the law school course of study. Despite some prior literature that suggests otherwise, however, LSAT and undergraduate GPA were only weakly predictive of first‐time bar passage among admitted students: the best prelaw model based on student admissions and demographic data identified just over one‐third of the students who ultimately failed the bar on the first attempt. Information from the first year of law school—even just performance in one first semester course—explained significantly more variation in bar passage. Furthermore, data from beyond the first year of legal study, including upper‐level course taking in bar‐tested subjects, enriched the predictive power of the model, enabling us to predict 78 percent of students who failed the bar compared to just 58 percent after the first year. These preliminary results provide important insights into bar passage, particularly given the increased public scrutiny around incoming student credentials, bar success, and law school performance and accreditation.
Innervation of internal female genital organs in the pig during prenatal development
Authors: Franke‐Radowiecka Amelia , Prozorowska Ewelina , Zalecki Michal , Jackowiak Hanna , Kaleczyc Jerzy
Published: July 2019

This study investigated the innervation of internal genital organs in 5‐, 7‐ and 10‐week‐old female pig foetuses using single and double‐labelling immunofluorescence methods. The structure and topography of the organs was examined using a scanning electron microscope (SEM). The investigations revealed differences in the innervation between the three developmental periods. Immunostaining for protein gene product 9.5 (PGP; general neural marker) disclosed solitary nerve fibres in the external part of the gonadal ridge and just outside of the mesenchyme surrounding mesonephric ducts in 5‐week‐old foetuses. Double‐labelling immunohistochemistry revealed that nerve fibres associated with the ridge expressed dopamine β‐hydroxylase (DβH; adrenergic marker) or vesicular acetylcholine transporter (VAChT; cholinergic marker). In 7‐week‐old foetuses, the PGP‐positive nerve terminals were absent from the gonad but some of them ran outside and along, and sometimes penetrated into the mesenchyme surrounding the tubal and uterine segments of the paramesonephric ducts and uterovaginal canal. Few axons penetrated into the mesenchyme. DβH‐positive fibres were found in single nerve strands or bundles distributed at the edge of the mesenchyme. VAChT‐positive nerve terminals formed delicate bundles located at the edge of the mesenchyme, and the single nerves penetrated into the mesenchyme. DβH was also expressed by neurons which formed cell clusters comprising also DβH‐ or VAChT‐positive nerve fibres. In 10‐week‐old foetuses, PGP‐positive nerve fibres were still absent from the ovary but some were distributed in the mesenchyme associated with the uterovaginal canal and uterine and a tubal segment of the paramesonephric ducts, respectively. DβH‐ or VAChT‐positive nerve fibres were distributed at the periphery of the mesenchyme associated with the uterovaginal canal. Some DβH‐ and many VAChT‐positive nerve fibres were evenly distributed throughout the mesenchyme. The clusters of nerve cells comprised DβH‐positive perikarya and DβH‐ or VAChT‐positive nerve fibres. The investigations revealed no DβH/VAChT‐positive nerve fibres or neurons as well as no nerve structures stained for calcitonin gene‐related peptide and/or substance P (sensory markers) associated with the genital organs in the studied prenatal periods.
Interaction between low‐level laser therapy and Guarana (Paullinia cupana) extract induces antioxidant, anti‐inflammatory, and anti‐apoptotic effects and promotes proliferation in dermal fibroblasts
Authors: Maldaner Daíse Raquel , Pellenz Neida Luiza , Barbisan Fernanda , Azzolin Verônica Farina , Mastella Moisés Henrique , Teixeira Cibele Ferreira , Duarte Thiago , Maia‐Ribeiro Ednea A. , da Cruz Ivana Beatrice Mânica , Duarte Marta Maria Medeiros Frescura
Published: July 2019

Background

Low‐level laser therapy (LLLT) has several clinical applications; however, its benefits are not universal. Therefore, combination therapy with LLLT and extracts from the guarana (Paullinia cupana) plant may improve its effectiveness as guarana extracts exhibit anti‐aging properties.

Objectives

To evaluate the antioxidant, anti‐inflammatory, anti‐apoptotic, and proliferative effects of combined LLLT and guarana extract therapy on human dermal fibroblasts.

Methods

Human dermal fibroblasts (HFF‐1) were cultured and initially exposed to several concentrations (1, 3, 5, 10, 30 µg/mL) of guarana extract. The experimental concentration of guarana extract was selected by analyzing cytokine levels, DNA oxidation, and apoptotic markers in LLLT‐exposed (4 J/cm2) and LLLT‐unexposed fibroblast cultures. After 72 hours, the cells were analyzed using spectrophotometric, fluorimetric, immunological, and gene expression (qRT‐PCR) assays. Flow cytometry was used to evaluate the effect of each treatment on cell cycle.

Results

Fibroblasts treated with guarana (5 µg/mL) exhibited anti‐inflammatory and anti‐apoptotic properties been used in complementary protocols. Combined guarana and LLLT treatment significantly decreased protein carbonylation, lipoperoxidation, and DNA oxidation, downregulated the mRNA and protein expression of pro‐inflammatory molecules, and upregulated IL‐10 gene and protein expression. Guarana plus LLLT also decreased the levels of caspases 1, 3, and 8, increased the percentage of S‐phase cells, and decreased FGF‐1 and KGF‐1 levels. Some of these changes were also observed after treatment with guarana or LLLT alone.

Conclusions

Our results suggest that concomitant treatment with guarana and LLLT may promote fibroblast biostimulation and thus is clinically relevant.
Investigating the effect of a symposium on sexual health care in prostate cancer among Dutch healthcare professionals
Authors: Grondhuis Palacios Lorena A. , Hendriks Nora , den Ouden Marjolein E. M. , Reisman Yacov , Beck Jack J. H. , den Oudsten Brenda L. , van Ek Gaby F. , Putter Hein , Pelger Rob C. M. , Elzevier Henk W.
Published: July 2019

Aims and objectives

To investigate whether a symposium aimed at healthcare professionals in the uro‐oncological field changes knowledge, competence and general practice regarding sexual dysfunction after prostate cancer treatment.

Background

Sexual dysfunction is not frequently discussed by healthcare professionals; lack of knowledge and training are two of the most often reported barriers. Provision of additional training could improve knowledge, competence and general practice of healthcare professionals.

Design

Two questionnaires were used in this pre–post study to determine knowledge, competence and general practice at the time of the symposium and six months afterwards.

Methods

In order to perform repeated measures to analyse alterations among participating healthcare professionals (n = 55), the McNemar's test was used. A STROBE checklist was completed.

Results

Seventy‐three per cent (n = 40) stated that not enough attention was paid to prostate cancer‐related sexual dysfunction during their education. Nurses felt significantly less competent in discussing sexual function, advising on sexual dysfunction and actively inquiring sexual complaints compared to other healthcare professionals. After the symposium, sexual dysfunction was significantly more often discussed. No significant effects were found on knowledge on sexual dysfunction, knowledge on treatment of sexual dysfunction, competence in discussing sexual function, advising on sexual dysfunction, actively inquiring sexual complaints and rate of referral. Tools needed to address sexual dysfunction concerned written information materials (75.5%) and a website containing adequate information (56.6%).

Conclusions

The symposium had no significant influence on knowledge, competence and rate of referral in men with sexual dysfunction after prostate cancer treatment. However, sexual dysfunction was more frequently discussed after the symposium, so increase of awareness of consequences of prostate cancer treatment was achieved.

Relevance to clinical practice

Consequences of prostate cancer treatment to sexual function should be taken in consideration in daily practice; written information materials and a website containing adequate information were indicated as valuable resources to address sexual dysfunction in routine consultations.
Substitution of corn silage with shredded beet pulp affects sorting behaviour and chewing activity of dairy cows
Authors: Naderi Nima , Ghorbani Gholam R. , Sadeghi‐Sefidmazgi Ali , Kargar Shahryar , Hosseini Ghaffari Morteza
Published: July 2019

This study aims to evaluate the effects of substituting increasing concentrations of shredded beet pulp (SBP) for corn silage (CS) on nutrient intake, sorting index, intakes of particle size and nutrients, meal and rumination patterns, and chewing activity of dairy cows. Four multiparous (126 ± 13 day in milk) and 4 primiparous (121 ± 11 day in milk) Holstein cows were used in a 4 × 4 Latin square design experiment with 4 periods of 21 days. Dietary treatments were (DM basis): 16% of dietary DM as CS without SBP (0SBP); 8% CS and 8% SBP (8SBP); 4% CS and 12% SBP (12SBP); and 0% CS and 16% SBP (16SBP). We observed a reduction in the extent of sorting against long particles and medium particles but for fine particles with increasing SBP levels in the diets. The number of eating bouts per day was lesser (8.2%) in cows fed SBP diets compared with 0SBP cows and corresponded with a reduction in eating time per d across treatments. The number of ruminating bouts per day was similar across diets (16.8 bouts/day), but substituting SBP for CS in the diets tended to decrease linearly ruminating bout length (5 min/bout) and tended to increase ruminating bout interval (8 min/day). Eating, ruminating and total chewing time when expressed as minutes per kilogram of forage NDF intake and peNDF > 8 intake increased when SBP was substituted for CS in the diets. Primiparous cows had greater ruminating time (57 m/day) and total chewing time (73 min/day), eating rate (0.01 kg of DM/min) compared with multiparous cows. Also, increasing forage NDF and peNDF>8, >8‐mm DM intakes are effective means of stimulating ruminating and chewing activities. This study showed that SBP could partially replace CS and not affect DM intake, but chewing activity may decrease slightly.
Enhanced junctional epithelial permeability in TRPV4‐deficient mice
Authors: Kitsuki Tomoko , Yoshimoto Reiko U. , Aijima Reona , Hatakeyama Junko , Cao Ai‐Lin , Zhang Jing‐Qi , Ohsaki Yasuyoshi , Mori Yoshihide , Kido Mizuho A.
Published: July 2019

Background and Objective

As the interface between the oral cavity and the teeth, the junctional epithelial barrier is critical for gingival defense. The junctional epithelium is subject to mechanical stresses from biting force or external insults such as bacterial attacks, but little is known about the effects of mechanical stimuli on epithelial functions. Transient receptor potential vanilloid 4 (TRPV4) functions as a mechanosensitive nonselective cation channel. In the present study, based on marked expression of TRPV4 in the mouse junctional epithelium, we aimed to clarify the putative links between TRPV4 and junctional complexes in the junctional epithelium.

Methods and Results

Histological observations revealed that the junctional epithelium in TRPV4‐deficient (TRPV4−/−) mice had wider intercellular spaces than that in wild‐type (TRPV4+/+) mice. Exogenous tracer penetration in the junctional epithelium was greater in TRPV4−/− mice than in TRPV4+/+ mice, and immunoreactivity for adherens junction proteins was suppressed in TRPV4−/− mice compared with TRPV4+/+ mice. Analysis of a mouse periodontitis model showed greater bone volume loss in TRPV4−/− mice compared with TRPV4+/+ mice, indicating that an epithelial barrier deficiency in TRPV4−/− mice may be associated with periodontal complications.

Conclusion

The present findings identify a crucial role for TRPV4 in the formation of adherens junctions in the junctional epithelium, which could regulate its permeability. TRPV4 may be a candidate pharmacological target to combat periodontal diseases.
Feeding of adult Ornithodoros tartakovskyi ticks using a modified artificial membrane feeding system
Authors: Lewis C. E. , Bartholomay L. C. , Blanchong J. A.
Published: July 2019

Development and maintenance of laboratory tick colonies provides reliable access to a variety of tick species at multiple life stages. Advances in techniques for the membrane feeding of ticks reduce the number of laboratory animals needed for colony maintenance. In the present study, modifications to the existing protocol for in vitro feeding of the argasid species Ornithodoros tartakovskyi were made. Adult O. tartakovskyi ticks of both sexes were allowed to feed to engorgement using a novel membrane feeding apparatus in a six‐well plate format with well‐inserts of laboratory‐grade, wax sealing film. Of the 193 ticks placed on the membrane, 89% (n = 172) fed until engorgement and subsequently detached. The modified feeding method described will aid in future laboratory tick‐based research because it allows for increased containment, ease of sorting, successful in vitro feeding, easy replacement of blood meals and a reduction in the total volume of blood meal required.
Reliability and validity of the Children's Depression Inventory–Japanese version
Authors: Ozono Shuichi , Nagamitsu Shinichiro , Matsuishi Toyojiro , Yamashita Yushiro , Ogata Akiko , Suzuki Shinichi , Mashida Naoki , Koseki Shunsuke , Sato Hiroshi , Ishikawa Shinichi , Togasaki Yasuko , Sato Yoko , Sato Shoji , Sasaki Kazuyoshi , Shimada Hironori , Yamawaki Shigeto
Published: July 2019

Background

Depression has major negative consequences for individuals and society, and psychological assessment tools for early disease detection are needed. The aim of this study was to investigate the reliability and validity of an updated Japanese version of the Children's Depression Inventory (CDI‐J) and set a cut‐off score for the detection of depression.

Methods

The participants consisted of 465 children and adolescents aged 7–17 years. The control (CON) groups consisted of students recruited from elementary and junior‐high school (CONEJ) and children recruited from among hospital staff members (CONRE), while the outpatient clinical (OPC) groups consisted of pediatric psychosomatic outpatients (OPCPD) and adolescent psychiatric outpatients (OPCPS). The CON and OPC CDI‐J scores underwent factor analysis using varimax rotation, followed by measurement invariance analysis. The Youth Self‐Report (YSR) was administered to assess concurrent validity. The Mini‐International Neuropsychiatric Interview was administered to the OPC group to diagnose current depressive symptoms. Receiver operating characteristics (ROC) analysis was conducted to evaluate case‐finding performance and to set cut‐off points for the detection of depression.

Results

The CDI‐J was reliable in terms of internal consistency (Cronbach α = 0.86; mean inter‐item correlation, 0.16). Re‐test reliability was substantial (mean interval 18 days: γ = 0.59, P < 0.05). The four‐factor solution exhibited adequate internal consistency (range, 0.52–0.73) and correspondence (Pearson correlation of 0.65 with the YSR) for both the CON and OPC groups. On ROC analysis the optimal cut‐off score was 23/24.

Conclusion

The CDI‐J can be used as a reliable and well‐validated instrument alongside standard diagnostic procedures.
The association of stillbirth with placental abnormalities in growth‐restricted and normally grown fetuses
Authors: Freedman Alexa A. , Silver Robert M. , Gibbins Karen J. , Hogue Carol J. , Goldenberg Robert L. , Dudley Donald J. , Pinar Halit , Drews‐Botsch Carolyn
Published: July 2019

Background

Stillbirth, defined as foetal death ≥20 weeks’ gestation, is associated with poor foetal growth and is often attributed to placental abnormalities, which are also associated with poor foetal growth. Evaluating inter‐relationships between placental abnormalities, poor foetal growth, and stillbirth may improve our understanding of the underlying mechanisms for some causes of stillbirth.

Objective

Our primary objective was to determine whether poor foetal growth, operationalised as small for gestational age (SGA), mediates the relationship between placental abnormalities and stillbirth.

Methods

We used data from the Stillbirth Collaborative Research Network study, a population‐based case‐control study conducted from 2006‐2008. Our analysis included 266 stillbirths and 1135 livebirths. We evaluated associations of stillbirth with five types of placental characteristics (developmental disorders, maternal and foetal inflammatory responses, and maternal and foetal circulatory disorders) and examined mediation of these relationships by SGA. We also assessed exposure‐mediator interaction. Models were adjusted for maternal age, race/ethnicity, education, body mass index, parity, and smoking status.

Results

All five placental abnormalities were more prevalent in cases than controls. After adjustment for potential confounders, maternal inflammatory response (odds ratio [OR] 2.58, 95% confidence interval [CI] 1.77, 3.75), maternal circulatory disorders OR 4.14, 95% CI 2.93, 5.84, and foetal circulatory disorders OR 4.58, 95% CI 3.11, 6.74 were strongly associated with stillbirth, and the relationships did not appear to be mediated by SGA status. Associations for developmental disorders and foetal inflammatory response diverged for SGA and non‐SGA births, and strong associations were only observed when SGA was not present.

Conclusions

Foetal growth did not mediate the relationships between placental abnormalities and stillbirth. The relationships of stillbirth with maternal and foetal circulatory disorders and maternal inflammatory response appear to be independent of poor foetal growth, while developmental disorders and foetal inflammatory response likely interact with foetal growth to affect stillbirth risk.
You Can't Fix What You Don't Measure: How ALICE Can Help Rebuild the Middle Class
Authors: Hoopes Stephanie , Treglia Dan
Published: July 2019

Seventy percent of Americans identify as middle class, but one in three middle‐income households do not earn enough to support their family at the most basic level, and four in five do not earn enough to afford a sustainable budget. This incongruity explains the increasing frustration of many workers. Yet official government measures do not capture this reality, and as a result, policy makers continue to create economic policies that perpetuate the structural mismatch between wages and costs. This Viewpoint essay addresses these shortcomings. After reviewing alternatives to the federal poverty level, it argues that the most realistic and accurate floor to the middle class is the ALICE (Asset Limited, Income Constrained, Employed) Household Survival Budget. The essay then turns to policies that help realign wages and cost of living and presents initiatives that are being implemented in states across the country. Four policy areas would enable more workers to support their families and fulfill the promise of being middle class in America: meaningful work with stable and sufficient wages, upskilling and digital retooling, fiscal cushion for periods of financial instability, and affordable credit.
An atypical Bacillus anthracis infection in a bull—A potential occupational health hazard
Authors: Friman Mari , Kakko Leila , Constantin Camelia , Simojoki Heli , Andersson Maria A. , Nagy Szabolcs , Salonen Heidi , Andersson Magnus
Published: July 2019

Bacillus anthracis infecting cattle is usually identified based on the typical symptom: sudden death. Bacillus anthracis causing atypical symptoms may remain undiagnosed and represent a potential occupational health hazard for, that is veterinarians and producers, butchers and tanners. In the year 2004, one case of sudden death in a dairy farm in southern Finland was diagnosed as bovine anthrax. Four years later 2008, an atypical case of anthrax was diagnosed in the same holding. The bull was taken to the Production Animal Hospital of the Faculty of Veterinary Medicine, University of Helsinki because of fever, loss of appetite and a symmetrically swollen scrotal sac. Penicillin treatment cured the fever but not the swollen scrotum. Before the intended therapeutic castration, a punctuate consisting of 10 ml fluid collected into a syringe from the scrotal sac was cultivated on blood agar at 37°C. After 24 hr, an almost pure culture of a completely non‐hemolytic Bacillus cereus‐like bacteria was obtained. The strain was identified as B. anthracis using Ba‐specific primers by the Finnish Food Safety Authority (RUOKAVIRASTO). After the diagnosis, the bull was euthanized and destroyed, the personnel were treated with prophylactic antibiotics and the clinic was disinfected. In this particular case, treatment with water, Virkon S and lime seemed to be effective to eliminate endospores and vegetative cells since no relapses of anthrax have occurred in 10 years. This case is the last reported anthrax case in Finland.
Ensuring effective restoration efforts with salt marsh grass populations by assessing genetic diversity
Authors: Gaynor Michelle L. , Walters Linda J. , Hoffman Eric A.
Published: July 2019

Smooth cordgrass (Spartina alterniflora) is a foundation species that naturally occurs along the Atlantic coast of North America and is often used in restoration due to its extensive rooting capacity and ability to halt erosion. Clonal species, such as S. alterniflora, are easy to rear for transplant, but using a predominantly asexual species for restoration may lead to genetically depauperate populations. We (1) identified if genetic diversity was maintained during restoration; (2) determined if genotypes from the native populations were genetically distinct from the restored populations; and (3) evaluated if current efforts limited the number of multiple copies of the same multilocus genotypes (MLG) within restoration sites along the shorelines of the Mosquito Lagoon (ML), Florida, United States. All objectives were addressed where only one representative of an identical MLG was retained within each population. We found that allelic richness (p = 0.618) and expected heterozygosity (p = 0.527) did not significantly differ between restored and natural populations. Furthermore, pairwise FST estimates between naturally occurring populations ranged from 0.021 to 0.178, while estimates ranged from approximately 0 to 0.084 among restored populations. When we evaluated differentiation between natural and restored populations, average FST was 0.087. Finally, we found that higher numbers of samples with multiple copies of the same MLG occurred in restored populations (31.4–55.9% of samples per population) compared to natural populations (0–11.8% of samples per population). Overall, we found that current restoration efforts in the ML are effective at maintaining natural levels of genetic diversity.
Market size and entry in international trade: Product versus firm fixed costs
Authors: Steingress Walter
Published: July 2019

This paper develops a theoretical framework to infer the nature of fixed costs from the relationship between entry patterns in international markets and destination market size. If fixed costs are at the firm level, firms take advantage of an intrafirm spillover by expanding firm‐level product range (scope). Few firms enter with many products and dominate international trade. If fixed costs are at the product level, an interfirm spillover reduces the fixed costs to export for all firms producing the product. The resulting entry pattern consists of many firms exporting different varieties of the same product. Using cross‐country data on firm and product entry, I find empirical evidence consistent with product‐level costs. More firms than products enter in larger markets offering their consumers lower prices and a greater variety of goods within the product category.
Prediction with High Dimensional Regression Via Hierarchically Structured Gaussian Mixtures and Latent Variables
Authors: Tu Chun-Chen , Forbes Florence , Lemasson Benjamin , Wang Naisyin
Published: July 2019

We propose a hierarchical Gaussian locally linear mapping structured mixture model, named HGLLiM, to predict low dimensional responses based on high dimensional covariates when the associations between the responses and the covariates are non-linear. For tractability, HGLLiM adopts inverse regression to handle the high dimension and locally linear mappings to capture potentially non-linear relations. Data with similar associations are grouped together to form a cluster. A mixture is composed of several clusters following a hierarchical structure. This structure enables shared covariance matrices and latent factors across smaller clusters to limit the number of parameters to estimate. Moreover, HGLLiM adopts a robust estimation procedure for model stability. We use three real data sets to demonstrate different features of HGLLiM. With the face data set, HGLLiM shows ability to model non-linear relationships through mixtures. With the orange juice data set, we show that the prediction performance of HGLLiM is robust to the presence of outliers. Moreover, we demonstrate that HGLLiM is capable of handling large-scale complex data by using the data acquired from a magnetic resonance vascular fingerprinting study. These examples illustrate the wide applicability of HGLLiM to handle different aspects of a complex data structure in prediction.
“The only equality is the pain”: An exploration of the Irish policy sphere's approach to “access” and “entitlement” in health care
Authors: Malone Patrick , Millar Michelle
Published: July 2019

This paper critically analyses how overarching policy goals and practices surrounding access and entitlement to health care (HC) have been dominated by a conflicting system of libertarian and equity‐based principles. We examine how this mixed‐motives system originated and the importance of policy legacies inherited from the Poor Laws era in shaping modern conceptions of access and entitlement to HC. We also considered how these determined the scope of state intervention in this policy domain. Drawing on empirical evidence and interviews with key stakeholders in Irish health policy, we explored the appetite to engage in meaningful HC reforms that address the growing gaps of inequity between higher and lower socio‐economic groups in society. Rather than emulating European counterpartsapos; emphasis on universal coverage within an egalitarian paradigm, Irish policy actors have sought to instill a spirit of fairness in HC delivery. Under the guise of equality of opportunity and equity, the policy focus has centred on directing publicly funded HC towards lower‐income groups and the most vulnerable in Irish society. However, we argue that the operation of the mixed‐motives structure has also created conflict and policy ambiguity surrounding overarching goals which frame the governance and consumption of HC in Ireland. This is evidenced by the dysfunction and complexity of the two‐tier system of public‐versus‐private access to HC services. Ultimately, we argue that the policy aspirations of equality that underpin the HC structures surrounding access and entitlement should be revisited to achieve greater health outcomes and create a more equal society.
Assessment of Citizens’ Populist Orientations: Development and Validation of the POPulist ORientation (POPOR) Scale
Authors: Roccato Michele , Corbetta Piergiorgio , Cavazza Nicoletta , Colloca Pasquale
Published: July 2019

Objectives

We developed and validated the POPulist ORientation (POPOR) Scale (composed of six five‐category items), operationalizing populist orientation as a unidimensional construct composed of six facets: (1) anti‐economic, financial, and intellectual establishment attitude; (2) anti‐political establishment; (3) conception of the people as a homogeneous and virtuous entity; (4) consideration of the people as legitimated to take part directly in political decision‐making processes; (5) need for a strong leader; and (6) loss of relevance of the traditional ideologies. To prevent response bias, we gave the POPOR Scale a forced‐choice format and a balanced structure.

Method

We surveyed a quota sample of 1,348 Italians extracted from the general population and analyzed the structure of the scale and its convergent validity via confirmatory factor analysis.

Results

The POPOR Scale showed a unidimensional structure and a good convergent validity. Supplemental analyses showed its structural invariance across gender, age, education, and area of residence.
A probabilistic explanation of Pearson's correlation
Authors: Liu Xiaofeng Steven
Published: July 2019

Pearson's product‐moment correlation can be explained by means of the probability of concordant pairs of observations on two continuous variables (ie, the order of the observations from two randomly selected individuals is the same between the two variables). The probability of concordant pairs features relatively easy computation and offers an alternative perspective on Pearson's correlations.
Who do we gain? Enhancement of blood supplies by additional testing for donors who travel
Authors: Reynolds C. A. , Cieply L. , Sell J. , Brailsford S. R.
Published: July 2019

Aims/Objectives

To describe the impact of additional testing on the England blood supply.

Background

The blood service for England, NHS Blood and Transplant, applies a system of deferral and testing to donors with potential exposure to Chagas disease, malaria and West Nile virus; however, testing costs must be justified. Here, we describe the donations and donors gained by testing.

Methods

Donation testing results and demographic data on donors in England where additional testing was applied were analysed in 2012–2016. The total number and proportion of donations tested, reactive and confirmed positive were calculated. Proportions of donors requiring additional tests were calculated by ethnic group for first‐time and repeat donors.

Results

Additional testing for travel was applied to 3·5% of NHSBT blood donations between 2012 and 2016. Over 98% of these tests were non‐reactive. Only malaria tests were confirmed positive, in 1·7% of donations tested. In first‐time donors, 45 and 40% of Asian and Black donors required an additional test, respectively, mainly for malaria. Testing for West Nile virus increased from 1·5% in 2012 to 2·2% of donations in 2016.

Conclusion

The majority of additional tests were screened negative, allowing approximately 64 000 donations to be released for issue annually. Donors most affected by malaria testing were more likely to have rare blood groups and be targeted for recruitment, whereas those given West Nile virus testing were mainly regular donors required for continuity of supply. These data show differences in the characteristics of donors by test and can be used to inform decisions about additional testing and deferrals.
Uncovering mechanisms of rubber biosynthesis in Taraxacum koksaghyz – role of cis‐prenyltransferase‐like 1 protein
Authors: Niephaus Eva , Müller Boje , van Deenen Nicole , Lassowskat Ines , Bonin Martin , Finkemeier Iris , Prüfer Dirk , Schulze Gronover Christian
Published: July 2019

The Russian dandelion Taraxacum koksaghyz synthesizes considerable amounts of high‐molecular‐weight rubber in its roots. The characterization of factors that participate in natural rubber biosynthesis is fundamental for the establishment of T. koksaghyz as a rubber crop. The cis‐1,4‐isoprene polymers are stored in rubber particles. Located at the particle surface, the rubber transferase complex, member of the cis‐prenyltransferase (cisPT) enzyme family, catalyzes the elongation of the rubber chains. An active rubber transferase heteromer requires a cisPT subunit (CPT) as well as a CPT‐like subunit (CPTL), of which T. koksaghyz has two homologous forms: TkCPTL1 and TkCPTL2, which potentially associate with the rubber transferase complex. Knockdown of TkCPTL1, which is predominantly expressed in latex, led to abolished poly(cis‐1,4‐isoprene) synthesis but unaffected dolichol content, whereas levels of triterpenes and inulin were elevated in roots. Analyses of latex from these TkCPTL1‐RNAi plants revealed particles that were similar to native rubber particles regarding their particle size, phospholipid composition, and presence of small rubber particle proteins (SRPPs). We found that the particles encapsulated triterpenes in a phospholipid shell stabilized by SRPPs. Conversely, downregulating the low‐expressed TkCPTL2 showed no altered phenotype, suggesting its protein function is redundant in T. koksaghyz. MS‐based comparison of latex proteomes from TkCPTL1‐RNAi plants and T. koksaghyz wild‐types discovered putative factors that convert metabolites in biosynthetic pathways connected to isoprenoids or that synthesize components of the rubber particle shell.
Maintaining power: Decarbonisation and recentralisation in Cuba’s Energy Revolution
Authors: Cederlöf Gustav
Published: July 2019

With the Energy Revolution of 2005, the energy and carbon intensity of the Cuban state‐economy decreased by over a third. More than an issue of low‐carbon transition, however, this article suggests that the Energy Revolution was an attempt to maintain social power relations through everyday energy use. Drawing on archival and ethnographic fieldwork in Cuba, the article conceptualises energy infrastructures as co‐constitutive of the ecological conditions for social life. Energy infrastructures shape human action and interaction by operationalising political‐economic regimes of energy distribution. The article traces the state‐socialist logic guiding Cuba's longstanding electrification campaign and shows how a multitude of market‐based energy systems during the 1990s “special period” undermined this logic. By examining three core interventions during the Energy Revolution, finally, it demonstrates how the Energy Revolution recentralised power relations through energy use, re‐establishing the hegemony of the socialist state. If energy use is seen as a political‐ecological process, the maintenance of energy infrastructure is an act that reinforces a socio‐ecological order and, hence, a set of political‐economic relations.
Iatrogenic cartilage injury associated with the use of stainless‐steel cannulas and silicone‐guarded cannulas for canine stifle arthroscopy
Authors: Cortés Isaac , Warnock Jennifer J. , Ranganathan Bharadhwaj , Bobe Gerd
Published: July 2019

Objective

To determine the ability to reduce iatrogenic cartilage injury (IACI) during canine stifle arthroscopy by using a silicone arthroscope cannula guard.

Study design

Ex vivo canine cadaver experimental study.

Animals

Paired canine stifles from 14 cadavers (≥20 kg).

Methods

Stifles (N = 28) were assigned to unguarded traditional or silicone‐guarded arthroscopy. Stifle arthroscopy and full joint exploration with meniscal probing was performed by a second‐year surgery resident (I.C.) in fourteen canine cadavers, alternating between left and right stifles for guarded vs unguarded arthroscopy. After arthroscopy, stifles were disarticulated, and india ink assay was performed to identify IACI. Total IACI number, lesion length and area, duration of procedure, and procedure difficulty score were recorded for each stifle.

Results

Unguarded arthroscopy resulted in more total IACI per joint (unguarded 5.2 ± 3.0, guarded 2.4 ± 1.4; P = .02), larger IACI area (unguarded 5.2 ± 4.2 mm2, guarded 2.3 ± 1.5 mm2; P = .02), and IACI length (unguarded 13.6 ± 6.9 mm, guarded 8.6 ± 5.9 mm; P = .03). No difference was identified in duration of procedure (unguarded 11.8 ± 5.2 minutes, guarded 13.8 ± 4.3 minutes; P = .79) or procedure difficulty score (unguarded 1.7 ± 0.6, guarded 1.6 ± 0.6 P = .73).

Conclusion

Silicone‐guarded arthroscope cannulas decreased IACI number and size during canine cadaveric stifle arthroscopy without increasing duration of procedure or surgical difficulty.

Clinical significance

Silicone‐guarded arthroscope cannulas may be safer than traditional cannulas for novice veterinary surgeons performing stifle arthroscopy.
Expression profile of human porcine endogenous retrovirus A receptors (HuPAR‐1, HuPAR‐2) and transcription factor activator protein‐2γ (TFAP‐2C) genes in infected human fibroblasts—Model in vitro
Authors: Wojdas Emilia , Łopata Krzysztof , Nowak Roman , Kimsa‐Dudek Magdalena , Łopata Paweł , Mazurek Urszula
Published: July 2019

Background

Xenotransplantation of porcine tissues raises concerns, especially in the context of the potential interspecies transmission of porcine endogenous retroviruses (PERVs). To date, the possibility of PERV infections of various human cells has been confirmed in vitro. PERVs infect cells coupling viral Env protein with adequate functional receptor on the surface of the host cell. So far, two PERV‐A receptors have been described in humans: HuPAR‐1 and HuPAR‐2. TFAP‐2C was described as one of the transcription factors engaged in the expression of HuPAR‐2.

Methods

Bacterial LPS, well known as a strong inflammation inducer, was used in this study to stimulate changes of the expression profile of inflammation‐related genes in human cells in vitro. The aim of the study was to investigate the expression profile of HuPAR‐1 and HuPAR‐2 and TFAP‐2C genes in human NHDF cells treated with LPS and/or infected with PERVs from PK15 cells. PERV infection and expression was confirmed by qPCR and RTqPCR. The expression of HuPAR‐1, HuPAR‐2, and TFAP‐2C genes was studied using HGU 133A 2.0 microarrays and RTqPCR.

Results

NHDF cells expressed both HuPAR‐1 and HuPAR‐2 genes with a higher expression of HuPAR‐1. LPS down‐regulated the expression of HuPAR‐1 and TFAP‐2C in NHDF cells, but had no effect on HuPAR‐2 expression. These changes induced by LPS were more pronounced in the presence of PERV infection.

Conclusion

As reported previously, treatment of NHDF cells with LPS decreased PERV‐A provirus integration and increased PERV‐A mRNA expression. PERV infection alone did not modulate the expression of HuPAR‐1, HuPAR‐2, and TFAP‐2C. This is the first study analyzing the expression profile of HuPAR‐1, HuPAR‐2, and TFAP‐2C in NHDF cells treated by LPS and/or infected by PERVs.
The Hypothesis of Fiscal Devaluation in Developing Countries: The Case of Gabon
Authors: BIDZO Médard MENGUE
Published: July 2019

In the absence of adjustment by exchange rates, it is suggested that the effects of a devaluation of the exchange rate through taxation be produced.The purpose of our study is thus to examine the plausibility of such an option in developing countries participating in a monetary union. From a normative perspective, we proceed to an empirical highlighting of the mechanism of classic fiscal devaluation, thanks to the estimation of a model with threshold effects on the data of the Gabonese economy.As a result, the option of fiscal devaluation is conceivable for Gabon. But, its effects would be small.
Examination of Trait Anxiety States of University Students Doing Sports in Team and Individually in Terms of Some Variables
Authors: Zengin Serkan
Published: July 2019

Research has been conducted for the students studying at Akdeniz University Faculty of Sports Sciences. In the research, it was aimed to investigate the trait anxiety states of students studying at Akdeniz University Faculty of Sports Sciences and a survey model was used in the study. This study is consisted of two parts; there are 6 items in determination of demographical variables in the first part. “Trait Anxiety Inventory” Scale consisting of 20 questions developed by Spielberger was used in the second part. Likert type four-point was used in the scale items given in the second and third parts (showing the statements “Almost Always”, “Sometimes”, “Usually”, “Almost Never”). Once the comparison of trait anxiety levels by the age groups is examined among the results of the study, it is seen that trait anxiety levels of participants differ at a statistically significant level by the age groups (p<0,05). It was concluded that the trait anxiety level of the participants in the age group of 20-21 and age group of 22-23 is significantly higher than the participants in the age group of 23+ (P<0,05). In conclusion, it is considered that those who do individual sports feel more anxiety states since the responsibility only belongs to themselves. Trainings minimizing the anxiety should be further offered to the individuals doing such sports. Individual team athletes who are at national team level may be more supported.
Temperature Survivability and Surge Analysis for Bhogat Marine Facility
Authors: Shukla Manuj , Grandhi Kalyan
Published: July 2019

This paper explains the complexity in marine tanker loading of highly waxy RJ Crude via Single Point Mooring System at Bhogat Terminal. It mainly presents the key challenges in temperature sustenance of Rajasthan Crude in the marine pipelines during the tanker loading operation. It also presents how the pump logic and valve closure timings are configured to prevent high pressure surge in the system.

Due to the waxy crude characteristics of Mangala Crude, it is required to always maintain the Crude temperature above its Wax Appearance Temperature of 65 Deg C. As the marine system partly consists of non-heated section like the under buoy and the floating hoses, it was required to simulate the temperature losses in the system and provide a pipeline flushing sequence at the end of the operation. Various flow and operational scenarios are modelled in OLGA and recommendations are implemented for the system. Similarly, Surge analysis was performed in PIPENET to determine acceptable valve closure timing for the tanker valves, breakaway couplings (BAC), SPM and PLEM valves to prevent overpressure in the marine system.

Based on the transient simulations, temperature loss during RJ crude export (at 4,636m3/hr) from terminal to the tanker in 24 hours is negligible (less than 10 Deg C). This indicates that the insulations in the pipelines are adequately designed for preventing heat loss. Whereas, the temperature in the hoses falls below 42 Deg C within 12 hours of shutdown which may lead to wax formation and may block the hoses. Therefore, RJ crude is to be flushed out of the system using flushing oil before it can cool to below its wax appearance temperature of 65 Deg C. It is recommended to insulate the bare pipe-works such as the PLEM, SPM and tanker if possible to facilitate a reasonable response time for setting up flushing oil displacement. It is also recommended that the pipelines are heated to 50 Deg C prior in advance of commencing flushing oil displacement operations to terminal and in preparation for RJ crude export.

Based on the hydraulic surge analysis, a closure time of 30 seconds is acceptable for PLEM valve closure. It is recommended to trip the export pumps at loading arm pressure High High of 7 bara. However, closure of both the breakaway couplings (BAC) cause pressure surges which exceed the MASP of the hoses for BAC closure times of 10 to 60 seconds.