bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison between minimal fluoroscopy and conventional approaches for visually guided laser balloon pulmonary vein isolation ablation
Authors: Huang Henry D. , Rodriguez Jason M. , Serafini Nicholas J. , Macias Carlos , Winterfield Jeffrey , Sharma Parikshit S. , Larsen Timothy , Krishnan Kousik , Trohman Richard G.
Published: May 2020

Introduction

Although balloon‐based techniques, such as the laser balloon (LB) ablation have simplified pulmonary vein isolation (PVI), procedural fluoroscopy usage remains higher in comparison to radiofrequency PVI approaches due to limited 3‐dimensional mapping system integration.

Methods

In this prospective study, 50 consecutive patients were randomly assigned in alternating fashion to a low fluoroscopy group (LFG; n = 25) or conventional fluoroscopy group (CFG; n = 25) and underwent de novo PVI procedures using visually guided LB technique.

Results

There was no statistical difference in baseline characteristics or cross‐overs between treatment groups. Acute PVI was accomplished in all patients. Mean follow up was 318 ± 69 days. Clinical recurrence of atrial fibrillation after PVI was similar between groups (CFG: 19% vs LFG: 15%; P = .72). Total fluoroscopy time was significantly lower in the LFG than the CFG (1.7 ± 1.4  vs 16.9 ± 5.9 minutes; P < .001) despite similar total procedure duration (143 ± 22 vs 148 ± 22 minutes; P = .42) and mean LA dwell time (63 ± 15 vs 59 ± 10 minutes; P = .28). Mean dose area product was significantly lower in the LFG (181 ± 125 vs 1980 ± 750 μGym2; P < .001). Fluoroscopy usage after transseptal access was substantially lower in the LFG (0.63 ± 0.43 vs 11.70 ± 4.32 minutes; P < .001). Complications rates were similar between both groups (4% vs 2%; P = .57).

Conclusions

This study demonstrates that LB PVI can be safely achieved using a novel low fluoroscopy protocol while also substantially reducing fluoroscopy usage and radiation exposure in comparison to conventional approaches for LB ablation.
Role of interleukin‐15 in cardiovascular diseases
Authors: Guo Lei , Liu Ming‐fei , Huang Ji‐niu , Li Jia‐min , Jiang Jun , Wang Jian‐an
Published: May 2020

Interleukin (IL)‐15 is a recently identified cytokine, which belongs to the interleukin‐2(IL‐2) family, and plays an important role in innate and adaptive immunoreaction. Given the fact that the structure of IL‐15 is partially similar to IL‐2, they share some common biological effects, including immunoregulation. IL‐2 was proven to protect cardiac function in mouse myocardial infarction models. Cardiovascular diseases (CVDs) dominate the cause of mortality worldwide. Besides atherosclerosis, inflammation is also widely involved in the pathogenesis of many CVDs including hypertension, heart failure (HF) and aneurysm. IL‐15, as a pro‐inflammatory cytokine, is up‐regulated in some cardiovascular diseases, such as myocardial infarction and atherosclerosis. The current understanding of IL‐15, including its signal pathway and cellular function, was described. Furthermore, IL‐15 has a protective effect in myocardial infarction and myocarditis by decreasing cardiomyocyte death and improving heart function. The inhibited effect of IL‐15 in ductus arteriosus (DA) should be focused on. IL‐15 promoted atherogenesis. IL‐15 may be a good target in treatment of cardiovascular diabetology. Finally, future research direction of IL‐15 deserves attention. Since IL‐15 plays several roles in CVDs, understanding the role of the IL‐15/IL‐15R system may provide a scientific basis for the development of new approaches that use IL‐15 for the treatment of CVDs.
The presence of eccentric hyperpigmentation should raise the suspicion of melanoma
Authors: Borsari S. , Peccerillo F. , Pampena R. , Lai M. , Spadafora M. , Moscarella E. , Lallas A. , Pizzichetta M.A. , Zalaudek I. , Del Regno L. , Peris K. , Pellacani G , Longo C.
Published: May 2020

Background

Melanocytic lesions with eccentric hyperpigmentation (EH), even though without other dermatoscopic features of melanoma, are often excised.

Objective

Aiming to understand whether the EH in a pigmented lesion is an accurate criterion of malignancy, we evaluated the capability of two evaluators, with different expertise, to correctly diagnose a melanoma when analysing a given lesion in toto versus a partial analysis, with only the EH or the non‐hyperpigmented portion (non‐EH) visible.

Methods

Dermatoscopic images of 240 lesions (107 melanomas and 133 nevi) typified by EH were selected. Facial, acral, mucosal lesions and lesions showing clear‐cut features of melanoma (except for atypical network) were excluded. Clinical and dermoscopic features (main pattern and numbers of colours) were described for all cases. Each image was split in two through a software so that only the EH or the non‐EH was visible. Two blinded evaluators examined three sets of images, two with customized images and one with the non‐modified ones: they were asked to give a dichotomous diagnosis (melanoma or nevus) for each image.

Results

Melanomas were significantly more frequently typified by colour variegation (3 colours in 44.8% and 4 colours in 41.1% of cases) and atypical network (88.1% in the EH). No significant differences in diagnostic accuracy emerged between the two evaluators. Sensitivity improved in the evaluation of the whole lesions (mean sensitivity 89.7%) in comparison with the evaluation of EH or non‐EH alone (72.7–62.6%). Specificity increased when evaluating the EH (54.1%). Positive predictive value (PPV) and likelihood ratio (LR+) of EH resulted 52.3% and 1.4, meaning that in one case out of two with EH is a melanoma.

Conclusions

Lesions with EH are challenging, regardless of dermoscopic experience. The EH is a robust criterion for malignancy, since the evaluation of the whole lesion, through an intralesional comparative approach, increases sensitivity.
Geriatric Screeners 2.0: Time for a Paradigm Shift in Emergency Department Vulnerability Research
Authors: Carpenter Christopher R. , Mooijaart Simon P.
Published: May 2020

This editorial comments on the article by Milisen et al. in this issue.
Supporting All Americans as We Age: #Decision2020 and Questions for Candidates
Authors:   American Geriatrics Society
Published: May 2020

Asking questions of our political candidates can help us understand where they stand on issues. To support that aim, American Geriatrics Society (AGS) leaders and public policy experts have developed a compendium of questions that AGS members and others can use to ascertain where candidates stand on issues important to achieving our vision for a world where we are all able to contribute to our communities and maintain our health, safety, and independence as we age, and where older people have access to high‐quality person‐centered care informed by geriatrics principles. This question guide will help hold officials accountable by encouraging those who run for any office, including and perhaps especially the presidency, to articulate a clear actionable vision to meet the needs of all older Americans by (1) ensuring access to geriatrics health professionals, (2) expanding Title VII geriatrics training programs, (3) ensuring our workforce is competent to care for older Americans, (4) reducing the toll and impact of chronic diseases, (5) ensuring access to adequate pain relief for older Americans living with advanced illness, (6) supporting American women, (7) supporting American families, and (8) addressing complexity in caring for older Americans. J Am Geriatr Soc 68:1178–1183, 2020.
Frailty Phenotype and Healthcare Costs and Utilization in Older Men
Authors: Ensrud Kristine E. , Kats Allyson M. , Schousboe John T. , Taylor Brent C. , Vo Tien N. , Cawthon Peggy M. , Hoffman Andrew R. , Langsetmo Lisa ,   for the Osteoporotic Fractures in Men Study (MrOS)
Published: May 2020

OBJECTIVES

To determine the association of the frailty phenotype with subsequent healthcare costs and utilization.

DESIGN

Prospective cohort study (Osteoporotic Fracture in Men [MrOS]).

SETTING

Six US sites.

PARTICIPANTS

A total of 1,514 community‐dwelling men (mean age = 79.3 years) participating in the MrOS Year 7 (Y7) examination linked with their Medicare claims data.

MEASUREMENTS

At Y7, the frailty phenotype was operationalized using five components and categorized as robust, pre‐frail, or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims data. Functional limitations were assessed by asking about difficulty performing instrumental activities of daily living. Total direct healthcare costs and utilization were ascertained during 36 months following Y7.

RESULTS

Mean of total annualized costs (2018 dollars) was $5,707 (standard deviation [SD] = 8,800) among robust, $8,964 (SD = 18,156) among pre‐frail, and $20,027 (SD = 27,419) among frail men. Compared with robust men, frail men (cost ratio [CR] = 2.35; 95% confidence interval [CI] = 1.88‐2.93) and pre‐frail men (CR = 1.28; 95% CI = 1.11‐1.48) incurred greater total costs after adjustment for demographics, multimorbidity, and cognitive function. Associations of phenotypic pre‐frailty and frailty with higher total costs were somewhat attenuated but persisted after further consideration of functional limitations and a claims‐based frailty indicator. Each individual frailty component was also associated with higher total costs. Frail vs robust men had higher odds of hospitalization (odds ratio [OR] = 2.62; 95% CI = 1.75‐3.91) and skilled nursing facility (SNF) stay (OR = 3.36; 95% CI = 1.83‐6.20). A smaller but significant effect of the pre‐frail category on SNF stay was present.

CONCLUSION

Phenotypic pre‐frailty and frailty were associated with higher subsequent total healthcare costs in older community‐dwelling men after accounting for a claims‐based frailty indicator, functional limitations, multimorbidity, cognitive impairment, and demographics. Assessment of the frailty phenotype or individual components such as slowness may improve identification of older community‐dwelling adults at risk for costly extensive care.
Continuity of Hospital Care and Feeding Tube Use in Cognitively Impaired Hospitalized Persons
Authors: Teno Joan M. , Mitchell Susan , Bunker Jennifer , Meltzer David , Gozalo Pedro
Published: May 2020

OBJECTIVES

Hospitalists are increasingly the attending physician for hospitalized patients, and the scheduling of their shifts can affect patient continuity. For dementia patients, the impact is unknown.

DESIGN

Longitudinal study using physician billing claims between 2000 and 2014 to examine the association of continuity of care with the insertion of a feeding tube (FT).

SETTING

US hospitals.

PARTICIPANTS

Between 2000 and 2014, 166,056 hospitalizations of patients with a prior nursing home stay, advanced cognitive impairment, and impairments in four or more activities of daily living (mean age = 84.2 years; 30.4% male; 81.0% white).

MEASUREMENTS

Continuity of care measured at the hospital level with the Sequential Continuity Index (SECON; range = 0 to 100; higher score indicates higher continuity).

RESULTS

Rates of a hospitalist acting as the attending physician increased from 9.6% in 2000 to 22.6% in 2010, whereas a primary care physician with a predominant outpatient focus acting as the attending physician decreased from 50.3% in 2000 to 12.6% in 2014. Post‐2010, a mixture of physician specialties increased from 55.5% to 66.4% with a reduction in hospitalists from 22.6% (2010) to 14.1% (2013). Continuity of care decreased over time with SECON dropping from 63.0 to 43.5. Adjusting for patient baseline risk factors, a nonlinear association was observed between SECON and FT insertion. Using cubic splines in the multivariate logistics regression model, the risk of FT insertion in hospitals where the SECON score dropped from 82 to 23 had an adjusted risk ratio (ARR) of FT insertion of 1.48 (95% confidence interval [CI] = 1.34‐1.63); hospitals in which SECON dropped from 51 to 23 had an ARR of FT insertion of 1.38 (95% CI = 1.27‐1.50).

CONCLUSION

Hospitalized dementia patients in hospitals in which continuity of care was lower had higher rates of FT insertions. Newer models of care are needed to enhance care continuity and thus ensure treatment consistent with likely outcomes of care and goals of care. J Am Geriatr Soc 68:1852‐1856, 2020.
Comment on: Coronavirus 2019 in Geriatrics and Long‐Term Care: The ABCDs of COVID‐19
Authors: Lopez Ruth Palan
Published: May 2020

See the Reply by D'Adamo et al.
Cosmetic camouflage as an adjuvant to vitiligo therapies: Effect on quality of life
Authors: Bassiouny Dalia , Hegazy Rehab , Esmat Samia , Gawdat Heba I. , Ahmed Ezzat Marwa , Tawfik Hebat‐Allah , Hegazy Amira Aly , Ibrahim Sarah
Published: May 2020

Background

Vitiligo is a pigmentary disorder associated with considerable psychological imbalance. Partial response to therapy and long duration for repigmentation are common. Meanwhile, camouflage may help through concealing vitiligo lesions and improving patient confidence and self‐esteem.

Aim

To assess the Dermatology Life Quality Index (DLQI) in vitiligo patients, and to determine the patients’ acceptance and willingness to utilize camouflage regularly and the impact of using camouflage as an adjuvant modality.

Patients/Methods

The study was carried out on 100 vitiligo patients who underwent thorough history taking, clinical examination, and DLQI assessment. Forty patients were randomly chosen, taught how to apply camouflage, and followed up over 1 month of regular application.

Results

Dermatology Life Quality Index in the 100 vitiligo patients was found to be 12.2 ± 3.9, denoting the very large effect on quality of life vitiligo has. It was significantly worse in female patients, adolescents, students, and high‐socioeconomic level patients, in visible sites and genitalia, and in unstable cases. There was a significant positive correlation between the DLQI and disease duration (r = 0.75, P < .001) and VES (r = 0.79, P < .001). The 40 cases on camouflage showed a significant percent reduction in their DLQI when compared to noncamouflage users (P: .00).

Conclusions

Dermatology Life Quality Index is significantly affected by vitiligo. Camouflaging is a technique that needs to be taught to the patient to overcome the anticipated problems that drive them away from using it; especially, it significantly improves their DLQI in their devastating disease.
Fatherhood in Complex Families: Ties between Adult Children, Biological Fathers, and Stepfathers
Authors: Hornstra Maaike , Kalmijn Matthijs , Ivanova Katya
Published: May 2020

Objective

We examined adult children's concurrent ties to biological fathers and stepfathers. Three mechanisms potentially determining the strength of father‐child and stepfather‐child ties were tested, namely, investment, interdependence, and substitution.

Background

As most research studied father‐child and stepfather‐child ties separately, our knowledge about the potential substitution dynamics between the two ties is limited.

Method

We used the Dutch Ouders en Kinderen in Nederland (OKiN) survey, which features an oversample of individuals, aged 25–45, who did not live with their two biological parents when growing up (N = 1,183; Mage = 31.89 [SD = 5.13]; 56% female). OKiN includes information on adults' relationships to all parent figures in their lives. Non‐recursive structural equation models were applied to account for the bidirectional influence between children's ties to biological fathers and stepfathers.

Results

Our findings suggested that the quality of the two father‐child ties are interrelated, that is, we found a small substitution effect (i.e., adult children were more likely to “choose” one father in the presence of both). We also found that the quality of father‐child and stepfather‐child ties was associated with the length of the parental investment period (i.e., investment). In addition, bonds with stepfathers were positively associated with the attitudes of the two fathers toward each other, while bonds with both fathers were associated with the quality of the tie between the biological parents (i.e., interdependence).

Conclusion

Overall, the weak substitution dynamic that we found implied that a poor tie with one father can partly be substituted by being close to another father.
Team Design Thinking, Product Innovativeness, and the Moderating Role of Problem Unfamiliarity
Authors: Nagaraj Varun , Berente Nicholas , Lyytinen Kalle , Gaskin James
Published: May 2020

Team design thinking in new product development (NPD) refers to a set of design‐oriented principles that can be embedded in the everyday routines of NPD teams. We theorize that team design thinking enables NPD teams to develop more innovative products––products that are useful and novel––by reducing the routine and cognition‐based inertia that constrains the team’s innovativeness. Through a study of 247 NPD projects, we investigate the relationships between team design thinking, product utility, and product novelty. Further, we also explore whether the team’s unfamiliarity with product contexts influences these relationships. Findings show that team design thinking is positively associated with useful products in both familiar and unfamiliar contexts, but that team design thinking is associated with product novelty only in familiar contexts. Findings also suggest that team design thinking can be framed as a dynamic capability that addresses routine and cognition‐based inertia by expanding the organization’s knowledge resource base, particularly in familiar contexts. A key implication of this research is that team design thinking will influence product utility in a variety of situations, but its influence on product novelty will be evident primarily in familiar contexts.
Genomic landscape of parallel domestication of upland rice and its implications
Authors: Wang Mei‐Xia , Jing Chun‐Yan , Wang Xiu‐Hua , Cai Zhe , Zhou Lian , Geng Mu‐Fan , Han Jing‐Dan , Guo Jie , Zhang Fu‐Min , Ge Song
Published: May 2020

Parallel domestication has been widely acknowledged but its genetic basis remains largely unclear. As an important rice ecotype, upland rice was assumedly domesticated multiple times in two rice subspecies (Indica and Japonica) and provides a feasible system to explore the genetic basis of parallel domestication. To uncover the genome‐wide pattern of genetic differentiation between upland and lowland rice and explore the parallelism of genetic changes during upland rice domestication, we obtained whole‐genome sequences of 95 rice landraces and yielded genome‐wide expression data for five tissues of representative accessions of upland and lowland rice. Our phylogenetic analyses confirmed multiple domestications of the upland ecotype in two rice subspecies. Genomic scans based on resequencing data identified substantial differentiation between the upland and lowland ecotypes with 11.4% and 14.8% of the genome diverged between the two ecotypes in Indica and Japonica, respectively. Further genome‐wide gene expression analyses found that 30% of effectively expressed genes were significantly differentiated between two ecotypes, indicating the importance of regulation changes in the domestication of upland rice. Importantly, we found that only 1.8% of differentiated genomes and 1.6% of differentially expressed genes were shared by upland Indica and upland Japonica, suggestive of largely unparallel genetic alterations during upland rice domestication. These findings not only provide new insights into the genetic basis of parallel domestication at the genome scale but could also facilitate genetic improvement and breeding of rice and crops in general.
How do microbiota associated with an invasive seaweed vary across scales?
Authors: Bonthond Guido , Bayer Till , Krueger‐Hadfield Stacy A. , Barboza Francisco Rafael , Nakaoka Masahiro , Valero Myriam , Wang Gaoge , Künzel Sven , Weinberger Florian
Published: May 2020

Communities are shaped by scale dependent processes. To study the diversity and variation of microbial communities across scales, the invasive and widespread seaweed Agarophyton vermiculophyllum presents a unique opportunity. We characterized pro‐ and eukaryotic communities associated with this holobiont across its known distribution range, which stretches over the northern hemisphere. Our data reveal that community composition and diversity in the holobiont vary at local but also larger geographic scales. While processes acting at the local scale (i.e., within population) are the main structuring drivers of associated microbial communities, changes in community composition also depend on processes acting at larger geographic scales. Interestingly, the largest analysed scale (i.e., native and non‐native ranges) explained variation in the prevalence of predicted functional groups, which could suggest a functional shift in microbiota occurred over the course of the invasion process. While high variability in microbiota at the local scale supports A. vermiculophyllum to be a generalist host, we also identified a number of core taxa. These geographically independent holobiont members imply that cointroduction of specific microbiota may have additionally promoted the invasion process.
On the relationship between sectorial and institutional structural changes
Authors: Bethencourt Carlos , Perera‐Tallo Fernando
Published: May 2020

Successful development processes involve not only ‘sectorial structural change’, shifts of factors between different productive sectors, but also, ‘institutional structural change’, shifts of factors from unproductive activities (predation) to productive ones. This paper analyzes the feedback process between the sectorial and the institutional structural changes in a model in which the labor share in agriculture is lower than in other sectors. Along the transition sectorial structural change emerges: employment in agriculture declines. Consequently, total labor share increases, raising the reward for working (while discouraging predation) and so, fostering institutional structural change. This, in turn, encourages capital accumulation, promoting sectorial structural change. This feedback mechanism widens differences in productivity and institutions among countries. Whereas zero‐cost policies aimed to build institutions have positive effects, costly policies have uncertain effects due to complex feedback mechanisms.
Visualisation of penetration of topical antifungal drug substances through mycosis‐infected nails by matrix‐assisted laser desorption ionisation mass spectrometry imaging
Authors: Endringer Pinto Fernanda , Bagger Charlotte , Kunze Gernot , Joly‐Tonetti Nicolas , Thénot Jean‐Paul , Osman‐Ponchet Hanan , Janfelt Christian
Published: May 2020

Background

Matrix‐assisted laser desorption ionisation mass spectrometry imaging (MALDI‐MSI) is a mass spectrometry‐based technique, which can be applied for compound‐specific imaging of pharmaceuticals in tissues samples. MALDI‐MSI technology is widely used to visualise penetration and distribution profile through different tissues but has never been used with nail tissue.

Objectives

This study used MALDI‐MSI technology to visualise distribution profile and penetration into ex vivo human mycosis‐infected toenails of three antifungal active ingredients amorolfine, ciclopirox and naftifine contained in topical onychomycosis nail treatment preparations, marketed as Loceryl®, Ciclopoli® and Exoderil®.

Methods

Three mycosis‐infected toenails were used for each treatment condition. Six and twenty‐four hours after one single topical application of antifungal drugs, excess of formulation was removed, nails were cryo‐sectioned at a thickness of 20 μm, and MALDI matrix was deposited on each nail slice. Penetration and distribution profile of amorolfine, ciclopirox and naftifine in the nails were analysed by MALDI‐MSI.

Results

All antifungal actives have been visualised in the nail by MALDI‐MSI. Ciclopirox and naftifine molecules showed a highly localised distribution in the uppermost layer of the nail plate. In comparison, amorolfine diffuses through the nail plate to the deep layers already 6 hours after application and keeps diffusing towards the lowest nail layers within 24 hours.

Conclusions

This study shows for the first‐time distribution and penetration of certain antifungal actives into human nails using MALDI‐MSI analysis. The results showed a more homogeneous distribution of amorolfine to nail and a better penetration through the infected nails than ciclopirox and naftifine.
The relationship between cognitive decline and motor dysfunction in Parkinson’s disease: A focused mini‐review on cognitive‐locomotor dual‐task interference
Authors: Mihara Masahito
Published: May 2020

Accumulating evidence suggests that motor symptoms other than resting tremors are affected by coexisting cognitive decline in Parkinson's disease (PD). These cognitive and motor interactions are characterized by the extent to which a concurrent cognitive task affects motor task performance in a dual‐task paradigm. Many studies have investigated cognitive‐postural/locomotor dual‐task interference in PD. Consistent with the notion that bipedal locomotor control requires high cortical demand, previous studies observed greater “dual‐task cost” in patients with PD compared with healthy subjects. This suggests that a segregated cortico‐basal ganglia network is involved in cognitive‐motor dual‐tasking and that cortico‐basal ganglia dysfunction would increase dual‐task interference in patients with PD. In addition, cortico‐brainstem networks may also play an important role in cognitive‐locomotor dual‐task interference. Herein, we discuss possible theoretical models and neural underpinnings of dual‐task interference in PD and future clinical applications of the dual‐task paradigm.
Functional neuroimaging evidence supporting the dual syndrome hypothesis of cognitive impairment in Lewy body disease
Authors: Hirano Shigeki
Published: May 2020

Elucidating the pathophysiology of cognitive impairment in Lewy body disease is important but complex because of its heterogeneous cause. This review gives an overview of the recent functional neuroimaging findings of dopaminergic image and perfusion/metabolism image studies in Parkinson's disease with dementia and dementia with Lewy bodies. Image results of cognitively impaired Lewy body disease, compared with healthy subjects or patients with Parkinson's disease without cognitive impairment, are addressed, and the predictive role of neuroimaging is discussed. Additionally, the association between cognition and striatal dopaminergic function in healthy subjects and perfusion changes due to cholinesterase inhibitors in Lewy body disease are described. The caudate dopaminergic system is a hub region for fronto‐striatal circuits that are associated with verbal memory and executive function. In contrast, the posterior brain region controls visuospatial and memory functions that are primarily regulated by the cholinergic system and, in some cases, may have concomitant Alzheimer's disease pathology. To segregate the anterior and posterior (dual) brain system, cumulative evidence from functional neuroimages is provided and discussed. The dual syndrome hypothesis is a pivotal concept for understanding the underlying mechanisms of cognitive impairment in Lewy body disease, especially in regard to neurotransmitters.
Characteristics and trends of flash droughts in Spain, 1961–2018
Authors: Noguera Iván , Domínguez‐Castro Fernando , Vicente‐Serrano Sergio M.
Published: May 2020

Flash droughts are characterized by rapid onset and intensification, as well as major environmental and agricultural impacts. In this study, we developed an objective method for identifying flash droughts using the standardized evaporation precipitation index (SPEI) based on a short time scale (1‐month) and high‐frequency data (weekly). The identification of flash droughts was focused on the development phase, anomalous decreases in index values in a short time period (4 weeks), and the magnitude of the events. The method was applied to mainland Spain and the Balearic Islands using a high spatial resolution gridded dataset for the period 1961–2018. For this period of 58 years, we characterized the occurrence of flash droughts and showed that for Spain, there was a large spatial and temporal variability in their frequency, with more occurring in the northwest than in the central and southern regions. The northern regions, where a higher frequency of flash droughts was found, showed negative trends in the frequency of flash droughts, while the regions subject to fewer flash drought events showed generally positive trends. We investigated the relative frequency of flash droughts affecting the study regions and found that they are a common phenomenon, as 40% of all droughts were characterized by rapid development. The findings of this study have important implications for drought assessment, monitoring, and mitigation.
Acute cytotoxicity and increased vascular endothelial growth factor after in vitro nitrogen mustard vapor exposure
Authors: McGraw Matthew D. , Kim So‐Young , White Carl W. , Veress Livia A.
Published: May 2020

Nitrogen mustard (NM) is a highly toxic alkylating agent. Inhalation exposure can cause acute and chronic lung injury. This study's aims were to develop an in vitro coculture model of mustard‐induced airway injury and to identify growth factors contributing to airway pathology. Primary human bronchial epithelial cells cultured with pulmonary endothelial cells were exposed to NM (25, 50, 100, 250, or 500 μM) or PBS (control) for 1 hour. Lactate dehydrogenase (LDH) and transepithelial electrical resistance (TEER) were measured before and 24 h after NM exposure. Fixed cultures were stained for hematoxylin and eosin or live/dead staining. Culture media were analyzed for 11 growth factors. A 1‐h vapor exposure to greater than or equal to 50 μM NM increased supernatant LDH, decreased TEER, and caused airway epithelial cell detachment. Endothelial cell death occurred at 500 μM NM. Vascular endothelial growth factor A (VEGF‐A) and placental growth factor (PlGF) expression increased in 500 μM NM−exposed cultures compared with PBS‐exposed control cultures. NM vapor exposure causes differential cytotoxicity to airway epithelial and endothelial injury in culture. Increased VEGF‐A and PlGF expression occurred acutely in airway cocultures. Future studies are required to validate the role of VEGF signaling in mustard‐induced airway pathology.
Shared micromobility: The influence of regulation on travel mode choice
Authors: Lo Dominic , Mintrom Chelsea , Robinson Kate , Thomas Ryan
Published: May 2020

Shared micromobility, in the form of e‐scooter sharing systems, was introduced to New Zealand (NZ) in late 2018 without a consistent national regulatory framework. This article reflects on the relationship between potential scooter‐share regulations and ridership. Examples of scooter‐share regulations overseas and existing research into similar bicycle‐ and moped‐sharing systems were synthesised into a framework for analysis. Results from an online survey in NZ suggested that regulations governing user behaviour have a negative effect on scooter‐share usage. They also indicated that micromobility technology in the right regulatory environment may offer social, environmental, and transport equity benefits.
RAC1mutation is not a predictive biomarker for PI3’‐kinase‐β‐selective pathway‐targeted therapy
Authors: Foth Mona , Parkman Gennie , Battistone Benjamin , McMahon Martin
Published: May 2020

Mutational activation of RAC1 is detected in ~7% of cutaneous melanoma, with the most frequent mutation (RAC1C85T) encoding for RAC1P29S. RAC1P29S is a fast‐cycling GTPase that leads to accumulation of RAC1P29S‐GTP, which has potentially pleiotropic regulatory functions in melanoma cell signaling and biology. However, the precise mechanism by which mutationally activated RAC1P29S propagates its pro‐tumorigenic effects remains unclear. RAC1‐GTP is reported to activate the beta isoform of PI3’‐kinase (PIK3CB/PI3Kβ) leading to downstream activation of PI3’‐lipid signaling. Hence, we employed both genetic and isoform‐selective pharmacological inhibitors to test if RAC1P29S propagates its oncogenic signaling in melanoma through PI3Kβ. We observed that RAC1P29S‐expressing melanoma cells were largely insensitive to inhibitors of PI3Kβ. Furthermore, RAC1P29S melanoma cell lines showed variable sensitivity to pan‐class 1 (α/β/γ/δ) PI3’‐kinase inhibitors, suggesting that RAC1‐mutated melanoma cells may not rely on PI3’‐lipid signaling for their proliferation. Lastly, we observed that RAC1P29S‐expressing cell lines also showed variable sensitivity to pharmacological inhibition of the RAC1 → PAK1 signaling pathway, questioning the relevance of inhibitors of this pathway for the treatment of patients with RAC1‐mutated melanoma.
Health literacy and its association with adherence in pediatric liver transplant recipients and their parents
Authors: Dore‐Stites Dawn , Lopez M. James , Magee John C. , Bucuvalas John , Campbell Kathleen , Shieck Victoria , Well Andrew , Fredericks Emily M.
Published: May 2020

Objective

Non‐adherence to pediatric regimens is a common concern. Low health literacy is correlated with poor outcomes in adults but is understudied in pediatrics. The current project aimed to determine the relationship between health literacy, adherence, and outcomes in pediatric liver transplant recipients. Hypotheses included a) parent and patient health literacy would be positively correlated; and b) low patient and/or parent health literacy would be negatively correlated with adherence and health outcomes.

Patients and Methods

Eligible participants were recruited during routine follow‐up visits in a pediatric liver transplant clinic. Parents and patients (>13 years old) completed 2 measures of health literacy. Patients ≥18 years completed health literacy measures without corresponding parent surveys. Adherence variables and health outcomes were obtained from medical records.

Results

Seventy‐nine patients across two sites completed the study. Variance in classification of health literacy between measures was observed; however, most parents (82%‐100%) scored within an “adequate literacy” range. More adolescents scored in lower health literacy ranges relative to the parents. Markers of SES were positively correlated with health literacy. Parent health literacy was negatively associated with biopsy‐proven rejection episodes and the number of hospitalizations; however, it was not associated with measures of tacrolimus adherence. There were no relationships observed between parent and adolescent health literacy.

Conclusions

Health literacy is an important consideration in managing patient care; however, available measures demonstrate variability in capturing the skills of patients. Effective communication strategies may ameliorate admittedly small, but negative, impacts of limited health literacy on outcomes.
A portrait of the immune response to proliferative kidney disease (PKD) in rainbow trout
Authors: Bailey Christyn , Holland Jason W. , Secombes Christopher J. , Tafalla Carolina
Published: May 2020

Proliferative kidney disease (PKD), caused by the myxozoan Tetracapsuloides bryosalmonae, is one of the most serious parasitic diseases of salmonids in which outbreaks cause severe economic constraints for the aquaculture industry and declines of wild species throughout Europe and North America. Given that rainbow trout (Oncorhynchus mykiss) is one of the most widely farmed freshwater fish and an important model species for fish immunology, most of the knowledge on how the fish immune response is affected during PKD is from this organism. Once rainbow trout are infected, PKD pathogenesis results in a chronic kidney immunopathology mediated by decreasing myeloid cells and increasing lymphocytes. Transcriptional studies have revealed the regulation of essential genes related to T‐helper (Th)‐like functions and a dysregulated B‐cell antibody type response. Recent reports have discovered unique details of teleost B‐cell differentiation and functionality and characterized the differential immunoglobulin (Ig)‐mediated response. These studies have solidified the rainbow trout T. bryosalmonae system as a sophisticated disease model capable of feeding key advances into mainstream immunology and have contributed essential information to design novel parasite disease prevention strategies. In our following perspective, we summarize these efforts to evaluate the immune mechanisms of rainbow trout during PKD pathogenesis.
Salmon immunological defence and interplay with the modulatory capabilities of its ectoparasite Lepeophtheirus salmonis
Authors: Braden Laura M. , Monaghan Sean J. , Fast Mark D.
Published: May 2020

The salmon louse Lepeophtheirus salmonis (Lsal) is an ectoparasitic copepod that exerts immunomodulatory and physiological effects on its host Atlantic salmon. Over 30 years of research on louse biology, control, host responses and the host‐parasite relationship has provided a plethora of information on the intricacies of host resistance and parasite adaptation. Atlantic salmon exhibit temporal and spatial impairment of the immune system and wound healing ability during infection. This immunosuppression may render Atlantic salmon less tolerant to stress and other confounders associated with current management strategies. Contrasting susceptibility of salmonid hosts exists, and early pro‐inflammatory Th1 type responses are associated with resistance. Rapid cellular responses to larvae appear to tip the balance of the host‐parasite relationship in favour of the host, preventing severe immune‐physiological impacts of the more invasive adults. Immunological, transcriptomic, genomic and proteomic evidence suggests pathological impacts occur in susceptible hosts through modulation of host immunity and physiology via pharmacologically active molecules. Co‐evolutionary and farming selection pressures may have incurred preference of Atlantic salmon as a host for Lsal reflected in their interactome. Here, we review host‐parasite interactions at the primary attachment/feeding site, and the complex life stage‐dependent molecular mechanisms employed to subvert host physiology and immune responses.
Effect of light and dark on the growth and development of downy mildew pathogen Hyaloperonospora arabidopsidis
Authors: Telli Osman , Jimenez‐Quiros Catherine , McDowell John M. , Tör Mahmut
Published: May 2020

Disease development in plants requires a susceptible host, a virulent pathogen, and a favourable environment. Oomycete pathogens cause many important diseases and have evolved sophisticated molecular mechanisms to manipulate their hosts. Day length has been shown to impact plant–oomycete interactions but a need exists for a tractable reference system to understand the mechanistic interplay between light regulation, oomycete pathogen virulence, and plant host immunity. Here we present data demonstrating that light is a critical factor in the interaction between Arabidopsis thaliana and its naturally occurring downy mildew pathogen Hyaloperonospora arabidopsidis (Hpa). We investigated the role of light on spore germination, mycelium development, sporulation, and oospore formation of Hpa, along with defence responses in the host. We observed abundant Hpa sporulation on compatible Arabidopsis under day lengths ranging from 10 to 14 hr. In contrast, exposure to constant light or constant dark suppressed sporulation. Exposure to constant dark suppressed spore germination, mycelial development, and oospore formation, whereas exposure to constant light stimulated these three stages of development. A biomarker of plant immune system activation was induced under both constant light and constant dark. Altogether, these findings demonstrate that Hpa has the molecular mechanisms to perceive and respond to light and that both the host and pathogen responses are influenced by the light regime. Therefore, this pathosystem can be used for investigations to understand the molecular mechanisms through which oomycete pathogens like Hpa perceive and integrate light signals, and how light influences pathogen virulence and host immunity during their interactions.
The Growth of the Evaluation Tree in the Policy Analysis Forest: Recent Developments in Evaluation
Authors: Lemire Sebastian , Peck Laura R. , Porowski Allan
Published: May 2020

The practice and profession of evaluation is continually evolving. From its early origin in the Great Society years of the 1960s, through its golden years of the 1970s, its transformation under the fiscal conservatism of the Reagan era in the 1980s, and in its maturation during the performance and results era of the 1990s, the field of evaluation continues to evolve in response to broader trends in society. This article examines recent developments and trends in the practice and profession of evaluation. Structured around the evaluation theory tree, the presentation of these developments elaborates on the three main branches of evaluation: methods, use, and valuing. The concluding discussion briefly addresses the central role of evaluation—and other types of knowledge production—in providing actionable evidence for use in public policy and program decision making.
Evaluation of cervical and uterine size, at 4 weeks postpartum, as a predictor of subsequent fertility in Jersey cattle
Authors: Poock Scott E. , Melendez Pedro , Caldeira Monica O. , Moore Stephen G. , Mayo Lauren M. , Molina‐Coto Roger , Lucy Matthew C.
Published: May 2020

Contents

Uterine and cervical size of Holstein dairy cows is reported among reasons for a decline in dairy cow fertility. Therefore, the objectives of this study were to (a) determine whether size of the cervix and uterus at 4 weeks postpartum impacted subsequent fertility at first service in Jersey cattle, (b) determine whether progesterone level at 4 weeks postpartum impacted cyclicity and (c) the association of the presence of corpus luteum and uterus and cervix size. Body condition scores at calving, presence of postpartum diseases, parity number and milk weights were taken from lactating Jersey dairy cows (N = 147) for 28 days postpartum. During the fourth week postpartum, a blood sample was obtained for progesterone concentration, and transrectal ultrasonography was performed by a high‐resolution ultrasound machine to determine cervical and uterine horn diameter, as well as ovarian structures measurements. Correcting for parity number, BCS at calving, presence of diseases and milk yield, cows with a cervix >2.54 ± 0.63 cm and uterine horn >2.25 ± 0.59 cm were less likely to become pregnant at first service (p = .04 andp = .003, respectively). The cows with larger cervix had a trend to be less likely to have a corpus luteum present at the 4th week of lactation (p = .067). Cows with larger uterine horn size were less likely to have a corpus luteum present at the 4th week of lactation (p = .015). It is concluded that a larger cervix and/or uterus during the postpartum was associated negatively with fertility and cyclicity in Jersey cows.
Risk of Antibiotic‐Resistant Staphylococcus aureus Dispersion from Hog Farms: A Critical Review
Authors: George Alexandra N. , Stewart Jill R. , Evans Jessica C. , Gibson Jacqueline MacDonald
Published: May 2020

The World Health Organization has declared antibiotic resistance “one of the biggest threats to global health.” Mounting evidence suggests that antibiotic use in industrial‐scale hog farming is contributing to the spread of antibiotic‐resistant Staphylococcus aureus. To capture available evidence on these risks, we searched peer‐reviewed studies published before June 2017 and conducted a meta‐analysis of these studies’ estimates of the prevalence of swine‐associated, antibiotic‐resistant S. aureus in animals, humans, and the environment. The 166 relevant studies revealed consistent evidence of livestock‐associated methicillin‐resistant S. aureus (MRSA) in hog herds (55.3%) raised with antibiotics. MRSA prevalence was also substantial in slaughterhouse pigs (30.4%), industrial hog operation workers (24.4%), and veterinarians (16.8%). The prevalence of swine‐associated, multidrug‐resistant S. aureus (MDRSA)—with resistance to three or more antibiotics—is not as well documented. Nonetheless, sufficient studies were available to estimate MDRSA pooled prevalence in conventional hog operation workers (15.0%), workers’ household members (13.0%), and community members (5.37%). Evidence also suggests that antibiotic‐resistant S. aureus can be present in air, soil, water, and household surface samples gathered in or near high‐intensity hog operations. An important caveat is that prevalence estimates for humans reflect colonization, not active infection, and the health risks of colonization remain poorly understood. In addition, these pooled results may not represent risks in specific locations, due to wide geographic variation. Nonetheless, these results underscore the need for additional preventive action to stem the spread of antibiotic‐resistant pathogens from livestock operations and a streamlined reporting system to track this risk.
Longitudinal Networks of Dyadic Relationships Using Latent Trajectories: Evidence from The European Interbank Market
Authors: Bianchi Federica , Bartolucci Francesco , Peluso Stefano , Mira Antonietta
Published: May 2020

Financial markets are ultimately seen as a collection of dyadic transactions. We study the temporal evolution of dyadic relationships in the European interbank market, as induced by monetary transactions registered in the electronic market for interbank deposits (e-MID) during a period of 10 years (2006–2015). In particular, we keep track of how reciprocal exchange patterns have varied with macro events and exogenous shocks and with the emergence of the Global Financial Crisis in 2008. The approach adopted extends the model of Holland and Leinhardt to a longitudinal setting where individuals’ temporal trajectories for the tendency to connect and reciprocate transactions are explicitly modelled through splines or polynomials, and individual-specific parameters. We estimate the model by an iterative algorithm that maximizes the log-likelihood for every ordered pair of units. The empirical application shows that the methodology proposed may be applied to large networks and represents the process of exchange at a fine-grained level. Further results are available in on-line supplementary material.
Dairy Livestock Interventions for Food Security in Uganda: What are the Implications for Women's Empowerment?*
Authors: Bain Carmen , Ransom Elizabeth , Halimatusa’diyah Iim
Published: May 2020

Women are increasingly the target of agricultural development programs aimed at reducing poverty and food insecurity, especially in sub‐Saharan Africa. Some feminist scholars argue that such efforts are driven more by concerns about the efficient use of resources than the rights of women and do little to transform gendered power relations. We examine how development interventions that target women affect household well‐being, especially food insecurity, empower women, and transform gendered power relations. Our study uses the case of the Gates Foundation funded East Africa Dairy Development (EADD) program in Uganda. Our methods include the Women's Empowerment in Agriculture Index survey and in‐depth interviews of women farmers and key informants, within the EADD program. We argue that the livestock sector provides critical insights into women's empowerment because livestock are not “socially neutral” in their gendered effects. Our study found that: (1) ownership of dairy cows enhanced important dimensions of women's empowerment and gender equity that benefited women and households; (2) women's labor responsibilities for dairy cows disempowered some women by increasing their time poverty and; (3) ownership of dairy cows provided a means for women to disrupt entrenched social norms related to gender roles within the household and agriculture.