bluuebunny/crossref_metadata_2025 huggingface dataset:
Chloroplast phylogenomics of liverworts: a reappraisal of the backbone phylogeny of liverworts with emphasis on Ptilidiales
Authors: Yu Ying , Yang Jun‐Bo , Ma Wen‐Zhang , Pressel Silvia , Liu Hong‐Mei , Wu Yu‐Huan , Schneider Harald
Published: July 2019

As one of the four main lineages diverging from the early diversification of land plants, the phylogeny of liverworts holds the information about nearly 500 Myr of independent adaptation to changing environments. Thus, resolving the phylogenetic history of liverworts will provide unique insights into the successful diversification of early land plants in terrestrial ecosystems. However, the deep diverging events of this group remain incompletely resolved, such as the definite position of Ptilidiales. Here, we aimed to reconstruct the backbone relationships of liverworts using 84 protein‐coding chloroplast genes, a dataset comprising 35 representatives from all major lineages of liverworts, and three phylogenetic analyses, namely maximum parsimony, maximum likelihood and Bayesian inference. To test the impact of composition biases, the phylogenetic analyses were carried out using three alignments representing the same dataset either as: (i) nucleotides, (ii) amino acids, or (iii) recoded nucleotides applying ambiguity base code. Chloroplast genome data consistently supported the monophyletic origin of three major lineages in liverworts, as well as the majority of backbone relationships. Ptilidiales were found to be sister to Jungermanniales. The rapid accumulation of G/C tracks as a consequence of increased GC content is an important cause for the long branches inferred in this group. Our study not only provides empirical evidence to support the significance of plastid genome sequencing to reconstruct the phylogeny of this important plant lineage, but also suggests that the GC content has played a critical role in the evolutionary dynamics of plastid genomes in land plants.
The accuracy of computer‐guided implant surgery with tooth‐supported, digitally designed drill guides based on CBCT and intraoral scanning. A prospective cohort study
Authors: Derksen Wiebe , Wismeijer Daniel , Flügge Tabea , Hassan Bassam , Tahmaseb Ali
Published: July 2019

Objectives

The purpose of this prospective cohort study was to evaluate computer‐guided implant surgery with tooth‐supported drill guides based on CBCT scans and intraoral scanning.

Materials and methods

For partially edentulous patients, a prosthetic and surgical planning was completed in the guided surgery software (coDiagnostiX) and drill guides were 3D‐printed accordingly. Three months after implant placement, an intraoral scan of the implant's position was used to evaluate the accuracy of placement using the coDiagnostiX treatment evaluation tool. Deviations were reported in degrees and in distance at implant's entry point and apex. Several risk factors, which might influence the accuracy, were evaluated separately: treated jaw, flap design, prior augmentations, amount of unrestored teeth, crowding, location of implants, cortical interference, and implant's length and diameter.

Results

A total of 66 patients received 145 Straumann tissue level implants that were eligible for accuracy analysis. The mean angular deviation was 2.72° ± 1.42. The mean three‐dimensional deviation at the implant's entry point was 0.75 mm ± 0.34. At implant's apex, the mean was 1.06 mm ± 0.44. The amount of unrestored teeth (p = .002 & p = .003), the implant's location (p < .001), the implant's length (p = .004), and cortical interference (p = .033) had a significant influence on the accuracy of placement. Implant survival was 99.3% (n = 1 failed implant) at 12 and 24 months.

Conclusions

Guided surgery with tooth‐supported drill guides made in a digital workflow is a feasible treatment option. However, deviations do occur and the implant's length, location, cortical interference and the amount of unrestored teeth have a significant influence on the accuracy.
Stance detection and mobile app recommendation discourse on tweets
Authors: R Muthusami , A Bharathi
Published: July 2019

Web‐based social networking such as microblogging administrations and long‐range informal communication locales are changing the way in which individuals collaborate on the web and search for data and opinions. An essential parameter of online networking discourse is searchability. A key semiotic asset supporting this capacity is the hashtag, a type of social label that enables microbloggers to insert metadata in online networking posts. In this paper, an attempt is made to analyze stance detection and app recommendation discourse on tweets in view of hashtag techniques, which is in the territory of etymology, and to spotlight the structure of dialect at the provision level. With a revival of enthusiasm for topics identified by modeling language at the discourse level, a graphical model of conversational structure (ie, the structural topic model) has been constructed by means of utilizing three methods: displaying words connected with topics or documents highly connected with topics, calculating topic correlations, and assessing associations between metadata and topical content, its capture of latent topics, and topical structures inside documents on a benchmark dataset (ie, SemEval 2016) has been scrutinized for stance detection, and data have been crawled from Twitter, using the hashtag #App for app recommendations.
Clinical Trial in a Dish: Personalized Stem Cell–Derived Cardiomyocyte Assay Compared With Clinical Trial Results for Two QT‐Prolonging Drugs
Authors: Blinova Ksenia , Schocken Derek , Patel Dakshesh , Daluwatte Chathuri , Vicente Jose , Wu Joseph C. , Strauss David G.
Published: July 2019

Induced pluripotent stem cells (iPSCs) have shown promise in investigating donor‐specific phenotypes and pathologies. The iPSC‐derived cardiomyocytes (iPSC‐CMs) could potentially be utilized in personalized cardiotoxicity studies, assessing individual proarrhythmic risk. However, it is unclear how closely iPSC‐CMs derived from healthy subjects can recapitulate a range of responses to drugs. It is well known that QT‐prolonging drugs induce subject‐specific clinical response and that all healthy subjects do not necessarily develop arrhythmias or exhibit similar amounts of QT prolongation. We previously reported this variability in a study of four human ether‐a‐go‐go‐related gene (hERG) potassium channel–blocking drugs in which each subject underwent intensive pharmacokinetic and pharmacodynamic sampling such that subjects had 15 time‐matched plasma drug concentration and electrocardiogram measurements throughout 24 hours after dosing in a phase I clinical research unit. In this study, iPSC‐CMs were generated from those subjects. Their drug‐concentration‐dependent QT prolongation response from the clinic was compared with in vitro drug‐concentration‐dependent action potential duration (APD) prolongation response to the same two hERG‐blocking drugs, dofetilide and moxifloxacin. Comparative results showed no significant correlation between the subject‐specific APD response slopes and clinical QT response slopes to either moxifloxacin (P = 0.75) or dofetilide (P = 0.69). Similarly, no significant correlation was found between baseline QT and baseline APD measurements (P = 0.93). This result advances our current understanding of subject‐specific iPSC‐CMs and facilitates discussion into factors obscuring correlation and considerations for future studies of subject‐specific phenotypes in iPSC‐CMs.
Cutaneous spindle cell adenolipoma with eccrine and apocrine differentiation
Authors: Farah Maya , Chung Hye Jin
Published: July 2019

Cutaneous spindle cell adenolipoma (SCAL) is a recently described rare variant of lipoma with 11 cases reported to date. Here we report a consultation case of a 77‐year‐old male who presented with a nodule on the right nasolabial fold, diagnosed as apocrine fibroadenoma or sebaceous hyperplasia by an outside pathologist. The specimen revealed an ill‐defined dermal tumor composed of mature adipocytes, bland spindle cells, ropey collagen, and dilated eccrine and apocrine glands and ducts in a fibromyxoid stroma. The spindle cells were positive for CD34 and negative for S100 protein and SOX10. These findings are consistent with those of cutaneous SCAL. The pathogenesis of this entity is controversial and includes a hamartomatous process, derivation from adipose tissue surrounding eccrine glands, or preexisting glands entrapment within a growing lipoma. In the present case, the glandular component is extensive and includes both eccrine and apocrine differentiation, which has not been previously described and further supports the hamartomatous nature. Awareness of this rare entity is helpful to prevent confusion with other look‐alike primary and metastatic cutaneous lesions.
A Muslim response to the ELCA document
Authors: Salem Feryal
Published: July 2019

This piece offers a Muslim perspective on the new interreligious engagement statement from the Evangelical Lutheran Church in America (ELCA).
Revisiting interreligious relations: The convergence of global context and ecclesial developments
Authors: Makari Peter E.
Published: July 2019

Following the important work of the 1980s and 1990s by the US churches and ecumenical bodies in developing interfaith statements and policies, significant events in both the US and international arenas were coincidental and motivational for US Christians to reconsider their interreligious engagement in a new context. This article examines the major contextual factors, as well as ecumenical developments with particular attention to the United Church of Christ and the National Council of Churches, which also will consider new statements in 2019.
Asymmetrical interspecific communication of predatory threat in mixed‐species colonies of lesser kestrels (Falco naumanni) and jackdaws (Corvus monedula)
Authors: Hare James F. , Sarà Maurizio , Hare Alexander J. , Campobello Daniela
Published: July 2019

Sympatric species derive benefits by attending to information conveyed by heterospecifics. Our previous finding of reduced vigilance among jackdaws and lesser kestrels residing in mixed‐species colonies suggested a reliance on interspecific communication of information regarding predatory threats. To test for interspecific communication of threat, we first determined whether jackdaw and lesser kestrel call structure varied with perceived threat. In this call production phase of our study, free‐living birds in mixed‐species colonies were presented with models representing a potential nest predator (European magpie) or with non‐threatening stimuli (wood pigeon or wooden dowel) in proximity to nests. We recorded and subsequently analysed those calls to determine if any temporal or frequency‐related call parameters differed by model type. In a second, perceptual phase of our study, we tested whether receivers perceive threat‐related variation in both conspecific and heterospecific call structure by playing back call exemplars recorded in response to the predator model or to innocuous control stimuli, to determine whether free‐living jackdaws or lesser kestrels respond differentially to playbacks of the different call types. We detected differences in vocalizations of both jackdaws and lesser kestrels relative to the model type presented, with more broadband (lesser kestrel) or noisy calls (jackdaws) in response to magpie versus innocuous model types. We also detected differential behavioural responses to call playbacks, with both jackdaws and lesser kestrels increasing vigilance and alarm calling in response to magpie‐elicited jackdaw calls, but not to other call types. Taken together, our results suggest that jackdaw, but not lesser kestrel vocalizations, communicate enhanced threat associated with European magpies as possible nest predators. This interspecific alarm communication benefits both jackdaws and lesser kestrels, and, at least in part, explains asymmetric responses of jackdaws and lesser kestrels to magpies attending mixed‐species colonies in nature.
Presenting health and medical geography: People, places, and change
Authors: Moon Graham , Sabel Clive
Published: July 2019

Assessments of the development of geography as a discipline, and studies of sub‐disciplinary development within geography, have generally focused on the subject matter under study. Consideration has concentrated on topics, theories, methods, and paradigm shifts identified by analyses of published literature. There has been rather less interest in the spatialisation of the practice and performance of the discipline by people and institutions (though there have been exceptions) and equally little attention to the evidence provided by geographical conferences. We address these lacunae in current knowledge through a quantitative study of changing disciplinary endeavour in health geography as evidenced by participation in the International Medical Geography Symposia. For 35 years this biennial meeting has been the flagship conference for health and medical geographers. We have obtained, reviewed, and coded the proceedings of all 17 symposia, analysing the submitted papers by location of symposia, lead authorship, affiliation, and country of authorship. We investigate the globalisation of the sub‐discipline and changes in key institutional involvement. Novel network analysis methods are used to identify changing linkages between research centres. What emerges is a complex sub‐discipline driven by the changing neoliberal context of higher education and marked by both continuities and discontinuities in its practitioner networks.
Effect of maturity stage at harvest on the ensilability of maize hybrids in the early and late FAO classes, grown in areas differing in yield potential
Authors: Marchesini Giorgio , Serva Lorenzo , Chinello Maria , Gazziero Matteo , Tenti Sandro , Mirisola Massimo , Garbin Elisabetta , Contiero Barbara , Grandis Daniel , Andrighetto Igino
Published: July 2019

The aim of this study was to assess the effects of earliness (according to FAO class), maturity stage at harvest and environmental conditions on the ensilability of maize hybrids described by their fermentation products and by a fermentation quality index (FQI). Maize hybrids belonging to early (n = 14) and late (n = 15) FAO classes were grown in low, medium and high potential yield areas and harvested at an early (EH), medium (MH) and late maturity stage (LH), that is, at 1/3, 2/3 and 5 d after the 2/3 milk line stage, respectively, according to a split‐plot design. Upon harvest, each sample (n = 522) was analysed for dry matter (DM) and water‐soluble carbohydrates (WSC) before being ensiled in vacuum‐packed bags (n = 1,044). After 60 days of conservation, samples were analysed for DM and fermentation products. In the pre‐ensiling phase, DM was higher in early hybrids (p = .001), low yield areas (p < .001) and at LH maturity (p < .001), whereas WSC contents were higher in early hybrids (p < .001), medium yield areas (p < .001) and at EH maturity (p < .001). With regard to silages, early hybrids had a higher FQI (p < .001), which was highest in areas with a high yield potential (p < .01) and at EH maturity (p < .01). Late hybrids proved to be better suited for low yield areas compared with early hybrids (p < .01) and had a higher FQI at EH and MH than at LH maturity (p < .01).
Beliefs about medicines as mediators in medication adherence in type 2 diabetes
Authors: Pereira Maria da Graça , Ferreira Gabriela , Machado José C. , Pedras Susana
Published: July 2019

Aims

This study analysed whether beliefs about medicines mediated the relationship between illness representations and medication adherence.

Background

Adherence to medication is required in diabetes treatment, contributing to decreased blood glycaemic levels. The knowledge and perception of patients about diabetes as well as the beliefs about medicines are considered to be key factors for medication adherence.

Design

The study used a cross‐sectional design that included 387 patients recently diagnosed with type 2 diabetes.

Methods

Participants were assessed, between 2010 and 2013, and answered the Medication Adherence Scale, the Beliefs about Medicines Questionnaire, and the Brief Illness Perception Questionnaire.

Results

The results of the path analysis showed that beliefs about medicines had a mediating role on self‐report medication adherence with the exception of beliefs about specific concerns with medicines. Therefore, both general beliefs and specific needs about medicines mediated the relationship between diabetes consequences and self‐report medication adherence as well as between treatment control and self‐report medication adherence. Needs about medicines mediated the relationship between personal control and self‐report medication adherence.

Conclusion

Health professionals should target beliefs about medicines besides illness representations regarding medication adherence. The current study may help optimize adherence to medication in early‐diagnosed type 2 diabetes patients.
Distribution‐free Approximate Methods for Constructing Confidence Intervals for Quantiles
Authors: Nagaraja Chaitra H. , Nagaraja Haikady N.
Published: July 2019

Quantile estimation is important for a wide range of applications. While point estimates based on one or two order statistics are common, constructing confidence intervals around them, however, is a more difficult problem. This paper has two goals. First, it surveys the numerous distribution‐free methods for constructing approximate confidence intervals for quantiles. These techniques can be divided roughly into four categories: using a pivotal quantity, resampling, interpolation, and empirical likelihood methods. Second, a method based on the pivotal quantity that has received limited attention in the past is extended. Comprehensive simulation studies are used to compare performance across methods. The proposed method is simple and performs similarly to linear interpolation methods and a smoothed empirical likelihood method. While the proposed method has slightly wider interval widths, it can be calculated for more extreme quantiles even when there are few observations.
The early stress response of maize (Zea mays L.) to chloride salinity
Authors: Zhang Xudong , Zörb Christian , Kränzlein Markus , Franzisky Bastian L. , Kaiser Hartmut , Geilfus Christoph‐Martin
Published: July 2019

Chloride is a micronutrient required for photosynthesis but when applied in the concentration of a macronutrient, it may also promote growth by regulating turgor. However, if chloride accumulates excessively, it can induce toxicity. The aim of this study was to identify physiological dysfunctions in maize (Zea mays L.) that arise in response to excessive chloride ion accumulation. For this, a novel water sensor was employed for the first time allowing the in vivo measurement of water content in the plant by using two near IR‐wavelengths with different absorption of water. This enabled to analyse whether water imbalances occurred. Chloride was given together with calcium as companying counter cation. Results show that most of the tested maize genotypes were able to maintain growth, photosynthesis and normal water content when stressed with concentrations as high as 757.1 mg chloride/kg soil dry matter. Leaf blades accumulated only 8.5 mg chloride/g dry matter, with the most genotypes not even showing salt stress necrosis at the leaves. A comparison between more tolerant and more sensitive genotypes revealed that restriction of chloride root‐to‐shoot translocation is a trait of chloride tolerance.
Subclinical atrial fibrillation detection with a floating atrial sensing dipole in single lead implantable cardioverter‐defibrillator systems: Results of the SENSE trial
Authors: Thomas George , Choi Daniel Y. , Doppalapudi Harish , Richards Mark , Iwai Sei , Daoud Emile G. , Houmsse Mahmoud , Kanagasundram Arvindh N. , Mainigi Sumeet K. , Lubitz Steven A. , Cheung Jim W.
Published: July 2019

Introduction

Subclinical atrial fibrillation (AF), in the form of cardiac implantable device‐detected atrial high rate episodes (AHREs), has been associated with increased thromboembolism. An implantable cardioverter‐defibrillator (ICD) lead with a floating atrial dipole may permit a single lead (DX) ICD system to detect AHREs. We sought to assess the utility of the DX ICD system for subclinical AF detection in patients, with a prospective multicenter, cohort‐controlled trial.

Methods and Results

One hundred fifty patients without prior history of AF (age 59 ± 13 years; 108 [72%] male) were enrolled into the DX cohort and implanted with a Biotronik DX ICD system at eight centers. Age‐, sex‐, and left ventricular ejection fraction‐matched single‐ and dual‐chamber ICD cohorts were derived from a Cornell database and from the IMPACT trial, respectively. The primary endpoint were AHRE detection at 12 months. During median 12 months follow‐up, AHREs were detected in 19 (13%) patients in the DX, 8 (5.3%) in the single‐chamber, and 19 (13%) in the dual‐chamber cohorts. The rate of AHRE detection was significantly higher in the DX cohort compared to the single‐chamber cohort (P = .026), but not significantly different compared to the dual‐chamber cohort. There were no inappropriate ICD therapies in the DX cohort. At 12 months, only 3.0% of patients in the DX cohort had sensed atrial amplitudes less than 1.0 mV.

Conclusion

Use of a DX ICD lead allows subclinical AF detection with a single lead DX system that is superior to that of a conventional single‐chamber ICD system.
Regional abnormalities on cardiac magnetic resonance imaging and arrhythmic events in patients with cardiac sarcoidosis
Authors: Okada David R. , Xie Eric , Assis Fabrizio , Smith John , Derakhshan Arsalan , Gowani Zain , Ambale‐Venkatesh Bharath , Gilotra Nisha A. , Zimmerman Stefan L. , Berger Ronald D. , Calkins Hugh , Lima Joao A. C. , Tandri Harikrishna , Chrispin Jonathan
Published: July 2019

Background

Patients with cardiac sarcoidosis (CS) may present with arrhythmic events (AE): atrioventricular block (AVB) and/ or ventricular arrhythmias (VA). We sought to: (a) use regional analysis of cardiac magnetic resonance imaging (CMR) to describe anatomic and functional phenotypes of patients with CS and AE; (b) Assess the association of regional CMR abnormalities with the combined endpoint of death, heart transplantation (HT) and AE; and (c) use machine learning (ML) to predict the combined endpoint based on CMR features.

Methods

we included 76 patients with CS and CMR. We analyzed cine images to determine regional longitudinal (LS) and radial strain (RS); and late gadolinium enhancement imaging to determine regional scar burden (%scar).

Results

Patients with AVB (n = 7), compared with those without, had higher %scar in the anterior (21.8 ± 27.4 vs 5.1 ± 8.9; P = 0.0005) and anteroseptal (19.3 ± 24.5 vs 3.5 ± 5.5; P < .0001) walls. Patients with VA (n = 12), compared with those without, had higher %scar in the basal inferoseptum (20.4 ± 30.8 vs 8.3 ± 13.4; P = .03). During mean follow‐up of 4.4 ± 3.3 years, four patients died or underwent HT; eight had VA; and zero developed AVB. Multiple regional abnormalities were associated with the combined endpoint, including scar in the anteroseptal wall (HR 1.06 [1.02‐1.09] per 1%scar increase, P = .002). The ML algorithm predicted the combined endpoint with a C‐statistic of 0.91.

Conclusion

Regional CMR abnormalities are associated with AE in patients with CS.
Regulatory T cells protected against abdominal aortic aneurysm by suppression of the COX‐2 expression
Authors: Liu Bin , Kong Jing , An Guipeng , Zhang Kai , Qin Weidong , Meng Xiao
Published: July 2019

CD4+CD25+ regulatory T cells (Tregs) have been shown to protect against the development of abdominal aortic aneurysm (AAA). Cyclooxygenase‐2 (COX‐2), a pro‐inflammatory protein, can convert arachidonic acid into prostaglandins (PGs). The present study was aimed to investigate the effect of Tregs on COX‐2 expression in angiotension II (Ang II)‐induced AAA in ApoE−/− mice. Tregs were injected via tail vein in every 2 weeks. Ang II was continuously infused by a micropump for 28 days to induce AAA. In vivo, compared with the control group, adoptive transfer of Tregs significantly reduced the incidence of AAA, maximal diameter, and the mRNA and protein expression of COX‐2 in mice. Immunofluorescence showed that Tregs treatment reduced COX‐2 expression both in smooth muscle cells (SMCs) and macrophages in AAA. In vitro, the Western blot analysis showed that Tregs reduced Ang II‐induced COX‐2 expression in macrophages and SMCs. Meanwhile, ELISA showed that Tregs reduced Ang II‐induced prostaglandin E2 (PGE2) secretion. Moreover, Tregs increased SMC viability and induced transition of macrophages phenotype from M1 to M2. In conclusion, Tregs treatment dramatically decreased the expression of COX‐2 in vivo and in vitro, suggesting that Tregs could protect against AAA through inhibition of COX‐2. The study may shed light on the immune treatment of AAA.
Combined bivalent human papillomavirus vaccine and Candida antigen versus Candida antigen alone in the treatment of recalcitrant warts
Authors: Marei Ayman , Nofal Ahmad , Alakad Rania , Abdel‐Hady Amina
Published: July 2019

Background

The burden of human papillomavirus (HPV) infection and HPV‐associated diseases is consistently growing worldwide. Several combination therapies are being tested nowadays for the treatment of recalcitrant warts, with promising results.

Aims

To evaluate the potential therapeutic role of combined bivalent HPV vaccine (Cervarix) and Candida antigen versus candida antigen alone in the treatment of multiple recalcitrant warts.

Patients/Methods

Forty patients with recalcitrant warts were enrolled into this study. They were divided into two groups (A and B), each including 20 patients. Patients in the group (A) received intralesional Candida antigen injection alone for five sessions at 2‐week intervals. Patients in the group B received combined treatment of bivalent recombinant HPV vaccine and intralesional Candida antigen. Candida antigen was administered as in the group A, while Cervarix vaccine was given intramuscularly at 0, 1, and 6 months as scheduled. Follow‐up was made monthly for 6 months to detect any possible recurrence.

Results

Eight patients (40%) in the group (A) showed complete clearance of warts after intralesional Candida antigen injection alone, while 14 patients (70%) in the group (B) showed complete regression of warts after the combined therapy. No significant side effects were reported in both groups, and no recurrence was detected.

Conclusion

Bivalent human papillomavirus vaccine combined with Candida antigen is a promising, effective, and safe modality for the treatment of multiple recalcitrant warts.
Successful treatment of late‐onset nevus comedonicus with Er:YAG laser
Authors: Aktaş Karabay Ezgi , Yapıcıer Özlem
Published: July 2019

Nevus comedonicus, a rare congenital hamartoma of the pilosebaceous unit, is characterized by keratotic plugging. It usually occurs after birth and during early childhood. It rarely appears in adulthood. Despite the benign nature of the condition, it usually requires treatment due to aesthetic reasons. Several treatments have been reported in nevus comedonicus, most of them resulting with recurrences. Here, we report a case of nevus comedonicus with adult onset, successfully treated with erbium‐doped yttrium aluminum garnet (Er:YAG) laser therapy.
Burden on parents of children with haemophilia: The impact of sociodemographic and child's medical condition
Authors: Myrin Westesson Linda , Sparud‐Lundin Carina , Baghaei Fariba , Khair Kate , von Mackensen Sylvia , Acuña Mora Mariela , Wallengren Catarina
Published: July 2019

Aims and objectives

To describe the perceived burden on parents of children with severe or moderate haemophilia and the impact of sociodemographic aspects and the child's medical condition on this.

Background

Parents of children with haemophilia face a multitude of demands. The child needs frequent intravenous injections, hospital visits, extra supervision and care. The child's illness and related management might have psychosocial effects on the parents.

Design

A multicentre, cross‐sectional study.

Methods

Caregiver burden was evaluated in 102 parents of children with haemophilia, using the HEMOCAB questionnaire which consists of 54 items divided into 13 domains which are to be answered on a 5‐point Likert scale. To assess the impact of sociodemographic aspects and clinical data on parental burden, linear regression analyses were undertaken. The study followed the STROBE checklist throughout the research process.

Results

Greater burden was seen in parents of children with past or present inhibitors, in parents of younger children, if a family member administered the clotting factor and in parents of children with overweight/obesity. No significant differences in burden were observed for type of haemophilia, if the child had bleeding in the past 12 months, if the child self‐infused, had another family member with haemophilia or if the parent had more children.

Conclusions

Parental perceived burden can be negatively affected by the child's medical condition; our results underline that healthcare professionals need to be aware of increased parental burden if the child is young, has or had inhibitors and has overweight/obesity.

Relevance to clinical practice

More psychosocial support from the healthcare professionals needs to be directed towards parents of younger children and particularly the parents of young children with inhibitors, thus decreasing the parental burden. Parental burden may be reduced if healthcare professionals more actively treat overweight and refer children to appropriate specialists.
Telemedicine in specialised palliative care: Healthcare professionals' and their perspectives on video consultations—A qualitative study
Authors: Funderskov Karen Frydenrejn , Boe Danbjørg Dorthe , Jess Mia , Munk Lene , Olsen Zwisler Ann‐Dorthe , Dieperink Karin B.
Published: July 2019

Aims and objectives

To explore the advantages and disadvantages of using video consultations, as experienced by specialised palliative care healthcare professionals, who are involved in palliative care at home.

Background

One challenge in the work of specialised palliative care teams is the substantial resources used in terms of time and transport to and from the patient's home. Video consultations may be a solution for real‐time specialised palliative home care.

Designs

Hermeneutic, postphenomenology.

Methods

An explorative qualitative study utilising data from field notes of an autobiographical diary, participant observations and semi‐structured interviews with healthcare professionals. The COREQ guideline was used for reporting the study. See Appendix S1. The data collection took place in patients' homes and at the Department of Oncology, Odense University Hospital, Denmark.

Results

Eight participants (n = 8); five community nurses; and three specialised palliative care team members—a head physician, a physiotherapist and a nurse—participated in the study. The healthcare professionals' knowledge was based on n = 82 video consultations with 11 patients. The range of video consultations was 3–18 per patient. The use of tablets in video consultations facilitated direct palliative care and led the community nurses and the specialised palliative care team nurse to co‐operate. Potential barriers against using video consultations are the discussions about personal, and private issues regarding the illness, while family members are present.

Conclusions

Video consultations in specialised palliative home care are feasible, and the technology can facilitate multidisciplinary participation and co‐operation among healthcare professionals. The continuous use of video consultations over time may increase the quality of specialised palliative home care.

Relevance to clinical practice

The use of video consultations can provide direct specialised palliative care over distance involving healthcare professionals, patients and their relatives.
Where cities fail to triumph: The impact of urban location and local collaboration on innovation in Norway
Authors: Fitjar Rune D. , Rodríguez‐Pose Andrés
Published: July 2019

The role of cities in fostering innovation has for long been taken for granted. Agglomeration and the knowledge spillovers generated in dense urban environments have been considered fundamental drivers of innovation. This view has, however, become challenged by research questioning the returns to physical agglomeration and local networking, placing instead more emphasis on the importance of interregional and international collaboration, and on innovation in peripheral regions. This paper delves into the debate on the role of cities for innovation by examining the interplay between urban location and local collaboration in Norway. It uses data from the Community Innovation Survey for 2006–2010 to map out the geographical dimension of R&D collaboration in Norwegian firms with a view to assessing whether different types of R&D collaboration in urban and rural locations affect firms’ propensity to innovate. The results show that local collaboration is associated with increased process and organisational innovation, while it does not produce higher levels of product or marketing innovation. Conversely, international collaboration is connected with higher probabilities of product, new‐to‐market and marketing innovations. Furthermore, location in urban or rural areas makes no difference for most innovation outcomes in Norway when other characteristics are controlled for. Location in cities also does not shape the returns to local R&D collaboration. Hence, the role of cities for innovation in Norway, whether in themselves or as sites for dense local interaction, is less relevant than the urban innovation literature would predict.
Efficacy and safety of applying a neonatal early‐onset sepsis risk calculator in China
Authors: He Yi , Chen Jie , Liu Zhenqiu , Yu Jialin
Published: July 2019

Aim

To evaluate and compare the performance of the early‐onset sepsis (EOS) risk calculator with procalcitonin (PCT), complete blood count (CBC) and C‐reactive protein (CRP) for predicting neonatal EOS.

Methods

This was a retrospective case–control study of neonates who were ≥34 weeks of gestation and ≤12 h of age at admission to our hospital between January 2017 and December 2018. Neonates with strictly defined EOS and those without evidence of infection were included in this study. We reviewed and collected the laboratory data and medical charts of the included neonates. The EOS risk scores for all neonates were calculated using the EOS risk calculator, and the results were analysed and compared with blood biomarkers.

Results

A total of 501 neonates, including 353 infected and 148 uninfected infants, met the inclusion criteria for the study. Comparing these predictors, PCT had the best predictive value (sensitivity: 87.5%, specificity: 95.5%), closely followed by the EOS risk calculator (sensitivity: 81.16%, specificity: 93.92%). Multivariate logistic regression found that risk scores calculated by the EOS risk calculator had strong associations with EOS as an independent risk factor (odds ratio: 57.37, P < 0.05). The combination of the EOS risk calculator, PCT, CBC and CRP could increase the predictive value of the model and reach an area under the receiver operating characteristic curve of 0.987 for predicting EOS.

Conclusions

In this pilot study, applying the EOS calculator in China, the EOS risk calculator and PCT showed good predictive value compared to CBC and CRP. Risk scores from the EOS risk calculator strongly correlated with EOS, and the EOS risk calculator offered increased predictive value when used in combination with blood biomarkers.
Oral supplementation with p‐coumaric acid protects mice against diabetes‐associated spontaneous destruction of periodontal tissue
Authors: Bhattarai Govinda , Min Chang‐Ki , Jeon Young‐Mi , Bashyal Rajendra , Poudel Sher B. , Kook Sung‐Ho , Lee Jeong‐Chae
Published: July 2019

Objective

Dietary bioactive materials having anti‐inflammatory and antioxidant potentials are able to inhibit diabetes‐associated periodontal complications. Although numerous studies indicate that administration of p‐coumaric acid (p‐CA) ameliorates diabetes and diabetes‐related complications, the roles of p‐CA on periodontal tissue destruction in diabetic mice and the possible mechanisms therein are not completely understood. In this study, we evaluated whether supplementation with p‐CA protects mice against diabetes‐associated spontaneous periodontal destruction and also explored the associated mechanism therein using in vivo and in vitro experimental systems.

Materials and Methods

C57BL/6 male mice were divided into sham, streptozotocin (STZ), and STZ+CA groups (n = 5/group). Sham group was intraperitoneally injected with sodium buffer, whereas other two groups were injected with the buffer containing 160 mg/kg of STZ. STZ‐induced diabetic mice received oral gavage with p‐CA (50 mg/kg) (STZ+CA group) or with buffer only (STZ group) daily for 6 weeks. The effect of p‐CA on diabetes‐associated spontaneous periodontal destruction was evaluated using μCT analysis, hematoxylin and eosin staining, tartrate‐resistant acid phosphatase staining, and immunohistochemical staining methods. The efficacies of p‐CA on cell proliferation, osteoblast differentiation, reactive oxygen species (ROS) accumulation, and antioxidant‐related marker expression were examined using human periodontal ligament fibroblasts (hPLFs) cultured under high glucose condition.

Results

Streptozotocin group exhibited periodontal tissue destruction along with increased inflammation, oxidative stress, and osteoclast formation, as well as with decreased osteogenesis. However, oral administration with p‐CA protected mice against STZ‐induced periodontal destruction by inhibiting inflammation and osteoclastic activation. STZ+CA group also showed higher expression of antioxidant and osteogenic markers in periodontal tissue than did STZ group. Treatment with high glucose concentration (30 mmol/L) impaired proliferation and osteoblast differentiation of hPLFs along with cellular ROS accumulation, whereas these impairments were almost completely disappeared by supplementation with p‐CA.

Conclusion

These findings demonstrate that supplementation with p‐CA inhibits diabetes‐associated spontaneous destruction of periodontal tissue by enhancing anti‐inflammatory, anti‐osteoclastogenic, and antioxidant defense systems in STZ‐treated mice.
Morphological variation pattern ofAquilegia ecalcarataand its relatives
Authors: Xue Cheng , Geng Fang‐Dong , Zhang Xiao‐Yan , Chang Xiao‐Peng , Kang Ju‐Qing , Huang Lei , Zhang Jian‐Qiang , Ren Yi
Published: July 2019

Aquilegia ecalcarataMaxim. is the only spurless species within the genusAquilegiaand comprises a monophyletic clade withA.yabeanaKitag.,A.kansuensisBrühl, andA.rockiiMunz. Our previous study on the genetic diversity of those four species revealed that the populations ofA. ecalcaratacan be divided into two groups, indicating possible genetic difference withinA.ecalcarata. However, it is not clear whether the genetic difference is related to the morphological variation among species and groups ofA. ecalcaratapopulations. To answer that question, the morphological variation patterns based on 22 floral and 19 vegetative traits from 42 populations, covering the entire distribution ofA. ecalcarataand its relatives, were analyzed in the present study. The result showed that: (i) the differences among the four species were reflected in the floral rather than the vegetative traits; (ii) populations ofA. yabeanaandA.rockiifell into one cluster each, and each of the six clusters occupied its own distribution range; (iii) one of twoA. ecalcarataclusters fell into a subgroup and shared common floral traits withA. rockii; (iv) the individuals ofA.ecalcarataform.ecalcarataand form.semicalcaratawere often mixed in the same population; and (v) the populations ofA. kansuensiswere split into two clusters, which differed obviously in floral traits. These results will provide an important morphological basis for the redefinition of species and lay a foundation for the further exploration of the “spurless”A. ecalcarata.
Potassium isotopic compositions of enstatite meteorites
Authors: Zhao Chen , Lodders Katharina , Bloom Hannah , Chen Heng , Tian Zhen , Koefoed Piers , Pető Mária K. , Wang (王昆) Kun
Published: July 2019

Enstatite chondrites and aubrites are meteorites that show the closest similarities to the Earth in many isotope systems that undergo mass‐independent and mass‐dependent isotopic fractionations. Due to the analytical challenges to obtain high‐precision K isotopic compositions in the past, potential differences in K isotopic compositions between enstatite meteorites and the Earth remained uncertain. We report the first high‐precision K isotopic compositions of eight enstatite chondrites and four aubrites and find that there is a significant variation of K isotopic compositions among enstatite meteorites (from −2.34‰ to −0.18‰). However, K isotopic compositions of nearly all enstatite meteorites scatter around the bulk silicate earth (BSE) value. The average K isotopic composition of the eight enstatite chondrites (−0.47 ± 0.57‰) is indistinguishable from theBSEvalue (−0.48 ± 0.03‰), thus further corroborating the isotopic similarity between Earth's building blocks and enstatite meteorite precursors. We found no correlation of K isotopic compositions with the chemical groups, petrological types, shock degrees, and terrestrial weathering conditions; however, the variation of K isotopes among enstatite meteorite can be attributed to the parent‐body processing. Our sample of the main‐group aubriteMIL13004 is exceptional and has an extremely light K isotopic composition (δ41K = −2.34 ± 0.12‰). We attribute this unique K isotopic feature to the presence of abundant djerfisherite inclusions in our sample because this K‐bearing sulfide mineral is predicted to be enriched in39K during equilibrium exchange with silicates.
What works in medical education, where and why?
Authors: Benassi Paul , Sockalingam Sanjeev
Published: July 2019

Benassi and Sockalingam argue that it is critical to understand the key ingredients of an intervention along with factors that influence implementation if we are to tanslate medical education research into practice.
Lali'an Versus Improved Cook Stoves: How Change Happens in Urban Households in Timor‐Leste
Authors: Nguyen Therese Thi Phuong Tam , McLennan Sharon
Published: July 2019

Most households in Timor‐Leste use lali'an, a traditional open fire method of cooking that has considerable environmental, health, and social impacts. Many of these impacts can be mitigated using simple, low‐cost, and more fuel‐efficient improved cook stoves (ICSs). Drawing on qualitative data from householders, key informants, and the researcher's observations, this article explores women's experiences of using ICS in Timor‐Leste. It outlines the economic and time cost for households using lali'an, and the health, social, and economic benefits of ICSs. Using the information–motivation–behavioral skills model, this study explores the dynamics of the decision‐making process and behavior change related to cooking technology. The findings show that women are primarily responsible for the household kitchen; however, they are not always in a position to make the decision to adopt an ICS. It is therefore imperative that the introduction and promotion of ICS to households in Timor‐Leste be accessible to women, as investment and awareness‐raising regarding ICS will contribute much to the satisfaction of women's basic needs, children's health, and reduction of deforestation in Timor‐Leste.
Burnout: Caring for critically ill and end‐of‐life patients with cancer
Authors: Pattison Natalie , Droney Joanne , Gruber Pascale
Published: July 2019

Background

Critical care and palliative care professionals treat and support seriously ill patients on a daily basis, and the possibility of burnout may be high. The consequences of burnout can include moral injury and distress, and compassion fatigue, which are detrimental to both care and staff.

Aims and objectives

To explore the incidence of moral distress in areas at high risk of burnout in a large cancer centre and to explore possible measures for addressing moral distress.

Design

A cross‐sectional survey.

Methods

The Maslach Burnout Inventory was administered to critical care, critical care outreach, and palliative care teams in a specialist tertiary cancer centre. Open questions on supportive measures were also included. Burnout data were categorised into three domains of emotional exhaustion, depersonalization and personal accomplishment, and free‐text analysis was conducted on the open‐question data.

Results

A total of 63 professionals responded across the teams (45% response rate). A low level of burnout was observed in the emotional exhaustion domain; depersonalization was higher in the critical care professionals; and overall, personal accomplishment was higher than normative scores. Free‐text analysis highlighted three categories of responses: Debriefing, Managing emotional well‐being, and Valuing individuals. There was a need to proactively recognize issues; undertake more debriefs; and open forums regarding cases, particularly with difficult deaths. Engaging all professionals, support to deal with families, and mandatory moral distress and resilience training were suggested, alongside a focus on team building through external activities such as group relaxation sessions and walks.

Conclusions

This study demonstrated a relatively low incidence of emotional exhaustion and depersonalization, and a slightly higher sense of personal accomplishment than normative scores despite staff working in an environment where high levels of burnout were expected.

Relevance to clinical practice

Staff highlighted possible solutions to reduce burnout, which included debriefing, managing emotional well‐being, and valuing individuals.
Rules versus Discretion: Inference Gleaned from Greenbook Forecasts and FOMC Decisions
Authors: Belongia Michael T. , Ireland Peter N.
Published: July 2019

From 1987 through 2013, the Federal Open Market Committee appears to have set its federal funds rate target with reference to Greenbook forecasts of the output gap and inflation and, at times, also to have made further adjustments to the funds rate as those forecasts were revised. If viewed in the context of the Taylor (1993) Rule, discretionary departures from the settings prescribed by Greenbook forecasts consistently presage business cycle turning points. Similarly, estimates from an interest rate rule with time‐varying parameters imply that, around such turning points, the FOMC responds less vigorously to information contained in Greenbook forecasts about the changing state of the economy. These results suggest possible gains from closer adherence to a rule with constant parameters.