bluuebunny/crossref_metadata_2025 huggingface dataset:
A refined diffuse cohesive approach for the failure analysis in quasibrittle materials—part II: Application to plain and reinforced concrete structures
Authors: De Maio Umberto , Greco Fabrizio , Leonetti Lorenzo , Luciano Raimondo , Nevone Blasi Paolo , Vantadori Sabrina
Published: August 2019

This work presents the numerical application of the diffuse cohesive interface model introduced in the Part I paper to the failure analysis of plain and reinforced concrete structures, subjected to complex loading conditions, inducing mixed‐mode fracture initiation and propagation. With the aim of capturing the interaction between concrete and steel reinforcements, the adopted fracture model is incorporated in a novel, more general numerical framework for the nonlinear analysis of reinforced concrete structures. Such a framework includes a newly proposed embedded truss model for the reinforcing bars, allowing them to be crossed by the neighboring propagating cracks. Comparisons with available experimental results are provided, assessing the reliability and the numerical accuracy of the proposed concrete model, with reference to plain specimens subjected to single‐crack propagation as well as to reinforced elements subjected to multiple cracking.
Prediction of multiaxial fatigue life for complex three‐dimensional stress state considering effect of additional hardening
Authors: Zhao Bingfeng , Xie Liyang , Song Jiaxin , Zhao Zhiqiang , Fan Fuyou , Xu Guoliang
Published: August 2019

In engineering practice, it is generally accepted that most of components are subjected to multiaxial stress‐strain state. To analyse this complicated loading state, different types of specimens of 2A12 (2124 in the United States) aluminium alloy were tested under multiaxial loading conditions and a new multiaxial fatigue analysis method for the state of three‐dimensional stress and strain is proposed. Elastic‐plastic finite element method (FEM) and a proposed vector computing method are used to describe the loading state at the critical point of specimen, by which the parameter ΓT is calculated at the new defined subcritical plane to consider the effect of additional cyclic hardening. Meanwhile, the principal equivalent strain is still calculated at the traditional critical plane. The new damage parameter is composed of different process parameters, by which the dynamic path of strain state, including loading environments and material properties, are fully considered in one loading cycle. According to experimental verifications with 2A12 aluminium alloy, the results show that the proposed method shows satisfactory, accurate, and reliable results for multiaxial fatigue life prediction in the state of three‐dimensional stress and strain.
Cumulative nonlinearity as a parameter to quantify mechanical fatigue
Authors: Hirschberg Valerian , Wilhelm Manfred , Rodrigue Denis
Published: August 2019

The cumulative nonlinearity (Qf) is proposed as a new parameter to quantify mechanical fatigue. The parameter Qf represents the (cycle number) integral of the ratio of the third harmonic to the fundamental one (I3/1), obtained via Fourier transform of the stress (torque), normalized by the square of the strain amplitude (γ0). The validation is performed on different polymers: polystyrene (PS) with different molecular weights, styrene‐acrylonitrile (SAN), polymethylmethacrylate (PMMA), and polytertbuthylmethacrylate (PtBMA) under strain controlled fatigue tests in a torsion rectangular set‐up. A power‐law correlation between the number of cycles to failure (Nf) and the cumulative nonlinearity was found for Nf > 1000 cycles, and the results were compared with well‐established failure criteria such as the cumulative stress and the dissipated energy density. It was found that the cumulative nonlinearity has superior prediction ability since it can quantify material changes during a test.
Delamination resistance of GFRP‐epoxy rods with nanoparticle‐ and microparticle‐modified matrix and its correlation with the fracture properties of epoxy nanocomposites
Authors: Burda Iurii , Barbezat Michel , Brunner Andreas J.
Published: August 2019

Pultruded glass fiber–reinforced plastic (GFRP) rods are industrially produced for various applications. The mechanical properties of GFRP rods can be tailored, eg, with modified epoxy matrix by adding microsized and nanosized fillers. In this work, we investigated the transferability of the fracture properties of epoxy nanocomposites to GFRP epoxy rods. For this purpose, nanosilica particles, micron‐sized rubber, and micron‐sized calcium carbonate were used as fillers. Firstly, epoxy plates with different combinations of nanosized and micron‐sized fillers were produced and their fracture toughness evaluated. Secondly, using binary and ternary epoxy filler systems as matrices, GFRP rods were produced, and their fracture toughness was determined using a modified testing procedure derived from standard composite double cantilever beam specimens. Lastly, the correlation between fracture properties of epoxy nanocomposites and GFRP rods was analysed. Besides that, the fractographic investigations of both epoxy nanocomposites and GFRP rods were carried out and discussed.
Water velocity regulates macro‐consumer herbivory on the benthic macrophyte Podostemum ceratophyllum Michx.
Authors: Wood James L. , Skaggs Jon W. , Conn Caitlin , Freeman Mary C.
Published: August 2019

Macrophytes influence aquatic ecosystems by increasing habitat complexity and providing trophic resources for aquatic fauna. While herbivory on freshwater macrophytes is widely documented in lakes and low‐velocity riverine habitats, the influence of herbivory on macrophytes in higher‐velocity habitats has rarely been examined.

We investigated the hypothesis that water velocity can influence consumption rates of the submerged macrophyte, Podostemum ceratophyllum, an angiosperm that grows attached to stable substrates in high water velocity riverine habitats throughout eastern North America. Known macro‐consumers of Podostemum include crayfishes, turtles, and waterfowl.

We estimated grazing pressure by conducting short‐term (up to 77‐day) transplant and consumer‐exclosure experiments, and quantified changes in Podostemum stem length when the plant was exposed to low (<0.5 m/s) and higher velocities in two Piedmont rivers in Georgia (USA). Podostemum transplanted into low‐velocity habitats rapidly lost stem length unless macro‐consumers were excluded from accessing the plant. In contrast, Podostemum transplanted into high‐velocity habitats showed little change or gained stem length.

We estimated that 85% (67–98%; 95% credible interval) of the daily stem growth (0.026 cm cm−1 day−1) in Podostemum was consumed during a 77‐day paired consumer‐access versus exclosure experiment conducted in mean water velocities of 0.35–0.5 m/s. We also found a positive relation (R2 = 0.58) between Podostemum biomass and water velocity (ranging between c. 0.1 and 1.3 m/s) in benthic samples collected over a 2‐month period.

We conclude that high water velocity reduces herbivory on Podostemum, and that water velocity can thus control the accrual of benthic plant biomass and the movement of plant‐derived materials through benthic food webs. Our research has implications for estimating resource storage and flux in lotic food webs and illuminates a mechanism by which flow regulation and management may affect basal resources in rivers.
Leveraging plant hydraulics to yield predictive and dynamic plant leaf allocation in vegetation models with climate change
Authors: Trugman Anna T. , Anderegg Leander D. L. , Sperry John S. , Wang Yujie , Venturas Martin , Anderegg William R. L.
Published: August 2019

Plant functional traits provide a link in process‐based vegetation models between plant‐level physiology and ecosystem‐level responses. Recent advances in physiological understanding and computational efficiency have allowed for the incorporation of plant hydraulic processes in large‐scale vegetation models. However, a more mechanistic representation of water limitation that determines ecosystem responses to plant water stress necessitates a re‐evaluation of trait‐based constraints for plant carbon allocation, particularly allocation to leaf area. In this review, we examine model representations of plant allocation to leaves, which is often empirically set by plant functional type‐specific allometric relationships. We analyze the evolution of the representation of leaf allocation in models of different scales and complexities. We show the impacts of leaf allocation strategy on plant carbon uptake in the context of recent advancements in modeling hydraulic processes. Finally, we posit that deriving allometry from first principles using mechanistic hydraulic processes is possible and should become standard practice, rather than using prescribed allometries. The representation of allocation as an emergent property of scarce resource constraints is likely to be critical to representing how global change processes impact future ecosystem dynamics and carbon fluxes and may reduce the number of poorly constrained parameters in vegetation models.
Correlates of seasonal change in the body condition of an Arctic top predator
Authors: Galicia Melissa P. , Thiemann Gregory W. , Dyck Markus G.
Published: August 2019

Climate‐driven sea ice loss has led to changes in the timing of key biological events in the Arctic, however, the consequences and rate of these changes remain largely unknown. Polar bears (Ursus maritimus) undergo seasonal changes in energy stores in relation to foraging opportunities and habitat conditions. Declining sea ice has been linked to reduced body condition in some subpopulations, however, the specific timing and duration of the feeding period when bears acquire most of their energy stores and its relationship to the timing of ice break‐up is poorly understood. We used community‐based sampling to investigate seasonality in body condition (energy stores) of polar bears in Nunavut, Canada, and examined the influence of sea ice variables. We used adipose tissue lipid content as an index of body condition for 1,206 polar bears harvested from 2010–2017 across five subpopulations with varying seasonal ice conditions: Baffin Bay (October–August), Davis Strait and Foxe Basin (year‐round), Gulf of Boothia and Lancaster Sound (August–May). Similar seasonal patterns were found in body condition across subpopulations with bears at their nadir of condition in the spring, followed by fat accumulation past break‐up date and subsequent peak body condition in autumn, indicating that bears are actively foraging in late spring and early summer. Late season feeding implies that even minor advances in the timing of break‐up may have detrimental effects on foraging opportunities, body condition, and subsequent reproduction and survival. The magnitude of seasonal changes in body condition varied across the study area, presumably driven by local environmental conditions. Our results demonstrate how community‐based monitoring of polar bears can reveal population‐level responses to climate warming in advance of detectable demographic change. Our data on the seasonal timing of polar bear foraging and energy storage should inform predictive models of the effects of climate‐mediated sea ice loss.
Variation in the gut microbial community is associated with the progression of liver regeneration
Authors: Bao Qiongling , Yu Liang , Chen Deying , Li Lanjuan
Published: August 2019

Aim

To highlight a potential dynamic interaction between intestinal bacteria (IB) and metabolites that might contribute to liver regeneration (LR).

Methods

Male Sprague–Dawley rats were subjected to surgical removal of two‐thirds of the liver and samples were collected over a 14‐day period. Intestinal community and metabolic profiles were characterized to establish their potential interactions during liver regeneration.

Results

Partial hepatectomy caused fluctuating changes in the gut microbiome, which paralleled the biological processes of LR. Briefly, the enhanced cell proliferation occurring within 30–48 h was associated with a decreased ratio of Firmicutes to Bacteroidetes reflected by a reduction in Ruminococcaceae and Lachnospiraceae, and an increase in Bacteroidaceae, Rikenellaceae, and Porphyromonadaceae, which was indicative of a lean phenotype. The microbiota derived from rats at 12–24 h and 3–14 days were characterized by elevated F/B ratios, suggesting the differing energy extract behaviors of microbiota during the course of LR. Functional changes of the shifted microbiota revealed by PICRUSt software confirmed the pyrosequencing results. The microbiome derived from hour 12 rats showed overpresentation of metabolism‐related modules. In contrast, the microbiome derived from day 2 rats was functionally unique in “replication and repair”, “amino acid metabolism,” and “nucleoid metabolism.” Upon examining the dynamic pattern of metabolic response, the specific pathways, including glycerophospholipid metabolism, taurine, and hypotaurine metabolism, were identified to be attributable to the systemic alterations in LR‐related metabolism. Moreover, our data indicated that several key functional bacteria were strongly related to perturbations of the above pathways.

Conclusion

Gut flora could play a central role in manipulating metabolic responses in LR.
Poorly differentiated neuroendocrine carcinoma of the head and neck: human papillomavirus tumour status/p16 status and impact on overall survival
Authors: Benzerdjeb Nazim , Traverse‐Glehen Alexandra , Philouze Pierre , Bishop Justin , Devouassoux‐Shisheboran Mojgan
Published: August 2019

Aims

Poorly differentiated neuroendocrine carcinoma (PDNEC) of the head and neck is a rare high‐grade neuroendocrine neoplasm. Human papillomavirus (HPV) status and p16 status are as yet unclear among PDNECs, owing to a lack of statistical analysis. The objective of the present study was therefore to evaluate their potential clinicopathological associations, and their prognostic impact on overall survival in PDNECs of the head and neck, regardless to HPV genotype.

Methods and results

All cases of PDNEC of the head and neck between 1998 and 2019 were identified from the database of the Lyon university hospital pathology department (n = 21); for these cases, p16 immunohistochemistry and HPV in‐situ hybridisation were performed. Published cases of PDNEC of the head and neck with assessment of HPV status and p16 status were identified in PubMed (n = 57). Local and published cases were pooled for analysis. HPV positive (HPV+) tumour status was found to be significantly associated with oropharyngeal localisation (P < 0.001) and overexpression of p16 (P < 0.001). Multivariate analysis, adjusted on tumour site, histological subtype, p16 status, HPV status, and source of the case, showed that oropharyngeal localisation [hazard ratio (HR) 3.031, 95% confidence interval (CI) 1.257–7.310] and being a small‐cell variant (HR 2.859, 95% CI 1.150–7.109) were significant predictors of worse overall survival; HPV+ tumour status was associated with better overall survival (HR 0.388, 95% CI 0.146–0.995).

Conclusions

HPV+ tumour status was associated with oropharyngeal PDNECs and with a better prognosis.
Sema3E is required for migration of cranial neural crest cells in zebrafish: Implications for the pathogenesis of CHARGE syndrome
Authors: Liu Zhi‐Zhi , Guo Jingjing , Lu Yanli , Liu Wenfeng , Fu Xiaofeng , Yao Tianbing , Zhou Yanjun , Xu Hong A.
Published: August 2019

CHARGE syndrome is a congenital disorder with multiple malformations in the craniofacial structures, and cardiovascular and genital systems, which are mainly affected by neural crest defects caused by loss‐of‐function mutations within chromodomain helicase DNA‐binding protein 7 (CHD7). However, many patients with CHARGE syndrome test negative for CHD7. Semaphorin 3E (sema3E) is a gene reported to be mutated in patients with CHARGE syndrome. However, its role in the pathogenesis of CHARGE syndrome has not been verified experimentally. Here, we report that the knockdown of sema3E results in severe craniofacial malformations, including small eyes, defective cartilage and an abnormal number of otoliths in zebrafish embryos, which resemble the major features of CHARGE syndrome. Further analysis reveals that the migratory cranial neural crest cells are scattered in the region of the hindbrain, and the postmigratory neural crest cells are reduced in the pharyngeal arches upon sema3E knockdown. Notably, immunostaining and time‐lapse imaging analyses of a neural crest cell‐labelled transgenic fish line, sox10:EGFP, show that the migration of cranial neural crest cells is severely impaired, and many of these cells are misrouted upon sema3E knockdown. Furthermore, the sox10‐expressing cranial neural crest cells are scattered in chd7 homozygous mutants, which phenocopied the phenotype in sema3E morphants. Overexpression of sema3E rescues the phenotype of scattered cranial neural crest cells in chd7 homozygotes, indicating that chd7 may control the expression of sema3E to regulate cranial neural crest cell migration. Collectively, our data demonstrate that sema3E is involved in the pathogenesis of CHARGE syndrome by modulating cranial neural crest cell migration.
Developmental enamel defects are associated with early childhood caries: Case‐control study
Authors: Corrêa‐Faria Patrícia , Paixão‐Gonçalves Suzane , Ramos‐Jorge Maria Letícia , Paiva Saul Martins , Pordeus Isabela Almeida
Published: August 2019

Background

Knowledge on the association between developmental enamel defects (DED) and early childhood caries (ECC) has importance for the drafting of prevention measures and oral healthcare planning.

Aim

To compare the frequency of ECC in children with and without DED and verify their association with sociodemographic factors.

Design

This case‐control study was carried out with Brazilian children aged one to five years. The case group made up of 98 children with ECC and the control group was made up of 98 children without ECC. DED were classified in diffuse opacity, demarcated opacity and enamel hypoplasia (Developmental Defects of Enamel Index). Sociodemographic data were collected by a questionnaire answered by parents. Statistical analysis used McNemar's test and logistic regression analyses.

Results

In the bivariate analysis, ECC was more frequent among children from families with poorer socioeconomic conditions (lower monthly household income [P ≤ .001] and lower maternal schooling [P = .001]) and among those with DED (P ≤ .001). The final logistical model showed that children with DED (OR: 1.94) and a monthly household income less than two Brazilian minimum salaries (OR: 2.24) were more likely to have ECC.

Conclusions

The occurrence of DED and lower household income were pre‐disposing factors for the occurrence of ECC.
Production and optical properties of Ce3+‐activated and Lu3+‐stabilized transparent gadolinium aluminate garnet ceramics
Authors: Sun Zhigang , Chen Ziyun , Wang Mengyao , Lu Bin
Published: August 2019

We first report the novel Ce3+‐activated and Lu3+‐stabilized gadolinium aluminate garnet (GAG) transparent ceramics derived from their precipitation precursors via a facile co‐precipitation strategy using ammonium hydrogen carbonate (AHC) as the precipitant. The resulting precursors in liquid phase were substantially homogeneous solid solutions and could directly convert into sinterable garnet powders via pyrolysis. Substituting 35 at.% of Lu3+ for Gd3+ was effective to stabilize the cubic GAG garnet structure and transparent (Gd,Lu)3Al5O12:Ce ceramics were successfully fabricated by vacuum sintering at 1715°C. The ceramic transparency was improved by optimizing the particle processing conditions and the best sample had an in‐line transmittance of ~70% at 580 nm (Ce3+ emission center) and over 80% in partial infrared region with a fine average grain size of ~4.5 μm. Transparent (Gd,Lu)3Al5O12:Ce ceramics have a short critical wavelength (<200 nm) and a maximal infrared cut‐off at ~6.6 μm. Both the (Gd,Lu)3Al5O12:Ce phosphor powder and the transparent ceramic exhibited characteristic yellow emission of Ce3+ with strong broad emission bands from 490 to 750 nm upon UV excitation into two groups of broad bands around 340 and 470 nm. The photoluminescence and photoluminescence excitation intensities as well as the quantum yield were greatly enhanced via high‐temperature densification. Both the phosphor powder and ceramic bulk had short effective fluorescence lifetimes.
Microstructural evolution and texture analysis of magnesium phosphate cement
Authors: Viani Alberto , Lanzafame Gabriele , Chateigner Daniel , El Mendili Yassine , Sotiriadis Konstantinos , Mancini Lucia , Zucali Michele , Ouladdiaf Bachir
Published: August 2019

Three‐dimensional quantitative image analysis from synchrotron X‐ray microcomputed tomography indicated a coarsening of the microstructure of magnesium potassium phosphate cements driven by crystallization of K‐struvite from the first amorphous product. Porosity and pore surface area increased because of the progressive build‐up of a network of elongated/tabular crystal domains, with density higher than the amorphous. The known increase in strength with time is thought to occur thanks to the overwhelming contribution of a developing interlocked lath‐shaped microstructure. Combined X‐ray and neutron diffraction texture analysis indicated that at least a fraction of K‐struvite nucleates at the surface of MgO grains, suggesting the intervention of more than one crystallization mechanism. The detected weak texture, compatible with a nearly random orientation of crystallites, and the isotropic pore fabric, are beneficial with respect to crack propagation.
Art Technology Integration: Digital Storytellying as a Transformative Pedagogy in Primary Education
Authors: Pavlou Victoria
Published: August 2019

The emergence of new media provides new tools for promoting critical thinking and creativity in an environment that encourages collaboration, co‐authoring and sharing ideas and artworks with audiences. Embedding new media in art lessons and integrating art with other disciplines not only promotes visual competence but also transversal competences necessary for the future lives of children. Despite the many benefits that this process entails, there is still no broad integration of new media in art lessons or art integration through technology in primary schools, as teachers are often oblivious of the new possibilities and means of engaging children. However, there is a need to embrace today’s dominant culture of communication if we really want to prepare children for the future. This article is about art technology integration in the primary classroom. It discusses ways of studying important real‐life issues with children and of bridging the gap between school life and daily life. It reports on two case studies with sixth grade classes (11–12 years old) that engaged in a stop motion animation project to communicate messages that were important to the children. Children shared powerful stories, anchored in real‐life contexts and developed critical thinking, communication, collaboration and creativity skills. The findings contribute to the discussions about arts integration that are grounded in empirical qualitative data. The implications of the study move beyond the art subject itself and highlight how generalist teachers can embrace interdisciplinarity and art integration, and view art as transformative pedagogy in the curriculum.
Examining the questionnaire on attitudes consistent with sexual offending
Authors: Gray Emma
Published: August 2019

Background

The Questionnaire on Attitudes Consistent with Sexual Offending (QACSO) is an assessment developed by Lindsay, Whitefield, Carson, Broxholme and Steptoe (2004). The QACSO was designed to assess cognitive distortions relating to sexual offending in males with intellectual disabilities (ID). Cognitive distortions form part of the offence chain in sexual offending and as such require effective assessment and treatment.

Method

The QACSO manual and studies utilizing the QACSO were examined.

Results

An overview of characteristics of the QACSO is outlined. The strengths and limitations of the measure are discussed, including validity and reliability of the measure and normative samples.

Conclusions

The QACSO is a valuable tool in assessing cognitive distortions in intellectual disability sexual offenders. Whilst there are some concerns about validity and reliability which it would be beneficial to address, overall the measure has utility in forensic practice and research, and is unique for being developed specifically for intellectual disability offenders.
Prevalence and predictors of chronic kidney disease among Ghanaian patients with hypertension and diabetes mellitus: A multicenter cross‐sectional study
Authors: Tannor Elliot K. , Sarfo Fred Stephen , Mobula Linda M. , Sarfo‐Kantanka Osei , Adu‐Gyamfi Rexford , Plange‐Rhule Jacob
Published: August 2019

The burden of chronic kidney disease (CKD) is rapidly rising in developing countries due to astronomical increases in key risk factors including hypertension and diabetes. We sought to assess the burden and predictors of CKD among Ghanaians with hypertension and/or diabetes mellitus in a multicenter hospital‐based study. We conducted a cross‐sectional study in the Ghana Access and Affordability Program (GAAP) involving adults with hypertension only (HPT), hypertension with diabetes mellitus (HPT + DM), and diabetes mellitus only (DM) in 5 health facilities in Ghana. A structured questionnaire was administered to collect data on demographic variables, medical history, and clinical examination. Serum creatinine and proteinuria were measured, and estimated glomerular filtration rate derived using the CKD‐EPI formula. A multivariable logistic regression model was used to identify factors associated with CKD. A total of 2781 (84.4%) of 3294 participants had serum creatinine and proteinuria data available for analysis. The prevalence of CKD was 242 (28.5%) among participants with both DM and HPT, 417 (26.3%) among participants with HPT, and 56 (16.1%) among those with DM alone. Predictors of CKD were increasing age aOR 1.26 (1.17‐1.36), low educational level aOR 1.7 (1.23‐2.35), duration of HPT OR, 1.02 (1.01‐1.04), and use of herbal medications aOR 1.39 (1.10‐1.75). Female gender was protective of CKD aOR 0.75 (0.62‐0.92). Among patients with DM, increasing age and systolic blood pressure were associated with CKD. There is high prevalence of CKD among DM and hypertension patients in Ghana. Optimizing blood pressure control and limiting the use of herbal preparations may mitigate CKD occurrence in high cardiovascular risk populations in developing countries.
Is obstructive sleep apnoea the most important determinant of reverse dipping? Hypothesis and evidence
Authors: Cuspidi Cesare , Gherbesi Elisa , Tadic Marijana
Published: August 2019

From the physiopathological point of view obstructive sleep apnoea (OSA) should be regarded as the phenotype with the highest potential to disrupt the normal circadian blood pressure (BP rhythm). Despite these assumptions, it is surprising, however, to note that the data supporting a link between OSA and paradoxical increase in nighttime BP (ie, the so‐called reverse dipping pattern) are still very limited and in some ways not entirely consistent. Available evidence on the association between OSA and reverse dipping (RD pattern), contrary to what is commonly thought, is still scanty. Given the potential negative synergistic effect of these two conditions, it is essential to have studies targeting this topic available soon.
Characterizing treatment‐related patient needs in atopic eczema: insights for personalized goal orientation
Authors: Augustin M. , Langenbruch A. , Blome C. , Gutknecht M. , Werfel T. , Ständer S. , Steinke S. , Kirsten N. , Silva N. , Sommer R.
Published: August 2019

Background

Atopic eczema (AE) is a common and burdensome chronic skin disease. Clinical guidelines suggest an evidence‐based, personalized and stepwise treatment approach. Only few studies have so far focused on the specific patient needs in treatment.

Objectives

To characterize therapeutic needs of patients with AE in routine care.

Methods

Nationwide cross‐sectional study in 91 dermatology practices and outpatient clinics. Descriptive statistics were used for valuation. Comparisons of HRQoL and general health status were performed including subgroups (age, gender and disease duration). Group comparisons of patient needs were performed for age groups, gender and disease duration. Correlations between patients’ needs (PNQ) and HRQoL, generic health status and severity were tested. In addition, a hierarchical regression analysis was performed to determine which variables contribute to explain the variance in patient needs.

Results

Analysis of 1678 patients (60.5% female, mean age 38.35 ± 15.92 years) revealed a high disease burden with mean SCORAD of 42.26 ± 18.63, mean DLQI of 8.49 ± 6.45 and mean EQ VAS of 63.62 ± 21.98. Among the patient needs that were most frequently rated as ‘quite important’/‘very important’ were as follows: ‘to be free of itching’ (96.0%), ‘to get better skin quickly’ (7.8%) and ‘to be healed of all skin defects’ (85.7%). In general, older people, women and patients who had been diagnosed with AE for 1 year or less rated the treatment needs as more important than younger patients, men and patients who had been diagnosed with AE for more than 1 year. Major determinants of higher needs were skin‐related quality of life impairments, higher disease severity and higher age.

Conclusions

Patients with AE show a high number and variety of therapeutic needs related to disease signs and symptoms, which are associated with individual disease burden. The patient needs vary substantially according to patient characteristics. Identification of patient‐specific needs may support personalized, patient‐centred care and shared decision‐making.
Systematic review on rapidity of onset of action for interleukin‐17 and interleukin‐23 inhibitors for psoriasis
Authors: Egeberg A. , Andersen Y.M.F. , Halling‐Overgaard A.‐S. , Alignahi F. , Thyssen J.P. , Burge R. , Mallbris L.
Published: August 2019

Several novel biologics are available or in development for moderate‐to‐severe plaque psoriasis. These drugs may differ in time until Psoriasis Area and Severity Index (PASI) response is obtained. In this systematic review, we examined the time to onset of action for interleukin (IL)‐17 and IL‐23 agents in the treatment of psoriasis. The primary objective was the weighted mean time needed for 25% and 50% of patients with psoriasis to achieve PASI90. The medical databases PubMed, Web of Science and EMBASE were searched using the following terms: psoriasis AND (ixekizumab OR secukinumab OR brodalumab OR risankizumab OR guselkumab OR tildrakizumab). A total of 27 studies were included for data extraction and qualitative synthesis, and 26 of these were quantitatively analysed. The shortest time to 25% and 50% of patients to achieved PASI90 were seen with brodalumab 210 mg every 2 weeks (Q2W; 3.5 weeks and 6.2 weeks, respectively) followed by ixekizumab 80 mg Q2W (4.1 and 7.4 weeks, respectively) and ixekizumab 80 mg Q4W (4.6 and 8.1 weeks, respectively) dosages. In conclusion, clinical trials yielded shorter time to onset of action in studies assessing approved dosing ranges of IL‐17 inhibitors compared with studies assessing IL‐23 inhibitors.
Microcomedones in non‐lesional acne prone skin New orientations on comedogenesis and its prevention
Authors: Fontao F. , von Engelbrechten M. , Seilaz C. , Sorg O. , Saurat J.H.
Published: August 2019

Background

In non‐lesional skin of acne patients, cyanoacrylate skin surface stripping can harvest a structure called microcomedone (MC) which is the earliest phase of comedogenesis; the root of any subsequent clinical lesion and a target for the prevention of acne relapses. More information is needed on the putative biochemical contributors (biomarkers) of comedogenesis expressed in MC.

Methods

Proteins expressed in MC were screened by proteomics, immunohistochemistry and Western blotting. The in vitro effects of a comedolytic Silybum marianum fruit extract (SMFE) were studied in sebocyte cultures by RNA‐Seq and modulation of CYP1A1 by qPCR and enzymatic activity. MC severity was correlated to lesions counts and keratin expression during 48 weeks in 23 acne patients using a topical comedolytic formulation containing SMFE.

Results

Two infundibular keratins, K75 and K79, co‐localized in MC with the sebocyte progenitor cell marker LRIG1 and were used as a biomarker of comedogenesis for the follow‐up of patients. In cultured sebocytes exposed to SMFE (i) transcriptomic analysis showed an up‐regulation by a factor of 15 of RNA coding for K75 and (ii) the gene expression and catalytic activity of CYP1A1 under exposure to dioxin was decreased. In the acne patients using SMFE, the MC index in non‐lesional skin decreased over time and remained until the 48th week, significantly lower than that of the first week. There was a high correlation between the decrease of MC index and the decrease and stability of the clinical lesions counts over time. Importantly, a low MC index status was found to be associated with a significant higher K75 expression in microcomedones.

Discussion

These observations provide new orientations on the mechanism of comedogenesis and its prevention. Maintaining a low MC status in non‐lesional skin is a sound target for the prevention of acne relapse and a good sentinel of acne remissions.
Predicting Hospital Readmissions from Home Healthcare in Medicare Beneficiaries
Authors: Jones Christine D. , Falvey Jason , Hess Edward , Levy Cari R. , Nuccio Eugene , Barón Anna E. , Masoudi Frederick A. , Stevens‐Lapsley Jennifer
Published: August 2019

OBJECTIVE

To use patient‐level clinical variables to develop and validate a parsimonious model to predict hospital readmissions from home healthcare (HHC) in Medicare fee‐for‐service beneficiaries.

DESIGN

Retrospective analysis using multivariable logistic regression and gradient boosting machine (GBM) learning to develop and validate a predictive model.

SETTING/PARTICIPANTS/MEAUREMENTS

A 5% national sample of patients, aged 65 years or older, with Medicare fee‐for‐service who received skilled HHC services within 5 days of hospital discharge in 2012 (n = 43 407). Multiple data sets were merged, including Medicare Outcome and Assessment Information Set, Home Health Claims, Medicare Provider Analysis and Review, and Master Beneficiary Summary Files, to extract patient‐level variables from the first HHC visit after discharge and measure 30‐day readmission outcomes.

RESULTS

Among 43 407 patients with inpatient hospitalizations followed by HHC, 14.7% were readmitted within 30 days. Of the 53 candidate variables, seven remained in the final model as individually predictive of outcome: Elixhauser comorbidity index, index hospital length of stay, urinary catheter presence, patient status (ie, fragile health with high risk of complications or serious progressive condition), two or more hospitalizations in prior year, pressure injury risk or presence, and surgical wound presence. Of interest, surgical wounds, either from a total hip or total knee arthroplasty procedure or another surgical procedure, were associated with fewer readmissions. The optimism‐corrected c‐statistics for the full model and parsimonious model were 0.67 and 0.66, respectively, indicating fair discrimination. The Brier score for both models was 0.120, indicating good calibration. The GBM model identified similar predictive variables.

CONCLUSION

Variables available to HHC clinicians at the first postdischarge HHC visit can predict readmission risk and inform care plans in HHC. Future analyses incorporating measures of social determinants of health, such as housing instability or social support, have the potential to enhance prediction of this outcome. J Am Geriatr Soc 67:2505–2510, 2019
A Sustainable Pathway to Consumer Wellbeing. The Role of Anticonsumption and Consumer Empowerment
Authors: Balderjahn Ingo , Lee Michael S.W. , Seegebarth Barbara , Peyer Mathias
Published: August 2019

This study investigates the effect of different anticonsumption constructs on consumer wellbeing. The study assumes that people will only lower their level of consumption if doing so does not also lower personal wellbeing. More precisely, this research investigates how specific subtypes of sustainable anticonsumption (e.g., voluntary simplicity, collaborative consumption, and debt‐free living) relate to different states of consumer's wellbeing (e.g., financial, psychosocial, and subjective wellbeing). This work also examines whether consumer empowerment can improve personal wellbeing and strengthen the anticonsumption wellbeing relationship. The results show that voluntarily foregoing consumption does not reduce wellbeing and consumer empowerment plays a significant role in supporting sustainable pathways to consumer wellbeing. This study reasons that empowerment improves consumer sovereignty, but may be detrimental for consumers heavily concerned about debt‐free living. The present investigation concludes by proposing implications for public and consumer policymakers wishing to promote appropriate sustainable (anticonsumption) pathways to consumer wellbeing.
BENFORD'S LAW AS AN INDICATOR OF SURVEY RELIABILITY—CAN WE TRUST OUR DATA?
Authors: Kaiser Micha
Published: August 2019

This paper analyzes how closely different income measures conform to Benford's law, a mathematical predictor of probable first digit distribution across many sets of numbers. Because Benford's law can be used to test data set reliability, we use a Benford analysis to assess the quality of six widely used survey data sets. Our findings indicate that although income generally obeys Benford's law, almost all the data sets show substantial discrepancies from it, which we interpret as a strong indicator of reliability issues in the survey data. This result is confirmed by a simulation, which demonstrates that household level income data do not manifest the same poor performance as individual level data. This finding implies that researchers should focus on household level characteristics whenever possible to reduce observation errors.
Enhanced muscle regeneration in freshwater prawn Macrobrachium rosenbergii achieved through in vivo silencing of the myostatin gene
Authors: Easwvaran Sarasvathi P. , Bhassu Subha , Maningas Mary B. B. , Othman Rofina Y.
Published: August 2019

Myostatin (MSTN) is an interesting negative growth‐regulating gene that has been well characterized in vertebrates but scantly described in invertebrates. The current study focuses on the downregulation of the MrMSTN gene and subsequently records any histological changes for giant freshwater prawn, Macrobrachium rosenbergii (Mr). In addition, the study also deals with the MrMSTN gene's influence on other growth‐related genes, which include myosin heavy chain, dystrophin‐dystroglycoprotein complex, tropomyosin, farnesoic acid o‐methyl transferase, arginine kinase, cyclophilin, and acyl CoA desaturase. The preliminary histological analysis following MrMSTN silencing favors muscle regeneration, which supports its functional role as a negative growth regulator and its significant effect on the expression of other growth‐related genes. Overall, our results show that the MrMSTN gene could therefore be a potential target for gene manipulation aimed at enhancing the growth and muscle development of M. rosenbergii, which could be beneficial in increasing the total mass production in the postlarva phase at the hatchery level.
Myths and social structure: The unbearable necessity of mythology in medical education
Authors: Martimianakis Maria Athina (Tina) , Tilburt Jon , Michalec Barret , Hafferty Frederic W.
Published: August 2019

Context

Myth busting engages scholars in the critical examination of commonly accepted but poorly evidenced claims with the goal of instilling quality and trust in knowledge making. The debunking of such knowledge “myths” and associated misguided practices purportedly serves to avert resources and attention from wasteful and dangerous scholarship. We address the myth that “all myths in medical education deserve to be busted”.

Methods

Using a critical narrative approach, we searched the medical education literature for orientations to myths and myth busting, and reviewed this literature analytically drawing from the sociology of science and Merton's concepts of manifest and latent functions. The results of this analysis are presented in the form of a narrative that deploys the articles reviewed to explore the utility of myth busting for medical education reform and begins with a brief exploration of the etymology of “myth” and how meaning making is related to symbols, practices and storytelling.

Results

Our analysis revealed the important function of myths in the social practice of medical education and practice. A deconstruction of five salient examples of the contemporary myth in medical education (the myth of the “ideal candidate”, the myth of “cut‐throats”, the myth of “cadaver stories”, the myth of “learning styles”, and the myth of “patient information leaflets”) demonstrates that myths continue to have material effects even after they have been busted.

Conclusions

Our analysis makes evident that myth busting disrupts, renegotiates and reconstitutes socio‐epistemic relationships rather than simply correcting falsehoods. We also argue that myths play important and inescapable roles in the social practice of medical education and the negotiation of values, and in constructing the conditions for group change and transformation. Imperatives related to humanism, compassion and patient engagement offer a healthy humanising counter‐mythologising that we suggest must survive any contemporary myth‐busting endeavour aimed at improving medical education practice.
Medical student strategies for actively negotiating hierarchy in the clinical environment
Authors: Vanstone Meredith , Grierson Lawrence
Published: August 2019

Context

Medical learning takes place in an extremely hierarchical environment. Medical students may struggle to understand how to succeed in such a rule‐bound environment that leaves them vulnerable to the influences of social power. This study explores how medical students experience the clinical learning environment from their low‐status positions in the social hierarchy.

Methods

Using constructivist grounded theory, we collected 88 hours of observation and 13 interviews with medical students completing clinical clerkships. Data collection focused on students’ interactions with their supervisors, colleagues and other staff members as they completed the core rotations of their clinical clerkships. Data analysts used a constant comparative approach to remain alert to the different ways in which medical students experienced and responded to social power used by their supervisors and colleagues.

Results

We describe a cyclical theory of how medical students appraised the environment, the needs and preferences of their supervisors and their personal resources in order to select and enact a strategy for interacting. They used these strategies when in the presence of supervisors, but also when supervisors were absent in preparation for the next interaction. The ways in which medical students chose and employed these strategies reflect a significant use of social and cognitive resources.

Conclusions

Power is an important component of the social culture of clinical learning environments; understanding the ways in which medical students experience and react to power can help educators, learners and administrators optimise learning opportunities. Medical education increasingly encourages students to exercise agency in seeking feedback and directing their own learning; this may be particularly challenging for students who cannot interpret social cues well, and those who lack social capital.
The dynamics of loose talk
Authors: Carter Sam
Published: August 2019

In non‐literal uses of language, the content an utterance communicates differs from its literal truth conditions. Loose talk is one example of non‐literal language use (amongst many others). For example, what a loose utterance of (1) communicates differs from what it literally expresses:

Lena arrived at 9 o'clock.

Loose talk is interesting (or so I will argue). It has certain distinctive features which raise important questions about the connection between literal and non‐literal language use. This paper aims to (i.) introduce a range of novel data demonstrating certain overlooked features of loose talk, and (ii.) develop a new theory of the phenomenon which accounts for these data. In particular, this theory is motivated by the need to explain minimal pairs such as ():

Lena arrived at 9 o'clock, but she did not arrive at 9 o'clock exactly.

?? Lena did not arrive at 9 o'clock exactly, but she arrived at 9 o'clock.

() and () agree in their truth conditions. Yet they differ in felicity. As such, they constitute a problem for any account which hopes to predict the acceptability of the loose use of a sentence from its truth conditions and the context of utterance alone.

Instead, it will be argued, to explain loose talk phenomena we must posit an additional layer of meaning outstripping truth conditions. This layer of meaning is shown to exhibit a range of properties, all of which point to its being semantically encoded. Thus, if correct, the theory provides a new example of how semantic meaning must extend beyond literal, truth‐conditional content.
Naming and epistemic necessity
Authors: Ninan Dilip
Published: August 2019

Kripke (1980) hypothesizes a link between rigidity and scope: a singular term is rigid over a spaceSof possibilities just in case it is scopeless with respect to modals that quantify overS. Kripke's hypothesis works well when we consider the interaction of singular terms with metaphysical modals, but runs into trouble when we consider the interaction of singular terms with epistemic modals. After describing the trouble in detail, and considering one non‐solution to it, I develop a novel version of dynamic semantics that resolves the problem.