bluuebunny/crossref_metadata_2025 huggingface dataset:
HER2 challenge contest: a detailed assessment of automated HER2 scoring algorithms in whole slide images of breast cancer tissues
Authors: Qaiser Talha , Mukherjee Abhik , Reddy PB Chaitanya , Munugoti Sai D , Tallam Vamsi , Pitkäaho Tomi , Lehtimäki Taina , Naughton Thomas , Berseth Matt , Pedraza Aníbal , Mukundan Ramakrishnan , Smith Matthew , Bhalerao Abhir , Rodner Erik , Simon Marcel , Denzler Joachim , Huang Chao‐Hui , Bueno Gloria , Snead David , Ellis Ian O , Ilyas Mohammad , Rajpoot Nasir
Published: August 2017

Aims

Evaluating expression of the human epidermal growth factor receptor 2 (HER2) by visual examination of immunohistochemistry (IHC) on invasive breast cancer (BCa) is a key part of the diagnostic assessment of BCa due to its recognized importance as a predictive and prognostic marker in clinical practice. However, visual scoring of HER2 is subjective, and consequently prone to interobserver variability. Given the prognostic and therapeutic implications of HER2 scoring, a more objective method is required. In this paper, we report on a recent automated HER2 scoring contest, held in conjunction with the annual PathSoc meeting held in Nottingham in June 2016, aimed at systematically comparing and advancing the state‐of‐the‐art artificial intelligence (AI)‐based automated methods for HER2 scoring.

Methods and results

The contest data set comprised digitized whole slide images (WSI) of sections from 86 cases of invasive breast carcinoma stained with both haematoxylin and eosin (H&E) and IHC for HER2. The contesting algorithms predicted scores of the IHC slides automatically for an unseen subset of the data set and the predicted scores were compared with the ‘ground truth’ (a consensus score from at least two experts). We also report on a simple ‘Man versus Machine’ contest for the scoring of HER2 and show that the automated methods could beat the pathology experts on this contest data set.

Conclusions

This paper presents a benchmark for comparing the performance of automated algorithms for scoring of HER2. It also demonstrates the enormous potential of automated algorithms in assisting the pathologist with objective IHC scoring.
Elastic‐viscoplasticity modeling of the thermo‐mechanical behavior of chalcogenide glass for aspheric lens molding
Authors: Zhou Tianfeng , Zhou Qin , Xie Jiaqing , Liu Xiaohua , Wang Xibin , Ruan Haihui
Published: August 2017

Chalcogenide glass (ChG), as an alternative material in place of single‐crystal germanium, is increasingly used in thermal imaging, night vision, and infrared guidance systems, etc., owing to their excellent formability through precision glass molding (PGM). The deformation mechanisms of these glasses at the molding temperature involve elasticity, plasticity, and viscous flow, which call for a new theoretical model to assist the design of PGM process. This paper investigates the thermo‐mechanical properties of Ge22Se58As20 at the temperature above its softening point and establishes a new elastic‐viscoplasticity model to describe its thermo‐mechanical behaviors. After determining the model parameters through cylindrical compression tests, the new constitutive model is implemented in finite element method (FEM) of PGM to form an aspheric ChG lens. And the agreement of displacement‐time curves between experimental and simulation results exhibit the validity of the proposed elastic‐viscoplastic constitutive model.
Rheological, thermal and microstructural properties of whey protein isolate‐modified cassava starch mixed gels at different pH values
Authors: Ren Fei , Yu Bin , Dong Die , Hou Zhao‐hua , Cui Bo
Published: August 2017

The objective of this study was to investigate the rheological, thermal and microstructural properties of whey protein isolate (WPI)‐hydroxypropylated cassava starch (HPCS) gels and WPI‐cross‐linked cassava starch (CLCS) gels at different pH values (5.75, 7.00 and 9.00). The rheological results showed that the WPI‐modified starch gels had greater storage modulus (Gʹ) values than the WPI‐native cassava starch gels at pH 5.75 and 7.00. Differential scanning calorimetry curves suggested that the phase transition order of the WPI and modified starch changed as the pH increased. Scanning electron microscopy images showed that the addition of HPCS and CLCS contributed to the formation of a compact microstructure at pH 5.75 and 7.00. A comprehensive analysis showed that the gelling properties of the WPI‐modified starch were affected by the difference between the WPI denaturation temperature and modified starch gelatinisation temperature and by the granular properties of the modified starch during gelatinisation. These results may contribute to the application of WPI‐modified starch mixtures in food preparation.
Designing an experiment with quantitative treatment factors to study the effects of climate change
Authors: Piepho H.‐P. , Herndl M. , Pötsch E. M. , Bahn M.
Published: August 2017

Experiments for studying the effects of climatic change on ecosystems often involve manipulation of one or several quantitative treatment factors of interest. Response surface regression is the method of choice for these types of experiment. Here, we describe the development of a design of a free air CO2enrichment experiment with two quantitative treatment factors, that is, elevated temperature andCO2enrichment. The design strategy takes account of budget constraints imposing limitations on the number of plots with elevated temperature andCO2levels. The approach is based on polynomial regression models and is focussed on an efficient estimation of interaction between the two treatment factors. Extension to more than two factors is straightforward. An analysis of soil moisture data demonstrates the overall suitability of the proposed design to analyse non‐linear interactions of two (or more) global change factors.
Study on crystallization behaviors of As–Se–Bi chalcogenide glasses
Authors: Yin Haiwei , Li Lei , Yang Guang , Wang Yang , Zheng Jianhua , Zeng Huidan , Chen Guorong
Published: August 2017

The crystallization behaviors of As–Se–Bi chalcogenide glasses were investigated by differential scanning calorimetry (DSC) and X‐ray diffraction (XRD). Three models were used to study the glass transition behavior and the activation energy. Results showed thermal stability of glass against crystallization decreased with Bi addition in As–Se–Bi system. The mechanism of crystal growth in glasses was also studied by the Avrami exponent n. For B0, B2.5, and B5, n values are 3.12, 1.59, and 2.21 (low temperature) and 4.61 (high temperature), respectively. The thermal stability of glass is in good agreement with glass network structure. It was found that glass network structures closely associated with the Bi content and As/Se ratio were studied by X‐ray diffraction and Raman spectroscopy. And the different ratios lead to the change in Bi2Se3 crystalline orientation.
Synthesis of fine zirconium carbide powder by carbothermal reaction of carbon‐coated zirconia particles
Authors: Cetinkaya Senol
Published: August 2017

In this study, a novel method for the synthesis of fine ZrC powder was presented. It consists of chemical vapor deposition (CVD) of C from CH4 on ZrO2 particles followed by carbothermal reaction. Firstly, optimal CVD conditions (1300 K and 30 minutes) yielding the stoichiometric amount of C deposit (23 wt%) were determined. Carbothermal reaction behavior of the carbon‐coated oxide particles was then investigated in Ar flow at 1700‐1800 K for 0‐120 minutes. Mass measurements, XRD and SEM techniques were used to characterize the products at various stages of the process. Lattice constants and mass losses of the samples increased to the levels of ZrC with increasing temperature and time. Almost pure ZrC powder (oxygen content: 0.59 wt%) with a mean particle size of ~170 nm was synthesized at 1800 K within 120 minutes. The present study demonstrates that ZrC powder can be synthesized at lower temperatures and shorter reaction times using C‐coated ZrO2 powders compared with the conventional method which uses a mixture of ZrO2 and solid C particles.
Outcomes of interventions for nurse leaders’ well‐being at work: A quantitative systematic review
Authors: Häggman‐Laitila Arja , Romppanen Johanna
Published: August 2017

Aims

The aim of this study was to gather, assess and synthesize current research knowledge on interventions that aimed to improve nurse leaders’ well‐being at work.

Background

The research evidence on interventions for nurse leaders’ well‐being at work has been sporadic and there are a lack of evidence‐based recommendations for effective interventions that inform practice, future studies and education.

Design

A quantitative systematic review, in accordance with the Cochrane Collaboration procedures and the reporting guidance in the PRISMA statement.

Methods

CINAHL, Cochrane, EBSCO, PubMed, PsycInfo and Scopus databases were searched from 2009 ‐ December 2016. The final data consisted of five studies, which were assessed with the Cochrane Risk of Bias Tool. The data were summarized narratively.

Results

The interventions were mainly concerned with stress management and were targeted at individuals. Four of the five interventions examined produced statistically significant outcomes on well‐being at work.

Conclusions

Stress management interventions that included mental exercises were the most successful. Interventions primarily reduced the stress experienced by participants, but the evidence on the stability of these outcomes was poor because of the short follow‐up periods. The certainty of evidence was low, indicating that the use of these interventions among nurse leaders might be beneficial. Further studies are needed to provide more reliable recommendations for their use. As the performance of nurse leaders influences organizations, through interpersonal relationships, it is important to pay more attention in the future to the development of organization‐ and person‐directed interventions and their combinations. A structural empowerment approach should also be considered.
Vertical subclassification predicts survival of molars with class II furcation involvement during supportive periodontal care
Authors: Tonetti Maurizio S. , Christiansen Allis L. , Cortellini Pierpaolo
Published: August 2017

Background

Furcation involvement is a major predictor of tooth survival. Focus has so far been on the predictive value of the horizontal component of furcation involvement. Residual periodontal support on each of the roots is likely to play a major role on retention of the furcated molar. Aim of this clinical audit study was to preliminarily assess the impact of vertical subclassification on tooth retention.

Methods

Tooth retention of class II furcated molars in 200 consecutive patients compliant with periodontal supportive care for a minimum of 10 years was retrospectively evaluated in a single practice. Randomly selected furcated molars were retrospectively diagnosed in terms of vertical subclassification (residual periodontal support on the most compromised root), and time to tooth extraction/loss was determined in clinical records. Kaplan–Meier survival curves were constructed.

Results

Ten‐year survival of molar with class II furcation involvement was 52.5%. Survival was 91% for subclass A, 67% for subclass B and 23% for subclass C. Mean years of survival were 9.5–10.1, 8.5–9.3 and 6–7.3 for subclasses A, B and C, respectively. Tests of equality of the survival distributions showed highly significant differences in all portions of the curve (p < .001). Stratified analyses by smoking showed significant differences for the two groups (p < .001). Hazard rates for tooth extraction/loss were 4.2 and 14.7 for subclasses B and C, respectively.

Conclusions

Residual periodontal support assessed as vertical subclassification of furcation involvement seems to be a good predictor of survival of molar with class II horizontal furcation. This has implication for prognosis, treatment planning and development of effective molar retention strategies.
Life history and initial assessment of fishing impacts on the by‐catch species Dules auriga (Teleostei: Serranidae) in southern Brazil
Authors: Rovani A. T. , Cardoso L. G.
Published: August 2017

The life history of Dules auriga, a small hermaphrodite serranid species inhabiting deep waters and a frequent component of the discarded catch of bottom trawling in southern Brazil, was studied to assess the fishery effects on the stock through the estimation of the remaining spawning‐potential ratio. Sampling was conducted throughout a year and included specimens to determine sex, maturity and age. Age was validated by the edge type and marginal‐increment analysis. The oldest and the largest individuals were 9 years and 195 mm total length. Growth parameters fitted to the von Bertalanffy equation were L∞ = 178·34 mm, k = 0·641 year−1 and t0 = −0·341 years. Length and age at first maturity were 140·72 mm and 2 years, respectively. The reproductive season was throughout the austral spring and summer. The assessment of the effects of fishing showed that it may have resulted in a loss of 50% of the spawning potential. This loss may be higher when taking into account the uncertainty in the life‐history parameters and could be considered of concern for the population. Fast growth, moderate longevity, long spawning season, small size and age at maturity make D. auriga relatively resilient to the removal of biomass by fishing. When considering the uncertainty, however, the losses of the spawning potential have been severely reducing the population resilience in the face of ecosystem changes.
Treatment and alternative usage possibilities of a special wastewater: Nejayote
Authors: Argun Mustafa Samil , Argun Mehmet Emin
Published: August 2017

Nejayote is the wastewater of alkaline cooking process (nixtamalization) and contains high amount of organic agent. Alkaline cooking is a very old process used in processing the corn. This process improves some nutritional and technological properties of corn. However, direct delivery of postprocess occurred nejayote to the receiving environment bears a great deal of environmental risk. In addition, due to bearing the nutritional transport of the compounds found in nejayote, these compounds have the potential to be used for different purposes upon being separated from the nejayote. In this study, treatment of nejayote, pollutant content to be reduced by ecological alkaline cooking practices, and possibilities of alternative applications have been reviewed.

Practical applications

Nejayote is a wastewater containing corn components such as germ parts, pericarp, cellulosic structures, proteins, calcium, and endosperm and possesses environment polluting dry matter varying in the range of approximately 1–15%. Throughout alkaline cooking process, considerable amount of nejayote occurs. For this reason, the development of alkaline cooking practices with less polluting nature, the use of nejayote to be purified or to be used in other processes prior to be disposed bears great importance in terms of environmental health.
Brain endothelial cells induce astrocytic expression of the glutamate transporter GLT‐1 by a Notch‐dependent mechanism
Authors: Lee Meredith L. , Martinez‐Lozada Zila , Krizman Elizabeth N. , Robinson Michael B.
Published: August 2017

Neuron‐secreted factors induce astrocytic expression of the glutamate transporter, GLT‐1 (excitatory amino acid transporter 2). In addition to their elaborate anatomic relationships with neurons, astrocytes also have processes that extend to and envelop the vasculature. Although previous studies have demonstrated that brain endothelia contribute to astrocyte differentiation and maturation, the effects of brain endothelia on astrocytic expression of GLT‐1 have not been examined. In this study, we tested the hypothesis that endothelia induce expression of GLT‐1 by co‐culturing astrocytes from mice that utilize non‐coding elements of the GLT‐1 gene to control expression of reporter proteins with the mouse endothelial cell line, bEND.3. We found that endothelia increased steady state levels of reporter and GLT‐1 mRNA/protein. Co‐culturing with primary rat brain endothelia also increases reporter protein, GLT‐1 protein, and GLT‐1‐mediated glutamate uptake. The Janus kinase/signal transducer and activator of transcription 3, bone morphogenic protein/transforming growth factor β, and nitric oxide pathways have been implicated in endothelia‐to‐astrocyte signaling; we provide multiple lines of evidence that none of these pathways mediate the effects of endothelia on astrocytic GLT‐1 expression. Using transwells with a semi‐permeable membrane, we demonstrate that the effects of the bEND.3 cell line are dependent upon contact. Notch has also been implicated in endothelia‐astrocyte signaling in vitro and in vivo. The first step of Notch signaling requires cleavage of Notch intracellular domain by γ‐secretase. We demonstrate that the γ‐secretase inhibitor N‐[N‐(3,5‐difluorophenacetyl)‐l‐alanyl]‐S‐phenylglycine t‐butyl ester blocks endothelia‐induced increases in GLT‐1. We show that the levels of Notch intracellular domain are higher in nuclei of astrocytes co‐cultured with endothelia, an effect also blocked by N‐[N‐(3,5‐difluorophenacetyl)‐l‐alanyl]‐S‐phenylglycine t‐butyl ester. Finally, infection of co‐cultures with shRNA directed against recombination signal binding protein for immunoglobulin kappa J, a Notch effector, also reduces endothelia‐dependent increases in enhanced green fluorescent protein and GLT‐1. Together, these studies support a novel role for Notch in endothelia‐dependent induction of GLT‐1 expression.

Cover Image for this issue: doi. 10.1111/jnc.13825.

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‘Prion‐like’ propagation of the synucleinopathy of M83 transgenic mice depends on the mouse genotype and type of inoculum
Authors: Sargent Dorian , Verchère Jérémy , Lazizzera Corinne , Gaillard Damien , Lakhdar Latifa , Streichenberger Nathalie , Morignat Eric , Bétemps Dominique , Baron Thierry
Published: August 2017

The M83 transgenic mouse is a model of human synucleinopathies that develops severe motor impairment correlated with accumulation of the pathological Ser129‐phosphorylated α‐synuclein (α‐synP) in the brain and spinal cord. M83 disease can be accelerated by intracerebral inoculation of brain extracts from sick M83 mice. This has also recently been described using peripheral routes, injecting recombinant preformed α‐syn fibrils into the muscle or the peritoneum. Here, we inoculated homozygous and/or hemizygous M83 neonates via the intraperitoneal and/or intracerebral routes with two different brain extracts: one from sick M83 mice inoculated with brain extract from other sick M83 mice, and the other derived from a human multiple system atrophy source passaged in M83 mice. Detection of α‐synP using ELISA and western blot confirmed the disease in mice. The distribution of α‐synP in the central nervous system was similar, independently of the inoculum or inoculation route, consistent with previous studies describing M83 disease. ELISA tests revealed higher levels of α‐synP in homozygous than in hemizygous sick M83 mice, at least after IC inoculation. Interestingly, the immunoreactivity of α‐synP detected by ELISA was significantly lower in M83 mice inoculated with the multiple system atrophy inoculum than in M83 mice inoculated with the M83 inoculum, at the first two passages. ‘Prion‐like’ propagation of the synucleinopathy up to the clinical disease was accelerated by both intracerebral and intraperitoneal inoculations of brain extracts from sick mice. This acceleration, however, depends on the levels of α‐syn expression by the mouse and the type of inoculum.

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The aberrantly expressed long non‐coding RNA in the substantia nigra and corpus striatum of Nrf2‐knockout mice
Authors: Liu Jian , Xu Yali , Kang Yunxiao , Cao Shanhu , Shi Geming , Cui Huixian , Sun Shaoguang , Wang Lei
Published: August 2017

Nuclear factor erythroid 2 like 2 (Nrf2) functions as a neuroprotective agent in Parkinson's disease (PD). This study aimed to investigate the key long non‐coding RNAs (lncRNAs) correlated with Nrf2, which might provide valuable information for the exploration of pathogenesis of PD. The lncRNA and mRNA expression profiling of substantia nigra and corpus striatum of Nrf2 (−/−) mice model was obtained from microarray analysis. The animal experiments conducted for this study were approved by the ethics committee of Hebei Medical University. Bioinformatics analyses were conducted, including differentially expressed lncRNAs/mRNA (differentially expressed lncRNA, DEL/differentially expressed mRNA, DEM) identification, DEL‐DEM coexpression network construction, and biological functions prediction. Quantitative real‐time polymerase chain reaction (qRT‐PCR) was subjected to validate abnormally expressed DELs and DEMs in the substantia nigra and corpus striatum of Nrf2 (−/−) mice model. A total of 48 DELs (37 down‐regulated and 11 up‐regulated) were identified both in Nrf2 (−/−) substantia nigra and corpus striatum; 96 DEMs and 643 DEMs were identified in the substantia nigra and corpus striatum, respectively. DEL‐DEM coexpressed network was constructed. LncRNA AK076880, AK036620, and AK020330 had high connectivity with DEMs both in the substantia nigra and corpus striatum. These DEMs were significantly enriched in signaling pathways such as the calcium signaling pathway, Huntington's disease, Alzheimer's disease, mitogen‐activated protein kinase (MAPK) signaling pathway, and the Wnt signaling pathway. Generally, qRT‐PCR validation results of selected DEMs and DELs were consistent with microarray data. The dysregulated DELs and DEMs in the substantia nigra and corpus striatum of Nrf2 (−/−) mice were identified. Our results might provide useful information for further exploring the pathogenesis mechanism of PD.

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Back School programme for nurses has reduced low back pain levels: A randomised controlled trial
Authors: Járomi Melinda , Kukla Aniko , Szilágyi Brigitta , Simon‐Ugron Ágnes , Bobály Viktória Kovácsné , Makai Alexandra , Linek Pawel , Ács Pongrác , Leidecker Eleonóra
Published: August 2017

Aims and Objectives

(i) To examine patient lifting techniques used by nurses, and (ii) to evaluate an effectiveness of the Spine Care for Nurses programme in chronic nonspecific low back pain syndrome reduction and the execution of proper patient lifting techniques.

Background

Millions of nurses around the world suffer from occupational‐related chronic nonspecific low back pain (chronic nonspecific low back pain syndrome). Generally, low back pain in nurses is a result of increased pressure on the spine and can be associated with improperly conducted patient lifting techniques.

Methods

A randomised controlled trial was conducted among 137 nurses with chronic nonspecific low back pain syndrome. Participants were randomised into an experimental and control group (experimental group n = 67, control group n = 70). Nurses in the experimental group attended the Spine Care for Nurses programme for 3 months. The programme consisted of didactic education, spine‐strengthening exercises and education on safe patient handling techniques. The control group only received a brief written lifestyle guidance. The Zebris WinSpine Triple Lumbar examination was used to analyse nurses’ patient lifting techniques (horizontal and vertical lifting). The lumbar pain intensity was measured with a 0–100 visual analogue scale.

Results

The pre‐intervention average chronic nonspecific low back pain syndrome intensity score on visual analogue scale decreased from 49.3 to the postintervention score of 7.5. The correct execution of vertical lifting techniques in the experimental group increased from 8.91%–97.01% (control group: 8.57% pre‐intervention test and postintervention test 11.42%). The horizontal patient lifting technique pre‐intervention increased from 10.44%–100% correct execution in the experimental group (control group: pre‐intervention test 10.00% and postintervention test 11.42%).

Conclusion

The Spine Care for Nurses programme significantly reduced chronic nonspecific low back pain syndrome and increased the number of properly executed horizontal and vertical patient lifting techniques in nurses.

Relevance to clinical practice

We recommend that healthcare organisations should consider the implementation of regular Spine Care for Nurses programmes as successful low back injury prevention programmes.
Registered nurses transitioning from acute care to primary healthcare employment: A qualitative insight into nurses' experiences
Authors: Ashley Christine , Brown Angela , Halcomb Elizabeth , Peters Kath
Published: August 2017

Aims and objectives

To describe the experiences of acute care registered nurses transitioning to primary healthcare settings.

Background

The worldwide increasing demand for primary healthcare services has resulted in skilled acute care nurses transitioning to primary healthcare settings to meet workforce requirements. Little is known about the experiences and challenges associated with the transition. Knowledge of this will enable employers to design appropriate support processes and transitioning nurses can make informed choices.

Methods

Semistructured interviews were conducted with nurses who had transitioned into primary healthcare employment in the last 5 years. Data analysis was undertaken using Braun and Clarke's (2006) thematic analysis approach.

Results

Thirteen nurses were interviewed, and two themes identified—role learning: the new environment, and role socialisation: transition validation. Role learning was influenced according to the quality of orientation programmes, previous experience, clinical knowledge and professional support. Support and professional respect from mentors and/or employers greatly assisted with role socialisation and the transition experience.

Conclusions

Transitioning to primary healthcare employment provides unique challenges which must be considered by employers if they are to attract and retain experienced acute care registered nurses.

Relevance to Clinical Practice

Understanding the experiences of nurses who transition from acute to primary healthcare employment can inform the design of orientation programmes and ongoing professional supports to address barriers and challenges. Targeted orientation and support has the potential to enhance recruitment and retention of experienced nurses in primary health care.
Attitudes towards people with physical or intellectual disabilities among nursing, social work and medical students
Authors: Kritsotakis George , Galanis Petros , Papastefanakis Emmanouil , Meidani Flora , Philalithis Anastas E. , Kalokairinou Athena , Sourtzi Panayota
Published: August 2017

Aims and objectives

To examine and compare undergraduate healthcare students’ attitudes towards people with physical or intellectual disabilities in Greece.

Background

The experience that people with disabilities have with health care is a complex interaction between their medical condition and the social and physical environment. Attitudes of the nursing and healthcare staff affect the quality of care and people's adaptation to their disability, self‐image and rehabilitation outcomes.

Design

Descriptive cross‐sectional survey.

Methods

Nursing, Social Work and Medicine students (N = 1007, 79.4% female) attending three universities (Athens, Crete) completed during 2014–2016 two standardised scales regarding physical (ATDP‐B) and intellectual disability (CLAS‐ID). Descriptive and multivariate logistic regression analyses were performed.

Results

Attitudes towards people with physical disabilities in Greece (ATDP‐B scores) were poor with scores just above the mid‐point. Medical studies and higher knowledge and work with individuals with physical disabilities signified marginally more positive attitudes. Gender and age displayed no associations with attitudes. Regarding intellectual disability (CLAS‐ID scores), nursing students had slightly less positive attitudes in “Similarity” but more positive attitudes in “Sheltering” subscales. Previous work and contact was related to more favourable and higher age to less favourable “Similarity” and “Sheltering” attitudes. Males had higher “Exclusion” scores. Those who knew people with intellectual disabilities had less favourable “Empowerment” attitudes. Knowledge was related to more positive attitudes in all four CLAS‐ID subscales.

Conclusions

Greek health and social care students showed poor attitudes towards people with physical and intellectual disability.

Relevance to clinical practice

When holding unfavourable attitudes, healthcare professionals become less involved with the people they care for and they do not provide nursing care to the best of their abilities. Undergraduate and continuing education, along with workplace enhancements, should aim to provide high‐quality health care to people with disabilities.
Interprofessionals’ definitions of moral resilience
Authors: Holtz Heidi , Heinze Katherine , Rushton Cynda
Published: August 2017

Aims and objectives

To describe common characteristics and themes of the concept of moral resilience as reported by interprofessional clinicians in health care.

Background

Research has provided an abundance of data on moral distress with limited research to resolve and help negate the detrimental effects of moral distress. This reveals a critical need for research on how to mitigate the negative consequences of moral distress that plague nurses and other healthcare providers. One promising direction is to build resilience as an individual strategy concurrently with interventions to build a culture of ethical practice.

Design/methods

Qualitative descriptive methods were used to analyse descriptive definitions provided by 184 interprofessional clinicians in health care attending educational programmes in various locations as well as a small group of 23 professionals with backgrounds such as chaplaincy and nonhealthcare providers.

Results

Three primary themes and three subthemes emerged from the data. The primary themes are integrity—personal and relational, and buoyancy. The subthemes are self‐regulation, self‐stewardship and moral efficacy.

Conclusions

Individual healthcare providers and healthcare systems can use this research to help negate the detrimental effects of moral distress by finding ways to develop interventions to cultivate moral resilience.

Relevance to clinical practice

Moral resilience involves not only building and fostering the individual's capacity to navigate moral adversity but also developing systems that support a culture of ethical practice for healthcare providers.
MRI Interscanner Agreement of the Association between the Susceptibility Vessel Sign and Histologic Composition of Thrombi
Authors: Bourcier Romain , Détraz Lili , Serfaty Jean Michel , Delasalle Beatrice Guyomarch , Mirza Mahmood , Derraz Imad , Toulgoat Frédérique , Naggara Olivier , Toquet Claire , Desal Hubert
Published: August 2017

BACKGROUND AND PURPOSE

The susceptibility vessel sign (SVS) on magnetic resonance imaging (MRI) is related to thrombus location, composition, and size in acute stroke. No previous study has determined its inter‐MRI scanner variability. We aimed to compare the diagnostic accuracy in‐vitro of four different MRI scanners for the characterization of histologic thrombus composition.

METHODS

Thirty‐five manufactured thrombi analogs of different composition that were histologically categorized as fibrin‐dominant, mixed, or red blood cell (RBC)‐dominant were scanned on four different MRI units with T2* sequence. Nine radiologists, blinded to thrombus composition and MRI scanner model, classified twice, in a 2‐week interval, the SVS of each thrombus as absent, questionable, or present. We calculated the weighted kappa with 95% confidence interval (CI), sensitivity, specificity and accuracy of the SVS on each MRI scanner to detect RBC‐dominant thrombi.

RESULTS

The SVS was present in 42%, absent in 33%, and questionable in 25% of thrombi. The interscanner agreement was moderate to good, ranging from .45 (CI: .37‐.52) to .67 (CI: .61‐.74). The correlation between the SVS and the thrombus composition was moderate (κ: .50 [CI: .44‐.55]) to good κ: .76 ([CI: .72‐.80]). Sensitivity, specificity, and accuracy to identify RBC‐dominant clots were significantly different between MRI scanners (P < .001).

CONCLUSION

The diagnostic accuracy of SVS to determine thrombus composition varies significantly among MRI scanners. Normalization of T2*sequences between scanners may be needed to better predict thrombus composition in multicenter studies.
Basic income guarantee: a review of implications for oral health
Authors: Chen Yi‐An , Quiñonez Carlos
Published: August 2017

Objectives

To: a) Familiarize readers with the concept of a basic income guarantee (BIG) and its different forms; b) Consider how BIG could improve oral health and decrease oral health disparities; c) Motivate readers to advocate for the evaluation of oral health outcomes in BIG experiments.

Methods

Published articles and book chapters that have analyzed and reviewed data from past BIG pilot projects were examined for their findings on health and socioeconomic outcomes.

Results

Our findings suggest various areas and mechanisms whereby BIG can influence oral health‐related outcomes, whether through impacts on work, illness and injury, education, a social multiplier effect, expenditure behavior, and/or mental illness and other health outcomes.

Conclusion

Our findings illustrate the importance of assessing oral health‐related outcomes in future BIG pilot projects.
The Perception and Attention Functions test battery as a measure of neurocognitive impairment in patients with suspected central disorders of hypersomnolence
Authors: Ramm Markus , Jafarpour Arsalan , Boentert Matthias , Lojewsky Nelly , Young Peter , Heidbreder Anna
Published: August 2017

The aim of the current study was to evaluate an attention test as a discriminative tool to measure neurocognitive impairment in patients with disorders of hypersomnolence. Chronic excessive daytime sleepiness is the main symptom in central disorders of hypersomnolence. For diagnostic purposes and treatment evaluation, reliable assessment of excessive daytime sleepiness is required. Thirty‐six patients with central disorders of hypersomnolence were compared with 20 healthy controls. All participants performed the ‘Perception and Attention Functions’ (WAF) of the Vienna Test System. Patients underwent polysomnography, Multiple Sleep Latency Test and Maintenance of Wakefulness Test. Patients were divided into two groups: (i) patients who met the criteria of disorder of hypersomnolence (objective excessive daytime sleepiness); and (ii) patients with subjective excessive daytime sleepiness, i.e. with normal Multiple Sleep Latency Test results. Group 1 consisted of 23 patients with objective excessive daytime sleepiness (11 with idiopathic hypersomnia, nine with narcolepsy type 1, three with narcolepsy type 2); group 2 included 13 patients with subjective excessive daytime sleepiness. The results showed cognitive impairment in patients with objective excessive daytime sleepiness and even in patients with subjective excessive daytime sleepiness. WAF tests identified distinct attention profiles in patients with narcolepsy type 1, idiopathic hypersomnia/narcolepsy type 2, and patients with subjective excessive daytime sleepiness. WAF test measures correlated with Maintenance of Wakefulness Test and the Epworth Sleepiness Scale, but not with Multiple Sleep Latency Test and the Fatigue Severity Scale. In conclusion, the multidimensional WAF test battery detects cognitive impairment even in patients that complain of excessive daytime sleepiness but have normal Multiple Sleep Latency Test results. WAF tests offer valuable information that adds to the existing polysomnographic measures in discriminating patients with different types of chronic excessive daytime sleepiness. The results provide new insights into cognitive dysfunction underlying different types of chronic excessive daytime sleepiness.
Studies on the behaviour and control of phlebotomine sandflies using experimental houses
Authors: KIRSTEIN O. D. , FAIMAN R. , KNIGIN A. , GUETA H. , STONE A. , WARBURG A.
Published: August 2017

Programmes for the control of phlebotomine sandflies (Diptera: Psychodidae), the vectors of leishmaniases, mainly target adults because larval breeding sites are generally unknown or inaccessible. To determine how blood‐questing sandfly females enter homes and to develop means for their control, an experimental house (EH) was constructed in a village endemic for cutaneous leishmaniasis. Initially, carbon dioxide (CO2)‐baited suction traps were installed inside the EH to attract and capture sandflies. For other experiments, the windows of the EH were fitted with CO2‐baited window entrance traps (WETs) that allow each window to be considered as a separate unit. The majority of captures inside the EH and in WETs consisted of Phlebotomus sergenti, a species that enters inhabited houses relatively infrequently. Analyses of collections in WETs and in sticky traps on external walls showed that sandflies entered windows having landed previously on the wall below or either side of the window. Shelves constructed below windows significantly reduced the numbers of sandflies that entered both the EH and inhabited houses. The lining of internal walls with insecticide‐impregnated fabric significantly increased mortality rates of sandflies captured inside the EH. To reduce the biting burden imposed by phlebotomine sandflies, several control measures must be integrated and sustained.
Present‐day sympatry belies the evolutionary origin of a high‐order polyploid
Authors: Wei Na , Tennessen Jacob A. , Liston Aaron , Ashman Tia‐Lynn
Published: August 2017

Disentangling the evolutionary histories of polyploids, especially those with high ploidies, can reveal fundamental processes in speciation. Despite occurring frequently during evolution, the origins of many extant polyploid plant species remain largely unknown.

By integrating linkage mapping, polyploid phylogeny and sex‐determining region (SDR) in a unified framework, we statistically evaluated evolutionary hypotheses concerning the origin of a recently recognized decaploid strawberry (Fragaria cascadensis).

The maximum‐likelihood phylogenies and topology tests across homeologous groups consistently rejected the seemingly parsimonious hypothesis of ‘contemporary sympatric speciation’ via hybridization between octoploid and diploid congeners. Instead, most chromosomes supported ‘ancient hybrid speciation’ between a maternal octoploid progenitor ancestral to extant octoploid strawberries and a paternal, extinct Fragaria iinumae‐like diploid progenitor, probably in Beringia during the Pleistocene. The absence of a shared SDR between the decaploid and other Fragaria is also consistent with an older origin rather than a recent hybrid origin in situ.

Our study reveals a long evolutionary history of the decaploid despite its recent discovery, and highlights the pitfalls of inferring polyploid origins from niche/range alone or combined with morphology. It can serve as an exemplary starting step towards building much‐needed model systems of established polyploids that have been, and remain to be, recognized.
Direct assessment of the metabolic origin of carbon atoms in glutamate from illuminated leaves using 13C‐NMR
Authors: Abadie Cyril , Lothier Jérémy , Boex‐Fontvieille Edouard , Carroll Adam , Tcherkez Guillaume
Published: August 2017

Glutamate (Glu) is the cornerstone of nitrogen assimilation and photorespiration in illuminated leaves. Despite this crucial role, our knowledge of the flux to Glu de novo synthesis is rather limited.

Here, we used isotopic labelling with 13CO2 and 13C‐NMR analyses to examine the labelling pattern and the appearance of multi‐labelled species of Glu molecules to trace the origin of C‐atoms found in Glu. We also compared this with 13C‐labelling patterns in Ala and Asp, which reflect citrate (and thus Glu) precursors, that is, pyruvate and oxaloacetate.

Glu appeared to be less 13C‐labelled than Asp and Ala, showing that the Glu pool was mostly formed by ‘old’ carbon atoms. There were modest differences in intramolecular 13C–13C couplings between Glu C‐2 and Asp C‐3, showing that oxaloacetate metabolism to Glu biosynthesis did not involve C‐atom redistribution by the Krebs cycle. The apparent carbon allocation increased with carbon net photosynthesis. However, when expressed relative to CO2 fixation, it was clearly higher at low CO2 while it did not change in 2% O2, as compared to standard conditions.

We conclude that Glu production from current photosynthetic carbon represents a small flux that is controlled by the gaseous environment, typically upregulated at low CO2.
A New Urgent Realism Is Making Negotiations With North Korea More Likely
Authors: Gardels Nathan
Published: August 2017

A top Chinese diplomat makes the case for new talks with North Korea.
Trump Now Has A Rare Window Of Opportunity To Defuse The North Korean Crisis
Authors: Perry William J.
Published: August 2017

Because China is now more deeply concerned about North Korea.
Dear Trump: The Iran Deal Worked. Apply The Same Approach To North Korea
Authors: Cortright David
Published: August 2017

The Iran nuclear deal is a model for creatively packaging pressures and inducements.
Financial Constraints on German Firms after the Crisis: Evidence from Threshold Panel Estimation
Authors: Tarassow Artur
Published: August 2017

This article studies the existence and magnitude of financial investment constraints in Germany between 2006 and 2012 with a special emphasis on small and medium‐sized firms. The core contention is that the sensitivity of the investment rate to the cash flow rate is a function of a firm's financial position contributing to its access to external finance. The application of a nonlinear panel threshold model reveals that the marginal effect of the cash flow rate on the investment rate is almost twice as strong for ‘high debt’ firms compared to ‘low debt’ firms. This result holds for six out of seven balance sheet threshold variables. For a single specification, the results reveal a non‐monotonic relationship between the cash flow rate and investment rate. Firm size, however, does not explain differences in the cash‐flow‐investment nexus.
PICKLE chromatin‐remodeling factor controls thermosensory hypocotyl growth of Arabidopsis
Authors: Zha Ping , Jing Yanjun , Xu Gang , Lin Rongcheng
Published: August 2017

Temperature is a major signal that governs plant distribution and shapes plant growth. High ambient temperature promotes plant thermomorphogenesis without significant induction of heat–stress responses. Although much progress of warm temperature‐mediated plant growth has been made during recent years, the thermomorphogenic signalling pathway is not well understood. We previously revealed that PICKLE (PKL), an ATP‐dependent chromatin remodelling factor, negatively controls photomorphogenesis in Arabidopsis thaliana. Here, we show that mutations in PKL lead to reduced sensitivity in hypocotyl elongation to warm temperature (28 °C). We demonstrate that CIRCADIAN CLOCK‐ASSOCIATED 1 (CCA1) directly binds to the specific promoter regions of PKL and its expression is reduced in the cca1 mutants. We find that the cca1 seedlings are also less sensitive to temperature‐mediated growth than the wild‐type plants. Furthermore, PKL affects the level of trimethylation of histone H3 Lys 27 associated with INDOLE‐3‐ACETIC ACID INDUCIBLE 19 (IAA19) and IAA29 and regulates their expression. We also identify 6 additional transcription factors as the upstream regulators of PKL. Our study thus reveals PKL and CCA1 as 2 novel factors in controlling plant growth in response to the elevated temperature environment and provides new insight into the integration of light and temperature signals through chromatin regulation.
Can You See Me Now? Video Supplementation for Pediatric Teledermatology Cases
Authors: Feigenbaum Dana F. , Boscardin Christy K. , Frieden Ilona J. , Mathes Erin F.D.
Published: August 2017

Background/Objectives

Digital video is widely available and is used sporadically in clinical settings to evaluate patients, but whether it helps improve clinical management has not been determined. The aim of this study was to assess whether recorded video in addition to still images can improve residents' diagnostic and management accuracy and confidence with pediatric teledermatology cases.

Methods

Dermatology residents from three programs were assigned alternately to an online survey with 15 pediatric teledermatology cases presented with still images only (still) or still images plus recorded video (mixed). Participants provided free‐text diagnoses and management recommendations and rated their confidence and image quality. Responses were scored using a modified script concordance grading key based on reference panelists' responses.

Results

Thirty‐one residents participated (response rate 57%). Participants in the mixed group scored significantly higher on management accuracy (87.6 ± 12.9 vs 71.7 ± 14.2; p = 0.003). Both groups performed better on more common conditions than less common conditions. The mixed group outperformed the still group on less common conditions with respect to management recommendations.

Conclusion

This novel study suggests that supplemental recorded video may improve the management accuracy of pediatric teledermatology consultations, particularly for complex cases. Residents may benefit from training in recording and interpreting video.
Cutaneous Small‐Vessel Vasculitis in Two Children with Inflammatory Bowel Disease: Case Series and Review of the Literature
Authors: Ho Tina , Orenstein Lauren A.V. , Boos Markus D. , White Kevin P. , Fett Nicole
Published: August 2017

Cutaneous small‐vessel vasculitis (CSVV) is an infrequent manifestation of pediatric inflammatory bowel disease (IBD). We report two cases of CSVV associated with ulcerative colitis, review the literature, and discuss the diagnostic evaluation of children who present with CSVV and abdominal pain. After excluding more common causes of CSVV and abdominal pain in children, including immunoglobulin A vasculitis (previously Henoch–Schönlein purpura), infectious colitis, and drug‐induced vasculitis, alternative diagnoses such as CSVV secondary to IBD or systemic vasculitis with gastrointestinal involvement must be considered.
Palmar Eccrine Hidradenitis Secondary to Trauma from Computer Gaming in an Adolescent After Bone Marrow Transplantation
Authors: Lee Lynette Ying , Koh Mark Jean‐Aan
Published: August 2017

A 14‐year‐old boy who had undergone a matched sibling bone marrow transplant for acute lymphoblastic leukemia presented with painful nodules on his palms after prolonged gaming on his computer and mobile phone. Histology showed a neutrophilic inflammatory infiltrate surrounding the acrosyringium and eccrine sweat coils in the deep dermis. The lesions resolved spontaneously with conservative management.