bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons from integrated care pilots in England
Authors: Edwards Nigel
Published: December 2019

Purpose

The purpose of this paper is to provide a summary of some of the lessons about implementing different types of integrated care.

Design/methodology/approach

The author used evidence from the author’s own evaluations and the findings of other researchers to identify some important lessons for policy makers and practitioners.

Findings

The author identifies eight high-level lessons which may be of interest to policy makers and practitioners working in the field.

Research limitations/implications

The lessons outlined in the paper provide only a starting point for those designing interventions or evaluation.

Practical implications

The changes required to implement integrated care are complex and are embedded in a complex context. Change of this type is difficult and generally takes longer to deliver than expected. The evaluation of these models often requires longer than is often available and needs to focus on the impact on the whole system rather than narrow measures, e.g. hospital utilisation.

Originality/value

This is a viewpoint paper synthesising evidence from the English pilot programmes in integrated care.
What do you know about me? Digital privacy and online data sharing in the UK insurance sector
Authors: Blakesley Ian R. , Yallop Anca C.
Published: December 2019

Purpose

In addition to data transforming the insurance sector from within, insurance consumers and their behaviour has transformed significantly over the past 20 years from traditional retail to, predominantly, online trading. Data are a fundamental part of how the sector operates, and the use of data in insurance is constantly evolving. This paper aims to explore consumer perceptions about digital privacy and their subsequent motivations to disclose personal data for insurance purposes.

Design/methodology/approach

The study uses an exploratory research approach based on in-depth interviews to generate metathemes to provide an understanding of consumer perceptions about digital privacy and data sharing in the insurance sector.

Findings

Consumers were extrinsically motivated to disclose data by financial reward and convenience; however, subsequent intrinsic motivations may be an influence on the initial motivations. Consumers perceived transactions as “fair” if they received the expected rewards, retained control of the data, and the data was not unilaterally used to their detriment. Concern for privacy was generally low, provided antecedent conditions were met.

Research limitations/implications

As the study uses an exploration for discovery approach, the main limitation of this study is its small sample. However, this research aimed to identify metathemes and issues that may be the focus of future research in this area and is, therefore, not proposing to suggest strong conclusions and definitive answers.

Originality/value

This paper presents the first empirical research to examine data privacy issues in the UK insurance context. It contributes to knowledge in the areas of motivation, applied ethics and online consumer behaviour in general.
Investigating thermal developing zone of compressible laminar flow inside hot tube
Authors: Abolpour Bahador , Shamsoddini Rahim
Published: December 2019

Purpose

Increasing the temperature of gas flows passing through hot tubes is one of the industrial interests. Operations in the gas phase with high temperature variations involve engineers with the compressible fluids problems. The paper aims to discuss this issue.

Design/methodology/approach

In this study, a mathematical three-dimensional turbulent model is applied for investigating the heat transfer and laminar gas flow inside the thermal developing zone of a hot tube. The Favre Averaged Navier–Stokes and energy equations and also the Reynolds Stress Model are numerically solved to obtain the fluid velocity and temperature profiles inside this the tube. This model is validated using the experimental data and also well-known formulas in this science.

Findings

Finally, effects of inlet volumetric flow rate, heating conditions of the tube wall and tube angle on the temperature and velocity distributions of the gaseous phase inside this zone are investigated.

Originality/value

The compressible laminar gas flow and also heat transfer in the thermal developing zone of a hot tube is studied using a three-dimensional turbulent model.
Impact of processing and packaging on the quality of murici jelly [Byrsonima crassifolia (L.) rich] during storage
Authors: Da Cunha Mariana Crivelari , Machado Patrícia da Silva , Araújo Ana Beatriz Silva , Carvalho Elisângela Elena Nunes , Vilas Boas Eduardo Valério de Barros
Published: December 2019

Purpose

The potential of the Cerrado fruit could be explored by development of new products, such as jellies that can be used to add value to the fruit, as well as to preserve this biome. This paper aims to evaluate the effect of processing, the glass packaging type and storage time on the quality of jelly, prepared from reconstituted murici pulp, over 12 months of storage.

Design/methodology/approach

The authors used a completely randomized design (CRD) in factorial 2 × 5, with two types of glass packaging (transparent and amber) and five storage periods (0, 3, 6, 9 and 12 months), with four replications and the experimental parcel consisting of 80 g of jelly (two bottles of 40 g). The quality of jelly was monitored through 12 months using physicochemical (proximal composition, color, soluble solids, titratable acidity and pH), microbiological (coliforms at 35 °C and 45 °C, filamentous fungi and Salmonella sp) and sensory analyses (sensory acceptance and purchase intent).

Findings

The pulp processing effectively affected the physicochemical and nutritional composition (proximal composition, soluble solids and color). It was found that only the storage time significantly influenced (p < 0.05) jelly quality, considering the variables analyzed, except the soluble solids, ash, dietary fiber and sensory texture attributes. However, the glass packaging factor (transparent and amber) did not result in significant changes in those variables. Moreover, the pulp processing allows a seasonal fruit with a short harvest period and short post-harvest life to be available to consumers as a new product throughout the year.

Originality/value

Based on the present study, the native Cerrado fruit such as murici [Byrsonima crassifolia (L.) Rich] is appreciated for its pleasant peculiarities such as color, aroma and taste; however, it is underutilized as food for lack of information and studies. Although the fruit does not have widespread use as food, it is necessary to make the population aware about its importance, not only as a source of nutrients, but also for its functional and sensory potential. Therefore, the production of murici jelly can increase consumption of the fruit, besides being a way to add value and extend the shelf life and sensory acceptance of the product prepared.
Review on electron beam based additive manufacturing
Authors: Negi Seema , Nambolan Athul Arun , Kapil Sajan , Joshi Prathamesh Shreekant , R. Manivannan , Karunakaran K.P. , Bhargava Parag
Published: December 2019

Purpose

Electron beam-based additive manufacturing (EBAM) is an emerging technology to produce metal parts layer-by-layer. The purpose of this paper is to systematically address the research and development carried out for this technology, up till now.

Design/methodology/approach

This paper identifies several aspects of research and development in EBAM.

Findings

Electron beam has several unique advantages such as high scanning speed, energy efficiency, versatility for several materials and better part integrity because of a vacuum working environment.

Originality/value

This paper provides information on different aspects of EBAM with the current status and future scope.
Metformin alleviates renal injury in diabetic rats by inducing Sirt1/FoxO1 autophagic signal axis
Authors: Xu Jiang , Liu Lin‐Qing , Xu Lin‐Lin , Xing Yan , Ye Shandong
Published: December 2019

Diabetic nephropathy (DN) is the major microvascular complication of diabetes mellitus and the most important cause of end‐stage renal disease worldwide. Metformin is the preferred oral hypoglycaemic drug for type 2 diabetes mellitus (T2DM). Recent studies have shown that besides lowering blood glucose, metformin also has protective effects on renal function, but its mechanism is not clear. In this study, we established a diabetic rat model by high‐fat feeding combined with intraperitoneal injection of streptozotocin. Their changes of renal function, oxidative stress, histopathology and structure, and autophagy were observed after 8 weeks of metformin treatment at different dose. Sirt1 inhibitor EX527 and metformin were used to observe whether the protective effect of metformin on DN kidney was achieved through the Sirt1/FoxO1 autophagic signalling pathway. The results showed that metformin could protect renal function by up‐regulating autophagy level, alleviating oxidative stress level of renal tissue and pathological and structural changes of glomeruli, and inhibiting the expression of extracellular matrix. Sirt1 inhibitor could block the protective effect of metformin on kidney of diabetic rats, suggesting that metformin could alleviate kidney injury in diabetic rats by inducing Sirt1/FoxO1 autophagy signal axis. So metformin could alleviate renal injury in diabetic rats, which may be achieved by regulating Sirt1/FoxO1 autophagic signalling pathway and inducing renal autophagy.
Share pledges, tone of earnings communication conferences, and market reaction: evidence from China
Authors: Zhao Wanlong , Zhang Wei , Xiong Xiong , Zou Gaofeng
Published: December 2019

We investigate how share pledging affects firms’ disclosures and influences investors in Chinese stock market. The tone of firm disclosures when there are shares pledged by controlling shareholders is more positive than that of firms without them. Considering tone inflation motivation and ability simultaneously, we find share pledge risk has an inverted U‐shaped relation with tone. Investors react positively to tone in short‐run windows, and firms with controlling shareholders’ pledges have higher stock returns for earnings communication conferences. We identify an inverted U‐shaped link between margin distance of controlling shareholders and stock returns for earnings communication conferences.
Antinuclear antibodies and recurrent miscarriage: Systematic review and meta‐analysis
Authors: Cavalcante Marcelo Borges , Cavalcante Candice Torres de Melo Bezerra , Sarno Manoel , da Silva Arlley Cleverson Belo , Barini Ricardo
Published: December 2019

Studies have investigated the relationship between antinuclear antibodies (ANA) and recurrent miscarriage (RM). The objective of this paper is to evaluate the presence of ANA as a risk factor for spontaneous abortion in patients with RM. By considering the guidelines of Preferred Reporting Items for Systematic Reviews and Meta‐Analysis, the authors performed systematic review and meta‐analysis by searching the databases of PubMed/Medline and SCOPUS. Review Manager, Version 5.3 performed the statistical analysis. Binary variables were analyzed by odds ratio (ORs) and 95% confidence interval (CI). The subgroup analysis compared the effect of different ANA titers. The authors analyzed the ANA patterns of immunofluorescence staining. Seven case‐control studies were selected. The frequency of positive ANA was statistically higher in the RM group (20.6%, 288/1400) as compared to the control group (6.7%, 72/1080). The meta‐analysis of the positive ANA showed a statistical difference between the two groups (OR 3.30, 95% CI 1.41‐7.73; I2 = 87%, P = .006). Studies have revealed different frequencies of ANA patterns of immunofluorescence. This meta‐analysis suggested that positive ANA might increase the risk of RM. However, it was not possible to conclude which ANA pattern of immunofluorescence staining is more frequent in the RM group.
Is pneumoperitoneum necessary for single‐incision laparoscopy‐assisted appendectomy for pediatric appendicitis?
Authors: Kambe Kosuke , Nagata Tomoyuki , Taniguchi Akihiro , Fukuda Ken‐ichiro , Yamaoka Nobuki , Iwata George
Published: December 2019

Introduction

Several studies have reported the treatment of pediatric appendicitis with single‐incision laparoscopy‐assisted appendectomy using a muscle hook without pneumoperitoneum to lift the abdominal wall. However, very few studies have investigated the advantages of this procedure. We examined the utility of this procedure in our department.

Methods

This study included 33 children with appendicitis who underwent single‐incision laparoscopy‐assisted appendectomy at our hospital from April 2011 to March 2018. Patients were divided into two groups depending on whether they underwent the procedure with pneumoperitoneum: the no pneumoperitoneum group (n = 12) and the pneumoperitoneum group (n = 21). The clinicopathological factors and surgical costs were compared between the two groups.

Results

In the pneumoperitoneum group, the procedure was initiated in four patients by lifting the abdominal wall but was changed to include a pneumoperitoneum because of difficulty. There were no significant differences between the two groups with regard to age, sex, or pathological severity. CT revealed a significant difference in the distance from the appendicular root to the umbilicus between the groups. There was a significant difference in the operative duration, but not in estimated blood loss or length of postoperative hospital stay. Complications were observed in one patient in each group. There was a significant difference in cost between the two groups.

Conclusions

Single‐incision laparoscopy‐assisted appendectomy without pneumoperitoneum is less expensive because certain supplies and CO2 are not required. Because there were no differences in the length of postoperative hospital stay or complications, this procedure may be safe in cases that are expected to be mild.
Epidermal growth factor receptor mRNA expression: A potential molecular escape mechanism from regorafenib
Authors: Matsusaka Satoshi , Hanna Diana L. , Ning Yan , Yang Dongyun , Cao Shu , Berger Martin D. , Miyamoto Yuji , Suenaga Mitsukuni , Dan Shingo , Mashima Tetsuo , Seimiya Hiroyuki , Zhang Wu , Lenz Heinz‐Josef
Published: December 2019

Regorafenib has improved the survival of patients with refractory metastatic colorectal cancer (mCRC), yet the mechanisms of inherited or acquired resistance are not well understood. A total of 50 patients with refractory mCRC were enrolled. Circulating tumor cell (CTC) enumeration was carried out at baseline, day 21 after initiation of regorafenib, and at the time of progression of disease (PD) using the CellSearch System (Veridex LLC, NJ, USA). Poly(A) mRNA was extracted from CTCs, and gene expression of epithelial and epithelial‐mesenchymal transition markers was analyzed by a multiplex‐PCR based DNA Chip. Patients with fewer than 3 CTCs at baseline and day 21 had a longer progression‐free survival than those with 3 or more CTCs (3.3 vs 2.0 months, P = .008 and 3.3 vs 2.0 months, P = .004, respectively). Patients with fewer than 3 CTCs at baseline and day 21 had a longer overall survival (OS) than those with 3 or more CTCs (10.0 vs 4.6 months, P < .001 and 8.7 vs 3.8 months, P = .003, respectively). In multivariable analysis, CTC counts remained significantly associated with OS at baseline and day 21 (P = .019 and P = .028). Circulating tumor cell EGFR gene expression was upregulated at day 21 and/or PD in 64% of patients. Patients had significantly increased EGFR expression at PD compared to baseline (P = .041) and at day 21 and/or PD compared to baseline (P = .004). Our findings suggest that CTC count and EGFR expression could be useful markers of regorafenib efficacy and outcomes. Upregulation of CTC EGFR expression might be a molecular escape mechanism under regorafenib therapy.
Changes in the prevalence of chronic conditions associated with abdominal obesity between 1999 and 2014
Authors: Randhawa Arshdeep K. , Ardern Chris I. , Kuk Jennifer L.
Published: December 2019

To examine the trends in chronic conditions after accounting for temporal differences in body mass index (BMI) and waist circumference (WC). Pooled cycles (1999‐2014) of the U.S. National Health and Nutrition Examination Survey (NHANES) were analysed (n = 36 959). The models were adjusted for caloric intake, smoking, medications use and physical activity. The prevalence of diabetes increased in women with general or abdominal obesity (BMI*time; WC*time, P < .05), but there were no differences in men. For hypertension, independent of BMI, the prevalence was not different over time in both sexes (P > .05), whereas for a given WC, there was a decrease in the prevalence over time in women (WC*time, P = .05). For dyslipidemia, independent of BMI, the prevalence decreased in men, whereas for a given WC, there was a decrease in the prevalence in both sexes (P < .05). Over the same time frame, blood pressure, low‐density lipoprotein and triglycerides decreased, while plasma glucose increased independent of general and abdominal obesity (P < .001). The relationship between obesity and chronic conditions has changed over time. There may be other changes that have altered how obesity is related with metabolic health markers over time. Further investigation is needed to better understand the current causes of chronic conditions.
ATP mediates the interaction between human blastocyst and endometrium
Authors: Gu Xiao‐Wei , Yang Yan , Li Tao , Chen Zi‐Cong , Fu Tao , Pan Ji‐Min , Ou Jian‐Ping , Yang Zeng‐Ming
Published: December 2019

Objective

Embryo implantation needs a reciprocal interaction between competent embryo and receptive endometrium. Adenosine triphosphate (ATP) produced by stressed or injured cells acts as an important signalling molecule. This study aims to investigate whether adenosine triphosphate (ATP) plays an important role in the dialogue of human blastocyst‐endometrium.

Materials and methods

The concentration of lactate was analysed in culture medium from human embryos collected from in vitro fertilization patients. Extracellular ATP was measured by ATP Bioluminescent Assay Kit. Ishikawa cells and T‐HESCs were treated with ATP, ATP receptor antagonist, ATP hydrolysis enzyme or inhibitors of ATP metabolic enzymes. The levels of gene expression were evaluated by real‐time PCR and immunoassay.

Results

We showed that injured human endometrial epithelial cells could rapidly release ATP into the extracellular environment as an important signalling molecule. In addition, blastocyst‐derived lactate induces the release of non‐lytic ATP from human endometrial receptive epithelial cells via connexins. Extracellular ATP stimulates the secretion of IL8 from epithelial cells to promote the process of in vitro decidualization. Extracellular ATP could also directly promote the decidualization of human endometrial stromal cells via P2Y‐purinoceptors. More importantly, the supernatants of injured epithelial cells clearly induce the decidualization of stromal cells in time‐dependent manner.

Conclusion

Our results suggest that ATP should play an important role in human blastocyst‐endometrium dialogue for the initiation of decidualization.
Skeleton construction upon local regression of the sponge body
Authors: Kishimoto Kouji , Sugano‐Yasunaga Wakana , Taniguchi Atsushi , Agata Kiyokazu , Nonaka Shigenori , Funayama Noriko
Published: December 2019

We previously revealed that the mechanism of demosponge skeleton construction is self‐organization by multiple rounds of sequential mechanical reactions of player cells. In these reactions, “transport cells” dynamically carry fine skeletal elements (spicules) on epithelia surrounding the inner body space of sponges (basal epithelium (basopinacoderm) and the endodermal epithelium (ENCM)). Once spicules pierce ENCM and apical pinacoderm, subsequently they are cemented to the substratum under the sponge body, or connected to other skeleton‐constructing spicules. Thus, the “pierce” step is the key to holding up spicules in the temporary periphery of growing sponges’ bodies. Since sponges can regress as well as grow, here we asked how skeleton construction occurs during local regression of the body. We found that prior to local basopinacoderm retraction (and thus body regression), the body became thinner. Some spicules that were originally carried outward stagnated for a while, and were then carried inwards either on ENCM or basopinacoderm. Spicules that were carried inwards on ENCM pierced epithelia after a short transport, and thus became held up at relatively inward positions compared to spicules carried on outwardly extending basopinacoderm. The switch of epithelia on which transport cells migrate efficiently occurred in thinner body spaces where basopinacoderm and ENCM became close to each other. Thus, the mechanisms underlying this phenomenon are rather mechanical: the combination of sequential reactions of skeleton construction and the narrowed body space upon local retraction of basopinacoderm cause spicules to be held up at more‐inward positions, which might strengthen the basopinacoderm's attachment to substratum.
Lutheran churches in Africa: Vitality, challenges, and opportunities for the new face of Lutheranism in the 21st century
Authors: Ng'weshemi Andrea M.
Published: December 2019

It is acknowledged and well documented that Christianity is rapidly changing from being the religion of Europe and North America to a religion of South America, Africa, and Asia. Of the three regions, Africa is experiencing the fastest Christian growth. This paper examines one of the many Christian denominations and movements that are participating in that growth in Africa, namely Lutheranism. Reasons behind the steady expansion, challenges faced, and the implications of the rise of Lutheranism in Africa will be highlighted.
Treatment and prevention of severe hypoglycaemia in people with diabetes: Current and new formulations of glucagon
Authors: Thieu Vivian T. , Mitchell Beth D. , Varnado Oralee J. , Frier Brian M.
Published: December 2019

Some therapies for diabetes increase the risk of hypoglycaemia, in particular all insulins and insulin secretagogues, including the glinides and sulfonylureas. Hypoglycaemia remains a major limiting factor to successful glycaemic management, despite the availability of prevention options such as insulin analogues, continuous glucose monitoring, insulin pumps, and dogs that have been trained to detect hypoglycaemia. Non‐severe (self‐treated) and severe (requiring assistance for recovery) hypoglycaemia rates are higher in people with type 1 diabetes, but those with insulin‐treated type 2 diabetes are also at risk. Education and regular review are essential between people with diabetes and their caregivers and healthcare professionals about symptoms, prevention and treatment. Awareness of the potential dangers of hypoglycaemia is fundamental to the optimal management of diabetes. When therapy is intensified to achieve glycaemic targets, it is important that people at risk of severe hypoglycaemia, and particularly their caregivers, have ready access to effective treatment for hypoglycaemia emergencies. The current and potential formulations of glucagon available for treatment of severe hypoglycaemia are reviewed.
The role of acetylcholine in negative encoding bias: Too much of a good thing?
Authors: Mineur Yann S. , Picciotto Marina R.
Published: December 2019

Optimal acetylcholine (ACh) signaling is important for sustained attention and facilitates learning and memory. At the same time, human and animal studies have demonstrated increased levels of ACh in the brain during depressive episodes and increased symptoms of anxiety, depression, and reactivity to stress when ACh breakdown is impaired. While it is possible that the neuromodulatory roles of ACh in cognitive and affective processes are distinct, one possibility is that homeostatic levels of ACh signaling are necessary for appropriate learning, but overly high levels of cholinergic signaling promote encoding of stressful events, leading to the negative encoding bias that is a core symptom of depression. In this review, we outline this hypothesis and suggest potential neural pathways and underlying mechanisms that may support a role for ACh signaling in negative encoding bias.
Habitat preferences and habitat restoration options for small‐bodied and juvenile fish species in the northern Murray–Darling Basin
Authors: Hutchison Michael , Norris Andrew , Nixon David
Published: December 2019

Degradation of instream habitats in the northern Murray–Darling Basin has occurred through numerous stressors, including siltation, clearing of bankside vegetation, intrusion of livestock and impacts of pest species. A better understanding of habitat preferences of native fish species could help guide future instream habitat restoration actions. The habitat choices of seven native fish species, juvenile Murray Cod (Maccullochella peelii), juvenile Golden Perch (Macquaria ambigua ambigua), juvenile Silver Perch (Bidyanus bidyanus), adult Murray–Darling Rainbowfish (Melanotaenia fluviatilis), adult Olive Perchlet (Ambassis agassizii), adult Un‐specked Hardyhead (Craterocephalus stercusmuscarum fulvus) and adult carp gudgeons (Hypseleotris spp.) were tested in preference troughs to help inform potential habitat restoration actions in the Condamine catchment. Each species was given a choice between pair combinations of open sandy habitat, submerged macrophytes, emergent plants and rocky rubble. Habitat preferences varied between species. Murray Cod, Golden Perch, carp gudgeons and Olive Perchlets preferred structure over open sandy habitat, whilst juvenile Silver Perch, Un‐specked Hardyhead and Murray–Darling Rainbowfish did not avoid open sandy habitats. Juvenile Murray Cod preferred rocky rubble habitat over all other habitat choices. Use of complex rock piles to provide nursery habitat for Murray Cod populations is a potential restoration option. Introduction of rock could also benefit Golden Perch and carp gudgeons. Use of emergent plants, submerged macrophytes and rocky rubble for habitat restoration all appear to have merit for one or more species of small‐bodied fishes or juvenile stages of larger sized fishes. Rocky rubble or floating attached macrophytes could be viable restoration options in areas too turbid to establish submerged macrophytes. These habitat interventions would complement existing actions such as re‐snagging and provision of fish passage to assist with sustainable management of native fish populations.
Corvids avoid odd evaluation by following simple rules in a risky exchange task
Authors: Dufour Valérie , Broihanne Marie‐Hélène , Wascher Claudia A. F.
Published: December 2019

In their natural environment, animals often make decisions crucial for survival, such as choosing the best patch or food, or the best partner to cooperate. The choice can be compared to a gamble with an outcome that is predictable but not certain, such as rolling a dice. In economics, such a situation is called a risky context. Several models show that although individuals can generally evaluate the odds of each potential outcome, they can be subject to errors of judgment or choose according to decision‐making heuristics (simple decision rules). In non‐human primates, similar errors of judgment have been reported and we have recently shown that they also use a decisional heuristics when confronted with a risky choice in an exchange task. This suggests a common evolutionary origin to the mechanisms underlying decision‐making under risk in primates. However, whether the same mechanisms are also present in more distantly related taxa needs to be further investigated. Other social species, like corvids, are renowned for their advanced cognitive skills and may show similar responses. Here, we analyse data on corvids (carrion crows, hooded crows, common ravens and rooks) tested in a risky exchange task comparable to the one used in non‐human primates. We investigated whether corvids could exchange according to the odds of success or, alternatively, whether they used a heuristic similar to the one used by non‐human primates. Instead, most corvids chose a course of action (either a low or high exchange rate) that remained constant throughout the study. In general, corvids’ mean exchange rates were lower compared to non‐human primates, indicating that they were either risk‐adverse or that they do not possess the cognitive capabilities to evaluate odds. Further studies are required to evaluate the flexibility in exchange abilities of these birds in exchange abilities of these birds.
Vegetation encroachment drives changes in the composition of butterfly assemblages and species loss in Mediterranean ecosystems
Authors: Ubach Andreu , Páramo Ferran , Gutiérrez Cèsar , Stefanescu Constantí
Published: December 2019

Land abandonment and loss of grazing have been amongst the primary drivers of landscape change in the Mediterranean basin in the recent decades. As a consequence, forest cover has greatly expanded in detrimental of semi‐natural grasslands, areas of cultivation and pasture mosaics. Although predictably important, the impact that this phenomenon has on biodiversity has remained largely unexplored, partly because of lack of appropriate data.

Here, we make use of an extensive citizen science program, the Catalan Butterfly Monitoring Scheme, to quantify the response of butterfly assemblages to vegetation encroachment in NE Spain. We first adapted an index to describe the preference of 147 butterfly species for open or closed habitats and found a strong association of most species for open habitats.

We developed a community index to record changes in 54 long‐term monitored sites (10 years or more), where plant communities were also periodically monitored. Butterfly assemblages have undergone changes toward species preferring closed habitats in 72% of the studied sites, in parallel to a process of vegetation encroachment in the region.

Community changes were linked to population trends, and could be locally predicted by the interaction of the preference of butterfly species for open or closed habitats and the magnitude of vegetation encroachment at each site. These changes were accompanied by frequent extinction events (4.53% of the studied populations), that were highly biased toward species preferring open habitats. Our study confirms and quantifies the threat that vegetation encroachment imposes on biodiversity in this highly diverse region.
Development and psychometric evaluation of the patient knowledge of, and attitudes and behaviours towards pressure ulcer prevention instrument (KPUP)
Authors: Shanley Emer , Moore Zena , Patton Declan , O'Connor Tom , Avsar Pinar , Nugent Linda , Beeckman Dimitri
Published: December 2019

The Patient Knowledge of, and Attitude and Behaviour towards Pressure Ulcer Prevention Instrument (KPUP) was developed and validated using a two‐stage prospective psychometric instrument validation study design. In Stage 1, the instrument was designed, and it is psychometrically evaluated in Stage 2. To establish content validity, two expert panels independently reviewed each item for appropriateness and relevance. Psychometric evaluation included construct validity and stability testing of the instrument. The questionnaire was administered to a convenience sample of 200 people aged more than 65 years, living independently in the community; reliability and stability were assessed by test/retest procedures, with a 1‐week interval. Mean knowledge scores at ‘test’ were 11.54/20 (95% CI = 11.10‐11.99, SD: 3.07), and ‘retest’ was 12.24 (95% CI = 11.81‐12.66, SD: 2.93). For knowledge, correlation between the test/retest score was positive (r=. 60), attitude section‐inter‐item correlations ranged from r = −.31 to r = .57 (mean intraclass correlation coefficient of r = .42), and internal consistency for the retest was the same as the test (α = .41 for the eight items). For health behaviours, individual inter‐item correlations for test items ranged from r = −.21 to r = .41 for the 13 standardised items. Psychometric testing of the KPUP in a sample of older persons in the community provided moderate internal consistency and general high test‐retest stability.
The Medieval Churchyard as an Urban Empty Space
Authors: Christensen Jakob Tue
Published: December 2019

The study applies the concept of ‘urban empty space’ as defi ned by Monica Smith to the adjacent churchyards of St. Alban and St. Canute, the latter being both a cathedral and a shrine for the royal saint, Canute the Holy. The aim is to demonstrate that the churchyard of St. Canute incorporated other temporary functions for the urban society, which subdivided the space into more labile areas or demarcations of use. The demarcations might, according to the concept, become contested areas between various users; thus, the article seeks to identify possible contestants through examining the built environment as well as the artefacts – in the present case, though, limited to the pottery. The article shows that the studied objects can shed new light on the urban empty space of the medieval churchyard. It is also a reminder that urban churchyards are not completely isolated loci of sanctity for the dead but are very much a part of urban life.
The Medieval Urban Churchyard as a Meeting Place
Authors: Jensen Jane Jark
Published: December 2019

The article presents the results of a study based on activity analysis of a medieval churchyard of St. Clemens in the urban setting of Copenhagen. The churchyard was in function from the 11th to 16th century revealing changes in layout and burial rites over time. A glimpse of the symbolic life of the medieval Copenhageners is also exposed and analysed. Moreover, the study of the churchyard reveals activities of a more secular nature and presents some of the activities that must have been part of everyday life in the medieval town. Thus, the churchyard has not only been an arena for meetings between the living and the dead but also a location for experiencing the urban life burgeoning outside the churchyard.

For comparison, a recently discovered contemporaneous churchyard at Rådhuspladsen is also discussed.
Neutrophil extracellular traps activate lung fibroblast to induce polymyositis‐related interstitial lung diseases via TLR9‐miR‐7‐Smad2 pathway
Authors: Zhang Sigong , Jia Xueqin , Zhang Qiuyue , Zhang Li , Yang Jing , Hu Caihong , Shi Junnian , Jiang Xiao , Lu Jinyue , Shen Haili
Published: December 2019

Excessive neutrophil extracellular trap (NET) formation may contribute to polymyositis (PM)‐associated interstitial lung diseases (ILD), but the underlying mechanism is not fully revealed. In this study, we found that NET accelerated the progression of ILD and promoted pulmonary fibrosis (PF) in vivo. miR‐7 expression was down‐regulated in lung tissue of PM group than control group, and NETs further decreased miR‐7 expression. TLR9 and Smad2 were up‐regulated in lung tissue of PM group than control group, and NETs further increased TLR9 and Smad2 expressions. In vitro experiments showed that PMA‐treated NETs accelerated the proliferation of LF and their differentiation into myofibroblast (MF), whereas DNase I decreased the promotion effect of NETs. Neutrophil extracellular trap components myeloperoxidase (MPO) and histone 3 also promoted the proliferation and differentiation of LF. In addition, we demonstrated that TLR9 involved in the regulation of NETs on LF proliferation and differentiation, and confirmed the interaction between miR‐7 and Smad2 in LF. Finally, miR‐7‐Smad2 pathway was confirmed to be involved in the regulation of TLR9 on LF proliferation and differentiation. Therefore, NETs promote PM‐related ILD, and TLR9‐miR‐7‐Smad2 signalling pathway is involved in the proliferation of LFs and their differentiation into MFs.
Commentary: Reducing adolescent suicide: a global imperative – a reflection on Glenn et al. (2020)
Authors: Brent David A.
Published: December 2019

Glenn and colleagues have examined rates of adolescent suicide across 45 countries and explored the role of sex, age, rurality and availability of guns and railways on suicide rates. Higher rates of adolescent suicide in New Zealand may be explained by the very high rate of adolescent suicide in young Maoris. Future work could be enhanced by reporting on national trends in suicide, reporting on rates broken down by race and ethnicity, and through the development of international psychological autopsy studies that could shed light on cross‐country differences. While this article found that income inequality was correlated with the male‐to‐female ratio of adolescent suicide across countries, the opposite trend has been reported in the United States. However, as noted by this article, the effects of poverty matter. The Move To Opportunity study found that when youth under the age of 13 were moved from a high poverty to a low poverty neighbourhood, there were enduring effects, including lower levels of depression and anxiety. While adolescent suicide is a global concern, reduction in the suicide rate may have local solutions, including those that address the pernicious effects of poverty and poor neighbourhoods on youth.
Assessing the repeatability, robustness to disturbance, and parent–offspring colony resemblance of collective behavior
Authors: Fisher David N. , Lichtenstein James L. L. , Costa‐Pereira Raul , Yeager Justin , Pruitt Jonathan N.
Published: December 2019

Groups of animals possess phenotypes such as collective behaviour, which may determine the fitness of group members. However, the stability and robustness to perturbations of collective phenotypes in natural conditions is not established. Furthermore, whether group phenotypes are transmitted from parent to offspring groups with fidelity is required for understanding how selection on group phenotypes contributes to evolution, but parent–offspring resemblance at the group level is rarely estimated. We evaluated the repeatability, robustness to perturbation and parent–offspring resemblance of collective foraging aggressiveness in colonies of the social spiderAnelosimus eximius. Among‐colony differences in foraging aggressiveness were consistent over time but changed if the colony was perturbed through the removal of individuals or via individuals’ removal and subsequent return. Offspring and parent colony behaviour were correlated at the phenotypic level, but only once the offspring colony had settled after being translocated, and the correlation overlapped with zero at the among‐colony level. The parent–offspring resemblance was not driven by a shared elevation but could be due to other environmental factors. The behaviour of offspring colonies in a common garden laboratory setting was not correlated with the behaviour of the parent colony nor with the same colony's behaviour once it was returned to the field. The phenotypes of groups represent a potentially important tier of biological organization, and assessing the stability and heritability of such phenotypes helps us better understand their role in evolution.
Competency‐based education calls for programmatic assessment: But what does this look like in practice?
Authors: Rich Jessica V. , Fostaty Young Sue , Donnelly Catherine , Hall Andrew K. , Dagnone J. Damon , Weersink Kristen , Caudle Jaelyn , Van Melle Elaine , Klinger Don A.
Published: December 2019

Rationale, aims, and objectives

Programmatic assessment has been identified as a system‐oriented approach to achieving the multiple purposes for assessment within Competency‐Based Medical Education (CBME, i.e., formative, summative, and program improvement). While there are well‐established principles for designing and evaluating programs of assessment, few studies illustrate and critically interpret, what a system of programmatic assessment looks like in practice. This study aims to use systems thinking and the ‘two communities’ metaphor to interpret a model of programmatic assessment and to identify challenges and opportunities with operationalization.

Method

An interpretive case study was used to investigate how programmatic assessment is being operationalized within one competency‐based residency program at a Canadian university. Qualitative data were collected from residents, faculty, and program leadership via semi‐structured group and individual interviews conducted at nine months post‐CBME implementation. Data were analyzed using a combination of data‐based inductive analysis and theory‐derived deductive analysis.

Results

In this model, Academic Advisors had a central role in brokering assessment data between communities responsible for producing and using residents' performance information for decision making (i.e., formative, summative/evaluative, and program improvement). As system intermediaries, Academic Advisors were in a privileged position to see how the parts of the assessment system contributed to the functioning of the whole and could identify which system components were not functioning as intended. Challenges were identified with the documentation of residents' performance information (i.e., system inputs); use of low‐stakes formative assessments to inform high‐stakes evaluative judgments about the achievement of competence standards; and gaps in feedback mechanisms for closing learning loops.

Conclusions

The findings of this research suggest that program stakeholders can benefit from a systems perspective regarding how their assessment practices contribute to the efficacy of the system as a whole. Academic Advisors are well positioned to support educational development efforts focused on overcoming challenges with operationalizing programmatic assessment.
PRICE PRESSURE OF TRADING AND EQUITY PRICES IN HEDGE FUND ACTIVISM
Authors: Mihov Atanas
Published: December 2019

In this article, I offer and examine a price pressure hypothesis, which states that stock prices of activism targets temporarily deviate from fundamentals. Increased demand for target stocks upon the formation of activist positions exerts upward pressure on targets’ stock prices in the short term. Such effects are driven by illiquid stocks whose prices are sensitive to order‐flow imbalances. When activists use private transactions, price pressure effects are muted. As buying pressure subsides and reverses over the long run, targets’ stock prices decline proportionately to predisclosure accumulations, driven again by illiquid stocks. These price dynamics have important implications for activists’ block‐formation strategies and, more generally, shareholder activism.
What about limb long bone nutrient canal(s)? – a 3D investigation in mammals
Authors: Houssaye Alexandra , Prévoteau Jocerand
Published: December 2019

The nutrient arteries, located in the long bone diaphysis, are the major blood supply to long bones, especially during the early phases of growth and ossification. Their intersection with the central axis of the medullary area corresponds to the ossification center, and their opening on the outer bone surface to the nutrient foramen. Nutrient arteries/foramen have essentially been analyzed in humans, and only to a much lesser extent in a few mammals. Some studies have taken measurements of the nutrient foramen; others have investigated the shape and orientation of the nutrient canals, although only partially. No studies have analyzed the nutrient canal in three dimensions inside the bone and the relationships between nutrient foramen, nutrient canal, growth, and physiology require further investigation. The current study proposes to investigate in three dimensions the shape of the nutrient canal in stylopod bones of various mammals. Qualitative and quantitative parameters are defined to discuss the diversity in, for example, morphology, orientation, and diameter encountered, resorting to two different datasets to maximize differences within mammals and then analyze variation within morphologically and phylogenetically closer taxa. This study highlights a strong intraspecific variation for various parameters, with limited biological signal, but also shows trends. It notably provides evidence that canals are generally more numerous and relatively thinner in less elongated bones. Moreover, it shows that the growth center is located distally in the humerus and proximally in the femur, and that the canals are essentially oriented towards the faster growing end, so that the nutrient foramen does not indicate the location of the growth center. This result seems general in mammals but cannot be generalized outside of Mammalia. Further analyses of the features of nutrient arteries in reptiles are required to make comparisons with the trends observed in mammals.
The use of mentholated popsicle to reduce thirst during preoperative fasting: A randomised controlled trial
Authors: Aroni Patricia , Fonseca Ligia F. , Ciol Marcia A. , Margatho Amanda S. , Galvão Cristina M.
Published: December 2019

Aims and objectives

To compare mentholated popsicle with usual care (absolute fasting) in the change of thirst intensity and discomfort of patients in the preoperative fasting.

Background

Thirst is defined as the desire to drink water, and it is considered to be a multifactorial symptom. In the preoperative fasting, the patient may experience intense thirst, often for a long time, that can lead to feelings of suffocation, desperation, fear and anxiety.

Design

A randomised controlled trial.

Methods

Forty patients, aged between 18–60 years, were randomised to mentholated popsicle group or absolute fasting group (twenty in each). The primary outcomes were thirst intensity, evaluated by a numeric scale ranging from 0 (no thirst)–10 (the worst possible thirst), and discomfort from thirst (evaluated by the Perioperative Thirst Discomfort Scale), both measured twice (baseline and after 20 min of intervention). The CONSORT checklist was used to report this study.

Results

Mean age was similar in both groups (38 years in the mentholated popsicle group and 39 in the absolute fasting group). At baseline, the mentholated popsicle group had higher median for the scales of intensity (6.5) and discomfort (7.5) from thirst than the absolute fasting group (5.0 and 5.0, respectively). At the end of 20 min, the popsicle group had a statistically significant decrease in intensity and discomfort from thirst (median decreases of 5.0 and 7.0 points, respectively) when compared to the absolute fasting group (median increases of 0.5 and 1.0 points, respectively).

Conclusions

The use of mentholated popsicle decreased the intensity and discomfort from thirst, and it is a viable strategy for the management of thirst in the preoperative fasting.

Relevance to clinical practice

In the preoperative fasting, making mentholated popsicles available to patients is an easy strategy to manage thirst, which might lead to better care.