bluuebunny/crossref_metadata_2025 huggingface dataset:
General practitioner‐type patients in emergency departments in metro North Brisbane, Queensland: A multisite study
Authors: Toloo Ghasem (Sam) , Bahl Nimisha , Lim David , FitzGerald Gerry , Wraith Darren , Chu Kevin , Kinnear Frances B , Aitken Peter , Morel Douglas
Published: December 2019

Objective

To estimate the proportion of ED patients in urban Queensland who are potentially suitable for general practitioner (GP) care.

Methods

A retrospective analysis was conducted using ED Information System data from Metro North Hospital and Health Service in Brisbane, Australia for three consecutive financial years (2014–2015 to 2016–2017). The hospitals included two Principal Referral and two Public Acute hospitals. GP‐type patients were calculated using the Australian Institute of Health and Welfare (AIHW), Australasian College for Emergency Medicine (ACEM) and the validated Sprivulis methods.

Results

Of the 822 841 ED presentations, 219 567 (27%) were potentially GP‐type patients by AIHW, 49 307 (6%) by ACEM and 61 836 (8%) by Sprivulis methods. The higher proportion of GP‐type presentations were during 08.00 to 17.00 hours by AIHW and ACEM methods. Of the lower‐acuity triage categories of 4 (286 154 presentations) and 5 (5658 presentations), AIHW estimated that 62% and 80% of the patients were GP‐type patients, as compared to 9% and 22% by ACEM, and 9% and 0.3% by Sprivulis method. The mean costs of adult GP‐type patients is $345 by the AIHW and $406 by the ACEM method, lower than non‐GP type patients ($706 and $622, respectively).

Conclusions

There is considerable variation in what is considered GP‐type ED presentations based on the three methods employed and this variation may have fuelled the debate surrounding what is ‘avoidable’ ED utilisation. Regardless, the study findings provide an interesting addition to defining and addressing appropriate utilisation of ED services.
Nicotine, cocaine, amphetamine, morphine, and ethanol increase norepinephrine output in the bed nucleus of stria terminalis of freely moving rats
Authors: Jadzic Dragana , Bassareo Valentina , Carta Anna R. , Carboni Ezio
Published: December 2019

The bed nucleus of stria terminalis (BNST) is a complex limbic area involved in neuroendocrine and behavioural responses and, in particular, in the modulation of the stress response. BNST is innervated by dopamine and norepinephrine, which are known to be involved in drug addiction. It is also known that several drugs of abuse increase dopamine transmission in the BNST, but there has been less research regarding the effect on norepinephrine transmission. Here, we have used the microdialysis technique to investigate the effect of several drugs of abuse on norepinephrine transmission in the BNST of freely moving rats. We observed that nicotine (0.2‐0.4 mg/kg), cocaine (2.5‐5 mg/kg), amphetamine (0.25‐0.5 mg/kg), and ethanol (0.5‐1.0 g/kg), dose‐dependently increased norepinephrine output while the effect of morphine at 3.0 was lower than that of 1.0 mg/kg. These results suggest that many drugs of abuse, though possessing diverse mechanisms of action, share the property of increasing norepinephrine transmission in the BNST. Furthermore, we suggest that the recurring activation of NE transmission in the BNST, due to drug administration, contributes to the alteration of the function that BNST assumes in how the behavioural response to stress manifests, favouring the establishment of the stress‐induced drug seeking.
Effects of nicorandil infusion on ECG parameters in patients with unstable angina pectoris and percutaneous coronary intervention
Authors: Wang Weiding , Zhang Xu , Chen Kangyin , Yin Li , Gong Mengqi , Liu Yang , Tse Gary , Wu Lin , Li Guangping , Liu Tong
Published: December 2019

Background

Percutaneous coronary intervention (PCI) is effective in treating patients with acute coronary syndrome (ACS) but is associated with some serious complications. Nicorandil is an anti‐anginal agent acting to improve microvascular circulation and to increase coronary blood flow. The objective of this article is to evaluate the effects of intracoronary injection followed with continuous intravenous injection of nicorandil on ECG parameters in patients with unstable angina pectoris (UA) undergoing PCI.

Methods

A single‐center, self‐controlled clinical trial was conducted at the Second Hospital of Tianjin Medical University between January 2019 and April 2019. Sixty‐three consecutive patients with UA who received coronary angiography and selective PCI were enrolled. ECG was recorded and analyzed before and 24 hr after nicorandil infusion.

Results

Patients were divided into three groups: control group (n = 23, aged 63.43 ± 12.55 years), short‐term, and prolonged use with nicorandil group (n = 20 and 20, aged 66.45 ± 8.06 years and 65.80 ± 9.49 years, respectively). Clinical characteristics and ECG parameters were similar before PCI among three groups (p > .05). In nicorandil treatment groups, intervals of QTd and Tp‐e in patients post‐PCI were significantly shorter than that in control and pre‐PCI (p < .05).

Conclusions

Nicorandil infusion reduces QTd and Tp‐e interval in patients with UA. Further studies will be needed to determine whether these electrophysiological changes are associated with a reduction of ventricular arrhythmias and improved outcomes.
Regional citrate anticoagulation for continuous renal replacement therapy in newborns and infants: Focus on citrate accumulation
Authors: Persic Vanja , Vajdic Trampuz Barbara , Medved Bojan , Pavcnik Maja , Ponikvar Rafael , Gubensek Jakob
Published: December 2019

Continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) in newborns and infants is challenging and accumulation of citrate can occur. There are only a few studies reporting the detailed data on RCA. We aimed to analyze RCA‐CRRT at our institution with focus on citrate accumulation. Critically ill newborns and infants up to 11 kg of body weight (BW), treated with RCA‐CRRT in the 2011‐2016 period were included in this retrospective observational study. Prismaflex(R) and Multifiltrate‐CiCa(R) dialysis monitors were used with either automated or manual RCA. Data was collected regarding the circuit lifetime, parameters of RCA, markers of citrate accumulation (total/ionized calcium ratio > 2.5), and metabolic complications. We included 10 children with mean age of 2.6 ± 3.8 months and BW of 4.6 ± 2.7 kg. In‐hospital mortality was 60%. RCA‐CRRT parameters were: blood flow 46 ± 9 mL/min (12 ± 5 mL/min/kg BW), citrate dose 2.8 ± 0.6 mmol/L of blood resulting in estimated citrate load to the patient of 1.7 ± 0.8 mmol/h/kg BW. In total, 57 dialysis circuits were used with mean filter lifetime of 39 ± 29 h. Citrate accumulation (total/ionized calcium ratio > 2.5) was observed in 7/10 patients and in 14/57 (25%) of circuits; those circuits were performed in children with lower age and BW, had higher relative blood flow and citrate load, while citrate dose was similar. When citrate load to the patient was used to predict citrate accumulation, AUC under the ROC curve was 0.78 and 1.7 mmol/h/kg BW was considered the optimal cutoff value (sensitivity 71% and specificity 72%). CRRT with RCA using equipment, developed for adult population, is feasible in newborns and infants. Signs of citrate accumulation developed relatively often. To prevent it, we suggest avoiding citrate loads above 1.7 mmol/h/kg BW, which can best be achieved by keeping the blood flow below 9 mL/min/kg BW.
Commentary: safety of anti‐TNF use in pregnancy
Authors: Hart Ailsa
Published: December 2019

THIS IS A SPECIAL COMMENTARY ON “INTENTIONAL INFLIXIMAB USE DURING PREGNANCY FOR INDUCTION OR MAINTENANCE OF REMISSION IN CROHN'S DISEASE” BY MAHADEVAN, U., KANE, S., SANDBORN, W.J., COHEN, R.D., HANSON, K., TERDIMAN, J.P., AND BINION, D.G., ORIGINALLY PUBLISHED IN AP&T IN 2005. DOI:10.1111/J.1365-2036.2005.02405.x
Editorial: biochemical responses do not tell the whole story in primary biliary cholangitis
Authors: Bowlus Christopher L. , Levy Cynthia
Published: December 2019

LINKED CONTENT

This article is linked to Murillo Perez et al paper. To view this article, visit https://doi.org/10.1111/apt.15533.
Decrease in the proportion of CD24hiCD38hi B cells and impairment of their regulatory capacity in type 1 diabetes patients
Authors: Wang Y , Qin Y , Wang X , Zhang L , Wang J , Xu X , Chen H , Hsu H-T , Zhang M
Published: December 2019

B10 cells restore immune balance by producing interleukin (IL)-10. Impaired B10 cell responses are related to numerous autoimmune diseases. However, the function of B10 cells in type 1 diabetes (T1D) patients is controversial. We hypothesized that there are numerical and functional defects of B10 cells in T1D. Sixty-two patients with T1D and 74 healthy volunteers were included in our study. We showed that B10 cells in human peripheral blood belong to a CD24hiCD38hi B cell subpopulation. CD24hiCD38hi B cells from healthy individuals possessed regulatory capacity, suppressed interferon (IFN)-γ, tumor necrosis factor (TNF)-α and IL-17A production and promoted IL-4 production and forkhead box protein 3 (FoxP3) expression in CD4+ T cells through an IL-10-dependent mechanism. Compared to healthy controls, B10 cell percentages in T1D were significantly lower (5·6 ± 3·5 versus 6·9 ± 3·3%; P < 0·05), produced less IL-10 (15·4 ± 4·3 versus 29·0 ± 4·5%; P < 0·001) and lacked regulatory capacity. In addition, Pearson's correlation analysis showed that the frequency of circulating B10 cells was negatively correlated with the frequency of CD4+IFN-γ+ and CD4+TNF-α+ T cells (r = −0·248 and r = −0·283, P = 0·008 and P = 0·017, respectively), positively correlating with the frequency of CD4+CD25+FoxP3+ T cells (r = 0·247, P = 0·001). These data offer direct proof that there is a deficiency of circulating CD24hiCD38hi B cells in peripheral blood of patients with T1D, which participate in the T1D immune imbalance involved in the development of T1D.
Risk perception and culture: implications for vulnerability and adaptation to climate change
Authors: Rühlemann Anja , Jordan Joanne C.
Published: December 2019

Perceptions of climate change play a critical role in determining the degree to which people are at risk throughout the world. The significance of culture in understanding why people perceive and respond to climate change in particular ways is largely ignored in mainstream climate change adaptation. This paper applies a critical realist approach to examine the sociocultural structures and causal mechanisms for inaction or (in)effective action between at‐risk people and the organisations responsible for dealing with climate change. The findings reveal that there are varying context‐specific sub‐narratives among heterogeneous groups of people at risk and organisations that lead to inaction or (in)effective action in response to climate change, often independent of risk perceptions and with unforeseen consequences for the vulnerabilities of at‐risk people. Specifically, sub‐narratives may create parallel and/or conflicting climate‐related perceptions and respective responses, legitimise unequal resource distribution, and justify the suppression and/or capitalisation of sub‐cultural and/or individual risk perceptions.
Early detection rate changes from a brain‐responsive neurostimulation system predict efficacy of newly added antiseizure drugs
Authors: Quraishi Imran H. , Mercier Michael R. , Skarpaas Tara L. , Hirsch Lawrence J.
Published: December 2019

Objective

Brain‐responsive neurostimulation (RNS System, NeuroPace) is used to treat medically refractory focal epilepsy and also provides long‐term ambulatory neurophysiologic data. We sought to determine whether these data could predict the clinical response to antiseizure drugs (ASDs).

Methods

First, newly added medications were identified in RNS System patients followed at a single epilepsy center. Daily detection rates including “episode starts” (predominantly interictal activity) and “long episodes” (often electrographic seizures) were compared before and after ASD initiation. Efficacy was determined from documentation of clinical improvement and medication retention. Next, the analysis was repeated on an independent sample of patients from a multicenter long‐term treatment trial, using an efficacy measure of ≥50% reduction in diary‐recorded seizure frequency after 3 months.

Results

In the single center cohort, long episodes, but not episode starts, had a significantly greater reduction in the first week for clinically efficacious compared to inefficacious medications. In this cohort, having no long episodes in the first week was highly predictive of ASD efficacy. In the multicenter cohort, both long episodes and episode starts had a significantly greater reduction for effective medications starting in the first 1‐2 weeks. In this larger dataset, a ≥50% decrease in episode starts was 90% specific for efficacy with a positive predictive value (PPV) of 67%, and a ≥84% decrease in long episodes was 80% specific with a PPV of 48%. Conversely, a <25% decrease in long episodes (including any increase) or a <20% decrease in episode starts had a predictive value for inefficacy of >80%.

Significance

In RNS System patients with stable detection settings, when new ASDs are started, detection rates within the first 1‐2 weeks may provide an early, objective indication of efficacy. These data could be used to identify responses to medication trials early to allow more rapid medication adjustments than conventionally possible.
The prohibition to abuse one's human rights: A theory
Authors: Wagrandl Ulrich
Published: December 2019

Supporters of communism, national socialism and radical Islamism, but also people who incite racial hatred or deny the Holocaust, see their rights severely curtailed by the abuse clause of Article 17 of the European Convention on Human Rights. To make sense of this provision, this paper first introduces the distinction between abusable and non‐abusable rights in order to delimit the scope of Article 17. Then, this paper suggests a “test” to spot instances of abuse of human rights by borrowing the concept of performative self‐contradiction from speech act theory. Article 17 is reconceptualised as dealing with conduct that self‐contradictorily uses rights but simultaneously denies their very idea. In this way, it becomes possible to make sense of and to unify the disparate case law that Article 17 has generated so far: it equally targets political human rights abuse, attacking liberal democracy in general; and exclusionary human rights abuse, attacking the rights of other people.
Gender and career optimism—The effects of gender‐specific perceptions of lecturer support, career barriers and self‐efficacy on career optimism
Authors: Aymans Stephanie C. , Kortsch Timo , Kauffeld Simone
Published: December 2019

Female university graduates tend to have less career success than their male counterparts. Career optimism is considered a crucial predictor of future career success, but little is known about predictors of career optimism. Based on Social Cognitive Career Theory (SCCT), we hypothesised that both perceived lecturer support and perceived career barriers impact career optimism via students’ self‐efficacy, and differentiated the model along gender lines using a subgroup path analysis. Two hundred and thirty‐two undergraduate psychology students from German universities answered an online questionnaire. Results revealed that the expected indirect effect of perceived lecturer support and perceived career barriers on career optimism via self‐efficacy was only identifiable in women. For men, we found a direct connection between perceived lecturer support and career optimism, as well as that an increase in perceived career barriers reduced males’ self‐efficacy. We were unable to identify any sex differences in career optimism.
Impact of surgery and adjuvant treatment on the outcome of extraocular sebaceous carcinoma: a systematic review and individual patient's data analysis of 206 cases
Authors: Giridhar Prashanth , Kashyap Lakhan , Mallick Supriya , Dutt Upadhyay Ashish , Rath Goura K.
Published: December 2019

Background

Extraocular sebaceous carcinoma (EOSC) is an aggressive malignancy of the sebaceous gland. Surgery is considered the cornerstone of treatment, but there is lack of clarity about extent and adjuvant treatment.

Methods

We conducted a systematic review and analysis of individual patient data of all published cases of EOSC to look into demography, pattern of care, importance of type of surgery, and other adjuvant treatment and survival outcome. A search of PubMed and Google Scholar was done with the key words sebaceous carcinoma, extraocular sebaceous carcinoma, and Muir‐Torre syndrome till December 2017. The data were compiled in an Excel chart and analyzed using SPSS IBM software.

Results

Data of 206 patients were retrieved. Median age at presentation was 65 years (range: 11–96 years). Surgery was performed in all except 13 patients. Of these 13, eight were deemed inoperable for extensive disease, and five had metastatic disease. Median PFS and OS for the entire cohort were 84 months (95% CI: 10–158 months) and 92 months (95% CI: 59–126 months). Univariate analysis revealed significantly poor survival for patients with a metastatic disease, regional nodal metastasis, and those with Mohs micrographic or incomplete surgery.

Conclusion

EOSC is a disease of elderly patients with good prognosis. Complete surgery with regional lymph node dissection is standard treatment. The role of adjuvant radiotherapy is debatable but can be considered in patients with incomplete surgery or high‐risk factors.
The consumer's index
Authors: ten Raa Thijs
Published: December 2019

Consumer's surplus measures the area under the demand curve between two prices, but is path dependent. There exists a path such that consumer's surplus tracks utility and an explicit formula is known for CES utilities. This paper shows that the CES‐based formula holds for any homothetic utility, and I call it the consumer's index. The index modifies consumer's surplus in two ways: the change in income is measured by its growth factor and the area under the demand curve is normalized by income.
Effects of credit limit on efficiency and welfare in a simple general equilibrium model
Authors: Pham Ngoc‐Sang , Pham Hien
Published: December 2019

We consider a simple general equilibrium model with two agents under the presence of financial market imperfections. Agents can borrow to realize their productive project up to the level of debt whose repayment reaches a fraction of the project's value (the so‐called credit limit). After characterizing the whole set of equilibria, we investigate the connection between credit limit, (individual and social) welfare, and efficiency. We also compute the optimal credit limit which maximizes the social welfare function.
Pollution and growth: The role of pension in the efficiency of health and environmental policies
Authors: Ngami Armel , Seegmuller Thomas
Published: December 2019

This paper analyzes the effect of a pay‐as‐you‐go pension system on the evolution of capital and pollution, and on the efficiency of an environmental versus health policy. In an overlapping generations model, we introduce endogenous longevity that depends on pollution and health expenditures. Global dynamics may display multiple balanced growth paths (BGPs). We show that by discouraging savings, a policy that promotes the pension system enlarges the environmental poverty trap. More surprisingly, the environmental policy has contrasting effects according to the significance of the pension system. If it has a small size, a more environmentally‐friendly policy enlarges the environmental poverty trap and leads to a rise in capital over pollution at the highest stationary equilibrium. In contrast, in economies where intergenerational solidarity is well developed, capital over pollution decreases at the highest BGP. In such a case, the environmental policy does not necessarily lead to a better longevity and growth.
Identification of an HLA‐A*24:02‐restricted α‐fetoprotein signal peptide‐derived antigen and its specific T‐cell receptor for T‐cell immunotherapy
Authors: Li Zhenjuan , Gong Haiping , Liu Qiuping , Wu Wanli , Cheng Jianting , Mei Yingyi , Chen Yaolong , Zheng Hongjun , Yu Xiaohong , Zhong Shi , Li Yi
Published: December 2019

Hepatocellular carcinoma (HCC) is the most common type of liver cancer with limited treatments. Asia has the highest HCC incidence rates; China accounts for over 50% of all HCC cases worldwide. T‐cell receptor (TCR) ‐engineered T‐cell immunotherapies specific for human leukocyte antigen (HLA) ‐A*02:01‐restricted α‐fetoprotein (AFP) peptide have shown encouraging results in clinics. HLA‐A*24:02 is more common than HLA‐A*02:01 in Asian countries, including China. Here we identified a novel HLA‐A*24:02‐restricted peptide KWVESIFLIF (AFP2–11) located in AFP signal peptide domain by mass spectrometric analysis of HLA‐bound peptides from HepG2 cells. A TCR (KWV3.1) specific for AFP2–11‐HLA‐A*24:02 was isolated from peripheral blood mononuclear cells of a healthy donor. The binding affinity of soluble KWV3.1 to its antigen was determined to be ~55 μm, within the affinity range of native TCRs for self‐antigens. KWV3.1‐transfected T cells could specifically activate and kill AFP2–11 pulsed T2‐A24 cells and AFP+ HLA‐A*24:02+ tumor cell lines, demonstrating that AFP2–11 can be naturally presented on the surface of AFP+ tumor cell lines. The newly identified antigenic peptide can provide a novel target for immunotherapeutic strategies for patients with AFP+ HLA‐A*24:02+ HCC.
The feasibility of vigorous resistance exercise training in adults with intellectual disabilities with cardiovascular disease risk factors
Authors: Weterings Stijn , Oppewal Alyt , Hilgenkamp Thessa I. M.
Published: December 2019

Background

The cardiovascular disease (CVD) risk is high in adults with intellectual disabilities. This CVD risk can potentially be decreased with a resistance training (RT) programme at vigorous intensity, following previous research on successful High‐Intensity Training programmes. Our aim was to explore the feasibility of a vigorous RT‐programme for adults with intellectual disabilities with CVD risk factors.

Method

Twenty‐four adults with intellectual disabilities with at least one CVD risk factor participated in a 24‐week RT‐programme. The training intensity was increased from novice (50%1RM) to vigorous (75%–80%1RM). Feasibility was based on the achieved training intensity at the end of the RT‐programme.

Results

Nineteen participants finished the RT‐programme. Feasibility was good as 58% (11 out of 19) of the participants worked out at vigorous intensity at the end of the programme.

Conclusions

It is feasible for the majority of adults with intellectual disabilities with CVD risk factors to exercise at vigorous intensity.
Disentangling the drivers of local species richness using probabilistic species pools
Authors: Karger Dirk Nikolaus , Wüest Rafael O. , König Christian , Cabral Juliano Sarmento , Weigelt Patrick , Zimmermann Niklaus E. , Linder Hans Peter
Published: December 2019

Aim

Local richness is a result of both regional richness and local site‐specific factors. We quantify the effects of different regional (dispersal, environmental filtering) and local (habitat selection) community assembly processes in the Cape reeds (Restionaceae) of the Cape flora and test if community assembly processes vary spatially.

Location

Southern Africa, Cape Floristic Region.

Taxon

Angiosperms, African Restionaceae (restios).

Methods

We calculate local probabilistic species pools, based on local species richness, dispersal rates and environmental filtering at a 4 km2 resolution. We then compare the relative contribution of the processes shaping the species pool spatially. Finally, we correlate observed species richness (based on 916 circular, 10 m diameter relevés) with the local species pools to test the explanatory power of additional local edaphic variables that could act as filters at very small scales.

Results

There is substantial spatial variation in the local probabilistic species pools. Within the central part of the Cape, the local pools are mostly influenced by environmental filtering, while along the periphery dispersal limitation dominates. Observed species richness is lower than the predicted species pool size, which forms an upper boundary of the potential species richness for a local site. Local, site‐specific edaphic factors help to explain the remaining differences between local species pool size and α‐richness.

Main conclusion

The analytical framework for inferring local probabilistic species pools provides a powerful tool for including the influence of regional species richness on variations in relevé α‐richness. This allows us to disentangle the various processes that operate at different spatial scales, and ultimately determine local restio species richness in the Cape Floristic Region.
Emperipolesis mediated by CD8+ T cells correlates with biliary epithelia cell injury in primary biliary cholangitis
Authors: Zhao Su‐xian , Li Wen‐cong , Fu Na , Zhou Guang‐de , Liu Shu‐hong , Jiang Li‐na , Zhang Yu‐guo , Wang Rong‐qi , Nan Yue‐min , Zhao Jing‐min
Published: December 2019

Primary biliary cholangitis (PBC) is an autoimmune disease characterized by chronic destruction of the bile ducts. A major unanswered question regarding the pathogenesis of PBC is the precise mechanisms of small bile duct injury. Emperipolesis is one of cell‐in‐cell structures that is a potential histological hallmark associated with chronic hepatitis B. This study aimed to clarify the pathogenesis and characteristics of emperipolesis in PBC liver injury. Sixty‐six PBC patients, diagnosed by liver biopsy combined with laboratory test, were divided into early‐stage PBC (stages I and II, n = 39) and late‐stage PBC (stages III and IV, n = 27). Emperipolesis was measured in liver sections stained with haematoxylin‐eosin. The expressions of CK19, CD3, CD4, CD8, CD20, Ki67 and apoptosis of BECs were evaluated by immunohistochemistry or immunofluorescence double labelling. Emperipolesis was observed in 62.1% of patients with PBC, and BECs were predominantly host cells. The number of infiltrating CD3+ and CD8+ T cells correlated with the advancement of emperipolesis (R2 = 0.318, P < .001; R2 = 0.060, P < .05). The cell numbers of TUNEL‐positive BECs and double staining for CK19 and Ki67 showed a significant positive correlation with emperipolesis degree (R2 = 0.236, P < .001; R2 = 0.267, P < .001). We conclude that emperipolesis mediated by CD8+ T cells appears to be relevant to apoptosis of BEC and thus may aggravate the further injury of interlobular bile ducts.
Comparison of different quantile regression methods to estimate predictive hydrological uncertainty in the Upper Chao Phraya River Basin, Thailand
Authors: Acharya Suwash C. , Babel Mukand S. , Madsen Henrik , Sisomphon Piyamarn , Shrestha Sangam
Published: December 2019

The estimation of predictive uncertainty and its application as a post‐processor of hydrological model output, such as water level, can provide additional information useful for short‐term hydrological forecasting. In this study, We applied quantile regression models for estimating predictive hydrological uncertainty and used it to derive probabilistic hydrological forecasts. Forecast water levels and associated forecast errors were used as predictor and predictand, respectively, to develop three regression models: (a) linear quantile regression (LQR), (b) weighted LQR and (c) LQR in Gaussian space using Normal Quantile Transformation. These different models for hydrological forecasting were developed for, and applied to, the operational flood forecasting system in the Upper Chao Phraya River, Thailand. The quality of these forecasts in terms of reliability, sharpness and overall skill were assessed using various graphical and numerical verification metrics. Results show that the improvement of forecast in terms of either reliability or sharpness depends upon the configurations used. With comparable overall performance, weighted LQR provided a relatively simple configuration, which can be used for estimating uncertainty in hydrological forecasting.
RNA‐Seq analysis reveals the potential molecular mechanisms of daidzein on adipogenesis in subcutaneous adipose tissue of finishing Xianan beef cattle
Authors: Liang Huan , Xu Lanjiao , Zhao Xianghui , Pan Ke , Yi Zhonghua , Bai Jun , Qi Xinglei , Xin Junping , Li Meifa , Ouyang Kehui , Song Xiaozhen , Liu Chanjuan , Qu Mingren
Published: December 2019

Daidzein has been reported to be effective in regulating lipid metabolism in animals. However, the molecular mechanisms of daidzein on adipogenesis in beef cattle are not yet reported and the results of daidzein on affecting lipid metabolism in other species have been conflicting. High‐throughput sequencing of mRNA (RNA‐Seq) technology was performed to elucidate the underlying molecular mechanisms of daidzein on adipogenesis in subcutaneous adipose tissue of finishing Xianan beef cattle. A total of 893 differentially expressed genes (DEGs) were identified by differential expression analysis, among which 405 genes were upregulated and 488 genes were downregulated. Bioinformatics analysis suggested that these DEGs were significantly enriched to the pathways related to lipid metabolism including ECM–receptor interaction, Glycolysis/Gluconeogenesis and Hedgehog signalling pathway. Daidzein significantly affected the candidate genes (Shh, Pec, Gli, Wnt6, DLK, IGFBP2, ID3 and C/EBPE) related to adipocyte differentiation. Besides, daidzein improved the ability of subcutaneous adipocytes in synthesizing triglycerides by directly using the long‐chain fatty acids and enhanced the efficiency of triglyceride synthesis of subcutaneous adipocytes in Xianan steers. In conclusion, daidzein plays a positive role not only in adipogenic differentiation, but also in triglyceride synthesis in subcutaneous adipose tissue of Xianan beef cattle.
Egg intervention effect on linear growth no longer present after two years
Authors: Iannotti Lora L. , Chapnick Melissa , Nicholas Jennifer , Gallegos‐Riofrio Carlos Andres , Moreno Patricia , Douglas Katherine , Habif David , Cui Yuhan , Stewart Christine , Lutter Chessa K. , Waters William F.
Published: December 2019

The Lulun Project, a randomized controlled trial conducted in 2015, found that one egg per day for 6 months during early complementary feeding reduced stunting by 47% and increased linear growth by 0.63 length‐for‐age Z (LAZ). This follow‐up cohort study (Lulun Project II) aimed to test whether the growth effect remained in the egg intervention group compared with the control group after approximately 2 years. Mothers or caregivers from the Lulun Project were recontacted and recruited for this study. Enumerators collected data on socio‐economic and demographic factors, 24‐hr frequency of dietary intakes, morbidities, and anthropometric measures of height, weight, and head circumference using World Health Organization protocols. Statistical analyses followed the same analytical plan as Lulun Project, applying generalized linear models and regression modelling to test group differences in height‐for‐age z (HAZ) from LAZ at Lulun Project endline, and structural equation modelling for mediation. One hundred thirty‐five mother–child dyads were included in Lulun II, with 11% losses to follow‐up from endline Lulun Project. Growth faltering across all children was evident with HAZ −2.07 ± 0.91 and a stunting prevelance of 50%. Regression modelling showed no difference between egg and control groups for the HAZ outcome and other anthropometric outcomes, and significant declines in HAZ from endline Lulun Project in the egg intervention are compared with control groups. Current dietary egg intake, however, was associated with reduced growth faltering in HAZ from Lulun Project endline to Lulun Project II, independent of group assignment and through mediation, explaining 8.8% of the total effect. Findings suggest the need for a longer intervention period and ongoing nutrition support to young children during early childhood.
Debunking myths in medical education: The science of refutation
Authors: de Bruin Anique B H
Published: December 2019

de Bruin argues that efforts to eradicate erroneous assumptions students and teachers hold about learning requires refutation, a process that combines both correct scientific knowledge and rejection of misconceptions.
Evidence for contrasting roles of dimethylsulfoniopropionate production in Emiliania huxleyi and Thalassiosira oceanica
Authors: McParland Erin L. , Wright Anna , Art Kristin , He Meagan , Levine Naomi M.
Published: December 2019

Dimethylsulfoniopropionate (DMSP) is a globally abundant marine metabolite and a significant source of organic carbon and sulfur for marine microbial ecosystems with the potential to influence climate regulation. However, the physiological function of DMSP has remained enigmatic for >30 yr. Recent insight suggests that there are different physiological roles for DMSP based on the cellular DMSP concentrations in producers.

Differential production of DMSP was tested with multiple physiological experiments that altered nitrate availability, salinity and temperature to create stressed growth and target different metabolic conditions in Emiliania huxleyi, a high DMSP producer and Thalassiosira oceanica, a low DMSP producer.

Emiliania huxleyi intracellular DMSP did not respond to metabolically imbalanced conditions, while Thalassiosira oceanica intracellular DMSP was significantly correlated to stressed growth rate across all conditions tested and exhibited a plastic response on a timescale of hours in nonsteady‐state.

The previous assumption that proposed DMSP mechanism(s) can be universally applied to all producers is shown to be unlikely. Rather, two distinct ecological roles for DMSP likely exist that differ by producer type, where: (1) the primary role of DMSP in high producers is a constitutive compatible solute; and (2) DMSP production in low producers is a finely tuned stress response.
High incidence of diaphragmatic myopotential oversensing by a specific implantable cardioverter defibrillator
Authors: Baldinger Samuel H. , Haeberlin Andreas , Servatius Helge , Seiler Jens , Noti Fabian , Lam Anna , Sweda Romy , Reichlin Tobias , Tanner Hildegard , Roten Laurent
Published: December 2019

Introduction

Diaphragmatic myopotential oversensing (dMPO) by implantable cardioverter defibrillators (ICDs) is thought to be a rare condition that can be misdiagnosed as lead failure and lead to unnecessary lead replacement. We observed several cases of dMPO in patients with Sorin/LivaNova ICDs (MicroPort Sci.). We sought to systematically assess the incidence of dMPO in patients with Sorin/LivaNova ICDs.

Methods and Results

A predefined number of 100 consecutive patients with Sorin/LivaNova ICDs were prospectively included in the device clinic of our center. Stored arrhythmia episodes were checked for spontaneous dMPO. In addition, we performed provocation maneuvers by Valsalva.

At least one episode of spontaneous or provoked dMPO was seen in 12 (12%) of the 100 patients included in the study (86% males, median age: 66 years). Nine of 89 patients (10%) with true bipolar and 3 of 11 patients (27%) with integrated bipolar sensing configuration were affected.

Spontaneous dMPO was observed in 7 of 58 patients (12%) with sensitivity programmed to 0.4 mV and in 2 of 42 patients (5%) with sensitivity programmed to 0.6 mV (not significant). In three patients, dMPO could be provoked with no spontaneous episodes recorded.

In two nonpacemaker‐dependent patients with a CRT‐D, ventricular pacing was temporarily inhibited. No antitachycardia therapy was triggered by dMPO in any patient.

Conclusions

DMPO is frequent in patients with Sorin/LivaNova ICDs, especially with sensitivity programmed to 0.4 mV. It also frequently occurs with true bipolar sensing configuration. DMPO should not be misinterpreted as lead failure to avoid unnecessary lead replacement.
Efficiency and legitimacy in collaborative public management: Mapping inter‐local agreements in England using social network analysis
Authors: Dixon Ruth , Elston Thomas
Published: December 2019

English councils have long aspired to be ‘self‐sufficient’, providing services within single jurisdictions with limited inter‐local collaboration. However, by 2017 almost all local councils (97 per cent) participated in one or more frontline or back‐office ‘shared service’ involving 338 distinct partnerships. We analyse this new‐found enthusiasm for inter‐council collaboration by performing exploratory social network analysis on organizational and financial data for all 353 English councils. We examine factors predicting collaboration and the characteristics of the service networks that result, focusing on resource, organizational and political considerations. Propensity to collaborate was found to be unpredictable, but partner choice was rational, driven by geographical proximity and similarity in organizational and resource characteristics. We argue that, according to the institutional theory of organizations, both efficiency and legitimacy influenced these reform choices, and the risks of fashionable collaboration were mitigated by careful partner selection. We highlight implications for future quantitative research into symbolic (non‐instrumental) forms of collaboration.
Pst DC3000 infection alleviates subsequent freezing and heat injury to host plants via a salicylic acid‐dependent pathway in Arabidopsis
Authors: Tuang Za Khai , Wu Zhenjiang , Jin Ye , Wang Yizhong , Oo Phyo Phyo Zin , Zuo Guoxin , Shi Huazhong , Yang Wannian
Published: December 2019

Abiotic stresses greatly affect the immunity of plants. However, it is unknown whether pathogen infection affects abiotic stress tolerance of host plants. Here, the effect of defense response on cold and heat tolerance of host plants was investigated in Pst DC3000‐infected Arabidopsis plants, and it was found that the pathogen‐induced defense response could alleviate the injury caused by subsequent cold and heat stress (38°C). Transcriptomic sequencing plus RT‐qPCR analyses showed that some abiotic stress genes are up‐regulated in transcription by pathogen infection, including cold signaling components ICE1, CBF1, and CBF3, and some heat signaling components HSFs and HSPs. Moreover, the pathogen‐induced alleviation of cold and heat injury was lost in NahG transgenic line (SA‐deficient), sid2‐2 and npr1‐1 mutant plants, and pathogen‐induced expression of cold and heat tolerance‐related genes such as CBFs and HSPs, respectively, was lost or compromised in these plants, indicating that salicylic acid signaling pathway is required for the alleviation of cold and heat injury by pathogen infection. In short, our current work showed that in fighting against pathogens, host plants also enhance their cold and heat tolerance via a salicylic acid‐dependent pathway.
Role of inflammasomes in the pathogenesis of periodontal disease and therapeutics
Authors: Marchesan Julie T. , Girnary Mustafa Saadat , Moss Kevin , Monaghan Eugenia Timofeev , Egnatz Grant Joseph , Jiao Yizu , Zhang Shaoping , Beck Jim , Swanson Karen V.
Published: December 2019

Inflammasomes are a group of multimolecular intracellular complexes assembled around several innate immune proteins. Recognition of a diverse range of microbial, stress and damage signals by inflammasomes results in direct activation of caspase‐1, which subsequently induces the only known form of secretion of active interleukin‐1β and interleukin‐18. Although the importance of interleukin‐1β in the periodontium is not questioned, the impact of inflammasomes in periodontal disease and its potential for therapeutics in periodontology is still in its very early stages. Increasing evidence in preclinical models and human data strongly implicate the involvement of inflammasomes in a number of inflammatory, autoinflammatory and autoimmune disorders. Here we review: (a) the currently known inflammasome functions, (b) clinical/preclinical data supporting inflammasome involvement in the context of periodontal and comorbid diseases and (c) potential therapies targeting inflammasomes. To clarify further the inflammasome involvement in periodontitis, we present analyses of data from a large clinical study (n = 5809) that measured the gingival crevicular fluid‐interleukin‐1β and grouped the participants based on current periodontal disease classifications. We review data on 4910 European‐Americans that correlate 16 polymorphisms in the interleukin‐1B region with high gingival crevicular fluid‐interleukin‐1β levels. We show that inflammasome components are increased in diseased periodontal tissues and that the caspase‐1 inhibitor, VX‐765, inhibits ~50% of alveolar bone loss in experimental periodontitis. The literature review further supports that although patients clinically present with the same phenotype, the disease that develops probably has different underlying biological pathways. The current data indicate that inflammasomes have a role in periodontal disease pathogenesis. Understanding the contribution of different inflammasomes to disease development and distinct patient susceptibility will probably translate into improved, personalized therapies.
Herpesvirus‐bacteria synergistic interaction in periodontitis
Authors: Chen Casey , Feng Pinghui , Slots Jørgen
Published: December 2019

The etiopathogenesis of severe periodontitis includes herpesvirus‐bacteria coinfection. This article evaluates the pathogenicity of herpesviruses (cytomegalovirus and Epstein‐Barr virus) and periodontopathic bacteria (Aggregatibacter actinomycetemcomitansandPorphyromonas gingivalis) and coinfection of these infectious agents in the initiation and progression of periodontitis. Cytomegalovirus andA. actinomycetemcomitans/P. gingivalisexercise synergistic pathogenicity in the development of localized (“aggressive”) juvenile periodontitis. Cytomegalovirus and Epstein‐Barr virus are associated withP. gingivalisin adult types of periodontitis. Periodontal herpesviruses that enter the general circulation may also contribute to disease development in various organ systems. A 2‐way interaction is likely to occur between periodontal herpesviruses and periodontopathic bacteria, with herpesviruses promoting bacterial upgrowth, and bacterial factors reactivating latent herpesviruses. Bacterial‐induced gingivitis may facilitate herpesvirus colonization of the periodontium, and herpesvirus infections may impede the antibacterial host defense and alter periodontal cells to predispose for bacterial adherence and invasion. Herpesvirus‐bacteria synergistic interactions, are likely to comprise an important pathogenic determinant of aggressive periodontitis. However, mechanistic investigations into the molecular and cellular interaction between periodontal herpesviruses and bacteria are still scarce. Herpesvirus‐bacteria coinfection studies may yield significant new discoveries of pathogenic determinants, and drug and vaccine targets to minimize or prevent periodontitis and periodontitis‐related systemic diseases.
Genomics of periodontal disease and tooth morbidity
Authors: Morelli Thiago , Agler Cary S. , Divaris Kimon
Published: December 2019

In this review we critically summarize the evidence base and the progress to date regarding the genomic basis of periodontal disease and tooth morbidity (ie, dental caries and tooth loss), and discuss future applications and research directions in the context of precision oral health and care. Evidence for these oral/dental traits from genome‐wide association studies first emerged less than a decade ago. Basic and translational research activities in this domain are now under way by multiple groups around the world. Key departure points in the oral health genomics discourse are: (a) some heritable variation exists for periodontal and dental diseases; (b) the environmental component (eg, social determinants of health and behavioral risk factors) has a major influence on the population distribution but probably interacts with factors of innate susceptibility at the person‐level; (c) sizeable, multi‐ethnic, well‐characterized samples or cohorts with high‐quality measures on oral health outcomes and genomics information are required to make decisive discoveries; (d) challenges remain in the measurement of oral health and disease, with current periodontitis and dental caries traits capturing only a part of the health‐disease continuum, and are little or not informed by the underlying biology; (e) the substantial individual heterogeneity that exists in the clinical presentation and lifetime trajectory of oral disease can be identified and leveraged in a precision medicine framework or, if unappreciated, can hamper translational efforts. In this review we discuss how composite or biologically informed traits may offer improvements over clinically defined ones for the genomic interrogation of oral diseases. We demonstrate the utility of the results of genome‐wide association studies for the development and testing of a genetic risk score for severe periodontitis. We conclude that exciting opportunities lie ahead for improvements in the oral health of individual patients and populations via advances in our understanding of the genomic basis of oral health and disease. The pace of new discoveries and their equitable translation to practice will largely depend on investments in the education and training of the oral health care workforce, basic and population research, and sustained collaborative efforts..
The Impact of Leaving Camps on Well‐being of Internally Displaced Persons in Northern Uganda
Authors: Tseng Fu‐Min , McPake Barbara , Edoka Ijeoma
Published: December 2019

The armed conflict in Northern Uganda led to a large number of internally displaced persons (IDPs). After the government announced the declaration of free movement on 30 October 2006, a large number of IDPs left camps. Transition from camp life to post‐camp life has important implications for population well‐being. This paper uses the Ugandan National Household Survey conducted in 2005‐2006 and 2009‐2010 and a difference‐in‐differences method to estimate changes in IDPs' well‐being measured by self‐reported heath as well as household food consumption. We do not find a significant effect of leaving camps on self‐reported illness and household food consumption but we find a significant effect on the choice of healthcare providers utilised. The postcamp effect was estimated to increase the use of non‐free health providers, an effect composed of more visits to informal providers and greater choice of formal private providers, when formal providers are utilised. Those findings shed light on policy‐relevant issues in the areas of land rights, recovery of public health systems and gender inequalities in well‐being.
A dynamic model for double‐bounded time series with chaotic‐driven conditional averages
Authors: Pumi Guilherme , Prass Taiane Schaedler , Souza Rafael Rigão
Published: December 2019

In this work, we introduce a class of dynamic models for time series taking values on the unit interval. The proposed model follows a generalized linear model approach where the random component, conditioned on the past information, follows a beta distribution, while the conditional mean specification may include covariates and also an extra additive term given by the iteration of a map that can present chaotic behavior. The resulting model is very flexible and its systematic component can accommodate short‐ and long‐range dependence, periodic behavior, laminar phases, etc. We derive easily verifiable conditions for the stationarity of the proposed model, as well as conditions for the law of large numbers and a Birkhoff‐type theorem to hold. A Monte Carlo simulation study is performed to assess the finite sample behavior of the partial maximum likelihood approach for parameter estimation in the proposed model. Finally, an application to the proportion of stored hydroelectrical energy in Southern Brazil is presented.