bluuebunny/crossref_metadata_2025 huggingface dataset:
Lokale chirurgische Therapie des kutanen Plattenepithelkarzinoms: Defizite und Kontroversen in der Literatur
Authors: Breuninger Helmut , Eigentler Thomas , Häfner Hans‐Martin , Leiter Ulrike
Published: October 2019

Der Einfluss der Primärexzision eines kutanen Plattenepithelkarzinoms auf die Prognose ist abhängig von den Risikofaktoren des Tumors, den chirurgischen Therapiemodalitäten und der histologischen Untersuchung.

Im Zuge der AWMF‐Leitlinie Plattenepithelkarzinom wurden mittels DELBI‐Verfahren die aussagekräftigsten Leitlinien herangezogen. Dies waren die schottische, die kanadische und die gemeinsame Leitlinie der EDF, EADO und EORTC. Die Aufarbeitung der Primärliteratur dieser Leitlinien zu oben genannten Themen ergab 49 Studien und 9 Reviews. Keine Studie bot ein prospektives randomisiertes Schema, 19 enthielten prospektiv erhobene Daten, 30 retrospektive Daten. Insgesamt zeigten die Studien heterogene Ergebnisse. Es gab Diskrepanzen hinsichtlich der Wertigkeit der Risikofaktoren zur lokoregionären Progression, wie Entdifferenzierung, Desmoplasie und perineuraler Invasion, teils auch Tumordicke und chirurgischer Konsequenzen. Auch bei der histologischen Aufarbeitung ergaben sich Unterschiede. Die Literatur unterscheidet prinzipiell zwei Methoden der histologischen Aufarbeitung: die konventionelle Histologie mittels Lamellen (Brotlaib‐Histologie) und die lückenlose Randschnitt‐Histologie. Für Letztere zeigten die Studien niedrige Rezidivraten, aber auch niedrige Metastasierungsraten, eventuell infolge risikoärmerer Kollektive gegenüber ersterer Methode. Bei Publikationen zur Brotlaib‐Histologie fehlten genaue Angaben über die definitive Aufarbeitung. Ebenso fehlten verwertbare Angaben zum primären Resektionsabstand.

Fazit: Die aktuelle Literatur ist uneinheitlich und insuffizient bezüglich der einzelnen prognostischen Faktoren und den Maßnahmen der chirurgischen Versorgung des kutanen Plattenepithelkarzinoms.
S3 guidelines: Epicutaneous patch testing with contact allergens and drugs – Short version, Part 1
Authors: Mahler Vera , Nast Alexander , Bauer Andrea , Becker Detlef , Brasch Jochen , Breuer Kristine , Dickel Heinrich , Drexler Hans , Elsner Peter , Geier Johannes , John Swen Malte , Kreft Burkhard , Köllner Arno , Merk Hans , Ott Hagen , Pleschka Silvia , Portisch Maria , Spornraft‐Ragaller Petra , Weisshaar Elke , Werfel Thomas , Worm Margitta , Schnuch Axel , Uter Wolfgang
Published: October 2019

Epicutaneous patch testing is the diagnostic standard for the detection of allergic contact dermatitis. The present guidelines are aimed at residents and board‐certified physicians in the fields of dermatology and allergology as well as other medical specialties involved in establishing the indication for patch testing and its execution in patients with contact dermatitis and other forms of delayed‐type hypersensitivity. The target audience also includes other health care providers and insurance funds.

Based on a systematic literature search and a formal consensus process (S3), the guidelines were developed by dermatologists in collaboration with pediatricians, occupational medicine physicians, nursing staff as well as patient representatives. The systematic methodological approach and appraisal of evidence upon which the recommendations are based are outlined in a separate method report that also contains evidence tables.

The guidelines address general aspects of patch testing as well as medicolegal issues. The recommendations given relate to topics such as the indication for patch testing, informed patient consent, as well as the choice of test substances, test chambers and test site, duration of exposure, reading times and interpretation of test reactions. Furthermore, recommendations are provided with respect to endogenous and exogenous factors, specific patient groups (children, pregnant women, immunosuppressed individuals) as well as possible risks and adverse events associated with patch testing using contact allergens.

Note: This publication is part 1 of the short version of the S3 guidelines for “Epicutaneous patch testing using contact allergens and drugs” (registry no. 013 – 018; date: March 20, 2019; valid until December 31, 2021). Part 2 of the short version will be published in the next issue. The long version of these guidelines can be accessed atwww.awmf.org. The method report is available as online publication (https://www.awmf.org/leitlinien/detail/ll/013‐018.html) and contains the evidence tables in its appendix.
Systemic sclerosis patients are at higher risk of hyperthyroidism and have a worse survival than those without hyperthyroidism: A nationwide population‐based cohort study
Authors: Akuka Aviram , Watad Abdulla , Comaneshter Doron , Cohen Arnon D. , Amital Howard , Bragazzi Nicola L.
Published: October 2019

Background

A high prevalence of thyroid disorders has been reported in patients with autoimmune diseases. The link between hyperthyroidism and systemic sclerosis (SSc) has been relatively overlooked, and only a few studies utilizing small samples or case reports have been reported so far.

Objectives

To investigate the association between SSc and hyperthyroidism.

Methods

We designed a case‐control study utilizing the medical database of the Clalit Health Services. Chi‐square and t tests were used for univariate analysis, and a logistic regression model was used for multivariate analysis.

Results

The study included 2,431 SSc patients and 12,710 age‐ and sex‐matched controls. The mean age of the study population was 63.32 ± 18.06 years (median 66 years), and female‐to‐male ratio was 4.5:1. Age (P < .0001, OR 1.03 [95% CI 1.02‐1.04]), female sex (P = .0015, OR 1.86 [95% CI 1.27‐ 2.74]) and diagnosis of SSc (P = .0011, OR 1.81[95% CI 1.27‐2.58]) were all independently associated with hyperthyroidism. Patients with SSc and hyperthyroidism had 1.54‐fold increase of mortality rates during a mean follow‐up of 17 years than SSc patients without hyperthyroidism, even though at the Cox multivariate survival analysis, only age (HR 1.06 [95% CI 1.06‐1.07], P < .0001) and diagnosis of SSc (HR 2.35 [CI 2.06 to 2.69], P < .0001) resulted associated with a higher risk of mortality.

Conclusions

Hyperthyroidism is highly prevalent among SSc patients and can negatively impact on their survival rates. Therefore, a pre‐emptive screening may be warranted in all SSc patients. Further studies are needed to evaluate whether tight control and optimal treatment for hyperthyroidism may lead to a reduction of all‐cause mortality in patients with SSc.
GRIND OR GAMBLE? AN EXPERIMENT ON EFFORT AND SPREAD SEEKING IN CONTESTS
Authors: Andersson Ola , Holm Håkan J. , Wengström Erik
Published: October 2019

We conduct a contest experiment to study if spread seeking and effort can be managed when participants can invest in increasing both the mean and the spread of an uncertain performance variable. Subjects are treated with different prize schemes and in accordance with theory, we observe higher investments in spread for the winner‐take‐all scheme. Both types of investments can be controlled with a three‐level prize scheme. However, the control management is imperfect and behavior is characterized by inertia. We also explore the correlation between effort and spread across subjects and find that is robustly positive.
Tri‐trophic interactions: bridging species, communities and ecosystems
Authors: Abdala‐Roberts Luis , Puentes Adriana , Finke Deborah L. , Marquis Robert J. , Montserrat Marta , Poelman Erik H. , Rasmann Sergio , Sentis Arnaud , van Dam Nicole M. , Wimp Gina , Mooney Kailen , Björkman Christer
Published: October 2019

A vast body of research demonstrates that many ecological and evolutionary processes can only be understood from a tri‐trophic viewpoint, that is, one that moves beyond the pairwise interactions of neighbouring trophic levels to consider the emergent features of interactions among multiple trophic levels. Despite its unifying potential, tri‐trophic research has been fragmented, following two distinct paths. One has focused on the population biology and evolutionary ecology of simple food chains of interacting species. The other has focused on bottom‐up and top‐down controls over the distribution of biomass across trophic levels and other ecosystem‐level variables. Here, we propose pathways to bridge these two long‐standing perspectives. We argue that an expanded theory of tri‐trophic interactions (TTIs) can unify our understanding of biological processes across scales and levels of organisation, ranging from species evolution and pairwise interactions to community structure and ecosystem function. To do so requires addressing how community structure and ecosystem function arise as emergent properties of component TTIs, and, in turn, how species traits and TTIs are shaped by the ecosystem processes and the abiotic environment in which they are embedded. We conclude that novel insights will come from applying tri‐trophic theory systematically across all levels of biological organisation.
Parkinson disease
Authors: Balestrino R. , Schapira A.H.V.
Published: October 2019

Parkinson disease (PD) is the most common neurodegenerative movement disorder. In Europe, prevalence and incidence rates for PD are estimated at approximately 108–257/100 000 and 11–19/100 000 per year, respectively. Risk factors include age, male gender and some environmental factors. The aetiology of the disease in most patients is unknown, but different genetic causes have been identified. Although familial forms of PD account for only 5%–15% of cases, studies on these families provided interesting insight on the genetics and the pathogenesis of the disease allowing the identification of genes implicated in its pathogenesis and offering critical insights into the mechanisms of disease. The cardinal motor symptoms of PD are tremor, rigidity, bradykinesia/akinesia and postural instability, but the clinical picture includes other motor and non‐motor symptoms. Its diagnosis is principally clinical, although specific investigations can help the differential diagnosis from other forms of parkinsonism. Pathologically, PD is characterized by the loss of dopaminergic neurons in the pars compacta of the substantia nigra and by accumulation of misfolded α‐synuclein, which is found in intra‐cytoplasmic inclusions called Lewy bodies. Currently available treatments offer good control of motor symptoms but do not modify the evolution of the disease. This article is intended to provide a comprehensive, general and practical review of PD for the general neurologist.
A review of thermochemical upgrading of pyrolysis bio‐oil: Techno‐economic analysis, life cycle assessment, and technology readiness
Authors: Sorunmu Yetunde , Billen Pieter , Spatari Sabrina
Published: October 2019

Technologies for upgrading fast pyrolysis bio‐oil to drop‐in fuels and coproducts are under development and show promise for decarbonizing energy supply for transportation and chemicals markets. The successful commercialization of these fuels and the technologies deployed to produce them depend on production costs, scalability, and yield. To meet environmental regulations, pyrolysis‐based biofuels need to adhere to life cycle greenhouse gas intensity standards relative to their petroleum‐based counterparts. We review literature on fast pyrolysis bio‐oil upgrading and explore key metrics that influence their commercial viability through life cycle assessment (LCA) and techno‐economic analysis (TEA) methods together with technology readiness level (TRL) evaluation. We investigate the trade‐offs among economic, environmental, and technological metrics derived from these methods for individual technologies as a means of understanding their nearness to commercialization. Although the technologies reviewed have not attained commercial investment, some have been pilot tested. Predicting the projected performance at scale‐up through models can, with industrial experience, guide decision‐making to competitively meet energy policy goals. LCA and TEA methods that ensure consistent and reproducible models at a given TRL are needed to compare alternative technologies. This study highlights the importance of integrated analysis of multiple economic, environmental, and technological metrics for understanding performance prospects and barriers among early stage technologies.
Does subjective assessment of dialyzer appearance reflect dialyzer performance in online hemodiafiltration?
Authors: Fazendeiro Matos João , Pinto Bruno , Felix Carla , Carvalho Helena , Ponce Pedro , Peralta Ricardo
Published: October 2019

Introduction: In post‐dilution online hemodiafiltration, a very thin balance subsists in preventing coagulation of the extracorporeal circuit (ECC) during treatment and bleeding in the patient, concerning dialyzer status and anticoagulation dose.

The aim of this study was to assess whether there are clinical outcome differences between the visual aspect of the dialyzer's status in terms of clotted fibers at end of dialysis treatments, single‐pool urea kinetic modeling (spKt/V) and substitution volume (SubsVol).

Methods: It is a multicenter, descriptive‐correlational study, involving 2829 patients during April 2016. Previous training was given to the Nursing staff to evaluate and classify both the dialyzer's and the venous chamber's appearance of the ECC venous line. Registration was performed at bedside immediately after the patient disconnection.

Findings and discussion: Mean age was 68.96 years (SD = 13.75), 60.8% were men. The average hematocrit was 33.91% (SD = 3.45%). The average dry weight was 68.53 kg (SD = 13.27 kg). Mean unfractioned heparin (UFH) dose was 58.13 IU/kg. Only 32.4% of the patients had a clean dialyzer at the end of treatment. 19.4% of patients finished the treatment with more than 10% of clotted fibers. Patients with no residual blood (clean, 32.4%) presented a higher UFH dose (66.32 IU/kg) compared to overall average dose. UFH dose had a significant effect on dialyzer status. There were significant differences in average of spKt/V and SubsVol between the category clean and the other categories of dialyzer's status.

Evaluating the dialyzer status represents an excellent opportunity to help the physicians to establish an ideal heparin dose. Only the category clean is significant to achieve the target. The nursing staff, by classifying the ECC appearance at patient's bedside and recording it in a centralized database, can be a major contributor to achieve an individualized and optimal UFH dose and subsequently better patient outcomes.
The relationship between antecedent creatinine decreases and outcomes in patients undergoing hemodialysis
Authors: Harada Tomonari , Sorimachi Hidemi , Obokata Masaru , Sunaga Hiroaki , Ishida Hideki , Ito Kyoko , Ogawa Tetsuya , Ando Yoshitaka , Kurabayashi Masahiko , Negishi Kazuaki
Published: October 2019

Introduction

Previous studies have demonstrated an association between low serum creatinine levels and adverse outcomes in patients undergoing maintenance hemodialysis. However, little is known regarding whether long‐term changes in serum creatinine predict outcomes independently and incrementally over a single point evaluation.

Methods

Serum creatinine data at index (June 2013) and for the 18 months prior to the index blood sampling (between January 2012 and June 2013) were evaluated in 346 hemodialysis patients. Patients were followed from the index blood sampling for primary (all‐cause mortality) and secondary (cardiovascular death) endpoints.

Findings

During a median follow‐up of 5.7 years, there were 82 all‐cause and 25 cardiovascular deaths. Compared to patients who survived, those who died displayed a greater time‐dependent reduction in creatinine levels during the 18 months prior to the index assessment, coupled with a greater decrease in predialysis body weight (interaction p = 0.007). Patients who displayed creatinine decline over the prior 18 months (∆ creatinine<0 mg/dL) had higher all‐cause mortality than those who maintained creatinine levels (∆ creatinine≥0 mg/dL). After adjustment for clinical factors and baseline creatinine index, antecedent creatinine decrease was independently associated with an increased risk of all‐cause mortality, with an incremental prognostic value over baseline creatinine index alone. A reduction in creatinine levels was also associated with cardiovascular death independent of the baseline creatinine index.

Discussion

A long‐term antecedent decrease in serum creatinine levels is independently associated with clinical outcomes in hemodialysis patients, with an incremental prognostic value over baseline creatinine index alone. Our data suggest that serial creatinine measurements are a useful prognosticator in practice.
Ledipasvir and sofosbuvir for 12 weeks for hepatitis C virus genotype 2 infection: A propensity score matched analysis
Authors: Ogawa Eiichi , Nomura Hideyuki , Nakamuta Makoto , Kawano Akira , Dohmen Kazufumi , Kajiwara Eiji , Satoh Takeaki , Koyanagi Toshimasa , Takahashi Kazuhiro , Ooho Aritsune , Azuma Koichi , Furusyo Norihiro , Kato Masaki , Shimoda Shinji , Hayashi Jun ,   The Kyushu University Liver Disease Study (KULDS) Group
Published: October 2019

Aim

Hepatitis C virus genotype 2 is common in East Asia, sub‐Saharan Africa, and Latin America. However, many countries in these areas lag behind other areas of the world in government approval for new direct‐acting antivirals. The aim of this study was to evaluate the treatment outcome of ledipasvir/sofosbuvir (LDV/SOF) for patients with chronic hepatitis C virus genotype 2 infection.

Methods

This is a two‐part multicenter, real‐world cohort study. Study 1 consisted of 58 consecutive patients who were treated with LDV/SOF for 12 weeks. Study 2 used propensity score matching for LDV/SOF (n = 58) and glecaprevir/pibrentasvir (n = 207) treatment groups (1:1) with a set of clinically important variables. Sustained viral response 12 weeks after the end of treatment (SVR12) and adverse events were evaluated in both studies.

Results

In study 1, the overall SVR12 rates of the intention‐to‐treat and modified intention‐to‐treat populations were 94.8% (55/58) and 96.5% (55/57), respectively. High SVR12 rates were observed in almost all subgroups, including older age, compensated cirrhosis, and treatment experience. In study 2, propensity score matching of the entire study population yielded 52 matched pairs with similar baseline characteristics. There were no statistically significant differences between the LDV/SOF (96.1%) and glecaprevir/pibrentasvir (98.0%) groups in the overall SVR12 rates of the modified intention‐to‐treat populations, and their rates of treatment discontinuation and adverse events were similar.

Conclusions

Treatment with LDV/SOF for hepatitis C virus genotype 2 resulted in a high rate of SVR12 and excellent tolerability. The outcomes of LDV/SOF were very similar to those of glecaprevir/pibrentasvir.
International Academic Mobility in Chinese Academia: Opportunities and Challenges
Authors: Larbi Frank Okai , Ashraf Muhammad Azeem
Published: October 2019

International academic mobility is an important dimension of the internationalization of higher education institutions, which aims to enact practical changes in economies and societies. Although many studies have investigated the mobility of international students, the mobility of international academics has been less investigated, particularly in the context of mainland China. This qualitative study explores the experience of international academics in Chinese academia. The study is based on semi‐structured interviews with twenty‐six international academics from different countries, working at different universities in Beijing. Through a four‐stage systematic analysis, the study shows that international academics’ engagement with mobility in Chinese academia can be characterized by a combination of gains and losses. This article explores how international academics view Chinese academia as either resourceful or restrictive for their academic career. It then discusses the hidden narratives concerning the challenges that international academics face in relation to mobility.
Autoreactive B cells in SLE, villains or innocent bystanders?
Authors: Hamilton Jennie A. , Hsu Hui‐Chen , Mountz John D.
Published: October 2019

The current concepts for development of autoreactive B cells in SLE (systemic lupus erythematosus) focus on extrinsic stimuli and factors that provoke B cells into tolerance loss. Traditionally, major tolerance loss pathways are thought to be regulated by factors outside the B cell including autoantigen engagement of the B‐cell receptor (BCR) with simultaneous type I interferon (IFN) produced by dendritic cells, especially plasmacytoid dendritic cells (pDCs). Later, in autoreactive follicles, B‐cells encounter T‐follicular helper cells (Tfh) that produce interleukin (IL)‐21, IL‐4 and pathogenic cytokines, IL‐17 and IFN gamma (IFNɣ). This review discusses these mechanisms and also highlights recent advances pointing to the peripheral transitional B‐cell stage as a major juncture where transient autocrine IFNβ expression by developing B‐cells imprints a heightened susceptibility to external factors favoring differentiation into autoantibody‐producing plasmablasts. Recent studies highlight transitional B‐cell heterogeneity as a determinant of intrinsic resistance or susceptibility to tolerance loss through the shaping of B‐cell responsiveness to cytokines and other environment factors.
Patterns of positivity: Positive affect trajectories among infants of mothers with a history of depression
Authors: Davis Molly , Goodman Sherryl H. , Lavner Justin A. , Maier Meeka S. , Stowe Zachary N. , Newport D. Jeffrey , Knight Bettina
Published: October 2019

This study examined positive affect (PA) trajectories over the first year of life among infants of mothers with a history of depression (N = 191) as well as predictors (i.e., maternal prenatal and postpartum depression symptoms, maternal parenting behaviors) of those trajectories. Infant PA was observed in play and feeding tasks during laboratory visits at 3, 6, and 12 months of age; parenting behaviors were observed at 3 months. Mothers completed questionnaires regarding their symptoms of depression throughout the prenatal period and during the first 3 months postpartum. Growth curve analyses indicated that infant PA increased across time, and this finding replicated across both the play and feeding tasks, though increases slowed over time. Neither maternal prenatal nor postpartum depression symptoms predicted infants' PA trajectories, but mothers' PA, positive parenting, and disengaged parenting were associated with infant PA during the play task. Our finding that infant PA increased over the first year postpartum suggests PA trajectories among infants of mothers with a history of depression may be indices of resilience, despite risks associated with their mothers' history of depression. Furthermore, this study highlights parenting behaviors that may be important targets of prevention and early intervention efforts to bolster infant PA.
Risk of major cardiovascular events in patients with psoriasis receiving biologic therapies: a prospective cohort study
Authors: Rungapiromnan W. , Mason K.J. , Lunt M. , McElhone K. , Burden A.D. , Rutter M.K. , Warren R.B. , Griffiths C.E.M. , Ashcroft D.M. ,   BADBIR Study Group
Published: October 2019

Background

The cardiovascular safety profile of biologic therapies used for psoriasis is unclear.

Objectives

To compare the risk of major cardiovascular events (CVEs; acute coronary syndrome, unstable angina, myocardial infarction and stroke) in patients with chronic plaque psoriasis treated with adalimumab, etanercept or ustekinumab in a large prospective cohort.

Methods

Prospective cohort study examining the comparative risk of major CVEs was conducted using the British Association of Dermatologists Biologics and Immunomodulators Register. The main analysis compared adults with chronic plaque psoriasis receiving ustekinumab with tumour necrosis‐α inhibitors (TNFi: etanercept and adalimumab), whilst the secondary analyses compared ustekinumab, etanercept or methotrexate against adalimumab. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using overlap weights by propensity score to balance baseline covariates among comparison groups.

Results

We included 5468 biologic‐naïve patients subsequently exposed (951 ustekinumab; 1313 etanercept; and 3204 adalimumab) in the main analysis. The secondary analyses also included 2189 patients receiving methotrexate. The median (p25–p75) follow‐up times for patients using ustekinumab, TNFi, adalimumab, etanercept and methotrexate were as follows: 2.01 (1.16–3.21), 1.93 (1.05–3.34), 1.94 (1.09–3.32), 1.92 (0.93–3.45) and 1.43 (0.84–2.53) years, respectively. Ustekinumab, TNFi, adalimumab, etanercept and methotrexate groups had 7, 29, 23, 6 and 9 patients experiencing major CVEs, respectively. No differences in the risk of major CVEs were observed between biologic therapies [adjusted HR for ustekinumab vs. TNFi: 0.96 (95% CI 0.41–2.22); ustekinumab vs. adalimumab: 0.81 (0.30–2.17); etanercept vs. adalimumab: 0.81 (0.28–2.30)] and methotrexate against adalimumab [1.05 (0.34–3.28)].

Conclusions

In this large prospective cohort study, we found no significant differences in the risk of major CVEs between three different biologic therapies and methotrexate. Additional studies, with longer term follow‐up, are needed to investigate the potential effects of biologic therapies on incidence of major CVEs.
Costs of preparing to implement a virtual reality job interview training programme in a community mental health agency: A budget impact analysis
Authors: Smith Matthew J. , Graham Andrea K. , Sax Rachel , Spencer E‐Shawn , Razzano Lisa A. , Smith Justin D. , Jordan Neil
Published: October 2019

Rational, aims and objectives

Individual Placement and Support (IPS) is an evidence based strategy for facilitating employment among adults with severe mental illness (SMI) where staff may lead mock job interviews to prepare clients for real‐world interviews (a method with limited scalability and cost effectiveness). A virtual reality job interview training program (VR‐JIT)—delivered via the internet—has demonstrated efficacy for increasing employment among adults with SMI. Now, VR‐JIT is being implemented with a community mental health agency (CMHA) and evaluated for its effectiveness within IPS. This study is a budget impact analysis, evaluating the costs of preparing a CMHA to implement VR‐JIT.

Method

Implementation preparation occurred over 7 months from October 1, 2016 to April 30, 2017. CMHA staff (n = 15) and external research partners (n = 3) tracked their hours completing implementation preparation activities. Salaries plus a 28% fringe benefit rate were used to derive a per‐hour salary amount for each individual and applied to each activity. Non‐labor equipment costs were obtained from purchase receipts. A budget impact analysis evaluated the expenditures associated with preparing the CMHA to implement VRJIT.

Results

The total implementation preparation costs equaled $25,482. Labor costs equaled $22,882 and non‐labor costs equaled $2,600. In total, 655 person‐hours were spent preparing for VR‐JIT implementation (e.g., preparing lab space, training, and supervising operations).

Conclusions

This study presents an initial evaluation of the budget impact of preparing to implement VR‐JIT in a CMHA. Cost considerations for future implementation preparation will be discussed. Given that the cost to prepare to implement an intervention can hinder its adoption, results provide an important analysis for decision‐makers that may enhance uptake. Future work will determine the cost‐effectiveness of VR‐JIT implemented within IPS. This study is registered at http://clinicaltrials.gov, NCT = 03049813, “Virtual Reality Job Interview Training: An Enhancement to Supported Employment in Severe Mental Illness.”
Independency of regulating RH and O2/CO2 concentration and its effect on the quality of strawberry at 25°C
Authors: Wu Yanhu , Li Dongli , Fu Yabo , Liao Ruijuan , Shi Jiazi , Wang Jigang , Xu Wencai
Published: October 2019

Strawberries have a short postharvest life due to their relatively high water content, high metabolic activity, and susceptibility to microbial rot. Traditional MAP, even antimicrobial film could not avoid strawberry decay at room temperature. To solve this problem, a new passive MAP (PMAP) is proposed in this article. The innovation of the PMAP lies in the special structure of the lid film. The lid film of PMAP consists of two function films, which is paratactic border‐connected. The one film (oxygen permeable film) only allows O2 (or CO2) to pass through, and the other film (water vapor permeable film) only allows water vapor to pass through. Thus, the O2 concentration and relative humidity in the PMAP could be controlled by the area and gas permeability of the dual pieces function films, respectively and independently. In this way, the PMAP could establish a modified atmosphere with any relative humidity without any change in O2 concentration. Results show that the O2 concentration and relative humidity in headspace can be accurately controlled by the designed PMAP. The PMAP could prolong the shelf life of strawberry to 5–6 days at 25°C and maintain the excellent taste, special flavor, good appearance, and nutrition.

Practical applications

In the packaging system, the area of the different functional films required can be calculated from the physiological effects of the strawberry, which in turn can independently control the physiological strength of the strawberry and RH in the headspace by controlling the area of different functional films. This will extend the shelf life of the retail strawberry. Not only that, but our design can be applied to another fruit packaging by simply selecting the right functional film. In addition, if we want to achieve other functions, such as antibacterial effects, simply add an antibacterial film to our packaging system. And this does not affect the headspace and humidity because they work completely independently. Therefore, our design has important practical significance for the preservation of fruits and vegetables.
A review of Code Blue activations in a single Regional Australian Healthcare Service: A retrospective descriptive study of RISKMAN data
Authors: Porter Joanne E. , Peck Blake , McNabb Tiffinee J. , Missen Karen
Published: October 2019

Background

In the case of life‐threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient.

Aims and objectives

The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six‐year period.

Methods

A quantitative retrospective descriptive study of Code Blue emergencies over a six‐year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1).

Findings

The majority of Code Blue activations were male (59%,n = 127) and aged between 70 and 89 years of age (43%,n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses’ change in shift, with the majority of Code Blues (27.8%,n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%,n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call.

Conclusion

This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation.

Relevance to clinical practice

Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events.
The Challenge of Universal Norms: Securing Effective Defence Rights Across Different Jurisdictions and Legal Cultures
Authors: Hodgson Jacqueline
Published: October 2019

This article considers the contribution of comparative empirical research in shaping best practice norms for custodial legal advice, and helping to address challenges in their implementation. It traces the role of ECtHR decisions and EU Directives in developing transnational norms to strengthen suspects’ right to legal assistance. Recognizing how these norms are translated into the national context, it considers the value of comparative empirical and socio‐legal research in helping to develop legislative and training measures; how roles and responsibilities are shared out in different legal systems and traditions; and practical arrangements that facilitate or inhibit the effectiveness of custodial legal advice in practice. There is a tension between framing transnational norms that are sufficiently universal to attract support, without being so broad as to lack any transformational force, and sufficiently detailed to ensure respect for core protections without imposing legal requirements too rigid and difficult to be absorbed into diverse processes of criminal justice.
Work by day and sleep by night, do not sleep too little or too much: Effects of sleep duration, time of day and circadian synchrony on flanker‐task performance in internet brain‐game users from teens to advanced age
Authors: Richards Anne , Kanady Jennifer C. , Huie John Russell , Straus Laura D. , Inslicht Sabra S. , Levihn‐Coon Andrew , Metzler Thomas J. , Neylan Thomas C.
Published: October 2019

Research elucidating the effects of sleep and circadian rhythm on cognitive performance is advancing, yet many important questions remain. Using flanker‐task performance scores from a large internet sample (N = 48,881) with repeated measures of cognitive performance and linked prior‐night self‐reported sleep duration, we analysed the relationship between sleep duration, time of day of task performance, and chronotype synchrony with performance in participants aged 15–80 years. Results indicate a performance peak at 7 hr habitual sleep duration, and point to a variable effect of deviation from habitual sleep duration depending on users’ habitual sleep duration and age. Time‐of‐day effects were notable for a steady decline in performance up until 01:00 hours–02:00 hours for the group as a whole, which was accounted for by nighttime deterioration on trials requiring inhibitory executive functioning, particularly in older subjects. Analyses did not demonstrate an advantage for playing in synchrony with self‐identified chronotype. Results strengthen findings indicating an inverted U‐shaped relationship between sleep duration and cognitive performance across a broad spectrum of age groups. These findings underscore the importance of daytime task performance for tasks requiring inhibitory function, especially in elderly people. Findings highlight the utility of large‐scale internet data in contributing to sleep and circadian science.
Acute administration of fructans increases the number of transient lower esophageal sphincter relaxations in healthy volunteers
Authors: Geysen Hannelore , Gielis Eva , Deloose Eveline , Vanuytsel Tim , Tack Jan , Biesiekierski Jessica R. , Pauwels Ans
Published: October 2019

Introduction

Dietary measures are often advised to patients with gastro‐esophageal reflux disease (GERD). Fermentable Oligo‐, Di‐, Mono‐saccharides and Polyols (FODMAPs) induce lower gastrointestinal (GI) symptoms. However, their effects on esophageal motility, including transient lower esophageal sphincter relaxations (TLESRs), reflux events and GERD symptoms are unknown. We investigated the effect of acute administration of two FODMAPs, fructose, and fructans, on the number of TLESRs, reflux episodes and symptom perception in healthy volunteers (HVs).

Materials

After an overnight fast, 20 HVs (10 males; 32.6 ± 2.8 years) underwent a high‐resolution impedance manometry. The number of TLESRs and reflux episodes was quantified during five hours after consumption of a high‐caloric meal (740 kcal) enriched with 40 g of either fructose, fructans or glucose (as placebo). Results were analyzed using mixed models.

Results

There was a trend for a change in the number of TLESRs between the three conditions (P = .06). Post hoc analysis revealed a trend toward a higher number of TLESRs in the fructan condition compared with placebo (Pcorr = .06). Acute administration of fructose did not influence the number of TLESRs. The total number of reflux events was not affected by either FODMAP condition. Lower esophageal sphincter (LES) pressures dropped significantly in the first postprandial hour to recover slowly back to baseline values (P < .0001), without any difference in LES pressure between the three conditions.

Conclusion

Ingestion of fructans increased the number of TLESRs slightly compared with placebo. The effect of FODMAPs such as fructans or a low FODMAP diet on reflux parameters in GERD patients remains to be investigated.
‘A most complex marriage arrangement’: recent advances on heterostyly and unresolved questions
Authors: Barrett Spencer C. H.
Published: October 2019

Heterostylous genetic polymorphisms provide paradigmatic systems for investigating adaptation and natural selection. Populations are usually comprised of two (distyly) or three (tristyly) mating types, maintained by negative frequency‐dependent selection resulting from disassortative mating. Theory predicts this mating system should result in equal style‐morph ratios (isoplethy) at equilibrium. Here, I review recent advances on heterostyly, focusing on examples challenging stereotypical depictions of the polymorphism and unresolved questions. Comparative analyses indicate multiple origins of heterostyly, often within lineages. Ecological studies demonstrate that structural components of heterostyly are adaptations improving the proficiency of animal‐mediated cross‐pollination and reducing pollen wastage. Both neutral and selective processes cause deviations from isoplethy in heterostylous populations, and, under some ecological and demographic conditions, cause breakdown of the polymorphism, resulting in either the evolution of autogamy and mixed mating, or transitions to alternative outcrossing systems, including dioecy. Earlier ideas on the genetic architecture of the S‐locus supergene governing distyly have recently been overturned by discovery that the dominant S‐haplotype is a hemizygous region absent from the s‐haplotype. Ecological, phylogenetic and molecular genetic data have validated some features of theoretical models on the selection of the polymorphism. Although heterostyly is the best‐understood floral polymorphism in angiosperms, many unanswered questions remain.
Plant Pathology 101: how to get away with infection
Authors: Peirats‐Llobet Marta , Lewsey Mathew G.
Published: October 2019

This article is a Commentary on He et al., 225: 896–912.
Shifting perspectives on the impacts of phenotypic plasticity
Authors: Wadgymar Susana M. , Austen Emily J.
Published: October 2019

This article is a Commentary on Ensing & Eckert, 224: 1184–1200.
Prevalence of healthy and unhealthy food and beverage price promotions and their potential influence on shopper purchasing behaviour: A systematic review of the literature
Authors: Bennett Rebecca , Zorbas Christina , Huse Oliver , Peeters Anna , Cameron Adrian J. , Sacks Gary , Backholer Kathryn
Published: October 2019

Policies to restrict unhealthy food and beverage price promotions have been recommended, as part of a broader strategy to reduce obesity, but little evidence underpins such recommendations. We aimed to synthesize the literature on the prevalence of healthy and unhealthy food and beverage price promotions and their potential influence on purchasing behaviour. Eight scientific databases (covering health, business, and marketing) and grey literature were systematically searched using search terms related to “food and beverage price promotions” up until July 2019. Articles were included if they examined prevalence of, and/or consumer response to, food and non‐alcoholic beverage price promotions, from a nutritional perspective. Of the 16 included studies, eight examined the prevalence of price promotions and eight examined the potential influence of price promotions on purchasing behaviour. Seven of the “prevalence” studies found that price promotions were more common for unhealthy foods and beverages. Seven “influence” studies found a greater proportion of price‐promoted purchases were for unhealthy compared with healthy products. Policies that reduce the prevalence and/or influence of price promotions on unhealthy foods and beverages may shift consumer purchasing away from unhealthy foods and beverages. Empirical studies are required to better understand how consumers and industry may respond to such policies.
Bathing suit ichthyosis: Two Burmese siblings and a review of the literature
Authors: Li Wendy , Oberlin Kate E. , Wilson Theodore E. , Haggstrom Anita N.
Published: October 2019

Bathing suit ichthyosis (BSI) is a subtype of autosomal recessive congenital ichthyosis (ARCI) characterized by the development of large platelike scales mainly limited to the trunk. It is caused by temperature sensitive variants in transglutaminase 1, encoded by the gene TGM1. We describe a rare case of intrafamilial variation in phenotypic expressivity in two Burmese siblings with BSI that demonstrates the heterogeneity of the disorder within the same family and even in the same individual across time. We also present a concise review of the genotypic spectrum of BSI from 54 cases reported in the literature as evidence that both environmental and additional genetic factors can significantly alter the clinical phenotype.
Methanogenic and fertilizing potential of aquaculture waste: towards freshwater farms energy self‐sufficiency in the framework of blue growth
Authors: Ndiaye Ndeye Aida , Maiguizo-Diagne Halima , Diadhiou Hamet Diaw , Ndiaye Waly Ndianco , Diedhiou Fulgence , Cournac Laurent , Gaye Mohamed Lamine , Fall Saliou , Brehmer Patrice
Published: October 2019

The fisheries sector, particularly aquaculture, is a fundamental source of nutrition for humans, particularly in developing countries. The modern development of fish farming requires energy for production systems. This study investigates the potential of using organic wastes derived from fish fattening to produce on‐farm energy through the process of methanization.Oreochromis niloticusfaeces methanogen potential was determined with (IFF) and without (UIFF) methanizer microbial inoculum. At the end of the manure methanation trials, the resulting digestates were tested as organic fertilizers for agriculture. The tests showed that inoculated fish faeces had faster biogas kinetics production compared with uninoculated fish faeces. In both cases, the produced biogas contained more than 60% methane (CH4) from the second week of incubation, indicating that it was of good quality. Furthermore, the total CH4volume was twice as larger in IFF compared with UIFF. Biofertilizer tests showed no significant differences for most of the growth parameters in onion and tomato when compared to the unfertilized control, except in one case for tomato plants, which significantly increased its aboveground biomass. The results show that fish faeces are good methanogenic substrates conducive to energy recovery that could facilitate farm autonomy; however, valorization of the digestates as biofertilizer still requires extensive agronomic optimization. Based on our results, we estimate that equivalents of energy need of almost ten millions of people could be covered using the aquaculture potential in freshwater fish faeces biogas worldwide or that at least aquaculture farm energy self‐sufficiency could be fostered.
When does open government shut? Predicting government responses to citizen information requests
Authors: Bagozzi Benjamin E. , Berliner Daniel , Almquist Zack W.
Published: October 2019

Methods for the analysis of “big data” on citizen‐government interactions are necessary for theoretical assessments of bureaucratic responsiveness. Such big data methods also stand to benefit practitioners' abilities to monitor and improve these emerging transparency mechanisms. We consider supervised latent Dirichlet allocation (sLDA) as a potential method for these purposes. To this end, we use sLDA to examine the Mexican government's (non)responsiveness to all public information requests filed with the federal Mexican government during the 2003–2015 period, and to identify the request topics most associated with (non)responsiveness. Substantively, our comparisons of the topics that are most highly predictive of responsiveness and nonresponsivess indicate that political sensitivity plays a large and important role in shaping official behavior in this arena. We thus conclude that sLDA provides unique advantages for, and insights into, the analysis of (i) textual records of citizen–government interactions and (ii) bureaucratic (non)responsiveness to these interactions.
Challenges in providing compatible blood with Rh genotype‐matching in Brazilian patients with sickle cell disease
Authors: Santos T. D. , Macedo M. D. , Menegati S. F. P. , Gilli S. , Castilho L.
Published: October 2019

Objectives

The aim of this study was to verify the possibility of performing prophylactic Rh genotype‐matching in Brazilian patients with sickle cell disease (SCD) and identify the genotypes that are lacking or insufficient in our donor cohort.

Background

Rh alloimmunisation is still a challenge in transfused patients with SCD. Rh genotype‐matching may mitigate Rh alloimmunisation.

Methods/Materials

We examined the transfusion requests for antigen‐matched donor units in SCD patients with Rh variants and compared the Rh altered alleles in the patients to the Rh allele frequency in a selected donor population. For each patient and donor, RBC antigen genotyping was performed using HEA, RHD and RHCE BeadChip arrays. Sequencing was used to clarify inconclusive results. Twenty‐one patients and 956 Brazilian blood donors were genotyped.

Results

According to our matching strategies, 47·6% of patients filled most of their unit requests, but 52·4% of patients had insufficient donors to fill their annual transfusion needs. We found different combinations of RHCE variant alleles in patients and donors, but the most frequent genotypes that are lacking or insufficient in our donor cohort are those associated with the lack of hrB and hrS high prevalence antigens and those co‐inherited with altered RHD alleles.

Conclusion

Our study shows that the provision of compatible blood with Rh genotype‐matching in Brazilian patients with SCD can be feasible but challenging and, efficient strategies of recruitment of African‐Brazilian donors must be developed.