bluuebunny/crossref_metadata_2025 huggingface dataset:
WELFARE COSTS OF SHIFTING TREND INFLATION: STAGGERED WAGE AND PRICE CONTRACTS
Authors: Lê Thanh Hà , Tô Trung Thành , Doan Ngoc Thang
Published: April 2019

We develop a New Keynesian model featuring staggered price and wage contracts to study welfare costs of exogenous variations in trend inflation. The analyses show that the consequences of constant positive trend inflation and shifting trend inflation are severe, especially when trend inflation is high. Among two channels, staggered wage contracts play a vital role in transmitting adverse impacts of constant and shifting trend inflation into the economy. Without the staggered wage channel, these costs are modest. We also conduct exercises to examine the sensitivity of welfare costs to a wide range of plausible parameters. The results show that if the price and wage friction are sufficiently large, the price and wage indexation level are sufficiently small, or there is upward biased trend inflation process, the welfare costs become larger.
Clinical and radiographic peri‐implant outcomes of short dental implants placed in posterior jaws of patients with treated generalized aggressive periodontitis: A 3‐year follow‐up study
Authors: Akram Zohaib , Vohra Fahim , Sheikh Saeed A. , Albaijan Refal , Bukhari Ishfaq A. , Hussain Mudassir
Published: April 2019

Background

Studies assessing clinical and radiographic peri‐implant parameters around short dental implants (SDIs) in treated generalized aggressive periodontitis (GAgP) patients are scant.

Objectives

This 3‐year follow‐up study aimed to compare the clinical peri‐implant and radiographic bone status around SDIs placed in partially edentulous patients treated for GAgP and periodontally healthy patients and to assess the implant success rate between both the groups.

Materials and Methods

A total of seven patients clinically diagnosed with GAgP and seven periodontally healthy patients was included in the clinical study. Forty‐eight (29 maxilla; 19 mandible) and 11 (8 maxilla; 3 mandible) SDIs were placed in the GAgP group and healthy group, respectively. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were recorded at six sites around all teeth and implants. Marginal bone loss (MBL) was studied incorporating in a specialized software and examined on a calibrated computer display screen with the help of an image analyzer. Patient satisfaction was recorded using a questionnaire sheet that contained questions regarding esthetics and function of the restorations.

Results

The implant survival rate after 3 years was 81.25%. BOP and CAL around SDIs of GAgP patients were significantly higher than in periodontally healthy subjects (P = .01) throughout the follow‐up. CAL around the teeth of GAgP patients was significantly greater during the follow‐up than around the teeth of periodontal healthy subjects (P = .02). The PI and BOP between the teeth and implants showed no statistical significant difference. The mean PD at teeth was 0.4 mm greater than at implants. Implants showed significantly increased attachment loss than teeth (P = .01). The overall mean satisfaction of visual analogue scale was 12.8 ± 1.45.

Conclusion

This short‐term follow‐up study indicates SDIs remain functionally stable in the posterior jaws of treated GAgP patients.
The use of nonfinancial performance measures in CEO bonus compensation
Authors: Cho MyoJung , Ibrahim Salma , Yan Yan
Published: April 2019

Research Question/Issue

In this study, we explore the relationship between the use of nonfinancial performance measures in Chief Executive Officer (CEO) bonus plans and CEO power, moderated by compensation committee monitoring. Furthermore, we investigate whether the inclusion of nonfinancial performance measures is associated with higher CEO bonus pay sensitivity to shareholder returns.

Research Findings/Insights

Using a sample of FTSE 350 firms during the period 2007–2013, we find that CEO power is significantly negatively related to the propensity of using nonfinancial performance measures. This negative relationship, however, is moderated by higher levels of compensation committee monitoring. We also find that firms combining nonfinancial and financial performance measures in CEO bonus plans tend to have stronger CEO bonus pay sensitivity to shareholder returns than firms using financial measures alone. Thus, our results suggest that boards of directors adopting nonfinancial performance measures are able to better align CEO incentives with shareholder interests. We find similar results when using the weight of nonfinancial performance measures in the bonus plan in our analyses.

Theoretical/Academic Implications

This study empirically supports the managerial power theory whereby powerful CEOs influence the choice of performance measures in their bonus plans. However, effective compensation committees are found to attenuate the influence of powerful CEOs and to better align their interests with those of shareholders. Our result of stronger bonus pay sensitivity to shareholder returns for firms combining nonfinancial with financial performance measures implies that the informativeness of these measures enhances the firm's ability to tie CEO bonus compensation to shareholder wealth.

Practitioner/Policy Implications

This study offers insights to members of boards of directors, especially compensation committee members, who are interested in improving the design of executive incentive contracts to better align managerial incentives to shareholder interests. Furthermore, the findings inform regulators about the importance of alternative performance measures in pay‐performance sensitivity and may warrant increased firm disclosure of the details of the pay structure.
Suppression of long non‐coding RNA TNRC6C‐AS1 protects against thyroid carcinoma through DNA demethylation of STK4 via the Hippo signalling pathway
Authors: Yang Liu‐Xue , Wu Ji , Guo Man‐Li , Zhang Yong , Ma Shao‐Gang
Published: April 2019

Objectives

Thyroid carcinoma (TC) represents a malignant neoplasm affecting the thyroid. Current treatment strategies include the removal of part of the thyroid; however, this approach is associated with a significant risk of developing hypothyroidism. In order to adequately understand the expression profiles of TNRC6C‐AS1 and STK4 and their potential functions in TC, an investigation into their involvement with Hippo signalling pathway and the mechanism by which they influence TC apoptosis and autophagy were conducted.

Methods

A microarray analysis was performed to screen differentially expressed lncRNAs associated with TC. TC cells were employed to evaluate the role of TNRC6C‐AS1 by over‐expression or silencing means. The interaction of TNRC6C‐AS1 with methylation of STK4 promoter was evaluated to elucidate its ability to elicit autophagy, proliferation and apoptosis.

Results

TNRC6C‐AS1 was up‐regulated while STK4 was down‐regulated, where methylation level was elevated. STK4 was verified as a target gene of TNRC6C‐AS1, which was enriched by methyltransferase. Methyltransferase’s binding to STK4 increased expression of its promoter. Over‐expressed TNRC6C‐AS1 inhibited STK4 by promoting STK4 methylation and reducing the total protein levels of MST1 and LATS1/2. The phosphorylation of YAP1 phosphorylation was decreased, which resulted in the promotion of SW579 cell proliferation and tumorigenicity.

Conclusion

Based on our observations, we subsequently confirmed the anti‐proliferative, pro‐apoptotic and pro‐autophagy capabilities of TNRC6C‐AS1 through STK4 methylation via the Hippo signalling pathway in TC.
Fetal Intra‐pericardial Morgagni Hernia with effusion affecting one member of a twin gestation
Authors: Abutaqa Mohammed , Tayeh Christelle , Charafeddine Fatme , Bitar Fadi , Arabi Mariam
Published: April 2019

Congenital diaphragmatic hernia (CDH) is a rare type of developmental defect of the diaphragm, occurring in 1 per 2000 pregnancies. Morgagni hernia, in particular, which results from an anterior defect of the diaphragm, is the least common type of CDH (5%). Herniation of the liver into the pericardial space, presenting as a thoracic mass with pericardial effusion, is an extremely rare form of Morgagni hernia. Such reported cases are few and occurred only in singleton pregnancies. To the best of our knowledge, we report the first case of fetal echocardiography and fetal MRI following referral due to large pericardial effusion.
Humility in Teaching
Authors: Waks Leonard J.
Published: April 2019

In order to extend our understanding of the relationship between humility and teaching, Leonard Waks investigates both humility and teaching as philosophical concepts and considers their conceptual connections. In doing so, he shows how humility is related conceptually to teaching in unexpected ways. He begins by offering some reflections on the term “humility” and its origins, and next moves to an analysis of the concept of humility. His analysis, first, distinguishes between negative and positive humility and then differentiates two types of positive humility: (1) analytic or self‐critical humility, and (2) immersive or transpersonal humility. After expanding on the meanings of these terms, Waks relates both types of positive humility to the three most developed contemporary philosophical conceptions of teaching: the analytic, feminist, and critical pedagogy conceptions. He relies exclusively on the classic, canonical, or paradigmatic formulations of these conceptions, showing that humility is at the heart of all three of these philosophical “paradigms.” Waks concludes that, while his analysis does not demonstrate that humility is a cardinal virtue of teaching, it does justify the hypothetical assertion that humility is a cardinal virtue if any of the three well‐developed conceptions, or any synthesis of them, is accepted.
Child Rearing, Risk, and Striving for Human Flourishing
Authors: Wolbert Lynne , de Ruyter Doret J. , Schinkel Anders
Published: April 2019

Parenthood can be characterized as a leap of faith; it is inevitably “risky.” Here, Lynne Wolbert, Doret J. de Ruyter, and Anders Schinkel argue that this characterization of parenthood seems opposite to the current use of the concept of “risk” in contemporary educational theory and policy, which emphasizes that risk is something that is best prevented or avoided. Otto Friedrich Bollnow distinguishes between avoidable risks, on the one hand, and existential risks (Wagnis), on the other. The authors contend that Bollnow's description of education as a Wagnis (1) reinforces the understanding of child rearing and striving for flourishing as inherently uncertain; (2) contributes to a clarification of the ways in which the concept of risk is being used in educational theory and policymaking; and (3) leads us to recognize “trust” as a key concept in discussing risk taking and child rearing.
Response to Edwards and Ogilvie
Authors: Foreman‐Peck James , Zhou Peng
Published: April 2019

Our article on ‘Late marriage as a contributor to the industrial revolution in England’ is intended to show that the evidence is consistent with the European marriage pattern being a major influence on long‐run English economic development, through the accumulation of human capital, broadly defined. Edwards and Ogilvie assert that our approach is inadequate because, they claim, we consider neither other influences on English industrialization, such as non‐familial institutions, nor other European economies where marriage age was high throughout the early modern period but where industrialization came later. We do allow for other influences on English industrialization in our model, and the observation that some late industrializers had later marriage than England does not refute our contention, which we test appropriately by simulating the model.
Can mispricing explain the value premium?
Authors: Jaffe Jeffrey F. , Jindra Jan , Pedersen David J. , Voetmann Torben
Published: April 2019

Empirical research finds that stocks with low market‐to‐book (MTB) ratios outperform stocks with high MTB ratios. Rhodes‐Kropf, Robinson, and Viswanathan separate the MTB ratio into mispricing and growth options components. We report that the mispricing component, but not the growth options component, predicts abnormal returns for up to 5 years. We also find that the mispricing component, but not the growth options component, provides incremental information relative to existing asset pricing models. Moreover, after controlling for mispricing, value no longer beats growth. Overall, our evidence is consistent with a behavioral explanation of the value premium.
Regulatory Soft Interventions in the Chinese Market: Compliance Effects and Impact on Option Market Efficiency
Authors: Hilliard Jimmy E. , Zhang Haoran
Published: April 2019

Securities Laws in China are administered by the China Securities Regulatory Commission (CSRC). The CSRC has great flexibility in administering securities laws since the committee represents the will of the state. Under the state‐controlled financial system, the CSRC works closely with state‐controlled financial firms and suggests, but does not mandate, actions to be taken in the equity market, especially during periods of extreme market stress. These suggestions, or soft interventions, have been used to block trades associated with short sales, significantly reducing short‐sales volume. With daily and intraday data, we investigate the impact of these interventions on put‐call parity and implied volatilities. There is overwhelming evidence of increased deviations from put‐call parity and changes in implied volatility after soft interventions. Our results are robust after allowing for bid‐ask spreads, taxes, transaction costs, and difference‐in‐differences comparisons with control securities in the Hong Kong market.
Evolutionary conserved pathway of the innate immune response after a viral insult in Paracentrotus lividus sea urchin
Authors: Chiaramonte Marco , Arizza Vincenzo , Russo Roberta
Published: April 2019

Despite the apparent simplicity of the body organization of echinoderms, their immune system is competent to perform a complex innate immune response, which is far from being well understood. The echinoderms represent the most advanced invertebrates that form a bridge with the primitive chordates. In fact, they possess numerous receptors and effectors that are used to obtain a fast immune response. After an infection, the humoral and cellular immune response determines a network in which the main protagonists are membrane and endosomal receptors. The recognition of nonself molecules by specific membrane receptors triggers the immune response, stimulating consecutive intracellular events. We have previously shown how the polyinosinic–polycytidylic acid (polyI:C) that mimics a viral infection is able to induce an immune response in the sea urchin Paracentrotus lividus immune cells. It activates a specific membrane receptor belonging to the Toll‐like receptor (TLR) family. Here, we show the activated expression pattern of some genes involved in the downstream cascade of TLR signalling pathway, such as Pl‐Tbk and Pl‐Irf, whose partial sequence was isolated from P. lividus immune cells. Their mRNA expression increases consequentially to the polyI:C stimulation and in a temporal way. In addition, we analysed the expression of Pl‐NF‐kB and we found that its upregulation was time‐dependent, preceding Pl‐Tbk and Pl‐Irf increase. Protein analysis showed that also some cytokine (TNF‐α and IL‐1α) expression increased after polyI:C insult. Therefore, the purpose of this study was to discover the molecular mechanisms of the innate defence strategies, similarly to vertebrates, implemented by the sea urchins in order to cope with viral infection challenge.
Percentage of hypochromic red cells as a potential screening test to evaluate iron status in blood donors
Authors: Amir Noraini , Md Noor Sabariah , Subbiah Indhira , Osman Malina , Seman Zainina
Published: April 2019

Introduction

Haemoglobin (Hb) levels are used to assess eligibility for blood donation but are not correlated with iron status. The percentage of hypochromic red cells (%Hypo‐He) has been suggested as a useful screening parameter for iron deficiency. The aim of this study was to determine the cut‐off level and accuracy of %Hypo‐He screening among blood donors.

Materials and Methods

A total of 170 blood donors were recruited into the study. Blood donors were classified into three groups: normal, latent iron deficiency and iron deficiency anaemia based on their Hb, serum ferritin and transferrin saturation (TSAT) levels. The diagnostic performance of %Hypo‐He was evaluated with a validation group comprising 160 blood donors.

Results

Receiver operating characteristic (ROC) curve analysis showed that %Hypo‐He is an excellent parameter for detecting iron deficiency, with an area under the curve (AUC) of 0.906, a confidence interval (CI) of 0.854‐0.957 at a cut‐off of 0.6%, and 74.51% sensitivity and 88.24% specificity. A moderate negative correlation between %Hypo‐He and TSAT (ρ = −0.576 [P < 0.001]) and a strong negative correlation between %Hypo‐He and serum ferritin (ρ = −0.703 [P < 0.001]) were found. A cut‐off value of 0.6% was applied to the validation group and showed 82.9% sensitivity and 96% specificity.

Conclusion

%Hypo‐He with a cut‐off value of 0.6% is a potential parameter with high sensitivity and specificity for evaluating iron status among blood donors. This parameter is suitable for screening because its measurement has a faster turnaround time than biochemical markers.
Public health nurses’ perinatal mental health training needs: A cross sectional survey
Authors: Noonan Maria , Galvin Rose , Jomeen Julie , Doody Owen
Published: April 2019

Aim

To examine public health nurses’ education, training, and professional support needs in perinatal mental health.

Background

Public health nurses have a key role in supporting maternal mental health including screening, support, referral, and decreasing stigmatization.

Design

A cross‐sectional survey.

Methods

Data were collected from a convenience sample of Irish public health nurses (N = 105) from December 2016–February 2018. The anonymous postal survey consisted of the Perinatal Mental Health Questionnaire, Mental Illness: Clinician's Attitudes scale and Perinatal Mental Health Learning Needs questionnaire.

Results

Public health nurses reported good levels of knowledge (77.2%) and confidence (83.8%) in recognising women experiencing stress, anxiety and depression. They indicated less confidence in caring (50.5%) for women. The average score for the Mental Illness: Clinician's Attitudes scale was 35.9 (SD 5.9), suggesting positive attitudes towards women with significant mental illness.

Conclusion

Public health nurses require educational opportunities to explore expressions of psychological distress across cultures and their own personal attitudes to mental health, systems of clinical supervision, and support pathways.

Impact

Generating new knowledge on the importance of incorporating an attitude component in perinatal mental health education for public health nurses.
Effects of digital terrain model uncertainties on high‐resolution urban flood damage assessment
Authors: Arrighi Chiara , Campo Lorenzo
Published: April 2019

This work investigates the impact of high‐resolution digital terrain model (DTM) uncertainties on the estimation of urban flood losses. Starting from a Light Detection And Ranging (LiDAR)‐derived DTM of an urban area, four digital terrain representations (raw data, building footprints filled, buildings as waterproof blocks, and different elevation data merged) are used to generate a computational mesh to run a 2D flood model for three inundation scenarios, differing in flood volumes. The most detailed DTM is obtained by merging the DTM with elevation points based on a two‐step optimal interpolation algorithm. A flood damage model based on stage‐damage curves is used to estimate monetary losses to structures at the building scale. Flood maps and flood losses are then compared for each terrain representation. The application of the method to an Italian urban district shows that (a) a significant mismatch between manually surveyed elevation points and DTM can be observed, (b) different sources of elevation data can be merged to obtain an optimal representation of the terrain, (c) in dense urban settlements, important differences in flood extent and losses (up to 180%) occur depending on terrain representation. Considerations on time effort required by the increasing detail of the DTM and on the transferability of the results are presented.
Decreasing length of limb immobilisation following nonelective transfemoral percutaneous coronary intervention: A randomised clinical trial
Authors: Santos Vinicius Batista , Melo Luize Máximo e , Assis Ana Raquel Viegas de , Moraes Juliana Brito de , Lopes Camila Takao , Lopes Juliana de Lima , Barros Alba Lucia Bottura Leite de
Published: April 2019

Aims and objectives

To assess the intensity and frequency of pain, use of analgesic drugs, and the incidence of paraesthesia, urinary retention and vascular complications upon decreasing affected limb immobilisation from 4–2 hrs after sheath removal in patients submitted to transfemoral percutaneous coronary intervention (PCI).

Background

After sheath removal from the femoral artery following urgent or emergency PCI, patients are maintained with limb immobilisation for a mean period of 4 hr.

Design

Randomised clinical trial (RCT) based on the CONSORT guidelines.

Method

Randomised clinical trial was performed in patients with Acute Coronary Syndrome submitted to transfemoral PCI. The intervention group was submitted to a supine position with the head of the bed elevated (30‐degree angle) with affected limb immobilisation for 2 hr after sheath removal and the control group for 4 hrs. The outcomes were pain complaints, need for analgesic drugs, incidence of paraesthesia, urinary retention and vascular complications. The outcomes were assessed immediately, 6, 12 and 24 hr after release from limb immobilisation before the patients were released from bed rest.

Results

A total of 150 patients (75 in each group) participated in the study. No significant differences in outcomes were observed between the groups, except in relation to the haematoma formation that was higher in the intervention group.

Conclusion

A reduced length of limb immobilisation after sheath removal following PCI does not change the frequency and intensity of pain, need of analgesic drugs, urinary retention and paraesthesia. The incidence of haematoma was higher in the intervention group, without significant clinical manifestations.

Relevance to clinical practice

The results of this study can be considered for patients submitted to elective, urgent or emergency PCI, who have a lower risk of complications, thereby allowing for decreased periods of limb immobilisation.
Nurses' information practice in municipal health care—A web‐like landscape
Authors: Østensen Elisabeth , Bragstad Line Kildal , Hardiker Nicholas R. , Hellesø Ragnhild
Published: April 2019

Aim

To uncover the characteristics of nurses' information practice in municipal health care and to address how, when and why various pieces of information are produced, shared and managed.

Background

Nursing documentation in the electronic patient record has repeatedly been found unsatisfactory. Little is known about how the information practice of nurses in municipal health care actually is borne out. In order to understand why nursing documentation continues to fail at living up to the expected requirements, a better understanding of nurses' information practice is needed.

Design

A qualitative observational field study. The study complied with the Consolidated Criteria for Reporting Qualitative Research.

Methods

Empirical data were collected in three Norwegian municipalities through participant observations and individual interviews with 17 registered nurses on regular day shifts. The data were analysed through thematic content analysis.

Results

Nurses' information practice in municipal health care can be described as complex. The complexity is reflected in four themes that emerged from the data: (1) web of information sources, (2) knowing the patient and information redundancy, (3) asynchronous information practice and (4) compensatory workarounds.

Conclusions

The complex and asynchronous nature of nurses' information practice affected both how and when information was produced, recorded and shared. When available systems lacked functions the nurses wanted, they created compensatory workarounds. Although electronic patient record was an important part of their information practice, nurses in long‐term care often knew their patients well, which meant that a lot of information about the patients was in their heads, and that searching for information in the electronic patient record sometimes seemed redundant.

Relevance to clinical practice

This study provides contextual knowledge that might be valuable (a) in the further development of information systems tailored to meet nurses' information needs and (b) when studying patient safety in relation to nurses' information practice.
Development and validation of the pressure ulcer management self‐efficacy scale for nurses
Authors: Dellafiore Federica , Arrigoni Cristina , Ghizzardi Greta , Baroni Irene , Conte Gianluca , Turrini Francesca , Castiello Gianluca , Magon Arianna , Pittella Francesco , Caruso Rosario
Published: April 2019

Background

Pressure ulcers (PUs) represent a current issue for healthcare delivery. Nurse self‐efficacy in managing PUs could predict patients’ outcome, being a proxy assessment of their overall competency to managing PUs. However, a valid and reliable scale of this task‐specific self‐efficacy has not yet been developed.

Objectives

To develop a valid and reliable scale to assess nurses’ self‐efficacy in managing PUs, that is, the pressure ulcer management self‐efficacy scale for nurses (PUM‐SES).

Methods

This study had a multi‐method and multi‐phase design, where study reporting was supported by the STROBE checklist (File S1). Phase 1 referred to the scale development, consisting in the items’ generation, mainly based on themes emerged from the literature and discussed within a panel of experts. Phase 2 focused on a three‐step validation process: the first step aimed to assess face and content validity of the pool of items previously generated (initial version of the PUM‐SES); the second aimed to assess psychometrics properties through exploratory factorial analysis; the third step assessed construct validity through confirmative factorial analysis, while concurrent validity was evaluated describing the relationships between PUM‐SES and an established general self‐efficacy measurement. Reliability was assessed through the evaluation of stability and internal consistency.

Results

PUM‐SES showed evidence of face and content validity, adequate construct and concurrent validity, internal consistency and stability. Specifically, PUM‐SES had four domains, labelled as follows: assessment, planning, supervision and decision‐making. These domains were predicted by the same second‐order factor, labelled as PU management self‐efficacy.

Conclusion

PUM‐SES is a 10‐item scale to measure nurses’ self‐efficacy in PU management. A standardised 0–100 scoring is suggested for computing each domain and the overall scale. PUM‐SES might be used in clinical and educational research.

Relevance to clinical practice

Optimising nurses’ self‐efficacy in PU management might enhance clinical assessment, determining better outcomes in patients with PUs.
Adolescents’ Subjective Social Status Predicts Day‐to‐Day Mental Health and Future Substance Use
Authors: Russell Michael A. , Odgers Candice L.
Published: April 2019

Adolescents’ subjective social status (SSS) is associated with mental and behavioral health outcomes, independent of socioeconomic status (SES). Many previous findings, however, come from cross‐sectional studies. We report results from a longitudinal study with 151 adolescents identified as at risk for early substance use and behavioral problems sampled from low‐SES neighborhoods. We examined whether adolescent's SSS predicted mental health (depression, anxiety, and inattention/impulsivity) measured over 30 days via ecological momentary assessment and risk for substance use at an 18‐month follow‐up. Results showed that with each perceived step “up” the SSS ladder, adolescents experienced fewer mental health symptoms in daily life and lower future substance use risk after adjusting for objective SES and previous psychopathology. Implications of these findings are discussed.
Evaluating the Effects of a Personal Hygiene Program on the Knowledge, Skills, and Attitudes of Intellectual Disabilities Teenagers and their Parents
Authors: Konuk Sener Dilek , Aydin Meryem , Cangur Sengul
Published: April 2019

To determine the effects of personal hygiene training on the knowledge, skills, attitudes and behavior of teenagers with mild intellectual disabilities (ID), this study employed a randomized controlled type, social cognitive theory design. A 10‐week, 10‐session program was given to the teenagers (17.38 ± 1.61 years) and their parent. Included in the program were activities covering the washing of hands/face/hair/body, oral hygiene/brushing teeth, clothing hygiene, and menstrual and genital hygiene. At the end of the program and again 3 months later, the personal hygiene habits of the teenagers were significantly improved compared to before the training program. Significantly positive changes were observed in hygiene habits compared to pretraining (p < .001). Compared to pretraining, a significant increase occurred in the skill behavior demonstrated by the teenagers (p < .001). Consequently, it is recommended that the program be implemented by healthcare professionals for all teenagers with mild ID and their parents.
An EFR‐Cf‐9 chimera confers enhanced resistance to bacterial pathogens by SOBIR1‐ and BAK1‐dependent recognition of elf18
Authors: Wu Jinbin , Reca Ida‐Barbara , Spinelli Francesco , Lironi Damiano , De Lorenzo Giulia , Poltronieri Palmiro , Cervone Felice , Joosten Matthieu H.A.J. , Ferrari Simone , Brutus Alexandre
Published: April 2019

The transfer of well‐studied native and chimeric pattern recognition receptors (PRRs) to susceptible plants is a proven strategy to improve host resistance. In most cases, the ectodomain determines PRR recognition specificity, while the endodomain determines the intensity of the immune response. Here we report the generation and characterization of the chimeric receptor EFR‐Cf‐9, which carries the ectodomain of the Arabidopsis thaliana EF‐Tu receptor (EFR) and the endodomain of the tomato Cf‐9 resistance protein. Both transient and stable expression of EFR‐Cf‐9 triggered a robust hypersensitive response (HR) upon elf18 treatment in tobacco. Co‐immunoprecipitation and virus‐induced gene silencing studies showed that EFR‐Cf‐9 constitutively interacts with SUPPRESSOR OF BIR1‐1 (SOBIR1) co‐receptor, and requires both SOBIR1 and kinase‐active BRI1‐ASSOCIATED KINASE1 (BAK1) for its function. Transgenic plants expressing EFR‐Cf‐9 were more resistant to the (hemi)biotrophic bacterial pathogens Pseudomonas amygdali pv. tabaci (Pta) 11528 and Pseudomonas syringae pv. tomato DC3000, and mounted an HR in response to high doses of Pta 11528 and P. carotovorum. Taken together, these data indicate that the EFR‐Cf‐9 chimera is a valuable tool for both investigating the molecular mechanisms responsible for the activation of defence responses by PRRs, and for potential biotechnological use to improve crop disease resistance.
Global population genomics of the forest pathogen Dothistroma septosporum reveal chromosome duplications in high dothistromin‐producing strains
Authors: Bradshaw Rosie E. , Sim Andre D. , Chettri Pranav , Dupont Pierre‐Yves , Guo Yanan , Hunziker Lukas , McDougal Rebecca L. , Van der Nest Ariska , Fourie Arista , Wheeler David , Cox Murray P. , Barnes Irene
Published: April 2019

Dothistroma needle blight is one of the most devastating pine tree diseases worldwide. New and emerging epidemics have been frequent over the last 25 years, particularly in the Northern Hemisphere, where they are in part associated with changing weather patterns. One of the main Dothistroma needle blight pathogens, Dothistroma septosporum, has a global distribution but most molecular plant pathology research has been confined to Southern Hemisphere populations that have limited genetic diversity. Extensive genomic and transcriptomic data are available for a D. septosporum reference strain from New Zealand, where an introduced clonal population of the pathogen predominates. Due to the global importance of this pathogen, we determined whether the genome of this reference strain is representative of the species worldwide by sequencing the genomes of 18 strains sampled globally from different pine hosts. Genomic polymorphism shows substantial variation within the species, clustered into two distinct groups of strains with centres of diversity in Central and South America. A reciprocal chromosome translocation uniquely identifies the New Zealand strains. Globally, strains differ in their production of the virulence factor dothistromin, with extremely high production levels in strain ALP3 from Germany. Comparisons with the New Zealand reference revealed that several strains are aneuploids; for example, ALP3 has duplications of three chromosomes. Increased gene copy numbers therefore appear to contribute to increased production of dothistromin, emphasizing that studies of population structure are a necessary adjunct to functional analyses of genetic polymorphisms to identify the molecular basis of virulence in this important forest pathogen.
Endothelin‐A receptor in gastric cancer and enhanced antitumor activity of trastuzumab in combination with the endothelin‐A receptor antagonist ZD4054
Authors: Shen Weisong , Xi Hongqing , Li Chenyang , Bian Shibo , Cheng Haidong , Cui Jianxin , Wang Ning , Wei Bo , Huang Xiaohui , Chen Lin
Published: April 2019

Endothelin‐A receptor (ETAR) is overexpressed in cancers and can function through transactivation of the epidermal growth factor receptor. We explored ETAR in gastric cancer and investigated the antitumor effect of trastuzumab in combination with the ETAR antagonist ZD4054. The expression of ETAR was significantly correlated with the expression of vascular endothelial growth factor. Univariate and multivariate analyses further showed that ETAR expression correlated with reduced survival in gastric cancer patients. In vitro, ZD4054 increased the antiproliferative effect of trastuzumab in gastric cancer cell lines. Moreover, the addition of ZD4054 to trastuzumab significantly increased apoptosis in gastric cancer cell lines. In vivo, tumor growth was considerably inhibited by treatment with ZD4054 and trastuzumab, and the tumor volume in the trastuzumab and ZD4054 combination group was smaller than in the other groups. The detection of ETAR could help predict the prognosis of gastric cancer patients. Additionally, this study provides support for the therapeutic use of the combination of ZD4054 and trastuzumab as an anticancer treatment, especially for gastric cancer.
Accuracy of pulse oximeters at low oxygen saturations in children with congenital cyanotic heart disease: An observational study
Authors: Kim Eun‐Hee , Lee Ji‐Hyun , Song In‐Kyung , Kim Hee‐Soo , Jang Young‐Eun , Yoo Seokha , Kim Jin‐Tae
Published: April 2019

Background

Pulse oximetry overestimates arterial oxygen saturation (SaO2) at less than 90% saturation in cyanotic children. The Masimo Blue sensor (Masimo Corp., Irvine, CA) is a pulse oximetry sensor developed for use in children with cyanosis. However, there remains a lack of research in actual clinical practice.

Aims

We evaluated the intraoperative performance of three different pulse oximeters to measure oxyhemoglobin saturation (SpO2) at low saturations in pediatric patients with cyanotic heart disease and the influence of clinical variables (SaO2, hemoglobin concentration, perfusion index, and weight) on the accuracy of the sensors.

Methods

This prospective observational study compared SpO2 measured using three pulse oximeters (Masimo Blue [Masimo Corp., Irvine, CA]; Masimo LNCS, and Nellcor [Medtronic, Dublin, Ireland]) at selected SaO2 ranges (≥85%, 75%‐84%, 60%‐74%, and < 60%). Accuracy was evaluated according to bias and Bland‐Altman analysis with appropriate correction for multiple measurements. Relationships between bias and clinical variables were assessed using a generalized estimating equation.

Results

Two hundred and fifty‐eight samples were analyzed. The mean overall bias (limits of agreement) of Masimo Blue, Masimo LNCS, and Nellcor sensor was −5.3 (−20.9 to 10.3%), −7.4 (−21.9 to 7.1%), and −7.4 (−22.5 to 15.1%), respectively. However, there was no difference in bias among the three sensors at SaO2 <60%. Generalized estimating equation showed that SaO2 value was associated with bias of all sensors. Perfusion index affected the bias of Blue sensor and LNCS sensor, and patients' weight was associated with bias of Nellcor sensor.

Conclusion

Masimo blue sensor demonstrated overall lower bias compared to the other two sensors. However, the accuracy of all sensors was similarly poor at SaO2 less than 60%. Bias was influenced by SaO2, perfusion index, and body weight.
Optimizing the spatial relocation of hospitals to reduce urban traffic congestion: A case study of Beijing
Authors: Wang Yuxia , Tong Daoqin , Li Weimin , Liu Yu
Published: April 2019

Traffic congestion represents an ongoing serious issue in many large cities. Many public facilities, such as hospitals, tend to be centrally located to ensure they are most accessible to local residents; as a result, they may contribute significantly to a city's traffic congestion. In this study, a multi‐objective spatial optimization model was provided to help formulate hospital relocation plans, taking into account both traffic congestion and hospital accessibility. Using intra‐urban movement data, we proposed a method to estimate the area‐wide traffic congestion caused by hospital visits and to identify potential hospitals to be relocated. An NSGA‐II (Non‐dominated Sorting Genetic Algorithm II) algorithm was applied to solve the hospital relocation optimization problem; we applied our model to study optimal hospital relocation plans in Beijing. Analysis results provide a tradeoff between traffic congestion relief and hospital accessibility. We discussed plans that significantly reduce traffic congestion while maintaining a high level of hospital accessibility. Our study has significant policy implications and provides insights for future facility planning and transportation planning.
A large deletion spanning XG and GYG2 constitutes a genetic basis of the Xgnull phenotype, underlying anti‐Xga production
Authors: Lee Yan Quan , Storry Jill R. , Karamatic Crew Vanja , Halverson Gregory R. , Thornton Nicole , Olsson Martin L.
Published: April 2019

BACKGROUND

The PBDX/XG gene encoding the Xga blood group antigen was described in 1994, but the genetic determinant of XG expression on RBCs was reported only in 2018. However, the frequencies of Xg(a−) individuals could not explain the rarity of anti‐Xga makers. We therefore sought to elucidate the molecular basis of the Xg(a−) phenotype in people producing anti‐Xga.

STUDY DESIGN AND METHODS

Two genomic DNA (gDNA) and 13 plasma‐derived cell‐free DNA (cfDNA) samples from anti‐Xga makers were investigated (14 males and one female). PBDX/XG exon sequencing was attempted on one gDNA sample. Polymerase chain reaction assays were developed and bioinformatics used to define a suspected deletion in all samples.

RESULTS

Investigation of one gDNA sample revealed a 114‐kb deletion (esv2662319) on the X chromosome that spans XG exons 4 through 10 and the downstream GYG2 gene. A 3555‐bp fragment bridging this deletion was amplified to confirm its presence. Another deletion‐specific polymerase chain reaction of 714 bp enabled identification of esv2662319 in both gDNA samples and eight cfDNA samples while ruling it out in one cfDNA. Males were hemizygous for esv2662319 and the female likely homozygous. Four cfDNA sample results were inconclusive, probably due to poor sample quality. Sanger sequencing recognized the recombination junctions as a heterogeneous LTR6B sequence.

CONCLUSION

We identified a large deletion on the X chromosome, resulting in a true, tissue‐wide Xgnull phenotype. This deletion was found in 10 of 11 anti‐Xga makers from which DNA could be amplified. One sample remained unexplained, indicating further heterogeneity to be explored.
Canadian expert consensus: management of hypersensitivity reactions to intravenous iron in adults
Authors: Lim Wendy , Afif Waqqas , Knowles Sandra , Lim Gloria , Lin Yulia , Mothersill Charmaine , Nistor Irina , Rehman Faisal , Song Christine , Xenodemetropoulos Ted
Published: April 2019

Background and Objectives

Rare but potentially life‐threatening hypersensitivity reactions can occur during the administration of intravenous iron. To provide guidance to healthcare professionals caring for adults receiving intravenous iron, a panel of 10 Canadian clinical experts developed a practical algorithm for the identification and management of hypersensitivity reactions to intravenous iron.

Materials and methods

A systematic search of PubMed to February 2018 was performed. Articles related to hypersensitivity reactions were selected for review. The algorithm was developed during a 1‐day live meeting based on the literature review and clinical expertise where evidence was lacking. The algorithm was then refined through an iterative process involving a web‐based platform and virtual meetings.

Results

The algorithm provides guidance to healthcare professionals in preparing for and administering IV iron, as well as recognizing and managing hypersensitivity reactions to intravenous iron. Considerations for re‐challenging patients who have experienced prior reactions are provided.

Conclusion

Healthcare professionals who are involved in the care of patients receiving intravenous iron should be trained to anticipate, recognize and manage hypersensitivity reactions to intravenous iron to optimize patient care.
Investigation of Blood Lactate Levels, Hearth Rates and Technical Performance of Hearing-Impaired Elite Male Greco-Roman Wrestlers
Authors: Kıvrak Ali Osman , Pepe Şirin
Published: April 2019

This study was conducted with hearing-impaired elite greco-roman wrestlers to determine the relationships and variations in heart rates (HR), blood lactate (La) levels and number of performances during the maximal effort and recovery periods. Voluntary 8 hearing-impaired elite male wrestlers with an average age of 21,75±2,05 years participated into present experiments. Resting heart rates of the athletes were determined before the maximal effort, blood samples were taken for lactate levels, athletes took warm up and stretching exercises for 15 minutes. For maximal effort, athletes performed hip-headlock throw technique for 2 minutes in 3 periods. Proper performances were counted and heart rates were measured in between the periods. To determine recovery characteristics of the athletes after maximal effort, HR and La levels were determined at 3rd, 15th and 30th minutes after maximal effort.Heart rate responds to hip-headlock throws at the end of the 1st period were lower than the heart rates at the end of the 2nd and 3rd periods and heart rates at the end of the 2nd period were lower than the heart rates at the end of the 3rd period (p<0.05). Number of performances in the 1st period was greater than the number of performances in the 2nd and 3rd periods and number of performances in the 2nd period was greater than the number of performances in the 3rd period (p<0.05). HR values increased and number of performances decreased with the progress of periods. There were significant differences in HR and number of performances of the periods (p<0.05).HR and La reached to the maximum levels right after the end of wrestling game and a significant decrease was observed after the 3rd minute of resting (p<0.00). Significant decreases continued at the 15th and 30th minutes of the resting as compared to the 3rd minute (p<0.00). Blood lactate levels also reached to the maximum at the 3rd minute of resting with the effort spend in the 3rd period; then significant decrease was observed at the 15th minute of resting (p<0.00) and significant decreases were also observed in blood lactate levels between the 15th and 30th minutes of resting (p<0.00).It was concluded based on present findings that increasing heart rates negatively influenced number of performances. In other words, tiredness had negative effects on number of performances. Present findings also revealed that during the recovery period, lactate levels decreased quite slower than heart rates. In this sense, it was assumed that La level was the primary criterion of the recovery.
Afasia de conducción como consecuencia de un astrocitoma anaplásico parieto – temporo – occipital izquierdo: estudio de caso
Authors: Aguilar Mejía Oscar Mauricio , Ramírez Bermejo Beatriz , Acevedo González Juan Carlos , Berbeo Calderón Miguel Enrique
Published: April 2019

La afasia de conducción es un trastorno caracterizado por un lenguaje espontáneo relativamente fluido, buena comprensión, pero dificultades en la repetición asociadas con parafasias fonológicas. Se ha atribuido a lesiones del fascículo arqueado por desconexión entre el lóbulo temporal posterior y el frontal, sin embargo se ha debatido esta postura, planteando que la integridad y funcionamiento del fascículo arqueado no es indispensable en la repetición verbal. Se presenta un caso de un sujeto varón de 23 años que, como consecuencia de un astrocitoma anaplásico recidivante que abarca áreas parietales y temporo-occipitales, presenta una afasia de conducción. Se plantea una reconceptualización de esta afasia, analizándola en términos clínicos, neuropsicológicos y en las redes neuronales existentes entre áreas cerebrales posteriores ipsilaterales y contralaterales.
Breaking Patient Confidentiality: Comparing Chilean and French Viewpoints Regarding the Conditions of its Acceptability
Authors: Olivari Cecilia , Munoz Sastre Maria Teresa , Guedj Myriam , Sorum Paul Clay , Mullet Etienne
Published: April 2019

The study examined the conditions under which lay people and health professionals living in Chile find it acceptable for a physician to break confidentiality to protect the wife of a patient with a sexually transmitted disease (STD). One hundred sixty-nine lay persons, 10 physicians, 17 psychologists, and 11 paramedical professionals indicated the acceptability of breaking confidentiality in 48 scenarios. The scenarios were all possible combinations of five factors: disease severity (severe, lethal); time taken to discuss this with the patient (little time, much time); patient’s intent to inform his spouse about the disease (none, one of these days, immediately); patient’s intent to adopt protective behaviors (no intent, intent); and physician’s decision to consult an STD expert (yes, no), 2 x 2 x 3 x 2 x 2. The study also compared Chilean and French views, using data gathered previously in France. A cluster analysis conducted on the overall set of raw data revealed groups of participants that found breaking confidentiality “always acceptable” (9%), requiring “consultation with an expert” (5%), “depending on the many circumstances” (70%), and “never acceptable” (11%)”. Despite clear differences in legislation and official codes of ethics between their two countries, Chilean and French lay people did not differ much in their personal convictions regarding the circumstances in which patient confidentiality can be broken or must not be broken. By contrast, Chilean physicians, in agreement with their code of ethics, were much less supportive than French physicians of complete respect of patient confidentiality in all cases