bluuebunny/crossref_metadata_2025 huggingface dataset:
An integrated social vulnerability assessment of riverine flood hazards in Shelby County, Tennessee
Authors: Shupe-Diggs Clarke , Diko Stephen Kofi , Santo Charles A.
Published: September 2020

Purpose

Vulnerability studies are commonly used to inform planning, as cities and regions seek to build resilience to environmental hazards. In Shelby County, Tennessee, socioeconomic census tract data were mapped to identify the socially vulnerable population and places to underpin strategies in the Mid-South Regional Resilience Master Plan (RRMP). While this is an important step in identifying vulnerability in the county, this paper aims to enhance the local analysis through an integrated approach that considers both social factors and environmental hazards in assessing vulnerability.

Design/methodology/approach

This paper conducts a social vulnerability assessment by integrating a social vulnerability index with risk exposure analysis at the census tract level to identify the population and places vulnerable to riverine flooding in Shelby County.

Findings

The analysis reveals that social vulnerability assessments that do not relate socioeconomic factors to specific environmental hazards such as riverine flooding underestimate the population and places that are vulnerable. For Shelby County, this has the tendency to undermine the prioritization and effectiveness of strategies to build resilience to riverine flooding and can worsen preexisting marginalization.

Practical implications

This paper recommends integrated vulnerability assessments for each of the environmental hazards identified in the Mid-South RRMP to augment existing resilience efforts in the county.

Originality/value

This paper enhances the understanding of social vulnerability assessments by consolidating the need for integrated assessment frameworks as basis for resiliency planning.
Understanding knowledge sharing through the working practices
Authors: Agrifoglio Rocco , Briganti Paola , Varriale Luisa , Metallo Concetta , Ferrara Maria
Published: September 2020

Purpose

Building upon the practice-based framework, this paper aims to focus on working practices for understanding how knowledge is transferred among health-care professionals within hospitals.

Design/methodology/approach

Using an ethnographic and interpretative approach, the authors conducted preliminary research based on a quali-quantitative methodology within one of the largest hospitals in Southern Italy.

Findings

This study allowed to achieve several results that could be significant and relevant within the health-care sector. First, this paper identified some of the main working practices and their associated activities in health care. Moreover, this paper identified the main organizational forms and/or tools enabling hospital personnel to share and learn the various types of knowledge for each of the prior identified practices.

Practical implications

Hospital managers should develop strategies and policies that take into account the nature and typology of knowledge-sharing processes among health-care professionals in terms of practices.

Originality/value

The paper contributes to practice-based studies identifying identified some of the main working practices, as well as the main tools for sharing and learning of the various types of knowledge.
Leading from the middle: vice-principals in Singapore as boundary spanners
Authors: Ho Jeanne , Kang Trivina , Shaari Imran
Published: September 2020

Purpose

The purpose of this paper is to examine leading from the middle, which is consistent with calls to distribute leadership, while expanding the direction of influence, from the normal top-down to include a bottom-up or lateral direction. The paper proposes that the position of the vice-principal enables the role incumbent to lead from the middle as a boundary spanner. The research question was what leadership from the middle looks like for vice-principals.

Design/methodology/approach

The study consisted of interviews of 28 vice-principals and 10 principals. A mixed case and theme-oriented strategy was adapted, with member checking with each vice-principal.

Findings

The findings indicate that in leading from the middle, vice-principals play boundary spanning roles of connecting, translating and brokering: (1) connecting between organisational levels, (2) translating between vision/direction and actualisation, (3) connecting between middle managers and (4) brokering and translating between the ministry and the school.

Originality/value

Leading from the middle is a nascent concept which is worth exploring, given the complexity of educational systems with multiple ecological levels, and the need for leadership to create coherence between the levels.
Knowledge management practice of medical cloud logistics industry: transportation resource semantic discovery based on ontology modelling
Authors: Zhou Fuli , He Yandong , Ma Panpan , Mahto Raj V.
Published: September 2020

Purpose

The booming of the Internet of things (IoT) and artificial intelligence (AI) techniques contributes to knowledge adoption and management innovation for the healthcare industry. It is of great significance to transport the medical resources to required places in an efficient way. However, it is difficult to exactly discover matched transportation resources and deliver to its destination due to the heterogeneity. This paper studies the medical transportation resource discovery mechanism, leading to efficiency improvement and operational innovation.

Design/methodology/approach

To solve the transportation resource semantic discovery problem under the novel cloud environment, the ontology modelling approach is used for both transportation resources and tasks information modes. Besides, medical transportation resource discovery mechanism is proposed, and resource matching rules are designed including three stages: filtering reasoning, QoS-based matching and user preferences-based rank to satisfy personalized demands of users. Furthermore, description logic rules are built to express the developed matching rules.

Findings

An organizational transportation case is taken as an example to describe the medical transportation logistics resource semantic discovery process under cloud medical service scenario. Results derived from the proposed semantic discovery mechanism could assist operators to find the most suitable resources.

Research limitations/implications

The case study validates the effectiveness of the developed transportation resource semantic discovery mechanism, contributing to knowledge management innovation for the medical logistics industry.

Originality/value

To improve task-resource matching accuracy under cloud scenario, this study develops a transportation resource semantic discovery procedure from the viewpoint of knowledge management. The novel knowledge management practice contributes to operational management of the cloud medical logistics service by introducing ontology modelling and creative management.
Beyond lurking and posting: segmenting the members of a brand community on the basis of engagement, attitudes and identification
Authors: Haverila Matti , McLaughlin Caitlin , Haverila Kai C. , Arora Mehak
Published: September 2020

Purpose

Brand communities are an increasingly important way for brands to interact with their customers, as they give brands an opportunity to learn from and interact with people with a demonstrated interest in the brand. Literature has explored the difference between lurkers and posters within these brand communities. However, there are other ways to segment members, just as there are many ways to segment customers of products and services – and this paper aims to be a step toward going beyond simple lurking vs posting behavior as a means of differentiating community members. As such, the purpose of this paper is to segment brand communities based on not only their participation behavior but also their identification with the brand community, loyalty and benefits gained from membership.

Design/methodology/approach

This study used a cross-sectional survey of members of various brand communities in North America. Partial least squares structural equation modeling together with finite mixture partial least squares and prediction-oriented segmentation was used to discover the distinct segments of brand community members.

Findings

The findings indicate that there are two distinct segments that behave differently regarding their behavior, attitudes and motives. Segment one has a stronger relationship between identification and other outcomes and is also more motivated by social enhancement than segment two. Thus, it is clear that brand community members can be segmented and served based on more than their posting behavior.

Originality/value

The members of brand communities have often been thought of as homogeneous. This paper is unique in identifying heterogeneity among the members of the brand community and demonstrates the need for brand community managers to identify these differences and manage the brand community accordingly.
The role of next‐generation sequencing in the investigation of ultrasound‐identified fetal structural anomalies
Authors: Kilby MD
Published: September 2020

Fetal structural anomalies have an impact on fetal mortality and morbidity. Next‐generation sequencing (NGS) may be incorporated into clinical pathways for investigation of paediatric morbidity but can also be used to delineate the prognosis of fetal anomalies. This paper reviews the role of NGS in the investigation of fetal malformations, the literature defining the clinical utility, the technique most commonly used and potential promise and challenges for implementation into clinical practice. Prospective case selection with informative pre‐test counselling by multidisciplinary teams is imperative. Regulated laboratory sequencing, bioinformatic pathways with potential variant identification and conservative matching with the phenotype is important.

Tweetable abstract

Prenatal exome sequencing in fetal structural anomalies yields diagnostic information in up to 20% of cases.
Gestational age limits for abortion and cross‐border reproductive care in Europe: a mixed‐methods study
Authors: De Zordo S , Zanini G , Mishtal J , Garnsey C , Ziegler A‐K , Gerdts C
Published: September 2020

Objectives

Little is known about the experiences of women who travel within Europe for abortion care from countries with relatively liberal laws. This paper aims to assess the primary reasons for travel among a sample of women who travelled from European countries with relatively liberal abortion laws to obtain abortion care mainly in the UK and the Netherlands.

Design

Multi‐country, 5‐year mixed methods study on barriers to legal abortion and travel for abortion.

Setting

UK, the Netherlands and Spain.

Population or Sample

We present quantitative data from 204 surveys, and qualitative data from 30 in‐depth interviews with pregnant people who travelled to the UK, the Netherlands and Spain from countries where abortion is legal on broad grounds within specific gestational age (GA) limits.

Methods

Mixed‐methods.

Main outcome measures

GA when presenting at abortion clinic, primary reason for abortion‐related travel.

Results

Study participants overwhelmingly reported travelling for abortion because they had exceeded GA limits in their country of residence. Participants also reported numerous delays and barriers to receiving care.

Conclusions

Our findings highlight the need for policies that support access to abortion throughout pregnancy and illustrate that early access to it is necessary but not sufficient to meet people’s reproductive health needs.

Funding

This study is funded by the European Research Council (ERC).

Tweetable abstract

This study shows that GA limits drive women from EU countries where abortion is legal to seek abortions abroad.
Estimating postmortem interval for human cadavers in a sub‐tropical climate using UV‐Vis‐near‐infrared Spectroscopy
Authors: Aitkenhead‐Peterson Jacqueline A. , Fancher James P. , Alexander Michael B. , Hamilton Michelle D. , Bytheway Joan A. , Wescott Daniel J.
Published: September 2020

Estimating postmortem interval (PMI) of surface found skeletal remains is challenging. This novel study used UV‐Vis‐NIR spectroscopy to scan soil collected from cadaver decomposition islands (CDIs) ranging from 15‐ to 963‐d postmortem and control soils. A decomposition product spectra model (DPS model) was constructed by deducting the control soil spectra from the CDI soil spectra for the estimation of postmortem indices: PMI (d), ADD4, ADD10, and ADD20. The DPS model (n = 55) was calibrated and subjected to a full cross‐validation. CalibrationR2and RPD for the DPS model ranged from 0.97 to 0.99 and from 6.1 to 9.9, respectively, for the four postmortem interval indices. ValidationR2and RPD for the DPS model ranged from 0.73 to 0.80 and from 1.9 to 2.2, respectively. The DPS model estimated postmortem intervals for three test CDIs in a clay soil under perennial grassland (test set 1; n = 3) and six CDIs in a sandy soil under a loblolly pine forest (test set 2; n = 6). Test set 1 had PMI prediction ranges from −69 to −117 days, −796 to +832 ADD4, +552 to +2672 ADD10, and −478 to −20 ADD20of observed PMI. Test set 2 PMI prediction ranged from −198 to −65 days, −9923 to +2629 ADD4, −6724 to +1321 ADD10, and −2850 to +540 ADD20of observed PMI. Test set 2 had poor predictions for two CDIs, for all measures of postmortem indices resulting in discussion of sampling depth, effect of body mass index (BMI), and scavenging.
Application of forward‐looking infrared (FLIR) imaging from an unmanned aerial platform in the search for decomposing remains
Authors: Butters Owyn , Krosch Matt N. , Roberts Michell , MacGregor Donna
Published: September 2020

Traditional methods of cadaver detection in outdoor environments include manual ground search, cadaver dogs, and manned aerial reconnaissance during daylight. These methods have limitations; however, a potential low‐cost alternative may be to employ thermal imaging equipment mounted on an unmanned aerial vehicle (UAV) to detect heat emitted by insect and bacterial activity on the decomposing remains. No studies have addressed the influence of wrappings on detection of maggot mass thermal signatures nor assessed thermal detection of smaller body fragments. We addressed these knowledge gaps by utilizing a two‐phase experimental approach to explore thermal detection of carcasses using UAV‐mounted infrared imaging. In Phase 1, pig body fragments were deposited on the surface or shallow buried. In Phase 2, whole pig carcasses were deposited in four conditions: on the surface uncovered, wrapped in plastic or carpet, or buried. Our results demonstrated that observable heat emissions from remains corresponded to peak insect activity during active decay and could be readily detected in uncovered whole carcasses and fragments. Although plastic and carpet wrappings partly impeded detection of insect heat signatures, these materials were clearly detectable themselves because of their contrast to the background ground surface. Thermal signatures of buried partial remains and disturbed gravesoil were also observed; however, the buried whole carcass transitioned to adipocere prior to the decay stage and without any insect colonization or heat signature. These data can inform operational implementation of this technique to complement existing search strategies to offer a robust, low‐cost alternative for use where scene characteristics allow.
Impact of malnutrition on health‐related quality of life in patients on maintenance hemodialysis
Authors: Nagy Eman , Mahmoud Mostafa , El‐kannishy Ghada , Sayed‐Ahmed Nagy
Published: September 2020

Malnutrition is considered as one of the most important risk factors that adversely affect the quality of life (QOL) in maintenance hemodialysis (MHD) patients. Many clinically useful nutrition assessment techniques are now available, but the usefulness of such techniques in predicting QOL in MHD patients had not been sufficiently tested. The aim of this study was to explore the relation between different nutritional assessment methods, and QOL and identify nutritional parameter that can best predict physical and mental domains of QOL in MHD patients. This cross‐sectional study involved 84 MHD patients. Nutritional status was assessed by using International Society of Renal Nutrition and Metabolism criteria for diagnosis of protein‐energy wasting (PEW), malnutrition inflammation score (MIS), subjective global assessment (SGA), anthropometric measurements, bioelectrical impedance analysis, and biochemical tests. Quality of life was evaluated by using the Kidney Disease Quality of Life (36 KDQOL‐36). Only mental health composite component of QOL (MHC) showed statistically significant differences between PEW and non‐PEW groups. MHC was correlated with serum albumin, MIS, and SGA. Physical health composite component (PHC) was correlated with age, hemodialysis duration, socioeconomic status, comorbidity, educational level, serum creatinine and ferritin, MIS, and SGA. On multiple linear regression analysis, MIS was found to be the most significant predictor of PHC while none of the nutritional parameters can predict MHC. Malnutrition is not uncommon problem in MHD patients that is associated with poor QOL. There are multiple factors associated with PHC and only malnutrition afflicts MHC in those patients.
Endoscopic sleeve gastroplasty with argon plasma coagulation: A novel technique
Authors: Itani Mohamad I. , Farha Jad , Sartoretto Adrian , Abbarh Shahem , Badurdeen Dilhana , de Moura Diogo T. H. , Kumbhari Vivek
Published: September 2020

Objective

The endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure in which the anterior and posterior aspects of the greater curvature are stitched endoscopically, producing a sleeve‐like anatomy mimicking that in a sleeve gastrectomy. However, suture dehiscence and enlargement of the stomach within months of the procedure have been observed. Argon plasma coagulation (APC) is widely used in gastrointestinal endoscopy and is able to induce scarring and fibrosis. We coupled ESG with APC to evaluate its potential to improve durability.

Methods

A 46‐year‐old woman with obesity presented for ESG. Her pre‐procedure weight was 117 kg with a body mass index (BMI) of 41.4 kg/m2. After each plication was complete, APC (60 W, argon flow rate 1.2 L/min) was used to ablate the mucosal surface of the exposed plicated mucosa. APC was applied until the mucosal color was dark brown, indicating adequate and successful mucosal and submucosal ablation.

Results

The procedure was successful, and the patient recovered without peri‐ or post‐operative complications. The procedure time was 47 minutes. A total of seven sutures were used. At 6‐month follow‐up the patient had lost 17 kg (37.5 lbs), equivalent to 14.5% total weight loss and had a BMI of 35.4 kg/m2. Endoscopic follow‐up at 6 months revealed enhanced fibrosis along the plications, resulting in a superior, sleeve‐like lumen.

Conclusions

The combination of ESG with APC may act synergistically to reduce weight without adding significant procedure time. Further investigation is needed to determine whether it should be widely recommended.
Effects of dehydroepiandrosterone on quality of life in premenopausal women with rheumatoid arthritis: A preliminary randomized clinical trial
Authors: Sandoughi Mahnaz , Kaykhaei Mahmoud Ali , Langarizadeh Elnaz , Dashipour Alireza
Published: September 2020

Aim

Chronic inflammation and subsequent use of glucocorticoids can lead to relative adrenocortical insufficiency in patients with rheumatoid arthritis (RA). Previously, adrenocortical hormone, dehydroepiandrosterone (DHEA) was shown as a potential therapy for autoimmune disorders. However, data regarding effects of DHEA in RA are limited. The aim of this study was to investigate the effects of DHEA on quality of life (QOL) in premenopausal rheumatoid arthritis patients.

Method

In this randomized double blinded, controlled trial 46 premenopausal rheumatoid arthritis patients were assigned to receive 50 mg/d DHEA (23 patients) or placebo (23 patients) for 12 weeks. Disease Activity Score of 28 joints – erythrocyte sedimentation rate (DAS28‐ESR) questionnaire, visual analog score and swollen and tender joint counts (both 0‐28) were used for assessment of disease activity. Persian‐validated World Health Organization Quality of Life Brief version (WHOQOL BREF) questionnaire was used to assess quality of life.

Results

In comparison to the control group more improvement in QOL (P = .025) and environment health (P = .001) was observed in the DHEA group. After adjustment for age and disease duration DHEA was associated with more improvement in QOL (P = .01), psychological (P = .02) and physical health (P = .03). A trend toward a decrease in ESR was observed in DHEA group (P = .06). DAS was improved in both groups; however, there was no significant change in DAS28 between groups (P = .88). Frequency of adverse events albeit minor was similar in both groups.

Conclusion

Our study supports a slightly superior effect of DHEA over placebo to improve QOL in premenopausal female patients with rheumatoid arthritis. We did not find improvement in DAS in the DHEA group over placebo.
General medical conditions and mortality in women with postpartum psychiatric disorders
Authors: Johannsen B. M. W. , Laursen T. M. , Bech B. H. , Munk‐Olsen T.
Published: September 2020

Background

Psychiatric patients have an increased risk of general medical conditions and mortality, but no study has systematically explored these outcomes among women with mental disorders following childbirth (postpartum psychiatric disorders: PPD). Therefore, we aimed to investigate the risk of subsequent general medical conditions and mortality in women with a broad spectrum of PPD.

Methods

This register‐based cohort study followed all Danish women born after January 1, 1960, until January 1, 2016. The exposure of interest was (i) mild‐moderate PPD: first‐ever prescription of psychotropic medication (ATC codes: N03‐N07) and (ii) severe PPD: first‐ever in‐ or out‐patient contact to a psychiatric facility, both within six months postpartum. Outcomes of interest were (i) hospital‐registered chronic medical conditions and (ii) mortality from natural and unnatural causes. We included 1 841 949 women representing 22 615 310 person‐years at risk.

Results

Among 15 852 women with mild‐moderate PPD and 4266 women with severe PPD, we found a higher risk of any subsequent general medical condition (mild‐moderate PPD: IRR 1.25; 95% CI 1.20–1.31 and severe PPD: IRR 1.35; 95% CI: 1.24–1.48) when compared to the female background population. Mortality from both natural and unnatural causes was higher in both groups: Mild‐moderate PPD: natural causes MRR 1.37; 95% CI: 1.17–1.61; unnatural causes MRR 1.52; 95% CI: 1.10–2.11, and severe PPD: natural causes MRR 1.42; 95% CI 1.02–2.00, and unnatural causes MRR 5.05; 95% CI: 3.40–7.51.

Conclusions

This first overview of general medical prognosis in PPD shows that women at either end of the spectrum are at increased risk of subsequent chronic medical conditions and overall mortality.
Incorporating drivers of reproductive success improves population viability analysis
Authors: Franklin Ashley D. , Lacy Robert C. , Bauman Karen L. , Traylor‐Holzer Kathy , Powell David M.
Published: September 2020

Population viability analysis (PVA) utilizes simulation models to project the genetic and demographic trajectories of populations over time. One benefit to using PVA to assist in ex situ population planning is the ability to compare outcomes from multiple management scenarios. Reproductive viability analysis (RVA), used to identify biological and reproductive characteristics of animals in breeding pairs that correlate with successful reproduction, is also beneficial, informing population managers on best practices for population planning. Our objectives were to: (1) compare genetic and demographic predictions for the managed North American ex situ fennec fox population from two PVA programs: Vortex and ZooRisk; (2) show how RVA results can be incorporated into PVAs in Vortex and how that affects PVA projections; and (3) perform a sensitivity analysis to investigate how uncertainty in the influence of factors on the reproductive success of fennec fox pairs affects variation in population projections. In this study, the relative and average genetic and demographic predictions were generally the same across both software programs when given similar inputs. The inclusion of factors that influence breeding success (RVA) in the PVA models resulted in a lower probability of extinction, less inbreeding accumulation, and slower loss of genetic diversity, due to an overall higher rate of reproductive success. The uncertainty in the negative effects of increasing female and male age, and the positive effect of female parity on reproductive success had the greatest effect on projected genetic diversity and inbreeding. Our study demonstrates that Vortex is capable of projecting the viability of ex situ populations with flexibility, and has the ability to incorporate complexity and uncertainty into population parameters. It also reveals that adjusting ex situ population management, more specifically the consideration of factors affecting reproductive success to create breeding pairs with a higher probability of success, will improve population sustainability.
Bevacizumab plus cisplatin/pemetrexed then bevacizumab alone for unresectable malignant pleural mesothelioma: A Japanese safety study
Authors: Nakano Takashi , Kuribayashi Kozo , Kondo Masashi , Morise Masahiro , Tada Yuji , Hirano Katsuya , Hayashi Morihiko , Tanaka Misa , Hirabayashi Masataka
Published: September 2020

Aims

Malignant pleural mesothelioma (MPM) is an aggressive malignancy with poor prognosis and limited treatment options. Cisplatin plus pemetrexed is the only approved first‐line treatment for patients with unresectable MPM. Recently, promising outcomes were observed with first‐line bevacizumab combined with cisplatin/pemetrexed, leading to the recommendation of this regimen as a first‐line treatment option for patients with MPM. Bevacizumab plus cisplatin/pemetrexed has been shown to be safe and effective in non–small cell lung cancer, however, there are no efficacy or safety data in Japanese patients with MPM treated with this regimen. We conducted a multicenter study to evaluate tolerability and safety for Japanese patients with chemotherapy‐naïve, unresectable MPM.

Methods

Eligible patients (n = 7) received bevacizumab plus cisplatin/pemetrexed (up to six cycles), then single‐agent bevacizumab until disease progression or onset of unacceptable adverse events (AEs), according to the 3+3 design analogy.

Results

One patient (14.3%) reported an AE (gastric ulcer) meeting tolerability criteria. All patients experienced gastrointestinal disorders, including nausea (grade 1/2 only, n = 6, 85.7%) and constipation (grade 1/2 only, n = 5, 71.4%). Five patients (71.4%) had grade 3 hypertension. Two patients discontinued treatment due to gastric ulcer (n = 1) and proteinuria (n = 1). At data cut‐off, four patients had stable disease, two had partial response and one had non‐complete response/non‐progressive disease due to the absence of target lesions.

Conclusions

Bevacizumab plus cisplatin/pemetrexed then bevacizumab was well tolerated in Japanese patients with MPM.
A novel Q‐value‐based nomogram for single intracorneal ring segment implantation versus standard manufacturer's nomogram combined with accelerated cross‐linking for treatment of keratoconus: a randomized controlled trial
Authors: Iqbal Mohammed , Elmassry Ahmed , Mounir Amr , Ibrahim Ola , Soliman Ashraf
Published: September 2020

Purpose

To compare the efficacy of implanting a single Keraring segment according to a novel Q‐value‐based nomogram (QN) to that of segment implantation according to the manufacturer's standard nomogram (SN), for keratoconus treatment.

Methods

This was a prospective, randomized controlled trial of 104 patients (104 eyes) with Amsler‐Krumeich grade 1 or 2 keratoconus, and type 1 or 2 cone asymmetry determined according to manufacturer's classification. They were randomly distributed into two groups: group A patients (n = 52) underwent Keraring implantation according to the SN, and group B patients (n = 52) underwent implantation of a single (210° arc‐length) Keraring segment according to the QN. Both treatments were combined with accelerated transepithelial cross‐linking, and follow‐up was 6 months. Main outcome measures were preoperative and postoperative visual acuity, subjective refraction and corneal topography.

Results

At postoperative month 6, group B exhibited statistically significantly higher values of mean uncorrected distance visual acuity (UDVA), sphere, K2, K‐average, K‐max and Q‐anterior (p = 0.02, 0.01, 0.002, 0.001, 0.0001 and 0.03, respectively) compared to that of group A. However, group A exhibited better refractive cylindrical improvements (p = 0.04). In group A, we documented spontaneous extrusion of one Keraring segment.

Conclusion

Single 210° arc‐length segment implantation using our objective QN was more efficacious for keratoconus treatment than using the subjective SN. The nomograms were comparable when the Q‐anterior value was >−1.00; however, the QN was superior to the SN when the Q‐anterior value was ≤−1.00. The QN yielded greater postoperative UDVA and smoother corneal remodelling than did the SN for treatment of grade 1 and 2 keratoconic eyes.
Keratin 1 attenuates hypoxic pulmonary artery hypertension by suppressing pulmonary artery media smooth muscle expansion
Authors: Zhang Li , Zeng Xi‐Xi , Li Yu‐Mei , Chen Shao‐Kun , Tang Li‐Yu , Wang Nan , Yang Xi , Lin Mo‐Jun
Published: September 2020

Aim

Abnormally activated vascular smooth muscle cells are key factors in pulmonary artery remodelling (PAR) and pulmonary artery hypertension (PAH). Keratin 1 is involved in inflammatory diseases; however, its role in PAH is unknown. We speculated that keratin 1 could regulate PASMCs and prevent PAH.

Methods

Rats were exposed to hypoxia (10% O2) or MCT (50 mg/kg, intraperitoneal injection) or treated with AAV6 virus. PAR was measured through HE and Masson staining. PASMC activities were measured using MTS assay, EdU and Western blot analyses after cell knockdown with siRNAs or overexpression with Krt1 vectors.

Results

1. Hypoxic PAR was associated with a decrease in keratin 1, especially in PASMCs. 2. Keratin 1 knockdown led to cell proliferation, migration and contraction to synthetic transformation, while keratin 1 overexpression attenuated hypoxia‐induced changes in PASMCs. 3. Decreased keratin 1 induced TLR7 upregulation and mediated increases in the inflammatory factors S100a8 and S100a9. 4. Keratin 1 overexpression reduced the inflammatory factor expression induced by TLR7 activation. 5. Further studies demonstrated that keratin 1 expression was negatively correlated with pulmonary vascular pressure following prolonged hypoxia. 6. Pre‐treatment with keratin 1 decreased pulmonary artery pressure and the right heart hypertrophy index and alleviated PAR in two model rats. 7. Keratin 1 exhibited a hypermethylation status in hypoxic pulmonary arteries in the sequencing. Hypoxia‐induced decrease in keratin 1 expression was associated with Dnmt1 upregulation induced by YY1 downregulation in PASMCs.

Conclusion

This study suggests that keratin 1 regulates PASMC expansion and has a preventive effect on PAH.
A stacked approach for chained equations multiple imputation incorporating the substantive model
Authors: Beesley Lauren J. , Taylor Jeremy M. G.
Published: September 2020

Multiple imputation by chained equations (MICE) has emerged as a popular approach for handling missing data. A central challenge for applying MICE is determining how to incorporate outcome information into covariate imputation models, particularly for complicated outcomes. Often, we have a particular analysis model in mind, and we would like to ensure congeniality between the imputation and analysis models. We propose a novel strategy for directly incorporating the analysis model into the handling of missing data. In our proposed approach, multiple imputations of missing covariates are obtained without using outcome information. We then utilize the strategy of imputation stacking, where multiple imputations are stacked on top of each other to create a large data set. The analysis model is then incorporated through weights. Instead of applying Rubin's combining rules, we obtain parameter estimates by fitting a weighted version of the analysis model on the stacked data set. We propose a novel estimator for obtaining standard errors for this stacked and weighted analysis. Our estimator is based on the observed data information principle in Louis' work and can be applied for analyzing stacked multiple imputations more generally. Our approach for analyzing stacked multiple imputations is the first method that can be easily applied (using R package StackImpute) for a wide variety of standard analysis models and missing data settings.
Quartz OSL chronology of the loess deposits in the Western Qinling Mountains, China, and their palaeoenvironmental implications since the Last Glacial period
Authors: Yang Shengli , Liu Nannan , Li Dongxue , Cheng Ting , Liu Weiming , Li Shuai , Chen Hui , Liu Li , Luo Yuanlong
Published: September 2020

Extensive loess deposits exist in the Western Qinling Mountains (WQM), which constitute the transition zone between the Tibetan Plateau and the Chinese Loess Plateau (CLP). These deposits are one of the most important terrestrial archives regarding past dust activity and environmental changes in East Asia; however, they remain insufficiently known and poorly understood. Herein, we conducted detailed quartz optically stimulated luminescence dating and multi‐proxy analysis on the Zhouqu loess sequence. Our results show that the loess on the high terrace of the Bailong River started to accumulate by at least ~60 ka. The mass accumulation rate (MAR) in Zhouqu significantly varied during the Last Glacial period. The Marine Isotope Stage (MIS) 3 MARs were relatively high and stable. The highest MAR occurred in MIS 2, with peak MARs during 25–19 ka, and it decreased with rapid changes during the Holocene. The discrepancy in the MARs of the WQM loess since the Last Glacial period compared with the rates in the CLP may imply different dust deposition processes in the WQM. The reconstructed palaeoenvironmental records indicate climate changes with warm‐moist climate patterns and low dust flux in interglacial periods and cold‐dry conditions with high dust flux in glacial periods, consistent with those on the CLP. The results contribute to better understanding of the linkages between dust accumulation and climate change in the WQM area.
Climatic structures and intensities of the last two glacials documented by terrestrial molluscs from Chinese loess sequences
Authors: Zhang Dan , Wu Nai‐Qin , Li Feng‐Jiang , Rousseau Denis‐Didier , Chen Xiao‐Yun , Dong Ya‐Jie , Lu Hou‐Yuan
Published: September 2020

Knowledge of the structures and intensities of past glaciations is crucial for understanding Quaternary palaeoclimatic evolution. Terrestrial molluscs are a reliable proxy of past environmental conditions and can provide specific climatic insights into glacials. Here we compare the climatic evolution of the last two glacials, based on mollusc fossils from the L2 and L1 loess units (equivalent to Marine Isotope Stages (MIS) 6 and 4–2, respectively) of the Xifeng and Luochuan sections of the Chinese Loess Plateau (CLP). The results show that both glacials had a tripartite structure but with different intensities, as indicated by variations in the abundance of the dominant cold‐aridiphilous (CA) mollusc species, Vallonia tenera and Pupilla aeoli. The first stage, from ~191 to 184 ka for MIS 6, and from ~71 to 57 ka for MIS 4, was characterized by a cold, arid climate, as indicated by the abundance of V. tenera and P. aeoli, and the limited occurrence of thermo‐humidiphilous (TH) species. The second stage, from ~184 to 155 ka for MIS 6, and from ~57 to 29 ka for MIS 3, was characterized by a relatively mild, humid climate, indicated by a decrease in V. tenera and P. aeoli, and an increase in TH species. The last stage, from ~155 to 130 ka for MIS 6, and from ~29 to 11.7 ka for MIS 2, experienced the coldest and driest conditions, as indicated by the dominance of V. tenera and P. aeoli in late MIS 6 and by the reduced occurrence of the grassland biomass, necessary for the growth of CA species, in MIS 2. The climate during MIS 2 was much colder and drier than that during late MIS 6. We suggest that the structures of the glacials were controlled mainly by insolation driven by changing astronomical configurations, amongst which obliquity likely played the major role. The different glacial intensities across the CLP may also have been related to variations in Northern Hemisphere ice sheets and the temperature of the tropical oceans.
Mouse models for abdominal aortic aneurysm
Authors: Golledge Jonathan , Krishna Smriti Murali , Wang Yutang
Published: September 2020

Abdominal aortic aneurysm (AAA) rupture is estimated to cause 200,000 deaths each year. Currently, the only treatment for AAA is surgical repair; however, this is only indicated for large asymptomatic, symptomatic or ruptured aneurysms, is not always durable, and is associated with a risk of serious perioperative complications. As a result, patients with small asymptomatic aneurysms or who are otherwise unfit for surgery are treated conservatively, but up to 70% of small aneurysms continue to grow, increasing the risk of rupture. There is thus an urgent need to develop drug therapies effective at slowing AAA growth. This review describes the commonly used mouse models for AAA. Recent research in these models highlights key roles for pathways involved in inflammation and cell turnover in AAA pathogenesis. There is also evidence for long non‐coding RNAs and thrombosis in aneurysm pathology. Further well‐designed research in clinically relevant models is expected to be translated into effective AAA drugs.

LINKED ARTICLES

This article is part of a themed issue on Preclinical Models for Cardiovascular disease research (BJP 75th Anniversary). To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.5/issuetoc
The phylogeny of Dendropsophini (Anura: Hylidae: Hylinae)
Authors: Orrico Victor G.D. , Grant Taran , Faivovich Julian , Rivera‐Correa Mauricio , Rada Marco A. , Lyra Mariana L. , Cassini Carla S. , Valdujo Paula H. , Schargel Walter E. , Machado Denis J. , Wheeler Ward C. , Barrio‐Amorós Cesar , Loebmann Daniel , Moravec Jiří , Zina Juliana , Solé Mirco , Sturaro Marcelo J. , Peloso Pedro L.V. , Suarez Pablo , Haddad Célio F.B.
Published: September 2020

The relationships of the hyline tribe Dendropsophini remain poorly studied, with most published analyses dealing with few of the species groups ofDendropsophus. In order to test the monophyly of Dendropsophini, its genera, and the species groups currently recognized inDendropsophus, we performed a total evidence phylogenetic analysis. The molecular dataset included sequences of three mitochondrial and five nuclear genes from 210 terminals, including 12 outgroup species, the two species ofXenohyla, and 93 of the 108 recognized species ofDendropsophus. The phenomic dataset includes 46 terminals, one per species (34Dendropsophus, oneXenohyla, and 11 outgroup species). Our results corroborate the monophyly of Dendropsophini and the reciprocal monophyly ofDendropsophusandXenohyla. Some species groups ofDendropsophusare paraphyletic (theD. microcephalus,D. minimus, andD. parvicepsgroups, and theD. rubicundulusclade). On the basis of our results, we recognize nine species groups; for three of them (D. leucophyllatus,D. microcephalus, andD. parvicepsgroups) we recognize some nominal clades to highlight specific morphology or relationships and facilitate species taxonomy. We further discuss the evolution of oviposition site selection, where our results show multiple instances of independent evolution of terrestrial egg clutches during the evolutionary history ofDendropsophus.
Decriminalising public drunkenness: Accountability and monitoring needed in the ongoing and evolving management of public intoxication
Authors: Pennay Amy , Savic Michael , Seear Kate , Volpe Isabelle , Manning Victoria , Room Robin
Published: September 2020

In light of the recent announcement from the Victorian (Australia) state government that they are moving to decriminalise public drunkenness and replace it with a ‘health‐based response’, it is timely to reflect on a number of important considerations identified from the academic literature on this topic. We briefly review a number of models of health‐care delivery that have been utilised in other jurisdictions, and suggest there are opportunities at a more principled level to respond more adequately to the decriminalisation of public drunkenness in Victoria (and elsewhere). First, embedding research and evaluation, particularly that draws on the needs, views and experiences of those who are deemed to be drunk in public, is essential from the outset, and must be ongoing to enable the continual refinement of models of care. Second, significant funding and intersectoral support are needed to ensure that the laws are not tokenistic and do not remain the responsibility of police. Third, there are opportunities to put policies and principles in place to ensure that police do not use more coercive powers to address concerns around public drunkenness. Most importantly, state‐wide education and training efforts are needed alongside the repeal of the law to ensure that emergency services and health‐care workers (as well as the community), have a good understanding of the contexts and needs of people who are considered drunk in public, and consequently treat them with care and respect.
Cognitive improvement after cochlear implantation in deaf children with associated disabilities
Authors: Micheletti Serena , Accorsi Patrizia , Giordano Lucio , Calza Stefano , Nassif Nader , Barezzani Maria G , Fazzi Elisa , Redaelli de Zinis Luca O
Published: September 2020

Aim

To monitor functional auditory and non‐verbal cognitive skills in children with cochlear implants who had associated disabilities over a 24‐month period and define how cochlear implantation may impact on non‐verbal cognition by restoring functional auditory skills.

Method

Sixty‐four children with cochlear implants (36 females, 28 males; mean age 4y 3mo, SD 3y 5mo, 9mo–14y 5mo) were recruited and divided into three groups: children with typical development group (TDG); children with associated disabilities not linked to non‐verbal cognitive disorders group (ADG1); and children with associated disabilities linked to non‐verbal cognitive disorders group (ADG2). Tests of functional auditory, communicative, and non‐verbal cognitive skills were performed before cochlear implantation and at 12 and 24 months after cochlear implantation.

Results

Functional auditory and communicative skills improved similarly in the three groups at 12 and 24 months after implantation. An increase in non‐verbal cognitive scores was present in children in the ADG2 from baseline to 12 and 24 months (p<0.01), whereas scores remained stable in children in the TDG and ADG1. The increased functional auditory skills scores after cochlear implantation corresponded to an increase in non‐verbal cognitive scores (p=0.032) in children in the ADG2.

Interpretation

Children with associated disabilities, especially if linked to non‐verbal cognitive disorders, benefitted from cochlear implantation. They improved their comprehension of acoustic information inferred from the environment, improving not only functional auditory skills but also non‐verbal cognition.

What this paper adds

Functional auditory and non‐verbal cognitive scores of deaf children with cognitive disorders improved after cochlear implantation.

Restored functional auditory skills improved non‐verbal cognition in deaf children with cognitive disorders.
Genomic ancestry and metabolic syndrome in individuals with type 1 diabetes from an admixed population: a multicentre, cross‐sectional study in Brazil
Authors: Barros B. S. V. , Santos D. C. , Melo L. G. N. , Pizarro M. H. , Muniz L. H. , Silva D. A. , Porto L. C. , Gomes M. B.
Published: September 2020

Aims

To evaluate the relationship between self‐reported colour‐race, genomic ancestry, and metabolic syndrome in an admixed Brazilian population with type 1 diabetes.

Methods

We included 1640 participants with type 1 diabetes. The proportions of European, African and Amerindian genomic ancestries were determined by 46 ancestry informative markers of insertion deletion. Two different sets of analyses were performed to determine whether self‐reported colour‐race and genomic ancestry were predictors of metabolic syndrome.

Results

Metabolic syndrome was identified in 29.8% of participants. In the first model, the factors associated with metabolic syndrome were: female gender (odds ratio 1.95, P < 0.001); diabetes duration (odds ratio 1.04, P < 0.001); family history of type 2 diabetes (odds ratio 1.36, P = 0.019); and acanthosis nigricans (odds ratio 5.93, P < 0.001). Colour‐race was not a predictive factor for metabolic syndrome. In the second model, colour‐race was replaced by European genomic ancestry. The associated factors were: female gender (odds ratio 1.95, P < 0.001); diabetes duration (odds ratio 1.04, P < 0.001); family history of type 2 diabetes (odds ratio 1.39, P = 0.011); and acanthosis nigricans (odds ratio 6.12, P < 0.001). Physical exercise (≥3 times a week) was a protective factor (odds ratio 0.77, P = 0.041), and European genomic ancestry was not associated with metabolic syndrome but showed an odds ratio of 1.77 (P = 0.05).

Conclusions

Although a higher level of European genomic ancestry was observed among participants with metabolic syndrome in the univariate analysis, this association did not persist after multivariable adjustments. Further prospective studies in other highly admixed populations remain necessary to better evaluate whether the European ancestral component modulates the development of metabolic syndrome in type 1 diabetes.
Prognostic implications of neutrophil‐lymphocyte ratio in COVID‐19
Authors: Jimeno Sara , Ventura Paula S. , Castellano Jose M. , García‐Adasme Salvador I. , Miranda Mario , Touza Paula , Lllana Isabel , López‐Escobar Alejandro
Published: September 2020

Background

The clinical presentation of COVID‐19 ranges from a mild, self‐limiting disease, to multiple organ failure and death. Most severe COVID‐19 cases present low lymphocytes counts and high leukocytes counts, and accumulated evidence suggests that in a subgroup of patients presenting severe COVID‐19, there may be a hyperinflammatory response driving a severe hypercytokinaemia which may be, at least in part, signalling the presence of an underlying endothelial dysfunction. In this context, available data suggest a prognostic role of neutrophil‐lymphocyte ratio (NLR) in various inflammatory diseases and oncological processes. Following this rationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may be useful in identifying patients with a poor prognosis in hospitalized COVID‐19 cases.

Design

A retrospective observational study performed at Hospital Universitario HM Puerta del Sur, Madrid, Spain, which included 119 patients with COVID‐19 from 1 March to 31 March 2020. Patients were categorized according to WHO R&D Expert Group.

Results

Forty‐five (12.1%) patients experienced severe acute respiratory failure requiring respiratory support. Forty‐seven (12.6%) patients died. Those with worse outcomes were older (P = .002) and presented significantly higher NLR at admission (P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed of NLR (P = .003) compared with follow‐up patients. In a multivariable logistic regression, age, cardiovascular disease and C‐reactive protein at admission and Peak NLR were significantly associated with death.

Conclusions

NLR is an easily measurable, available, cost‐effective and reliable parameter, which continuous monitoring could be useful for the diagnosis and treatment of COVID‐19.