bluuebunny/crossref_metadata_2025 huggingface dataset:
Constructing a measure of health literacy in Sub-Saharan African countries
Authors: McClintock Heather F , Alber Julia M , Schrauben Sarah J , Mazzola Carmella M , Wiebe Douglas J
Published: July 2019

We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006–15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy. Logistic regression was employed to examine the relationship between demographic characteristics and health literacy. A total of 224 751 individuals between the ages of 15 and 49 years were included. The derived health literacy measure demonstrated good internal consistency (Cronbach’s α = 0.72) and good content validity. The prevalence of high health literacy overall was 35.77%; females 34.08% and males 39.17%; less than or equal to primary education 8.93%, some secondary education 69.40% and ≥complete secondary 84.35%. High health literacy varied across nations, from 8.51% in Niger to 63.89% in Namibia. This is the first known study to evaluate a measure of health literacy relying on the NAM definition utilizing a large sample from 14 countries in Sub-Saharan Africa. Our study derived a robust indicator of NAM-defined health literacy. This indicator could be used to examine determinants and outcomes of health literacy in additional countries.
ZP1 mutations are associated with empty follicle syndrome: evidence for the existence of an intact oocyte and a zona pellucida in follicles up to the early antral stage. A case report.
Authors: Dai Can , Chen Yongzhe , Hu Liang , Du Juan , Gong Fei , Dai Jing , Zhang Shuoping , Wang Mingyi , Chen Jing , Guo Jing , Zheng Wei , Lu Changfu , Wu Yueren , Lu Guangxiu , Lin Ge
Published: July 2019

Empty follicle syndrome (EFS) is the complete failure to retrieve oocytes after ovarian stimulation. Although LHCGR and ZP3 were identified as causative genes, it is still unclear what happens to these patients’ oocytes, and the pathogenesis of EFS remains obscure. Here, we identified six novel ZP1 mutations associated with EFS and female infertility that was inherited recessively in five unrelated families. Studies in CHO-K1 cells showed that these mutations resulted in either degradation or truncation of ZP1 protein. Immunohistochemistry using ovarian serial sections demonstrated that all preantral follicles had normal architecture, but with a thin ZP, lacking ZP1, surrounding the growing oocytes. The antral follicles were also defective in normal cumulus–oocyte complex organisation, leading us to speculate that the lack of ZP1 might lead to oocyte degeneration or increased fragility of the oocyte during follicular puncture, ultimately resulting in EFS. To our knowledge, this is the first study that presents morphological evidence showing normal preantral folliculogenesis with abnormal ZP assembly in EFS patients. Our data provides a better understanding of the biological functions of ZP1 in human ZP assembly and folliculogenesis and gives new insights into the pathogenesis of EFS and possible therapeutic developments.
Performance of the transoral circular stapler for oesophagogastrectomy after induction therapy
Authors: Wang Lily , Milman Steven , Ng Thomas
Published: July 2019

OBJECTIVES

Patients undergoing oesophageal anastomosis may be at an increased risk for leak after induction therapy for oesophageal cancer, with intrathoracic leaks having significant morbidity. The outcomes of utilizing transoral circular stapler for the creation of a thoracic anastomosis have not been well studied in this patient population.

METHODS

Patients with oesophageal cancer undergoing induction chemotherapy/radiation followed by Ivor Lewis oesophagogastrectomy were evaluated. All thoracic anastomoses were constructed with transoral circular stapler. Primary outcomes evaluated were the rates of anastomotic leak and stricture.

RESULTS

Over 7 years, 87 consecutive patients were evaluated, among whom 69 (79%) were male. The median age was 63 years, median body mass index (BMI) was 27 kg/m2 and median age-adjusted comorbidity index was 5. Median operative blood loss was 400 ml and median operative time was 300 min. Major complications (grade ≥3) were seen in 19 (22%), including anastomotic leak in 2 (2.3%), both successfully treated with temporary covered metal stent. The median duration of hospital stay was 10 days, and 1 (1.2%) death was reported at 90 days due to cancer recurrence. Stricture occurred in 8 (9.2%), and median time to dilation was 109 days and median number of dilations was 1. Univariable analysis found BMI to be significantly higher in patients with an anastomotic leak versus those without (43 vs 27 kg/m2, P = 0.002). No variables were found to be predictive of anastomotic stricture.

CONCLUSIONS

The use of the transoral circular stapler for thoracic anastomosis results in a consistent formation of the anastomosis, with low leak and stricture rates in the setting of induction chemotherapy/radiation. Leaks that do occur appear to be amenable to stent therapy.
Segre Indices and Welschinger Weights as Options for Invariant Count of Real Lines
Authors: Finashin Sergey , Kharlamov Viatcheslav
Published: July 2019

In our previous paper [5] we have elaborated a certain signed count of real lines on real hypersurfaces of degree $2n-1$ in $P^{n+1}$. Contrary to the honest “cardinal” count, it is independent of the choice of a hypersurface and, by this reason, provides a strong lower bound on the honest count. In this count the contribution of a line is its local input to the Euler number of a certain auxiliary vector bundle. The aim of this paper is to present other, in a sense more geometric, interpretations of this local input. One of them results from a generalization of Segre species of real lines on cubic surfaces and another from a generalization of Welschinger weights of real lines on quintic three-folds.
$q$
-Racah Ensemble and Discrete Painlevé Equation
Authors: Dzhamay Anton , Knizel Alisa
Published: July 2019

The goal of this paper is to investigate the missing part of the story about the relationship between the orthogonal polynomial ensembles and Painlevé equations. Namely, we consider the $q$-Racah polynomial ensemble and show that the one-interval gap probabilities in this case can be expressed through a solution of the discrete $q$-P$\left (E_7^{(1)}/A_{1}^{(1)}\right )$ equation. Our approach also gives a new Lax pair for this equation. This Lax pair has an interesting additional involutive symmetry structure.
The Uncertainty Trade-off: Reexamining Opportunity Costs and War
Authors: Spaniel William , Malone Iris
Published: July 2019

Conventional wisdom about economic interdependence and international conflict predicts that increasing opportunity costs make war less likely, but some wars occur after costs grow. Why? We develop a model that shows that a nonmonotonic relationship exists between the costs and probability of war when there is uncertainty over resolve. Under these conditions, increasing the costs of an uninformed party's opponent has a second-order effect of exacerbating informational asymmetries about that opponent's willingness to maintain peace. We derive conditions under which war can occur more frequently and empirically showcase the model's implications through a case study of Sino-Indian relations from 1949 to 2007. This finding challenges how scholars traditionally believe economic interdependence mediates incentives to fight: instruments such as trade have competing effects on the probability of war.
Plasma exposures following posaconazole delayed-release tablets in immunocompromised children and adolescents
Authors: Tragiannidis Athanasios , Herbrüggen Heidrun , Ahlmann Martina , Vasileiou Eleni , Gastine Silke , Thorer Heike , Fröhlich Birgit , Müller Carsten , Groll Andreas H
Published: July 2019

Background

Posaconazole is a recommended option for antifungal prophylaxis in paediatric patients >12 years of age. However, little is known about plasma exposures and safety following administration of the delayed-release tablets (DRTs) in children and adolescents.

Methods

In a retrospective observational study, we analysed steady-state trough concentrations of posaconazole in all paediatric patients who had received the DRT formulation between May 2015 and December 2018 for antifungal prophylaxis. Dosing was guided by a published population pharmacokinetic model with weight-based dosing. Drug concentrations in plasma were measured by a validated tandem MS method. Liver function and drug discontinuations due to adverse effects were also assessed.

Results

A total of 34 patients (21 male, 13 female; median age 12 years, range 5–17 years; median body weight 43.5 kg, range 16–84 kg) undergoing treatment for haemato-oncological disorders (n=23) or immunosuppression for polyarthritis (n=1) or post-allogeneic HSCT (n=11) received posaconazole DRTs for a median of 70 days (range 9–391 days). The median first steady-state trough plasma concentration following model-derived dosing was 1607 ng/mL (range 501–8485 ng/mL) with trough concentrations being above the dosing target of ≥700 ng/mL in 32/34 patients (94%). Considering all (first and subsequent) trough concentrations, target attainment was 90% (63/70 samples). Posaconazole was well tolerated without adverse event-related discontinuations or breakthrough infections.

Conclusions

Administration of posaconazole DRTs to paediatric patients guided by a population pharmacokinetic-derived dosing algorithm resulted in predictable and potentially effective exposures and was well tolerated over prolonged time periods.
Nonconvex optimization-based inverse spectral decomposition
Authors: Ma Ming , Zhang Rui , Liu Yong , Gao Haoyang , Guo Yu
Published: July 2019

As a time–frequency analysis tool, inverse spectral decomposition (ISD) could be utilized to obtain a high-resolution time–frequency map via the inversion strategy. In the established inversion function, an analytic signal is disintegrated as a coefficient matrix whose elements represent the weights of the wavelet components with the different dominant frequencies and the time location in the complex wavelet library. By using a sparse constraint, a high-quality inverse decomposition result could be generated. In this paper, a modified ISD technique based on a nonconvex optimization algorithm is proposed to pursue a sparser coefficient solution found in the inversion processing by decreasing the redundant information. This new approach applies the lp(0 < p < 1) penalty term to build an accurate mapping relationship between the original signal and its time–frequency spectrum. This adequate regularization in reconstructed function serves as a better alternative to the l1 norm one in conventional ISD. Lower signal-to-noise ratio (SNR) and much weaker incoherence of wavelet library cannot impact on the accuracy of output with the ISD based on the lp norm (0 < p < 1) constraint. Synthetic data tests with the Gabor transform, the conventional ISD method and the nonconvex optimization-based ISD are applied to demonstrate the performance gaps. In the real application area, a blended image with instantaneous spectral attribute volumes produced by the new approach assists the identification of the geological anomalous body, which is verified via a physical model data and field data tests.
A new refracturing candidate selection method for multi-fractured horizontal wells in tight oil reservoirs
Authors: Guo Jianchun , Tao Liang , Liu Yuxuan , He Na , Zhou Xiaofeng
Published: July 2019

Refracturing technology has been widely applied to increase the production rate of multi-fractured horizontal wells (MFHWs) and enhance ultimate recovery. However, due to the complicated relationships between various parameters, it is often difficult to select candidate wells for refracturing. A novel method combining analytic hierarchy process (AHP), grey relation analysis (GRA) and fuzzy logic was proposed in this study to evaluate refracturing potential of wells from reservoir quality and initial completion efficiency. First, based on the parameters of the constructed wells, several elements were chosen as appraisal factors. AHP was used to establish a multi-parameter evaluation system for refracturing treatment. Then, GRA was used to calculate the weight coefficient and sort out the main factors that influence fracturing result. Finally, GRA was coupled with fuzzy logic to determine the classification threshold of reservoir quality. A novel comprehensive evaluation score (CES) was proposed to determine the priority of the refracturing wells. The method was successfully applied to a tight oilfield in Northeast China and the optimum refracturing potential area was selected based on the reservoirs quality and completion efficiency by using quadrant analysis. Average daily oil production increased from 2.3 to 17.6 tons per day after refracturing treatment. The method can be used to identify refracturing candidates quickly and economically.
Introduction
Authors: Smits Jasper A. J. , Powers Mark B. , Otto Michael W.
Published: July 2019

Chapter 1 introduces exposure therapy as an empirically supported, simple, and flexible strategy to reduce a broad spectrum of worries, anxieties, and fears. It describes both what exposure therapy is and what it is not, including many common myths about exposure therapy. The authors describe the art of “playing” with fear as an overall approach. In addition, personalized exposure therapy is introduced as driven by careful case formulation. Unlike a strict manualized approach, this book emphasizes the importance of flexibility using a transdiagnostic yet person-centered focus. Finally, the chapter describes how to use this book, including a review of the chapters and the book’s overarching goals.
General Approach
Authors: Smits Jasper A. J. , Powers Mark B. , Otto Michael W.
Published: July 2019

Chapter 3 outlines the general approach to exposure therapy including three phases: planning for exposure therapy, delivering exposure therapy, and processing exposure therapy. The first phase includes specific steps to take in planning for exposure therapy including the initial phone contact, administering a questionnaire battery, conducting the intake, and initiating self-monitoring. These steps guide the case formulation focused on maintaining factors (triggers/cues, appraisals, emotions, and actions/behaviors). Next the delivery of exposure therapy begins with socialization to the exposure therapy model and further planning by working together on an exposure planning worksheet. Exposure should then be delivered in a systematic, deliberate, repeated, and prolonged manner. Typical obstacles and traps to progress are discussed. Finally, the chapter describes postexposure processing, drawing attention to what was (and was not) learned and assigning homework.
Assessing Success
Authors: Smits Jasper A. J. , Powers Mark B. , Otto Michael W.
Published: July 2019

Chapter 4 describes the core yardsticks of improvement. The chapter describes how success is defined from both patient and therapist perspectives and how this is modified from early to later sessions. Patients naturally want to have less anxiety. Therapists, however, know the only way to achieve this goal is to go through (rather than around) the discomfort. Once fear is no longer the enemy, the anxiety eventually goes away. Assessment includes actions and measures before, during, and after exposure. Overall, exposure therapy is on track when the patient is approaching his or her feared cues, responding differently to fear/emotions/thoughts, and shifting his or her specific appraisals of threat to appraisals of safety. Finally, we also describe the importance of assessing patient engagement and command of the exposure therapy model.
Fear of Emotions and Related Physical Sensations
Authors: Smits Jasper A. J. , Powers Mark B. , Otto Michael W.
Published: July 2019

Chapter 5 provides an overview of fear of emotions and related physical sensations and introduces exposure methods to address the fear of what lies within. This chapter is particularly focused on planning, delivering, and processing in vivo exposures to fear of fear (interoceptive exposure). The chapter describes how to modify the exposures to fit with different patient presentations and across multiple contexts, while fading the use of safety behaviors. Case examples are presented along with methods to avoid traps that can impede improvement. Research shows that relative comfort with the experience of anxiety-related symptoms predicts resilience in a wide range of situations.
Combining Exposure Therapy with Medications
Authors: Smits Jasper A. J. , Powers Mark B. , Otto Michael W.
Published: July 2019

Chapter 8 covers the impact of combined medication and exposure treatments. Any time two treatments coincide, there is a risk that patients may wonder what gains are associated with which treatment. Fortunately, the research supports that patients who are taking medications still benefit from exposure therapy. However, if medication is discontinued after therapy, there is a risk of relapse due to misattribution and withdrawal symptoms. This is particularly true for benzodiazepine medications. Ideally, patients will agree to either eliminate use of benzodiazepines before exposure begins or at least switch from an as needed basis to scheduled dosing regimen. If, however, the patient completes exposure in the context of a medication he or she intends to discontinue, the authors recommend several strategies to protect against relapse. Interoceptive exposure can be helpful in preparing for a medication taper by learning safety even during uncomfortable withdrawal sensations. In addition, the authors recommend a slow taper combined with exposure before, during, and after medication discontinuation.
Introduction to Accommodation of Child Anxiety
Authors: Lebowitz Eli R.
Published: July 2019

This chapter introduces the concept of family accommodation and discusses its relation to other aspects of parenting behavior. The chapter provides definitions of family accommodation and illustrates the concept through examples of common accommodations of child anxiety symptoms. The chapter also describes two methods for categorizing accommodations. Accommodations can be classified based on either the form of accommodation provided or based on the domain of anxiety symptom that is being accommodated. Examples of each are provided, including illustrative examples of accommodation in each of the common anxiety disorders. The chapter also reviews accommodation provided by individuals other than parents, including teachers, siblings, and other relatives.
Reducing Accommodation to Treat Child Anxiety
Authors: Lebowitz Eli R.
Published: July 2019

This chapter discusses reducing family accommodation as a means of treating childhood anxiety. The chapter covers both reducing family accommodation as a stand-alone treatment and reducing family accommodation as part of a broader treatment strategy that also includes direct child-based therapy. Research supporting the efficacy of reducing family accommodation to treat child anxiety is reviewed, and practical considerations such as when to introduce the topic of family accommodation and how to optimize the sequence of child and parent work are discussed. Additional benefits of reducing family accommodation, including improved family functioning, positive impact on siblings, and improved parent–child relationship are also discussed.
Planning How Parents Will Reduce Accommodation
Authors: Lebowitz Eli R.
Published: July 2019

Effectively helping parents to reduce family accommodation of childhood anxiety requires careful and thoughtful planning. This chapter provides guidance on formulating effective and realistic plans for changes in parental behavior aimed at reducing family accommodation of child anxiety symptoms. A well-crafted plan will be focused, specific, and pragmatic. It will also avoid the common pitfalls that can hinder implementation, which are discussed in the next chapter. This chapter also provides guidelines and examples for communicating the plan to the child and maintaining a supportive parental attitude. Clinical anecdotes and sample texts enrich the chapter and bring the content to life.
Disentangling interstellar plasma screens with pulsar VLBI: combining auto- and cross-correlations
Authors: Simard D , Pen U-L , Marthi V R , Brisken W
Published: July 2019

Current methods of measuring distances to pulsar scattering screens rely on a single screen dominating the scintillation pattern. We present a novel technique to reconstruct the scattered flux of a pulsar and solve for the scattering geometry in cases where the scattering environment along the line of sight to the pulsar is complex and may be composed of multiple scattering screens. This technique combines interferometric visibilities with cross-correlations of single-station intensities. It takes advantage of the fact that if one considers the interference of radiation from two points in the scattered image in delay–delay rate space, the visibilities are sensitive to the mean angular position of the points, while the cross-correlated intensities are sensitive to their angular separation. By combining the visibilities and the cross-correlated intensities, it is possible to measure the angular locations of both points in the pair. We show that this technique is able to reconstruct the published scattering geometry of PSR B0834+06. We then apply this technique to one-dimensional simulations of more complicated scattering systems, where we find that it can distinguish features from different scattering screens. This technique holds promise for studies of the interstellar medium and pulsars themselves: It will allow the application of scintillometry techniques, such as resolving pulsar emission regions using interstellar scattering, to sources for which a current lack of understanding of the scattering environment has precluded their use.
Host galaxies of high-redshift extremely red and obscured quasars
Authors: Zakamska Nadia L , Sun Ai-Lei , Strauss Michael A , Alexandroff Rachael M , Brandt W N , Chiaberge Marco , Greene Jenny E , Hamann Fred , Liu Guilin , Perrotta Serena , Ross Nicholas P , Wylezalek Dominika
Published: July 2019

We present Hubble Space Telescope 1.4–1.6 $\mu$m images of the hosts of 10 extremely red quasars (ERQs) and six type 2 quasar candidates at z = 2–3. ERQs, whose bolometric luminosities range between 1047 and 1048 erg s−1, show spectroscopic signs of powerful ionized winds, whereas type 2 quasar candidates are less luminous and show only mild outflows. After performing careful subtraction of the quasar light, we clearly detect almost all host galaxies. The median rest-frame B-band luminosity of the ERQ hosts in our sample is $10^{11.2}\, \mathrm{L}_{\odot }$, or ∼4L* at this redshift. Two of the 10 hosts of ERQs are in ongoing mergers. The hosts of the type 2 quasar candidates are 0.6 dex less luminous, with 2/6 in likely ongoing mergers. Intriguingly, despite some signs of interaction and presence of low-mass companions, our objects do not show nearly as much major merger activity as do high-redshift radio-loud galaxies and quasars. In the absence of an overt connection to major ongoing gas-rich merger activity, our observations are consistent with a model in which the near-Eddington accretion and strong feedback of ERQs are associated with relatively late stages of mergers resulting in early-type remnants. These results are in some tension with theoretical expectations of galaxy formation models, in which rapid black hole growth occurs within a short time of a major merger. Type 2 quasar candidates are less luminous, so they may instead be powered by internal galactic processes.
Clumpy galaxies in cosmological simulations: the effect of ISM model
Authors: Inoue Shigeki , Yoshida Naoki
Published: July 2019

We study influence by models of interstellar medium (ISM) on properties of galaxies in cosmological simulations. We examine three models widely used in previous studies. The ISM models impose different equations of state on dense gas. Using zoom-in simulations, we demonstrate that switching the ISM models can control formation of giant clumps in massive discs at redshifts z ∼ 1–2, while their initial conditions and the other settings such as stellar feedback are unchanged. Thus, not only feedback but ISM models can also be responsible for clumpy morphologies of simulated galaxies. We find, however, that changing the ISM models hardly affects global properties of galaxies, such as the total stellar and gas masses, star formation rate, metallicity, and stellar angular momentum, irrespective of the significant difference of clumpiness; namely the ISM models only change clumpiness of discs. In addition, our approach provides a test to investigate impact by clump formation on the evolution of disc galaxies using the same initial conditions and feedback. We find that clump formation does not significantly alter the properties of galaxies and therefore could not be the causes of starburst or quenching.
Binary radial velocity measurements with space-based gravitational-wave detectors
Authors: Wong Kaze W K , Baibhav Vishal , Berti Emanuele
Published: July 2019

Unlike traditional electromagnetic measurements, gravitational-wave observations are not affected by crowding and extinction. For this reason, compact object binaries orbiting around a massive black hole can be used as probes of the inner environment of the black hole in regions inaccessible to traditional astronomical measurements. The orbit of the binary’s barycentre around the massive black hole will cause a Doppler shift in the gravitational waveform, which is in principle measurable by future space-based gravitational-wave interferometers, such as the Laser Interferometer Space Antenna (LISA). We investigate the conditions under which these Doppler shifts are observable by LISA. Our results imply that Doppler shift observations can be used to study the central region of globular clusters in the Milky Way, as well the central environment of extragalactic massive black holes.
Rayleigh–Taylor unstable flames at higher Reynolds number
Authors: Hicks E P
Published: July 2019

Rayleigh–Taylor (RT) unstable flames are a key component of Type Ia and Iax supernovae explosions, but their complex hydrodynamics is still not well understood. These flames are affected not only by the RT instability, but also by the turbulence it generates. Both processes can increase the flame speed by stretching and wrinkling the flame. This makes it hard to choose a subgrid model for the flame speed in full star Type Ia or Iax simulations. Commonly used subgrid models get around this difficulty by assuming that either the RT instability or turbulence is dominant and sets the flame speed. In previous work, we evaluated the physical assumptions and predictive abilities of these two types of models by analysing a large parameter study of 3D direct numerical simulations of RT unstable flames. Surprisingly, we found that the flame dynamics is dominated by the RT instability and that RT unstable flames are very different from turbulent flames. In particular, RT unstable flames are thinner rather than thicker when turbulence is strong. In addition, none of the turbulent flame speed models adequately predicted the flame speed. We also showed that the RT flame speed model failed when the RT instability was strong, suggesting that geometrical burning effects also influence the flame speed. However, these results depended on simulations with Re ≲ 720. In this paper, we extend the parameter study to higher Reynolds number and show that the basic conclusions of our previous study still hold when the RT-generated turbulence is stronger.
The complete local volume groups sample – III. Characteristics of group central radio galaxies in the Local Universe
Authors: Kolokythas Konstantinos , O’Sullivan Ewan , Intema Huib , Raychaudhury Somak , Babul Arif , Giacintucci Simona , Gitti Myriam
Published: July 2019

Using new 610 and 235 MHz observations from the giant metrewave radio telescope (GMRT) in combination with archival GMRT and very large array (VLA) survey data, we present the radio properties of the dominant early-type galaxies in the low-richness subsample of the complete local-volume groups sample (CLoGS; 27 galaxy groups) and provide results for the radio properties of the full CLoGS sample for the first time. We find a high radio detection rate in the dominant galaxies of the low-richness subsample of 82 per cent (22/27); for the full CLoGS sample the detection rate is 87 per cent (46/53). The group-dominant galaxies exhibit a wide range of radio power, 1020–1025 W Hz−1 in the 235 and 610 MHz bands, with the majority (53 per cent) presenting point-like radio emission, 19 per cent hosting currently active radio jets, 6 per cent having remnant jets, 9 per cent being diffuse, and 13 per cent having no detected radio emission. The mean spectral index of the detected radio sources in the 235−610 MHz frequency range is found to be $\alpha _{235}^{610}\sim$0.68, and $\alpha _{235}^{1400}\sim$0.59 in the 235−1400 MHz one. In agreement with earlier studies, we find that the fraction of ultrasteep spectrum sources (α > 1.3) is ∼4 per cent, mostly dependent on the detection limit at 235 MHz. The majority of point-like systems are found to reside in dynamically young groups, whereas jet systems show no preference between spiral-rich and spiral-poor group environments. The mechanical power of the jet sources in the low-richness sample groups is estimated to be ∼1042–1044 erg s−1 with their black hole masses ranging between 2 × 108 and 5 × 109 M⊙. We confirm previous findings that while radio jet sources tend to be associated with more massive black holes, black hole mass is not the decisive factor in determining jet activity or power.
Bayesian Estimation of Past Population Dynamics in BEAST 1.10 Using the Skygrid Coalescent Model
Authors: Hill Verity , Baele Guy
Published: July 2019

Inferring past population dynamics over time from heterochronous molecular sequence data is often achieved using the Bayesian Skygrid model, a nonparametric coalescent model that estimates the effective population size over time. Available in BEAST, a cross-platform program for Bayesian analysis of molecular sequences using Markov chain Monte Carlo, this coalescent model is often estimated in conjunction with a molecular clock model to produce time-stamped phylogenetic trees. We here provide a practical guide to using BEAST and its accompanying applications for the purpose of drawing inference under these models. We focus on best practices, potential pitfalls, and recommendations that can be generalized to other software packages for Bayesian inference. This protocol shows how to use TempEst, BEAUti, and BEAST 1.10 (http://beast.community/; last accessed July 29, 2019), LogCombiner as well as Tracer in a complete workflow.
Impacts of uORF codon identity and position on translation regulation
Authors: Lin Yizhu , May Gemma E , Kready Hunter , Nazzaro Lauren , Mao Mao , Spealman Pieter , Creeger Yehuda , McManus C Joel
Published: July 2019

Translation regulation plays an important role in eukaryotic gene expression. Upstream open reading frames (uORFs) are potent regulatory elements located in 5′ mRNA transcript leaders. Translation of uORFs usually inhibit the translation of downstream main open reading frames, but some enhance expression. While a minority of uORFs encode conserved functional peptides, the coding regions of most uORFs are not conserved. Thus, the importance of uORF coding sequences on their regulatory functions remains largely unknown. We investigated the impact of an uORF coding region on gene regulation by assaying the functions of thousands of variants in the yeast YAP1 uORF. Varying uORF codons resulted in a wide range of functions, including repressing and enhancing expression of the downstream ORF. The presence of rare codons resulted in the most inhibitory YAP1 uORF variants. Inhibitory functions of such uORFs were abrogated by overexpression of complementary tRNA. Finally, regression analysis of our results indicated that both codon identity and position impact uORF function. Our results support a model in which a uORF coding sequence impacts its regulatory functions by altering the speed of uORF translation.
C6orf203 is an RNA-binding protein involved in mitochondrial protein synthesis
Authors: Gopalakrishna Shreekara , Pearce Sarah F , Dinan Adam M , Rosenberger Florian A , Cipullo Miriam , Spåhr Henrik , Khawaja Anas , Maffezzini Camilla , Freyer Christoph , Wredenberg Anna , Atanassov Ilian , Firth Andrew E , Rorbach Joanna
Published: July 2019

In all biological systems, RNAs are associated with RNA-binding proteins (RBPs), forming complexes that control gene regulatory mechanisms, from RNA synthesis to decay. In mammalian mitochondria, post-transcriptional regulation of gene expression is conducted by mitochondrial RBPs (mt-RBPs) at various stages of mt-RNA metabolism, including polycistronic transcript production, its processing into individual transcripts, mt-RNA modifications, stability, translation and degradation. To date, only a handful of mt-RBPs have been characterized. Here, we describe a putative human mitochondrial protein, C6orf203, that contains an S4-like domain—an evolutionarily conserved RNA-binding domain previously identified in proteins involved in translation. Our data show C6orf203 to bind highly structured RNA in vitro and associate with the mitoribosomal large subunit in HEK293T cells. Knockout of C6orf203 leads to a decrease in mitochondrial translation and consequent OXPHOS deficiency, without affecting mitochondrial RNA levels. Although mitoribosome stability is not affected in C6orf203-depleted cells, mitoribosome profiling analysis revealed a global disruption of the association of mt-mRNAs with the mitoribosome, suggesting that C6orf203 may be required for the proper maturation and functioning of the mitoribosome. We therefore propose C6orf203 to be a novel RNA-binding protein involved in mitochondrial translation, expanding the repertoire of factors engaged in this process.
Should we continue to counsel families to use hydrolyzed formulas as a means of allergy prevention in high-risk infants?
Authors: Burke Megan , Chan Edmond S , Abrams Elissa M
Published: July 2019

The prevalence of food allergy in North America is high, and has increased over time. As a result, focus has shifted from treatment to allergy prevention. Previous studies have suggested that hydrolyzed formula may prevent atopic dermatitis in high-risk infants. As a result, multiple international guidelines including the Canadian Paediatric Society (CPS) position statement on allergy prevention recommend the use of hydrolyzed formula as a means of allergy prevention in mothers who are not breastfeeding or using donor breastmilk. However, a recent systematic review has not supported an association between use of hydrolyzed formula and allergy prevention. In addition, studies are emerging supporting the use of early and regular cow’s milk formula as a means of cow’s milk allergy prevention.
Unemployment and mortality in a large Italian cohort
Authors: d’Errico Angelo , Piccinelli Cristiano , Sebastiani Gabriella , Ricceri Fulvio , Sciannameo Veronica , Demaria Moreno , Di Filippo Paola , Costa Giuseppe
Published: July 2019

Background

Aim of this study was to examine the association between unemployment and mortality, taking into account potential confounders of this association. A secondary objective was to assess whether the association between unemployment and mortality was modified by lack of household economic resources.

Methods

Prospective cohort composed of a representative sample of Italian subjects 30–55 years who participated in the Italian National Health Survey 1999–2000, followed up for mortality up to 2012 (15 656 men and 11 463 women). Data were analyzed using Cox regression models, stratified by gender and adjusted for health status, behavioral risk factors, socioeconomic position and position in the household. The modifying effect of the lack of economic resources was assessed by testing its interaction with unemployment on mortality.

Results

Among women, unemployment was not associated with mortality, whereas among men, higher mortality was found from all causes (HR = 1.82), which was not modified by lack of economic resources, and from neoplasms (HR = 1.59), cardiovascular diseases (HR = 2.58) and suicides (HR = 5.01).

Conclusions

Results for men were robust to the adjustment for main potential confounders, suggesting a causal relationship between unemployment and mortality. The lack of effect modification by economic resources supports the relevance of the loss of non-material benefits of work on mortality.
The impact of fatigue in rheumatoid arthritis and the challenges of its assessment
Authors: Santos Eduardo J F , Duarte Catia , da Silva José A P , Ferreira Ricardo J O
Published: July 2019

Fatigue is one of the most important symptoms for patients with RA, and imposes a great burden on patients’ lives, being associated with significantly reduced health-related quality of life. Although being recognized by the rheumatology community as a major gap in the current management of the disease, fatigue has not been easy to measure and conceptualize. Part of the problem seems to reside in the multidimensional causality of this phenomenon, which may warrant dedicated measures and interventions. Although there are several instruments available to measure it, no consensus has yet been reached to recommend a ‘gold-standard’. This review aims at synthesizing the role of fatigue in the global impact of RA; describing validated instruments and their psychometric properties as measures of fatigue among patients with RA; and finally proposing a clinically meaningful, valid and feasible process to measure fatigue in clinical practice.
[18F]FDG positron emission tomography and ultrasound in the diagnosis of giant cell arteritis: congruent or complementary imaging methods?
Authors: Imfeld Stephan , Aschwanden Markus , Rottenburger Christof , Schegk Elke , Berger Christoph T , Staub Daniel , Daikeler Thomas
Published: July 2019

Objectives

[18F]Fluorodeoxyglucose (FDG)-PET/CT and US are both well established for diagnosing GCA. The present study investigates their accuracy and whether they provide overlapping or complementary information in a cohort of patients presenting with suspicion of GCA.

Methods

We selected consecutive patients from our cohort of suspected GCA cases that underwent both extended vascular US and PET/CT for diagnostic work-up between December 2006 and August 2012.

Results

A total of 102 patients were included. Diagnosis of GCA was confirmed in 68 patients and excluded in 34 patients (controls). Vasculitic changes in US were most often found in the temporal artery with 32 positive findings on each side, followed by the popliteal artery (10 right, 9 left) and the subclavian/axillary artery (7 right, 8 left). By contrast, PET/CT showed vasculitis most frequently in the vertebral (23 right, 33 left) and common carotid arteries (32 right, 24 left), followed by the subclavian arteries (16 right, 18 left), and the thoracic (17) and abdominal aorta (23). In 37/68 GCA patients PET/CT and US both revealed vasculitic findings, 11/68 had positive findings in US only and 14/68 in PET/CT only. Specificity of US was higher (one false-positive vs five false-positive in PET/CT). On a single segment level, only 20 of 136 positive segments were positive in both imaging modalities.

Conclusion

PET/CT measuring vessel wall metabolism and US vessel wall morphology showed a comparable diagnostic accuracy for GCA. However PET/CT and US were often discrepant within single vascular regions. Thus PET/CT and US should be considered as complementary methods, with a second imaging modality increasing the diagnostic yield by 16–20%.
Translatome Profiling of Plum Pox Virus–Infected Leaves in European Plum Reveals Temporal and Spatial Coordination of Defense Responses in Phloem Tissues
Authors: Collum Tamara D. , Stone Andrew L. , Sherman Diana J. , Rogers Elizabeth E. , Dardick Christopher , Culver James N.
Published: July 2019

Plum pox virus (PPV) is the causative agent of sharka, a devastating disease of stone fruits including peaches, apricots, and plums. PPV infection levels and associated disease symptoms can vary greatly, depending upon the virus strain, host species, or cultivar as well as developmental age of the infected tissues. For example, peaches often exhibit mild symptoms in leaves and fruit while European plums typically display severe chlorotic rings. Systemic virus spread into all host tissues occurs via the phloem, a process that is poorly understood in perennial plant species that undergo a period of dormancy and must annually renew phloem tissues. Currently, little is known about how phloem tissues respond to virus infection. Here, we used translating ribosome affinity purification followed by RNA sequencing to identify phloem- and nonphloem-specific gene responses to PPV infection during leaf development in European plum (Prunus domestica L.). Results showed that, during secondary leaf morphogenesis (4- and 6-week-old leaves), the phloem had a disproportionate response to PPV infection with two- to sixfold more differentially expressed genes (DEGs) in phloem than nonphloem tissues, despite similar levels of viral transcripts. In contrast, in mature 12-week-old leaves, virus transcript levels dropped significantly in phloem tissues but not in nonphloem tissues. This drop in virus transcripts correlated with an 18-fold drop in phloem-specific DEGs. Furthermore, genes associated with defense responses including RNA silencing were spatially coordinated in response to PPV accumulation and were specifically induced in phloem tissues at 4 to 6 weeks. Combined, these findings highlight the temporal and spatial dynamics of leaf tissue responses to virus infection and reveal the importance of phloem responses within a perennial host.
Using pharmacogenetics in primary care
Authors: Murfin Melissa
Published: July 2019

Pharmacogenetics offers a way to personalize medication prescribing for patients. Through the use of genetic tests that identify variations in enzymes important to drug metabolism, PAs can have patients' genetic information before prescribing a medication. This may reduce the risks of adverse reactions and lost treatment time when patients are given drugs to which they are unlikely to respond. Laboratory testing can identify common genetic variants that alter how the body metabolizes drugs. PAs with knowledge of these variants can choose medications that are more personalized and effective for each patient. Clinical pharmacogenetic guidelines are under development and will help providers identify which drugs are most likely to be affected by genetic variations so they can prescribe for patients based on their specific genetic phenotypes.
Outcomes of a Longitudinal Quality Improvement and Patient Safety Preclerkship Curriculum
Authors: Dumenco Luba , Monteiro Kristina , George Paul , Rougas Steven , Dollase Richard
Published: July 2019

Purpose

To evaluate whether quality improvement (QI) and patient safety (PS) training in preclerkship medical education resulted in students’ development and retention of knowledge, application-based and perceived skills, and attitudes throughout clerkships.

Method

A longitudinal QI/PS curriculum with multimodal curricular components was implemented in the preclerkship curriculum between 2015 and 2017 at the Warren Alpert Medical School of Brown University, Rhode Island. Assessments were administered at baseline (T1), end of year 1 (T2), Clinical Skills Clerkship (T3), and end of clerkships (T4) in the intervention cohort (n = 97). In 2018, T4 data for this cohort were compared with a prior control cohort (n = 97) at T4.

Results

Results of knowledge-based multiple-choice questions (MCQs) (t[134] = −1.57, P < .001) and application-based skills (t[132] = −8.91, P < .001) demonstrated significant improvement from T1 to T2 (intervention cohort). Assessments of perceived skills showed significant growth from T1 to T2 (t[137] = −23.38, P < .001). Performance on application-based skills significantly improved from T2 to T3 (t[123] = −4.11, P < .001). Compared with the control cohort, the intervention cohort had significantly higher scores on MCQs (t[187.88] = 3.98, P < .001), application-based skills (t[72.69] = 6.40, P < .001), perceived skills (t[106.99] = 5.24, P < .001), and attitudes (t[152] = 5.86, P < .001).

Conclusions

Incorporation of preclerkship QI/PS training resulted in improvements in knowledge, application-based and perceived skills, and attitudes that were retained throughout clerkships.
Exploring the Socialization Experiences of Medical Students From Social Science and Humanities Backgrounds
Authors: Lam Justin T.H. , Hanson Mark D. , Martimianakis Maria Athina (Tina)
Published: July 2019

Purpose

To explore the structural, cultural, and interpersonal issues that may contribute to the inadvertent marginalization of medical students with social science and humanities (SSH) backgrounds.

Method

Using the hidden curriculum as an analytic construct, the lead author interviewed 14 medical students with SSH backgrounds at the University of Toronto Faculty of Medicine from February to October 2015. The authors analyzed the interview transcripts for common themes around positive and negative cultural, structural, and interpersonal dimensions of the socialization process.

Results

Participants reported barriers to applying to medical school: needing to complete prerequisite courses and to do well on an exam geared toward those with a strong science background (the Medical College Admission Test) and lacking an application cohort. Some participants felt they were not ideal candidates for medical school. Participants appreciated how their SSH backgrounds and associated skill sets shaped both their perspectives on patient care and their developing professional identities. However, they perceived that others largely deemed their previous training as irrelevant, and they felt marginalized in medical school by peers, instructors, and the curriculum. These experiences led both to self-censorship, which enabled them to seem to conform to normative behaviors, and to the pursuit of reaffirming elective experiences.

Conclusions

The existing hidden curriculum inadvertently marginalizes SSH medical students; their experiences likely reflect the socialization experiences of other students from underrepresented backgrounds. Curricular and institutional reforms are imperative to shift the hidden curriculum toward one of epistemological inclusion that better supports students from nontraditional backgrounds.